The Ultimate IMG Residency Guide: Thank You Notes & Follow-Up Strategies

Why Thank You Notes Matter So Much for IMGs

For many program directors, faculty, and coordinators, your thank you email after interview is the last impression they’ll have of you before ranking decisions. For an international medical graduate, that impression carries extra weight.

You’re not only showing professionalism; you’re also:

• Reinforcing that you understand U.S. professional etiquette
• Demonstrating written English skills and clarity of communication
• Reminding the program who you are and why you fit well there
• Showing genuine interest—especially important in competitive programs

A thoughtful residency thank you note will not magically overturn a poor interview, but it can:

• Solidify a positive impression
• Differentiate you from other applicants
• Keep you “top of mind” when the committee discusses you

For IMGs, who often face visa questions, limited U.S. clinical experience, and implicit bias, every professional interaction counts. That’s why an IMG residency guide to follow‑up is essential for your match strategy.

This article will walk you through:

• When and how to send thank you notes
• What to say (with templates tailored for IMGs)
• Common mistakes that hurt more than help
• Ethical and NRMP‑compliant post interview follow up
• Example scenarios for different interview experiences

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Core Principles of an Effective Residency Thank You Note

Before we get into templates, it helps to internalize a few core principles that apply to every program and every specialty.

1. Be Timely (But Not Instant)

• Best window: Within 24–48 hours of your interview
• Same day is fine, but avoid sending from your phone in the parking lot right after the interview; rushed messages often have errors.
• Past 72 hours is still better than nothing, but loses some impact.

Why this matters for IMGs: Timely, polished communication counters stereotypes about unfamiliarity with U.S. norms and reassures programs you’ll communicate reliably as a resident.

2. Keep It Short and Focused

Program directors and faculty receive dozens (sometimes hundreds) of emails in peak season. Aim for:

• 1 concise subject line
• 3–6 short paragraphs (6–12 sentences total)
• One clear main message: “Thank you + I’m interested + here’s why we fit.”

Long emails risk being skimmed or ignored entirely.

3. Individualize Each Email

Do not send the same generic paragraph to everyone.

Individualization means:

• Referencing something specific you discussed
• Highlighting a part of the program that genuinely stood out
• Connecting your background to their program in a clear, concrete way

Even with templates, you must personalize at least 2–3 details.

4. Choose Email Over Handwritten Notes

In U.S. culture, handwritten notes can be thoughtful, but:

• They arrive too late to influence decisions
• They can get lost in hospital mail
• Many faculty work partly remote or across sites

Email is expected, fast, and easily saved or forwarded to the selection committee.

5. Maintain Professional Neutrality About Ranking

Under NRMP rules, you cannot be forced to reveal your rank list, and programs should not ask. You also should not make promises you might not keep.

Safe, ethical phrasing includes:

• “Your program remains a top choice for me.”
• “I will be ranking your program highly.”

Avoid:

• “I will rank you #1” (unless you are completely certain and intend to follow through)
• Anything that sounds like a contract or guarantee

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Step‑by‑Step: How to Plan Your Post‑Interview Follow-Up

Step 1: Collect Accurate Contact Information

Before you leave the interview day (or virtual session):

• Write down the name, title, and email of each interviewer.
• If emails are not given, ask the program coordinator:
  • “May I have the best email to send a brief thank you to Dr. ___?”
• For panel interviews with several faculty at once, it’s acceptable to:
  • Send individual thank yous if you have everyone’s email, or
  • Send one email addressed to the main interviewer and ask them to extend thanks to the rest of the panel.

Always verify spelling of names and titles—attention to detail matters.

Step 2: Use a Simple, Clear Subject Line

Your subject line should be immediately understandable and searchable. Examples:

• “Thank you – [Your Name], [Specialty] Interview on [Date]”
• “Appreciation for today’s interview – [Your Name] (IMG applicant)”
• “Thank you for the interview – [Program Name], [Your Name]”

Avoid overly creative or emotional subject lines like “My dream program!!!” or “Grateful beyond words!!!”

Step 3: Follow a Professional Email Structure

General structure:

1. Greeting
2. Expression of gratitude
3. A specific detail you appreciated or discussed
4. A brief reiteration of your fit and interest
5. Polite closing

Example outline:

• Greeting: Dear Dr. [Last Name],
• Paragraph 1: Thank them for time and opportunity
• Paragraph 2: Reference something you discussed
• Paragraph 3: Connect your background and their program
• Closing: Reaffirm interest + sign‑off

Step 4: Proofread Meticulously

As an IMG, your email is often your only written sample they see. Common issues:

• Articles (a/an/the)
• Prepositions (in/at/on/to)
• Verb tense consistency
• Run‑on sentences

Strategies:

• Write in a document first, run spellcheck
• Read aloud before sending
• Ask a trusted friend or mentor to review a sample thank you email after interview season begins

Step 5: Track Your Follow-Up

Use a simple spreadsheet or note system with columns:

• Program name
• Date of interview
• Interviewers’ names and roles
• Date thank you sent
• Follow‑up actions (if any)
• Notes about your impression

This helps you stay organized, especially if you’re interviewing at many programs in a short time.

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Email Templates & Examples Tailored for IMGs

Below are practical templates you can adapt. Do not copy‑paste verbatim; programs often see repeated phrases across applicants. Use them as a structure and change the specifics.

1. General Thank You to a Faculty Interviewer

Scenario: You had a positive conversation and felt the program might be a good fit.

Subject: Thank you – [Your Name], [Specialty] Interview on [Date]

Dear Dr. [Last Name],

Thank you for taking the time to speak with me during my interview at the [Program Name] [Specialty] Residency on [interview date]. I appreciated the opportunity to learn more about your program and the community you serve.

Our discussion about [specific topic you discussed – e.g., resident autonomy in the ICU, global health electives, or caring for a diverse immigrant population] particularly resonated with me. As an international medical graduate from [Country], I was encouraged to hear how your residents are supported in [related program feature – e.g., transitioning to the U.S. healthcare system, building communication skills, or pursuing research].

I remain highly interested in [Program Name] because of its [two or three strengths you noticed – e.g., strong clinical training, emphasis on mentorship, and commitment to serving underserved patients]. I believe my experiences in [brief mention – e.g., working in resource‑limited settings, research interest, or language skills] would allow me to contribute meaningfully to your residency.

Thank you again for your time and consideration. I hope to have the opportunity to train at [Program Name].

Sincerely,
[Your Full Name], MD
ERAS AAMC ID: [Number]
[Preferred email] | [Phone number]

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2. Thank You to the Program Director (PD)

It is standard for each applicant to send a separate email to the program director, even if you already met them in a group session.

Subject: Thank you for the interview – [Your Name], [Specialty] Residency

Dear Dr. [Last Name],

Thank you for the opportunity to interview for the [Program Name] [Specialty] Residency on [interview date]. It was a privilege to meet you and learn more about your vision for the program.

I was particularly impressed by [example: your emphasis on resident well‑being and mentorship, the close relationship between residents and faculty, or the clear structure for progressive autonomy]. As an international medical graduate, I value programs that offer strong support for trainees adapting to the U.S. healthcare system, and it was reassuring to hear about [a specific resource – e.g., your orientation curriculum, simulation training, or faculty advising model].

The combination of [list 2–3 features: clinical volume, diversity of patients, teaching culture, research opportunities, etc.] makes [Program Name] especially appealing to me. I am confident that my background in [briefly mention – e.g., internal medicine in a high‑volume public hospital, quality improvement projects, or teaching medical students] aligns well with the mission of your residency.

Thank you again for your time and consideration. I will be ranking your program highly.

Best regards,
[Your Full Name], MD
ERAS AAMC ID: [Number]

Note: The phrase “I will be ranking your program highly” is ethically safe and NRMP‑compliant, yet signals genuine interest.

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3. Thank You to the Program Coordinator

Program coordinators often have significant influence and are crucial to your communication with the program.

Subject: Thank you for coordinating the interview day – [Your Name]

Dear [Ms./Mr./Mx.] [Last Name],

I wanted to thank you for your excellent organization and support during the [Program Name] [Specialty] Residency interview day on [date]. The schedule and instructions you provided made the process very smooth, especially for me as an international medical graduate interviewing from [location/time zone].

I appreciated the opportunity to meet the residents and faculty and to learn more about the program. Please extend my thanks to everyone involved in the interview day.

It was a pleasure to learn more about [Program Name], and I remain very interested in the opportunity to train there.

Sincerely,
[Your Full Name], MD
ERAS AAMC ID: [Number]

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4. When the Interview Did Not Go Perfectly

Sometimes you feel you didn’t answer a question well or were very nervous. Do not apologize excessively or re‑argue your candidacy. Instead, use the residency thank you note to steady the impression.

Subject: Thank you – [Your Name], [Specialty] Interview

Dear Dr. [Last Name],

Thank you for taking the time to speak with me during my interview at the [Program Name] [Specialty] Residency on [date]. It was a pleasure to learn more about your work in [specific field or area] and about the structure of the residency.

Our conversation about [topic – e.g., caring for complex patients in a safety‑net hospital, or your research in cardiology] further confirmed my interest in [Program Name]. Having trained as an international medical graduate in [Country], I am particularly drawn to your program’s commitment to [e.g., serving diverse communities, academic excellence, resident mentorship].

I appreciate your consideration of my application and would be honored to contribute to your team.

Best regards,
[Your Full Name], MD

You don’t need to confess mistakes; focus on your genuine appreciation and fit.

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5. One “Global” Thank You Note (If Individual Emails Are Not Possible)

In rare cases, you may not get individual emails for every interviewer.

Subject: Thank you for the interview day – [Your Name], [Specialty] Residency

Dear Dr. [PD Last Name] and the [Program Name] Team,

Thank you for the opportunity to interview for the [Program Name] [Specialty] Residency on [date]. I appreciated meeting the faculty and residents, and I am grateful for the time everyone invested in sharing details about the program.

Hearing about [2–3 specifics: the curriculum structure, the supportive culture among residents, and the diverse patient population] reinforced my strong interest in [Program Name]. As an international medical graduate, I am excited by the prospect of training in a program that combines [e.g., rigorous clinical training] with [e.g., strong teaching and mentorship].

Please extend my sincere thanks to all who participated in the interview day. I would be honored to join your program.

Sincerely,
[Your Full Name], MD

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Post Interview Follow Up Beyond Thank You Notes

A thank you email after interview is your immediate follow‑up, but in some situations, additional contact is appropriate and useful.

When Is Additional Follow-Up Appropriate?

1. Significant change in your application

   • New USMLE score released
   • New publication accepted
   • Completion of a U.S. clinical experience or observership
   • New leadership role or award

2. Clarifying logistics

   • Visa sponsorship questions (if not fully answered during the interview)
   • Questions about start date, contract, or orientation

3. Communicating strong interest later in the season

   • Some applicants send a brief “interest letter” closer to rank list time
   • This must remain NRMP‑compliant and truthful

How to Write a Brief Update Email

Subject: Application update – [Your Name], [Specialty] Residency Applicant

Dear Dr. [Last Name],

I hope you are doing well. I am writing to share a brief update regarding my application to the [Program Name] [Specialty] Residency.

Since my interview on [date], [briefly describe update – e.g., my manuscript on diabetic nephropathy has been accepted for publication in X journal; I have successfully completed a four‑week U.S. clinical observership in internal medicine at Y hospital; I received my Step 2 CK score of ___]. I remain very interested in [Program Name] because of [one specific reason tied to your earlier conversation or program features].

Thank you again for your time and consideration.

Sincerely,
[Your Full Name], MD

Limit such follow‑ups to one or two per program at most, and only if the update is meaningful.

What About “Love Letters” and Ranking Intentions?

In many specialties, applicants send a “letter of intent” to one program saying they are their top choice. This practice is controversial but common.

Key points for IMGs:

• If you choose to send such a letter, send it to only one program.
• Use honest wording you can stand behind.
• Never suggest any agreement or obligation that could violate NRMP rules.

Safer stronger‑interest phrasing:

• “Your program is my top choice, and I intend to rank [Program Name] first on my rank list.” (Use this only if 100% true.)
• “I will be ranking your program at the very top of my list.” (Also should be truthful.)

Remember: Programs may or may not adjust their rank list based on these messages, but misleading statements can damage your reputation and that of your medical school.

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Common Mistakes IMGs Should Avoid in Thank You Notes

1. Overly Formal or Stiff Language

Some IMGs default to very formal language, which can sound distant or unnatural in U.S. culture.

Less effective:

“I humbly request you to consider my candidacy in your esteemed institution, for which I shall be ever grateful.”

Better:

“Thank you for considering my application to your residency. I would be honored to train at your program.”

Aim for polite, clear, and professional—not archaic or overly deferential.

2. Sharing Too Much Personal Emotion

It’s fine to express enthusiasm and appreciation, but avoid:

• “This is my only hope.”
• “Your program is my last chance to become a doctor in the U.S.”
• Very long personal narratives in your follow‑up

Programs want committed residents, not applicants under extreme emotional pressure.

3. Asking for Feedback on Your Interview

Do not ask:

• “How did I do?”
• “Could you please tell me my ranking position?”
• “What are my chances of matching at your program?”

These place programs in an uncomfortable position and violate norms.

4. Repeated, Excessive Emails

A polite thank you and, if appropriate, one later update is usually enough.

Avoid:

• Weekly emails “checking in”
• Messaging multiple faculty repeatedly on the same topic
• Asking residents to lobby on your behalf

Too many messages can create a negative impression, even if each one is polite.

5. Grammatical or Spelling Errors in Key Names and Titles

Always double‑check:

• Program name (e.g., “Internal Medicine Residency at University Hospital,” not “Internal Medicine at the University of Hospital”)
• Interviewer’s title (Dr., Program Director, Associate Program Director)
• Spelling of surnames

These details show professionalism and respect.

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Action Plan: A Simple System for IMGs to Follow

To put this IMG residency guide into practice, use this simple workflow for each interview:

1. Immediately after the interview day

   • Take 10–15 minutes to write down:
     • Key program strengths
     • Topics discussed with each interviewer
     • Anything that excited or concerned you
   • Confirm spelling of names and roles

2. Within 24 hours

   • Draft individual thank you emails to:
     • Program director
     • Your main faculty interviewers
     • Program coordinator
   • Personalize each note with at least one specific detail
   • Proofread and send

3. 1–2 weeks later (optional, if truly needed)

   • Send a brief update email only if you have new, important information

4. Late in the season (optional and selective)

   • If you decide to send a letter of intent or strong interest, choose one program and remain honest and NRMP‑compliant.

By systematizing your post interview follow up, you reduce stress and improve consistency across all programs.

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FAQ: Thank You Notes & Follow-Up for IMGs

1. Is it mandatory to send a thank you email after every residency interview?
No, it is not mandatory, and some programs explicitly say that thank you notes are not expected. However, in most cases, sending a brief, professional email is considered good etiquette and can only help you—as long as it’s sincere, specific, and error‑free. For an international medical graduate, it’s also an opportunity to demonstrate strong communication skills and professionalism in the U.S. context.

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2. What if the program says on their website that they do not want thank you notes?
If a program clearly states “Please do not send thank you notes,” respect their preference. Ignoring this can make you appear unable to follow instructions. In such cases, limit your communication to necessary logistical questions or important application updates (e.g., new exam scores or publications).

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3. Should I send a physical, handwritten residency thank you note instead of an email?
In residency recruitment, handwritten notes are generally unnecessary and often impractical. They might arrive after rank lists are finalized and can be lost in hospital mail systems. Email is faster, expected, and more easily shared with the selection committee. If you feel strongly about a handwritten note, you may send it in addition—but only after you have already sent a timely email.

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4. Can a thank you note really change my ranking at a program?
A thank you note alone is unlikely to transform a weak application into a highly ranked one. However, it can:

• Reinforce a positive impression
• Highlight your fit more clearly
• Keep you memorable among many applicants

For borderline decisions, a thoughtful follow‑up can tip the balance slightly in your favor. More importantly, it builds a habit of professional communication that will serve you well as a resident and beyond.

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By approaching thank you notes and follow-up with clarity, professionalism, and authenticity, you transform a small task into a strategic tool in your residency journey—especially as an IMG working to stand out in a competitive, unfamiliar system.