Essential Guide for Non-US Citizen IMGs: Researching Med-Psych Residency Programs

Choosing the right medicine-psychiatry residency is especially complex when you are a non-US citizen IMG or foreign national medical graduate. You are balancing immigration rules, visa options, limited program spots, and your own career goals in a smaller, highly specialized field. A systematic program research strategy can turn this overwhelming process into a structured, manageable project.

Below is a step-by-step guide to how to research residency programs specifically for medicine psychiatry combined training as a non-US citizen IMG—what to look for, where to look, and how to evaluate what you find.

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Understanding the Medicine-Psychiatry Landscape as a Non-US Citizen IMG

Before you dive into spreadsheets and emails, you need a clear understanding of what makes med psych residency unique and how that interacts with your status as a non-US citizen IMG.

What Is a Combined Medicine-Psychiatry Residency?

Medicine-psychiatry combined programs:

• Are 5-year integrated residencies
• Lead to board eligibility in both Internal Medicine and Psychiatry
• Include continuous training in both fields (not two separate residencies back-to-back)
• Prepare you for careers in:
  • Integrated primary care / behavioral health
  • Consultation-liaison (psychosomatic) medicine
  • Addiction medicine
  • Public and community psychiatry with complex medical comorbidity
  • Academic medicine and research at the intersection of mind and body

Programs are relatively few in number compared to categorical internal medicine or psychiatry. That means:

• You will apply to a small, specialized pool of programs
• Each program is different in structure, philosophy, and culture
• You cannot rely only on name recognition; deep program research is essential

Why Program Research Is Even More Critical for Non-US Citizen IMGs

As a non-US citizen IMG or foreign national medical graduate, you face additional variables:

• Visa sponsorship (J-1 vs H-1B, and whether the program sponsors at all)
• IMG friendliness (historical acceptance of IMGs, especially non-US citizens)
• ECFMG certification timing and USMLE completion requirements
• Potential bias or unfamiliarity with your school or country of training
• Need for strong support systems (mentoring, onboarding, wellness) while adjusting to a new healthcare system and culture

Because med psych programs are small, some will not sponsor visas or will strongly prefer US graduates. Instead of guessing, you need to systematically identify programs truly open to and experienced with non-US citizen IMGs.

Your program research strategy must therefore include:

• Content about training quality and fit, plus
• Hard filters: visa policies, IMG match history, and institutional rules that can block your application before anyone reads it

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Step 1: Build a Master List of Medicine-Psychiatry Programs

Research starts with knowing what programs exist and how to find them.

Use Official Sources First

1. ACGME and NRMP

   • Search ACGME for “Internal Medicine/Psychiatry” combined programs.
   • Use NRMP’s “Participating Programs” for the current Match year to confirm which med psych programs are active and taking applicants.
   • Note:
     • Program name
     • Institution
     • City and state
     • NRMP program code (for later application work)

2. ERAS / AAMC Residency Explorer (if available to you)

   • If you have access, use the filters:
     • Specialty: Internal Medicine/Psychiatry
     • Location: open to preference (US-wide at this stage)
   • Export or manually record:
     • Number of positions per year
     • Program type (university, community, university-affiliated)

3. Society/Association Lists

   • Check:
     • American Association of Directors of Psychiatric Residency Training (AADPRT) – sometimes lists combined programs
     • American Association of Public and Community Psychiatry or psychosomatic medicine societies for clues about med psych–friendly institutions

The goal is to create a comprehensive initial list, even if some programs end up being filtered out later.

Create a Tracking Spreadsheet

From the very beginning, track your data. A simple spreadsheet with one row per program will help you avoid confusion.

Suggested columns (you will fill some of these in later):

• Program name
• Institution
• City, State
• NRMP code
• Program website URL
• Visa policy (J-1, H-1B, both, none)
• IMG status (IMG-friendly, IMG-possible, IMG-unfriendly / unclear)
• Number of med psych positions
• ACGME program ID
• Type: university / university-affiliated / community
• Fellowship tracks or strengths (addiction, C-L, integrated care, etc.)
• University hospital / VA / county exposure
• Notes on call schedule / rotation structure
• Research opportunities
• US clinical experience required? (Y/N)
• Minimum USMLE/COMLEX scores (if specified)
• Contact email
• Application deadline
• Your personal interest rating (1–5)

This master file becomes your program research dashboard.

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Step 2: Filter Programs by Visa Sponsorship and IMG Friendliness

The most important early filters for non-US citizen IMGs are visa sponsorship and historical openness to IMGs. There is no point spending hours evaluating a program that will not even consider a foreign national medical graduate for visa reasons.

Identifying Visa Policies

On each program’s website, look for:

• “For Applicants,” “International Graduates,” or “Eligibility Requirements” sections
• GME office or institutional graduate medical education pages
• Keywords: “J-1 visa,” “H-1B visa,” “visa sponsorship,” “international medical graduates”

Common patterns you will see:

1. J-1 only

   • “We sponsor J-1 visas through ECFMG only.”
   • Common among university and teaching hospitals.

2. J-1 and H-1B

   • “Eligible for J-1 and H-1B visas.”
   • Often require:
     • All USMLE Steps passed on first attempt
     • ECFMG certification by rank list deadline
     • Strong justification to hospital for H-1B sponsorship

3. No visa sponsorship

   • “We do not sponsor visas.”
   • “Applicants must be US citizens or permanent residents.”
   • These programs can be removed from your list immediately.

4. Unclear or missing information

   • Many med psych programs rely on institutional GME policies rather than specifying it on the program page.
   • Check the overall GME website. If still unclear, you may need to email.

Mark each program in your spreadsheet as:

• J-1 only
• J-1 and H-1B
• No sponsorship
• Unclear – follow-up needed

For many non-US citizen IMGs, J-1 is the most realistic path. If you are specifically aiming for H-1B, your list will be much shorter and you must be even more strategic.

Assessing IMG Friendliness

Knowing how to research residency programs as a foreign national medical graduate also means learning to interpret who a program actually interviews and matches.

Key strategies:

1. Check Current Resident Profiles

   • On the med psych program website, look for a “Residents” page.
   • Note:
     • How many residents are IMGs
     • Are there non-US medical schools represented?
     • Are there residents from your region (e.g., South Asia, Middle East, Latin America, Eastern Europe)?
   • If no IMGs at all over several classes, the program may be less IMG-friendly—even if they say “we accept IMGs.”

2. Review Faculty Bios

   • Faculty from international backgrounds can be a positive sign.
   • A PD or APD who is an IMG may be more understanding of your pathway.

3. Use Match Data (Indirectly)

   • Public NRMP data rarely breaks out med psych specifically, but:
     • Check if the institution’s internal medicine or psychiatry programs have historically matched IMGs.
     • If the main IM or psychiatry programs are very IMG-averse, the med psych track might be similar.

4. Educated Guess Classification

   • After your review, categorize programs in your sheet:
     • IMG-friendly (clearly multiple current IMGs; welcoming language)
     • IMG-possible (some signs of openness, maybe 1–2 IMGs)
     • IMG-unfriendly or unknown (no IMGs visible, vague or restrictive wording)

No single sign is perfect, but patterns matter. Use them to shape your initial application strategy.

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Step 3: Deep-Dive into Training, Culture, and Fit

Once you’ve applied the hard filters (visa and IMG eligibility), the next step in your program research strategy is to evaluate training quality, structure, and personal fit for medicine psychiatry combined programs.

Analyze Rotation Structure and Curriculum

For med psych residency, the balance and integration of medicine and psychiatry are critical.

On each program’s site, look for a year-by-year rotation schedule:

Key questions:

• How many months per year are medicine vs psychiatry?
• Are there med-psych integrated rotations, such as:
  • Consultation-liaison psychiatry on medicine floors
  • Collaborative care in primary care clinics
  • Medical-psychiatric units
• Is the training block (e.g., 3 months medicine, 3 months psych) or longitudinal (e.g., one day a week of psych continuity clinic during medicine blocks)?
• Is there protected outpatient time in both disciplines in later years?

Compare this to your learning preferences. For example:

• If you want strong inpatient internal medicine skills first, a program with medicine-heavy PGY-1 and PGY-2 might suit you.
• If you are drawn to continuous integrated care, a program with longitudinal med psych experiences may be better.

Look for Program Strengths Aligned with Your Goals

Combined medicine psychiatry training can lead you in many directions. Look for program-specific strengths:

Common focus areas:

• Consultation-Liaison / Psychosomatic Medicine
  • Strong C-L rotations, academic faculty in psychosomatic medicine
• Addiction Medicine
  • Co-located addiction clinics, methadone/Suboxone programs, faculty with addiction boards
• Integrated Primary Care
  • Collaborative care clinics, FQHC partnerships, behavioral health integration projects
• Severe Mental Illness with Medical Comorbidity
  • County hospital or public psychiatry focus, complex patient populations
• Research and Academic Careers
  • NIH-funded projects, med psych faculty publishing regularly, research curriculum

As a non-US citizen IMG, think about where your combined skills will be most marketable later, especially if you may need to fulfill J-1 waiver service obligations or work in underserved areas.

Evaluate Clinical Sites and Patient Populations

Medicine-psychiatry is especially powerful in settings where medical and psychiatric illness are both complex.

Look for:

• Multiple clinical sites:
  • University hospital
  • VA medical center
  • County or safety-net hospital
  • Community mental health centers
• Diverse patient populations:
  • Socioeconomic diversity
  • High prevalence of substance use disorders
  • Complex medical illness with psychiatric comorbidity

This diversity matters for:

• Your clinical skill development
• Future job opportunities in integrated care
• Meeting potential J-1 waiver requirements (often in underserved communities)

Assess Culture and Support for IMGs

Beyond curriculum, culture matters immensely, especially if you are adapting to a new country and health system.

Clues to look for:

• Orientation and Onboarding:

  • Do they mention structured intern orientation?
  • Support for learning US documentation, billing, EMRs?

• Mentorship Programs:

  • Do residents have assigned mentors?
  • Are there specific supports for IMGs?

• Wellness and Burnout Prevention:

  • Explicit wellness initiatives, mental health support for residents
  • Peer support groups or reflective practice sessions

• Flexibility and Understanding:

  • Statements about diversity and inclusion
  • Indications that the program values different educational and cultural backgrounds

If the website is vague, this is an area to ask about during interviews or in informational emails.

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Step 4: Use External Tools and Networks to Verify and Enrich Your Research

Program websites show you what the program wants you to see. To truly master how to research residency programs, you need additional data sources.

Online Tools and Databases

1. Residency Explorer (when accessible)

   • Check:
     • Average Step scores
     • Percentage of IMGs historically
     • Type of medical schools of prior matches
   • While med psych may have smaller datasets, even limited data is helpful.

2. Doximity and Other Ranking Sites

   • Use cautiously.
   • Med psych programs are often not ranked meaningfully due to small numbers.
   • Still, you can:
     • Identify institutional reputation in IM and psychiatry separately
     • See where alumni go for fellowship or jobs

3. Google and PubMed Searches

   • Search “[Program Name] medicine psychiatry combined” or “[Institution] psychosomatic medicine” to find:
     • Program-related publications
     • Faculty doing med psych research
     • Conference presentations

Social Media and Resident Voices

• Twitter/X, LinkedIn, Instagram

  • Many residencies have accounts showcasing:
    • Resident activities
    • DEI initiatives
    • Integrated care projects
  • Residents may post about their clinic experiences or med psych identity.

• YouTube

  • Some programs host:
    • Virtual open houses
    • Recorded Q&A sessions
  • These recordings often reveal program culture, PD personality, and priorities.

Networking and Direct Contact

Especially as a foreign national medical graduate, proactive communication can help fill gaps in your understanding.

1. Attend Virtual Open Houses

   • Common in smaller specialties like med psych.
   • Prepare specific questions (training, support for IMGs, visa handling).
   • Take notes and update your spreadsheet after each session.

2. Email Residents or Alumni

   • Look for contact emails on program websites.
   • Send a short, respectful message:
     • Introduce yourself as a non-US citizen IMG interested in med psych
     • Ask 2–3 focused questions (e.g., support for IMGs, integration of medicine and psychiatry, visa experience).
   • Avoid asking:
     • “What are my chances?”
     • “Can you guarantee an interview?”
   • Do ask:
     • “How supportive has the program been with visa logistics?”
     • “How comfortable did you feel as an IMG when you started?”

3. Leverage Faculty Mentors

   • If you have US clinical experience:
     • Ask attendings if they know specific med psych programs or PDs.
   • Attend med psych or psychosomatic medicine talks and introduce yourself.

Each outside perspective helps you move from marketing image to real picture of program life.

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Step 5: Prioritize and Create a Targeted Application List

By now, you should have:

• A full list of medicine psychiatry combined programs
• Visa and IMG-friendliness data
• Notes on curriculum, culture, and strengths
• Feedback from residents or open houses (for some programs)

Next, transform this information into a clear application plan.

Categorize Programs into Tiers

For each program, assign yourself a realistic interest and feasibility rating based on:

• Visa sponsorship (hard requirement)
• IMG friendliness / historical openness
• Your USMLE scores and clinical experience
• Your fit with the program’s strengths and culture

You might group programs as:

1. High Priority (Core List)

   • Clear visa sponsorship
   • Demonstrated or likely IMG-friendliness
   • Strong match with your interests (e.g., integrated care, addiction, C-L)
   • Reasonable competitiveness relative to your profile

2. Moderate Priority (Reach or Stretch)

   • Visa sponsorship present
   • Fewer or no IMGs historically, but nothing explicitly anti-IMG
   • Very strong programs or highly attractive locations

3. Low Priority or Exclude

   • No visa sponsorship or unclear/inconsistent information
   • Strong signals of being IMG-averse
   • Curriculum misaligned with your goals

For med psych, the total number of programs is small, so you may still apply to nearly all that meet your visa and feasibility filters. The point of this exercise is to help you focus your energy—e.g., in tailoring personal statements, preparing for specific interviews, and ranking later.

Example: Applying Strategy as a Non-US Citizen IMG

Imagine:

• You are a foreign national medical graduate from India
• USMLE Step 1: Pass, Step 2 CK: 242
• 3 months US clinical experience in psychiatry, 1 month in internal medicine
• Goal: Career in integrated primary care and public psychiatry

Your filters might be:

• Only programs with J-1 sponsorship at minimum
• Prefer programs with:
  • History of IMGs
  • Strong community/public psychiatry and integrated care experiences
  • Faculty doing work in health disparities or population health

You might identify:

• 3–4 high-priority programs that clearly match all of the above
• 3–4 moderate-priority programs that are strong academically with less obvious IMG representation
• 1–2 J-1-only but very research-heavy or specialized places you keep as aspirational

This systematic approach beats random application and helps you use your time and resources wisely.

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Step 6: Prepare Targeted Communication and Questions for Each Program

Effective program research also prepares you to present yourself well when you contact programs or attend interviews.

Emailing Programs About Visa and Eligibility

When information is truly unclear, you can send a concise email to either:

• The program coordinator
• Or the GME office (if that seems more appropriate)

Include:

• Who you are (non-US citizen IMG; ECFMG status if applicable)
• Your interest in medicine psychiatry combined specifically
• A very specific question (e.g., visa sponsorship type, eligibility cutoffs)

Example:

Dear [Coordinator’s Name],

I am an international medical graduate and a non-US citizen, currently [ECFMG certified / in the process of obtaining ECFMG certification], with a strong interest in combined Internal Medicine/Psychiatry training.

I am writing to confirm whether your Medicine-Psychiatry residency program is able to sponsor visas for non-US citizen IMGs for the upcoming Match cycle, and if so, whether the institution sponsors J‑1, H‑1B, or both.

Thank you very much for your time and assistance.

Sincerely,
[Your Name]

Use their response to update your spreadsheet and refine your application list.

Preparing Program-Specific Questions for Interviews

Remember that evaluating residency programs continues during interviews. Based on your research, prepare questions such as:

• “How have you supported prior non-US citizen IMGs in adapting to both internal medicine and psychiatry training?”
• “Can you describe how your med psych residents are integrated into both departments and how their dual identity is supported?”
• “What types of careers have your recent medicine psychiatry combined graduates pursued, particularly those on J-1 visas?”
• “Are there opportunities for residents to participate in integrated primary care or collaborative care projects, especially in underserved populations?”

These questions show that:

• You’ve done your homework,
• You understand med psych as a distinct pathway,
• You are thinking ahead as a non-US citizen IMG about career and visa-related realities.

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FAQs: Program Research for Non-US Citizen IMGs in Medicine-Psychiatry

1. As a non-US citizen IMG, should I apply to both med psych and categorical programs?

Yes. Because the number of medicine psychiatry combined programs is limited, many non-US citizen IMGs apply to a mix of:

• Med psych programs
• Categorical Internal Medicine
• Categorical Psychiatry

This broadens your chances while still pursuing your ideal path. When researching and ranking, be honest about which track best aligns with your long-term goals, especially considering visa and waiver considerations.

2. How can I tell if my application is competitive enough for med psych programs?

Review:

• USMLE scores relative to typical internal medicine and psychiatry benchmarks for IMGs
• Amount and quality of US clinical experience, especially in IM or psychiatry
• Strength of your letters of recommendation, preferably from US faculty
• Clear personal statement explaining why you want combined training and how you’ll use it

Then, check your profile against available data (Residency Explorer, program websites, PD comments in open houses). If your scores are modest but you have strong US experience and a compelling med psych story, you can still be competitive—especially at programs historically friendly to IMGs.

3. Do med psych programs have different visa rules than other residencies at the same institution?

Usually no, but implementation can differ. Often:

• Visa sponsorship policies are set at the institutional GME level.
• However, smaller or specialized programs like med psych may:
  • Have less experience with H-1B
  • Be more cautious about timing for ECFMG certification

This is why part of how to research residency programs includes verifying with both program and GME when necessary.

4. How early should I start researching and contacting programs?

Ideally:

• 12–18 months before applying:
  • Build your master list
  • Understand visa and IMG policies
  • Align your clinical experiences and research to med psych interests
• 6–9 months before ERAS:
  • Attend virtual open houses
  • Reach out with specific questions
  • Finalize your target list and application strategy

Starting early gives you time to strengthen your CV, secure US letters, and tailor your application to the programs where you have the best combination of fit, eligibility, and opportunity.

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A thoughtful, organized program research strategy is one of the most powerful tools you have as a non-US citizen IMG aiming for a medicine psychiatry combined career. By systematically evaluating visa policies, IMG friendliness, curriculum, culture, and outcomes, you move from hoping to strategically positioning yourself for the programs that can genuinely support your goals in both medicine and psychiatry.