United States Otolaryngology
Residency: What is Required and How
Can Non-US Residents Get a Position
John M. Del Gaudio, MD
Professor and Residency Program Director
Department of Otolaryngology
Emory University School of Medicine
Atlanta, GA, USA
Overall Match Results
2008
• US Medical Graduates – 94% matched
• Foreign Medical Grads – 55% matched
– Most common specialties
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Internal Medicine
Family Medicine
Psychiatry
Pediatrics
Preliminary Surgery
US Otolaryngology PGY-1 Positions
Available By Year
2006
264
2007
270
2008
273
2009
275
US Otolaryngology Residency Match
2009 Figures
• Programs 104
• Positions offered – 275
• Applicants
– US Seniors– Non-US seniors -
343
51
• Matched
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US seniors 263 (77%)
Us non-senior Grads- 5
US- IMGs2
(20% non-US seniors)
Non-US IMG 3
Keys to Obtaining a Residency Spot
• Medical School Performance
– Grades
– Clinical Rotation reviews
– Honors
• Alpha Omega Alpha Medical Honor Society
• USMLE scores
• Letters of Recommendation
• Extracurricular activities
– Volunteer work
– Organizational involvement
• Clinical rotation at preferred program
Keys to Obtaining a Residency Spot
• Familiarity
– Students that perform well on a rotation at a
particular program have a better chance of
matching at that program than an equally
qualified or even better qualified candidate who
didn’t rotate there.
– A known quantity compared to an unknown
– This factor is more heavily weighted than most
other factors in ranking residents in the match
Barriers to Foreign Medical Grads
obtaining Oto residency position
• Competitiveness of US applicants
– One of most competitive specialties
– Attract most accomplished medical students
• Difference in medical school curriculum
• Concern for communication problems
– Language barriers
• VISA issues
– Program unfamiliarity with Visa options
• Lack of familiarity of programs with foreign medical grads as
residents
VISAS
• J1 (visitor exchange Visa)
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Most common
Sponsored by ECFMG
Maximum of 7 years for training
At completion of training required to return to LAST country of
residence for 2 years
• Waivers possible
– Cannot apply for citizenship or green card
• H1B (working Visa)
– No restrictions
– Sponsored by hospital
– Can apply for citizenship or green card
OtoMatch.com
Resource for information on obtaining an
Otolaryngology Residency position
FMG section written by
Oswaldo Henriquez, Jr. MD (Emory Oto resident)
Emory OTO Foreign Residents
• JNM- Accepted outside of the match for PGY-2
year when program increased from 2 to 3
residents per year.
– Graduated medical school in Colombia and was
performing a preliminary year surgery internship at
Emory
– Excellent recommendations from Surgery faculty and
Otolaryngology residents who interacted with him
– Excellent performance as resident, joined
Otolaryngology faculty for 1 year
– First Otolaryngology Resident to be accepted into the
Emory General Plastic Surgery Fellowship program
Emory OTO Foreign Residents
• OH- PGY-3 at Emory
– Graduated medical school in Caracas, Venezuela
– Performed 1 year of research in Laryngology at Emory
Voice Center
• Proved self to be a hard worker, dependable, and a good
personality
– Successfully matched in Otolaryngology at Emory the
following year
• With recommendations from Oto faculty, his wife
was offered a research position in Ophthalmology
and matched at Emory the following year
Barriers to Foreign Residency Grads
obtaining Oto Fellowship position
• Ability to get an unrestricted state license
– Unrestricted license allows independent practice
• Permits billing for services
• Joining faculty as instructor with faculty privileges and
responsibilities
– Can be on-call independently
– Can schedule surgical cases as attending surgeon
» Allows better training as the “Teaching Physician”
– Restricted state license (Training license) allows
supervised training (i.e. resident status)
• Can’t bill for services independently, take call, or have junior
attending status
US Otolaryngology Board Certification
Requirements
• Passed USMLE exams
• Completed an ACGME approved Otolaryngology
Residency Program
– Each program can only graduate as many residents
each year as they are approved to have by the ACGME
– A program may have more residents than approved by
the ACGME but only the approved number can take
the ABO certification exam each year
• Non-categorical residents
Status of Foreign Medical School Grads
that Complete US Residency
• Can sit for American Board of Otolaryngology
Certification Exam
• Have the same status as US born graduates of
residency programs
• Only issue for US practice would be Visa or
citizenship
Conclusions
• It is difficult, but not impossible, for a foreign
medical graduate to obtain a US residency
position
• Familiarity of program with resident is the
most important factor
– Perform an elective Oto rotation at US program
• Be familiar with Visa requirements and other
barriers