Caribbean IMG Guide: Researching Med-Peds Residency Programs Effectively

Understanding the Med-Peds Landscape as a Caribbean IMG

Medicine-Pediatrics (Med-Peds) is a competitive, relatively small specialty. As a Caribbean IMG, you face additional layers of complexity when planning your medicine pediatrics match: fewer programs, variable IMG-friendliness, stricter USMLE expectations, and sponsorship issues. That makes how to research residency programs not just important, but critical.

Before you build any program list, you need to understand three things:

1. What Med-Peds is structurally

   • A 4-year combined internal medicine and pediatrics residency
   • Leads to dual board eligibility (ABIM + ABP)
   • Typically housed within large academic centers or strong community systems
   • Often emphasizes primary care, complex care, transitions of care, hospital medicine, and sometimes global health

2. What makes Med-Peds unique in residency selection

   • Very small number of positions per program (often 4–8 residents per year)
   • Strong emphasis on academic performance and USMLE scores
   • High value placed on fit, maturity, and clear understanding of Med-Peds as a career
   • Programs often know each other well; faculty networks are tight

3. What it means to be a Caribbean IMG in this space

   • Many Med-Peds programs rarely or never take IMGs
   • A subset are consistently IMG-friendly, including some with a history of Caribbean graduates
   • Your program research strategy must be data-driven and realistic, while still ambitious

If you’re coming from a Caribbean medical school (SGU, AUA, Ross, Saba, etc.), you also have one advantage: these schools often publish detailed match lists. You can use these to see patterns in Caribbean medical school residency outcomes specifically in Med-Peds.

Your goal in research is to build a tiered, targeted list of programs where:

• You meet or exceed objective criteria
• There is demonstrated IMG acceptance
• Your career goals and the program’s strengths meaningfully align

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Step 1: Clarify Your Med-Peds Profile and Priorities

Before you start searching program websites, you must define who you are as an applicant and what you actually want from a Med-Peds residency. This will guide every decision in evaluating residency programs.

1.1 Know Your Objective Metrics

Make an honest appraisal of your:

• USMLE scores (Step 1, Step 2 CK)
• Clinical grades and class percentile
• US clinical experience (IM, Peds, or Med-Peds)
• Gap years or interruptions
• Red flags (failures, professionalism issues)

For a Caribbean IMG in Med-Peds:

• Many programs prefer solidly above-average scores (e.g., Step 2 in the 220s–240s or higher; exact cutoffs vary)
• A fail on Step 1 or Step 2 does not always eliminate you, but shrinks your realistic program list
• Strong, recent US clinical experience in IM, Peds, or Med-Peds is almost mandatory

This reality doesn’t mean you can’t match; it means you must:

• Target programs with a known history of taking IMGs
• Apply broadly and strategically
• Use research to avoid wasting applications on impossible programs

1.2 Define Your Career and Life Priorities

List your top 5–7 priorities. Some examples:

Career priorities

• Strong training in:
  • Hospital medicine (adult and pediatric)
  • Primary care / continuity clinic
  • Complex care / transitions of care
  • Med-Peds subspecialties (e.g., cardiology, ID, rheumatology)
• Academic vs community-oriented training
• Global or underserved care
• Research or QI opportunities

Life priorities

• Geographic region (e.g., East Coast vs Midwest vs South)
• Proximity to family/friends
• Cost of living
• Climate (winters can be a real factor)
• Visa requirements (J-1 vs H-1B)

Write these down. Throughout your program research strategy, you’ll return to this list to decide which programs truly belong on your final rank list.

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Step 2: Build a Comprehensive Med-Peds Program Universe

Now you’re ready to start actual research on programs. This phase is about casting a wide net and then narrowing.

2.1 Identify Every Med-Peds Program

Start with the official sources:

• ACGME and AMA FREIDA:
  • Filter by specialty: “Internal Medicine-Pediatrics”
  • Export or manually record all programs, with:
    • Institution name
    • City and state
    • ACGME ID
    • Program website link
• Specialty organizations:
  • Medicine-Pediatrics specific organizations (like the National Med-Peds Residents’ Association, NMPRA) often maintain lists of Med-Peds programs and links

Create a spreadsheet with columns for:

• Program name
• City/State
• Hospital system (e.g., academic center, community system)
• Program director name
• Website URL
• Contact email
• Notes (to be filled in later)

Aim to capture every ACGME-accredited Med-Peds program. There are not many compared to categorical internal medicine or pediatrics, so completeness is feasible.

2.2 Add Caribbean-IMG-Specific Data Sources

For Caribbean IMGs, you should also leverage:

• Your school’s match list (e.g., SGU residency match data, Ross, AUA, etc.)
  • Search specifically for “Medicine-Pediatrics” or “Med-Peds”
  • Note which programs have previously taken graduates from your school
• Alumni network
  • Talk to recent graduates who matched into Med-Peds
  • Ask:
    • Where did you interview?
    • Which programs seemed more open to Caribbean IMGs?
    • Any programs you felt were not IMG-friendly?

This step converts a generic list of Med-Peds programs into a Caribbean medical school residency–relevant pool.

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Step 3: How to Research Residency Programs in Depth

Once you have your list, the next step is the deep dive. This is where many applicants either:

• Skim websites superficially, or
• Get overwhelmed and give up on systematic evaluation

You want a middle path: structured, repeatable, and focused on Caribbean IMG-relevant data.

3.1 Start with Core Objective Filters

For each program, answer these questions first:

1. Does this program accept IMGs?

   • Look for statements like:
     • “We consider applications from international medical graduates.”
     • “Recent IMGs in our program include…”
   • Use FREIDA filters: “International Medical Graduates Accepted”
   • Check current resident bios for:
     • Non-US schools
     • Caribbean schools specifically

2. Do they sponsor visas, and which type?

   • Most commonly:
     • J-1 via ECFMG
     • Some may offer H-1B, but far fewer in Med-Peds
   • If you need an H-1B, your list will shrink dramatically
   • If you’re flexible with J-1, more options open

3. Do they list score cutoffs or requirements?

   • Minimum Step 2 score (or old Step 1 requirements)
   • Time since graduation limits (e.g., “within 3–5 years”)
   • US clinical experience requirements

If a program:

• Does not take IMGs
• Does not offer the visa you need
• Or explicitly states requirements you cannot meet

→ Mark it clearly in your spreadsheet (e.g., “No IMG,” “No visa,” “Score cutoff too high”) and strongly consider removing it from your target list.

3.2 Evaluate Training Quality and Structure

Next, move beyond IMG filters and look at training quality. This is key in evaluating residency programs even if they take IMGs.

On each program website, look for:

Curriculum structure

• Distribution of rotations:
  • Adult wards vs peds wards
  • ICU exposure (MICU, PICU, NICU)
  • Emergency medicine
  • Ambulatory blocks and continuity clinic
• Unique med-peds experiences:
  • Combined clinics (e.g., transition clinics for congenital heart disease, CF, sickle cell)
  • Med-Peds specific rotations (e.g., adolescent medicine, developmental peds with adult follow-up)
• Elective time and flexibility:
  • Can you explore subspecialties you’re interested in?

Board pass rates

• Some programs publish board exam pass rates for:
  • Internal medicine boards
  • Pediatrics boards
• Look ideally for:
  • High, consistent pass rates (e.g., >90% over several years)

Faculty and mentorship

• Presence of Med-Peds faculty (not just categorical IM and Peds attendings)
• Evidence of:
  • Med-Peds program leadership involved in national organizations
  • Faculty engaged in scholarship (QI, research, advocacy)

Document meaningful findings in your spreadsheet:

• “Strong ICU exposure”
• “Limited elective time”
• “Excellent med-peds continuity clinics”

3.3 Assess Culture, Fit, and Support for IMGs

This is harder to quantify, but extremely important—especially for Caribbean IMGs who may be adjusting to:

• A new system
• A new country
• Potential bias against IMGs

Look for:

Resident bios and photos

• Are there current or recent residents from:
  • Caribbean schools?
  • Other IMGs?
• Diversity in background and training paths suggests openness

Program values

• Explicit mentions of:
  • Inclusion, diversity, and equity
  • Support for international graduates
  • Wellness and mentorship

Educational support

• Formal board review curricula
• Academic half-days
• Simulation labs
• Feedback systems

IMG-specific example:

• If you see multiple alumni from SGU or other Caribbean schools in recent years, that’s a powerful sign the program is open to Caribbean medical school residency applicants and has systems that have supported them successfully.

Keep track of this in your notes as:

• “IMG presence: strong/moderate/none”
• “Diversity valued: yes/no/unclear”

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Step 4: Strategically Narrowing and Tiering Your Program List

By now, your spreadsheet should be populated with:

• Objective filters (IMG, visas, score expectations)
• Curriculum elements
• Med-Peds-specific features
• Cultural and support factors

Now you convert this into a tiered target list for your medicine pediatrics match.

4.1 Create Tiers Based on Realistic Chances

A common, effective approach is to group programs into:

1. Reach programs

   • Historically more competitive
   • Fewer IMGs or high average scores
   • You meet some, but not all, ideal metrics
   • You still have a plausible story (e.g., strong Med-Peds interest, leadership, research)

2. Target programs

   • Programs where:
     • Your metrics are roughly in line with current residents
     • IMGs are regularly accepted
     • You meet all listed requirements
   • These should form the core of your application strategy

3. Safety programs

   • Historically more IMG-friendly
   • Clearly aligned with your metrics
   • Strong fit with your visa needs and graduation year

For a Caribbean IMG applying Med-Peds, an example distribution might be:

• 20–30% reach
• 50–60% target
• 20–30% safety

The actual number of programs depends on your budget and competitiveness, but Med-Peds is small enough that most Caribbean IMGs will benefit from applying broadly within reason.

4.2 Incorporate SGU and Other Caribbean Match Data

If you’re from SGU or another large Caribbean school with good match data, you can refine tiers by:

• Identifying programs with repeat Caribbean matches
• De-prioritizing programs with no history of Caribbean IMGs (especially if they are also highly competitive)

For example, if the SGU residency match lists a Med-Peds program that has taken one or more SGU grads over several years:

• Move that program up from “reach” to “target,” or from “target” to “highly favorable target”

This is where being a Caribbean IMG can actually give you better data than many US graduates, because your school’s match records are rich in detail.

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Step 5: Advanced Program Research Strategy and Practical Tips

Once you have your tiered list, refine it with deeper, higher-yield research techniques that many applicants overlook.

5.1 Use Resident Perspectives

Beyond official websites, use:

• NMPRA resources (if available)
• Resident-led blogs or social media accounts
  • Program-specific Instagram or Twitter/X accounts
  • Resident podcasts or Q&A sessions

Look for answers to:

• What do residents actually say about:
  • Workload and call schedule?
  • Teaching quality?
  • How supported they feel as individuals?
• Do current residents seem enthusiastic, burnt out, or disengaged?

As a Caribbean IMG, note especially:

• Any commentary from IMGs about how they were welcomed and supported
• Any hints of bias or lack of understanding toward non-US graduates

5.2 Contacting Programs Strategically (When Appropriate)

Cold emailing every program is not helpful, but targeted outreach can be smart:

Who to contact:

• A Med-Peds chief resident
• A current Med-Peds resident who is an IMG or Caribbean grad
• A faculty member whose interests align with yours (e.g., global health, complex care)

What to ask (brief, respectful emails):

• “I’m a Caribbean IMG strongly interested in Med-Peds, and I’m exploring programs that support international graduates. Could you share any advice about how IMGs are integrated and supported in your program?”
• “I noticed several Med-Peds residents with international backgrounds. As a Caribbean IMG, do you have any guidance on how best to demonstrate fit with your program?”

Never:

• Ask for special treatment
• Ask if they’ll interview you
• Attach your entire CV unsolicited (you can summarize briefly in 1–2 lines)

5.3 Aligning Your Application Materials with Program Research

Your research is not just for building a list; it should shape:

• Your personal statement
• How you complete ERAS program-specific fields
• How you respond during interviews

For example:

• If a program has a strong focus on complex care and transition clinics, mention your interest in:
  • Caring for youth with chronic conditions as they become adults
• If a program emphasizes underserved populations, highlight:
  • Experience in resource-limited settings (including your Caribbean clinical sites)
  • Commitment to health equity

This level of alignment signals genuine, thoughtful interest—which matters even more in a small specialty like Med-Peds.

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Putting It All Together: A Sample Workflow for a Caribbean IMG in Med-Peds

To make this concrete, here is a streamlined step-by-step workflow you could follow over 2–4 weeks:

1. Week 1: Build the universe

   • Use FREIDA + Med-Peds organization lists to identify all Med-Peds programs
   • Create spreadsheet with basic program details
   • Add Caribbean-school-specific data (SGU or other match lists)

2. Week 2: Apply objective filters

   • For each program, document:
     • IMG acceptance (yes/no/unclear)
     • Visa sponsorship (J-1/H-1B/none)
     • Score and graduation year requirements
   • Remove clearly impossible programs (no IMG, no required visa, explicit cutoffs you cannot meet)

3. Week 2–3: Evaluate training and culture

   • For each remaining program, review:
     • Curriculum, board pass rates, Med-Peds clinics
     • Resident bios (looking for IMGs and Caribbean grads)
     • Any stated values re: diversity, education, wellness
   • Note strengths and concerns in your spreadsheet

4. Week 3: Tier your programs

   • Group into reach, target, safety based on:
     • Competitiveness
     • IMG-friendliness
     • Alignment with your metrics and goals
   • Cross-check with Caribbean match history (e.g., SGU residency match patterns)

5. Week 3–4: Refine and personalize

   • Conduct targeted outreach to 5–10 key programs
   • Adjust tiers if you gain new information
   • Use program insights to refine your personal statement and ERAS content

By the end, you’ll have:

• A coherent, data-driven list of Med-Peds programs
• Clear reasoning for each program choice
• Application materials that speak the language of Med-Peds and of the specific programs you’re targeting

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Frequently Asked Questions (FAQ)

1. As a Caribbean IMG, how many Med-Peds programs should I apply to?
Because Med-Peds is small and somewhat competitive, many Caribbean IMGs benefit from applying broadly but strategically. Specific numbers depend on your profile, but it is common for IMGs to apply to most, if not all, Med-Peds programs where:

• IMGs are accepted
• Visa needs are met
• You reasonably meet or approach their academic expectations
  In parallel, some applicants also apply to categorical internal medicine or pediatrics programs to increase total match chances.

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2. How can I tell if a Med-Peds program is truly IMG-friendly?
Use multiple data points:

• Current residents: Do you see IMGs or Caribbean graduates among them?
• Match lists: Does your Caribbean school (e.g., SGU residency match reports) show prior matches at that program?
• Program statements: Explicit support for IMGs or mention of international graduates
• Visa sponsorship: Clear, consistent support for J-1 (and occasionally H-1B) No single factor is perfect, but a combination of:
• Prior Caribbean grads, plus
• Visible IMGs in current classes, plus
• Explicit openness to international graduates
  is a strong sign of IMG-friendliness.

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3. Should I prioritize Med-Peds programs with strong research if I’m an IMG?
Research can help, especially if:

• You’re interested in academic careers or fellowships
• You have prior scholarly work to build on
  However, for Med-Peds, clinical training quality and program fit usually matter more than raw research volume. As a Caribbean IMG, it’s often better to prioritize:
• Programs that train strong, independent clinicians
• Supportive environments with a track record of helping IMGs succeed
  If you enjoy research, look for programs that balance:
• Solid clinical exposure
• Reasonable opportunities for QI or scholarly projects

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4. How do I balance geographic preference with realistic chances as a Caribbean IMG?
Start by identifying your non-negotiables (e.g., visa type, absolute geographic constraints). Then:

• Within your preferred regions, identify all IMG-friendly Med-Peds programs
• If that list is small or highly competitive, expand geographically until you have:
  • Multiple target programs
  • A few safety options
    Many Caribbean IMGs ultimately broaden geography—at least for training—because Med-Peds programs are concentrated in certain areas, and being flexible can significantly improve your medicine pediatrics match odds.

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By approaching how to research residency programs as a structured, evidence-based process, you position yourself—especially as a Caribbean IMG—to navigate the Med-Peds landscape with clarity and purpose. Thoughtful program research doesn’t guarantee a match, but it dramatically increases the chances that, when you do match, it will be to a program aligned with your goals, values, and potential.