Essential Research Strategies for US Citizen IMGs in Global Health Residency

Understanding Research During Residency as a US Citizen IMG in Global Health

For a US citizen IMG interested in global health, research during residency is more than a résumé booster—it’s a strategic pathway into an academic, advocacy, or leadership career in international medicine. Programs increasingly expect residents, especially those on a global health residency track or academic residency track, to contribute to resident research projects. As an American studying abroad, you are already in a unique position to leverage international experience; structured research can turn that background into clear, marketable expertise.

This article will walk you through:

• Why research during residency matters specifically for US citizen IMGs and global health
• Types of research projects that fit a global health focus
• How to choose programs and mentors that support research
• Practical strategies to launch and complete projects during busy clinical years
• How to turn your residency work into publications, presentations, and a long‑term research portfolio

Throughout, the emphasis is on realistic, actionable steps tailored to your situation as a US citizen IMG.

---

Why Research Matters for US Citizen IMGs in Global Health

1. Differentiating Yourself in a Competitive Space

Global health is a popular interest, but relatively few residents translate that interest into rigorous scholarship. As a US citizen IMG, you may already feel pressure to “prove” your capabilities relative to US grads. High-quality research during residency does exactly that:

• Demonstrates you can handle complex academic work in the US system
• Shows persistence, initiative, and follow-through
• Provides objective “deliverables” (posters, papers, abstracts, QI projects)

Example:
Two candidates apply for a global health fellowship. Both have overseas experience. One has “volunteered at a clinic in Guatemala” while the other has led a retrospective study on maternal mortality at the same clinic, produced a poster at an international conference, and co-authored a paper. The second candidate looks like a future academic global health leader—not just an interested volunteer.

2. Building a Foundation for an Academic or Policy Career

If you’re considering:

• An academic residency track
• A global health residency track
• Future global health fellowships (e.g., in infectious diseases, maternal-child health, health systems, or international emergency medicine)
• Roles in NGOs, WHO/PAHO, CDC, or ministries of health

then a research portfolio is almost essential. These paths rely on:

• Ability to analyze data and programs
• Knowledge of research methods
• Capacity to write grants and scholarly manuscripts

Residency is the first time you’ll have both institutional affiliation and some protected time (even if limited) to build that portfolio.

3. Making Your International Experience Count

As an American studying abroad, you may already have exposure to:

• Different health systems and resource-limited settings
• Unique clinical pathologies and population health issues
• Language and cultural skills

Research helps formalize and share that knowledge:

• Publishing on health outcomes in your medical school’s country
• Conducting implementation science on programs you helped with
• Comparing health systems between your training country and the US

This bridges your IMG background with your future role in US-based global health and international medicine.

---

Types of Research Projects That Fit a Global Health Focus

Global health research is broader than just overseas clinical trials. During residency, think strategically about what is both feasible and impactful given limited time and resources.

1. Clinical Research with Global Health Relevance

These projects focus on diagnosis, treatment, and outcomes of conditions that disproportionately affect low- and middle-income countries (LMICs) or immigrant populations.

Examples:

• Retrospective chart review on tuberculosis outcomes in an urban safety-net hospital
• Study of delayed presentation in patients with Chagas disease among Latin American immigrants
• Comparison of maternal morbidity rates among recent refugees versus non-refugees

Why it’s feasible during residency:

• Uses existing data (electronic medical records)
• Often doesn’t require complex infrastructure
• Aligns with your day-to-day clinical work

2. Health Systems, Policy, and Implementation Science

Global health is, at its core, about systems. Research here looks at how care is delivered, financed, or organized.

Examples:

• Evaluating the impact of task-shifting (nurses or community health workers managing specific chronic diseases)
• Studying barriers to referral completion among patients in a rural partner site
• Implementing and assessing a new triage protocol in a resource-limited emergency department

For residents, implementation science and quality improvement (QI) projects are particularly approachable:

• Many residency programs already require QI projects
• These can be shaped with a global health lens (e.g., “scalable interventions for low-resource settings”)
• They count as scholarship if rigorously designed and disseminated

3. Epidemiology and Population Health

Useful if your program partners with international sites or serves large immigrant/refugee communities.

Examples:

• Studying the prevalence of non-communicable diseases (NCDs) in a refugee cohort
• Epidemiologic analysis of vaccine uptake among immigrant children
• Geospatial analysis of access to care for undocumented communities

This is especially aligned with residents inclined toward public health, MPH degrees, or future CDC/WHO work.

4. Education and Capacity-Building Research

Global health increasingly prioritizes equitable partnerships and local capacity-building.

Examples:

• Assessing the impact of a resident-led ultrasound training curriculum for clinicians in a partner hospital
• Evaluating an online global health curriculum for US and LMIC trainees
• Studying best practices for bidirectional exchanges (LMIC trainees visiting US institutions and vice versa)

This area is valuable if you’re interested in academic global health leadership, curriculum development, or working on a global health residency track.

5. Qualitative and Mixed-Methods Projects

Quantitative projects may seem more “traditional,” but qualitative research is highly relevant in global health:

• Interviews with patients on barriers to antiretroviral therapy adherence
• Focus groups with community health workers about burnout or task load
• Mixed-methods evaluation of a mobile health (mHealth) intervention

These projects:

• May be more manageable with small sample sizes
• Provide depth on context, culture, and patient experience
• Are highly publishable in global health and implementation journals

---

Choosing a Residency and Setting Yourself Up for Research Success

1. Target Programs with a Global Health or Academic Focus

As a US citizen IMG, your first challenge is matching into the right residency. If research during residency and global health are priorities, intentionally target:

• Programs with a global health residency track or designated global health pathway
• Departments with a Division of Global Health / International Medicine
• Internal medicine, pediatrics, family medicine, EM, OB-GYN programs known for international partnerships
• Programs that highlight resident research projects and “protected research time” in their websites and recruitment materials

On program websites, look for:

• Lists of recent resident publications and conference abstracts
• Named global health faculty and their areas of scholarship
• Details on international electives and associated research
• Options for an academic residency track or research track

During interviews, ask residents:

• “How many residents publish or present each year?”
• “Is there structured mentorship for research?”
• “Do global health electives involve research opportunities, or are they purely clinical?”
• “Is there funding for resident travel to conferences or project sites?”

2. Leverage Your IMG Background Strategically

Being an American studying abroad can be framed as a research strength:

• Mention any student research you did overseas: audits, case series, public health projects
• Highlight your understanding of LMIC health systems and access to local collaborators
• Emphasize language skills and cultural familiarity that can facilitate data collection or fieldwork

Example repositioning:
Instead of “I went to medical school in X because I didn’t get into the US,” say:
“I trained in X, which gave me direct exposure to [tropical diseases / resource-limited settings / post-conflict health systems]. I’ve started exploring this through [project], and I’m excited to deepen that work through structured research during residency.”

3. Early Communication: Start Before Day 1

Once matched:

• Email the program director and any listed global health or research leads before residency starts.
• Briefly share your interests: “I’m a US citizen IMG with experience in [country/setting] interested in global health research, especially [area]. I’d love to talk about ongoing resident research projects I could join.”
• Ask to be looped into research meetings, global health interest groups, or ongoing projects.

Showing initiative early sets you up for greater involvement and better mentorship.

---

Practical Strategies to Conduct Research During Busy Residency Years

Residency is demanding; ambitious projects can stall if not designed with your schedule in mind. Here’s how to be strategic.

1. Start Small and Attach to Existing Projects

For PGY-1 and early PGY-2:

• Join an existing project rather than starting from scratch.
• Offer to help with a discrete, manageable task: data extraction, literature review, translation of questionnaires, or drafting methods.
• Aim to become a second or third author initially; you’ll learn the process while building your CV.

Global health-specific entry points:

• Ask: “Are there ongoing projects with our partner sites that need help with data cleaning or analysis?”
• Many international collaborators need assistance interpreting data for English-language journals—this is a perfect role for you.

2. Choose Feasible Study Designs

Feasible during residency:

• Retrospective chart reviews
• Secondary data analyses (e.g., national or institutional datasets)
• QI or implementation projects that align with your clinical rotations
• Survey-based studies with limited data collection periods
• Qualitative interviews that can be scheduled flexibly

More difficult but not impossible:

• Prospective cohort studies or complex RCTs (these may require multi-year planning and strong team support)
• Multi-site international projects requiring extensive travel (possible but need careful time and funding planning)

Use one key litmus test:
“Can I realistically complete data collection and at least one manuscript draft before graduation, even with call, night float, and rotation changes?”

3. Protect Time and Build Structure

You won’t “find” free time; you must deliberately create it.

Tactics:

• Negotiate elective time:

  • Many programs allow a “research elective.” Plan it with your mentor 6–12 months in advance.
  • Use this block for intensive data analysis and writing, not for starting a brand-new project.

• Micro-scheduling:

  • Set a weekly research block (e.g., 2–3 hours on your golden day or post-call afternoon).
  • Treat research time like clinic: it’s on your schedule, and you show up.

• Accountability:

  • Join or form a small resident research group that meets monthly to share progress and setbacks.
  • Agree on deliverables (e.g., “first draft of introduction by next meeting”).

4. Understand Basic Research Infrastructure

Learn early:

• How to access your institution’s IRB process
• Who provides statistical support (biostatistics core, school of public health)
• How to get REDCap or secure database access
• How funding is handled for resident research projects

As a US citizen IMG, you may be less familiar with US institutional bureaucracy—ask explicitly:

• “Is there an IRB liaison for residents?”
• “Does the department have a standard template for QI vs human subjects research?”
• “Who usually helps residents with power calculations and analysis?”

5. Leverage International Partnerships Thoughtfully

If your program has international partners:

• Start with projects that the local team prioritizes. Global health ethics emphasizes partner-driven agendas.
• Offer skills you bring: literature review, manuscript writing, data management, grant drafting.
• Guard against “helicopter research”—parachuting in briefly and leaving without sustained engagement or capacity-building.

If your home medical school country has ongoing research:

• Maintain relationships with mentors there.
• Explore joint projects with your US program, such as comparative analyses or multinational cohorts.
• Ensure IRB approval in both the local country and your US institution when required.

---

Turning Resident Research into a Long-Term Global Health Career

1. Build a Coherent Narrative

Think of your projects as building blocks toward a recognizable niche, for example:

• “Implementation of chronic disease management in resource-limited settings”
• “Maternal health among refugees and migrants”
• “Emergency care systems strengthening in LMICs”
• “Infectious disease epidemiology and HIV care continuum”

As you choose projects, ask:

• Does this align with my long‑term interests?
• Will this help me apply for a fellowship, MPH, or academic role later?

A US citizen IMG with a focused, consistent narrative is extremely competitive—your international background and scholarship reinforce each other.

2. Disseminate: Posters, Talks, and Publications

Aim for output from each project:

• Local presentations: Departmental research days, hospital QI meetings
• Regional/national conferences: e.g., CUGH (Consortium of Universities for Global Health), APHA, specialty conferences with global health tracks
• Manuscripts: Even case series or QI projects can be publishable with robust methods

Don’t underestimate smaller wins:

• Case reports of unusual presentations from your medical school country or immigrant populations
• Short communications on program implementation
• Co-authorship on faculty-led papers

These build your CV and signal sustained engagement in international medicine and global health.

3. Connect Research to Next-Step Opportunities

Your research during residency can directly facilitate:

• Global health fellowships:
  Use your projects to identify mentors and sites for fellowship applications.

• MPH or MSc in Global Health:
  Your resident research projects can:

  • Strengthen applications
  • Provide topics for capstone or thesis work
  • Serve as pilot data for longer-term studies

• Early-career academic positions:
  Publications plus conference presentations help secure:

  • Instructor or assistant professor roles
  • Global health program coordinator or pathway director positions

As a US citizen IMG, you’ll often be asked: “What distinguishes you from other applicants?” A concrete record of scholarly work in global health is one of the most powerful answers you can give.

4. Maintain Ethical and Equitable Partnerships

Global health research carries unique ethical responsibilities. Throughout your projects:

• Prioritize local authorship and leadership when working with LMIC partners
• Share data and findings transparently with communities involved
• Avoid exploitative practices (e.g., collecting data without long-term collaboration or benefit to local systems)

Residency is when you establish your professional identity; building an ethical approach now will shape your reputation for years to come.

---

Common Pitfalls and How to Avoid Them

Pitfall 1: Overcommitting to Too Many Projects

Symptom: You say yes to multiple resident research projects and end up with many unfinished drafts.

Solution:

• Cap yourself at 1–2 major projects at a time.
• Ask up front: “What is the realistic authorship plan?” and “What is the expected timeline?”
• Prioritize depth and completion over breadth.

Pitfall 2: Waiting Too Long to Start

Symptom: You intend to “start research later,” realize in PGY-3 that you haven’t, and scramble.

Solution:

• Join at least one project within the first 6–9 months of PGY-1.
• Even a small role gets you into the research ecosystem and builds momentum.

Pitfall 3: Choosing Projects Misaligned with Your Goals

Symptom: Your CV shows a random scattering of topics with no global health thread.

Solution:

• Before saying yes, ask: “Does this relate to global health, international medicine, or underserved populations?”
• If not, limit to 1–2 such projects at most, unless they provide crucial methods or mentorship experience.

Pitfall 4: Neglecting Mentorship

Symptom: You start a project but stall due to lack of guidance, feedback, or institutional know‑how.

Solution:

• Identify at least two mentors:

  • Content mentor (global health, specific disease/region)
  • Methods mentor (epidemiology, qualitative methods, biostatistics)

• Schedule regular check-ins and come prepared with specific questions or draft sections.

---

FAQs: Research During Residency for US Citizen IMGs in Global Health

1. I’m a US citizen IMG with no prior research experience. Will that hurt my chances of doing research during residency?

Lack of prior research is not a deal-breaker, especially if you trained in a system where research opportunities were limited. Programs mainly want to see:

• Curiosity and motivation
• Willingness to learn research methods
• Commitment to following through

Be honest about your starting point and emphasize other strengths (international experience, language skills, familiarity with specific health systems). Once in residency, start with smaller roles on existing resident research projects and build upward.

2. Is it realistic to do global health fieldwork overseas during residency?

Yes, but it requires careful planning:

• Use elective time or designated global health blocks.
• Align trips with ongoing projects so you’re not starting from scratch.
• Make sure all IRB approvals and logistics (data storage, translations, local permissions) are in place before traveling.
• Protect yourself against overextension—don’t combine intense call months with back-to-back overseas work.

Some residents focus on data analysis, virtual collaboration, and domestic populations (e.g., refugees, immigrants) during residency and then expand fieldwork in fellowship; that’s also a valid path.

3. How important is it to be first author on publications as a resident?

First-authorship is valuable but not mandatory for every project. A balanced portfolio might include:

• 1–2 first-author works (case reports, small studies, QI projects)
• Several co-authored papers and abstracts
• Posters and talks at conferences

Quality and coherence of your work—particularly its connection to global health and international medicine—often matter more than a single first-author line. As a US citizen IMG, any authorship in reputable venues helps demonstrate academic capability.

4. Should I pursue an MPH during or after residency if I’m interested in global health research?

An MPH or similar degree can be very beneficial, especially if you plan a career in academic global health or public health leadership. Consider:

• During residency:

  • More challenging, but some programs offer integrated research or global health tracks with built-in MPH options.
  • Best if there is formal protected time and institutional support.

• After residency:

  • Easier to focus fully on coursework and thesis.
  • Many fellowships (e.g., global health, ID with global health focus) include tuition support for an MPH.

If your long-term goals are heavily research- or policy-oriented, an MPH can significantly enhance your skills and competitiveness, but it’s not mandatory for every global health path.

---

By approaching research during residency deliberately—choosing the right environment, mentors, and projects—you can transform your US citizen IMG background into a compelling, research-driven global health career. Your unique perspective as an American studying abroad is a strength; structured scholarship is how you convert that strength into lasting impact.