Module 3: How To Find IMG Friendly Programs (& Increase Your Chance of Matching)

Welcome to Module 3 on How to Find IMG Friendly Welcome to this module. In this section, what I'll tell you or teach you is how you can point out the states that are considered IMG friendly based on the current data. Then I'll show you two ways to find IMG programs that you can apply into. Very briefly, one of them would be to do a manual method, and I'll show you the resources that you can use and how to triage these programs. The second way, which is a lot easier but costs more money, is how to use a filtering resource. So you have a manual method and a filtering resource. I'll also show you specifically how to set up a list that works for We also have a worksheet in this section right at the bottom. You can download that PDF and it will help you work through finding IMG for any programs. As In this module as well, you'll find some audio recordings of one on one coaching sessions that we've had with other IMGs or group coaching sessions. This could be of use to you, especially if you just want to listen in on another person's coaching session or specifically a class where we go over how to really find these programs item by item and carry most of the information that you'll I hope that you pay close attention, but I want you to remember one thing indeed, there is no such thing as an IMG friendly program because you can be the one to create an IMG friendly program. You may be the first IMG at a program who hasn't hired any IMGs in the last few years. Reason being they may interview several IMGs, but for whatever reason. Algorithm just does not allow these IMGs to fall on the rank So the fact that you do not see an IMG listed on a program's website doesn't directly mean it is not IMG friendly. I want you to keep that at the back of your because, for example, where I went to residency, they hadn't had an IMG for the year before my year or the two years leading up to my If I just looked at that information, I would have felt like, well, maybe they're not IMG friendly, right? But that's a because you can be the one to define and create an IMG friendly program. However, in this section, I'll show you how you can gauge what programs are looking for applicants just like yourself. And then I'll give you a filtering resource that you can leverage. If you don't want to do a manual process, stay tuned. Let's get into the module.

Welcome to this session on how to find IMG friendly programs. As always, I am Dr. Lum. Let’s get right into it.

Part one, I will start off with this quote for us, “As long as you keep searching, the answers will come.” This is by Joan Baez. One of the most common reasons why people don’t match is because they are not targeting programs that are likely to admit them.

Usually if you say you have a hundred applications that you sent out. If all those 100 programs are only focused on programs that have not historically prioritized IMG on their rank list, evidenced by who is an actual current resident at that program. You will run the risk of matching or not matching into the programs that you ended up with on your rank list.

What I mean by this is each program has a website. When you go over their website, you will see who the prior residents are, who the current residents are and where they went to school. That could be a really strong sign as to how IMG friendly a program is.

Another thing to remember is even though that has been used time and time again. It is important to remember that you can be the reason why a program becomes IMG friendly. The simple fact that a program is not historically known to be IMG friendly does not mean that you don’t stand a chance to get into that program. 

I want us to look at some few things in this lecture and I want us talk about how do you find programs that you’re more likely to be invited for interview into and eventually rank on their list. That is what we will be focusing on during this lecture.

We will move to the next slide. How many IMG friendly programs exist? We don’t have a fixed number because that number is fluid. It changes each year. There are programs that maybe since 2000, they did not admit anyone that was considered as IMG but in 2003, they admitted IMG. In 2004, they might not have one. In 2005, they might have one.

What it really means is that each year is fluid, so I don’t like to focus on programs as a whole. I want us to focus on spots because at the end of the day, you as an IMG that is currently taking this course. Your goal is to just get into one spot. It is not about how many programs exist.

Like in the previous module, I showed you the doctor who matched after having one interview. It is really not about how many programs exist. It is about how many spots are there that have accepted IMG here in the recent past. What are your odds of fitting yourself into one of those spots? Because there are two things. One, the first step is to get an interview, which means that the program does not care that you are an IMG, because the program invited you for an interview that means they want you. Then the second step after the interview is how you get on to the rank list and be higher up even as an IMG. It all boils down to the spots that exist for you to fit in.

Let’s just look at some data because sometimes I think we get bogged down by the fact that IMG have not matched in the past. We know people who have been gone through the match three or four times and given up and moved on. That is fine and fair. Some people are going to move on, but if you are the person that has the commitment to persist. That is what is most important in this whole entire journey, is a commitment to persist and to keep pushing until you reach your final goal. Visualizing, positive self-talk, maintaining a mindset that is going to succeed.

Before we go into that, I want to touch on the number of spots that actually may exist again, not a fixed number. Let us look at the data to see how many spots have accepted IMG here in the last few years. How about that? That would be a good place to start.

Case studies, we are going to look at 2020 data. This is the result of match that happened in March of 2020. Total number of positions in that year, meaning these people applied in September 2019. A total number of these positions in the match are 34,266 spots. That is a lot of people. That means 34,266 doctors to fill those spots.

That could be medical students that are fourth year, fifth pathway, US IMG, non-US IMG, DO students as well as MD students, which fall under the medical students criteria. Total number of US IMG that matched is 3,154. If you are watching this right now and you are a US citizen or a US person with a green card, you are wondering about your odds of matching.

Think about this. There are 3,154 spots that were filled by US IMG in the year 2020. Meaning in June of 2020, US IMG, 3,154 of them started residency or will be starting residency. What does that tell you? That you only need one. You only need one. You just need to be that person that makes it 3,153 or 3,154. There are a lot of opportunities for IMG. That is my message. There is an opportunity for IMG. What really matters is how to distinguish yourself and make yourself competitive to fit into that spot. That is why your letters are going to be important. That’s why your clinical experience is going to be important.

Clinical experience at an academic center is even more important. Clinical experience at an academic center with a residency program in the specialty of your choice is even most important. A letter from a program director is even the most important.

Total number of non-US IMG that matched is 4,222. So 4,222 people who need visas matched in the year 2020. There are going to be 4,222 people that are doctors like you requiring visas or required visas that matched. The US Embassy across the world will be given out 4,222 visas. Can you tell me again why you think you can’t match? When in this particular year, we are looking at a case study of one year. Every year is different. We are looking at a case study of one year. This year is historically known to have been the best performance for IMG in 30 years. 61% of IMG matched in 2020. That means in 2019, out of all the IMG that applied into residency, 61% of them matched.

Are you still wondering what your odds are? What I am trying to do here is to help your mindset. I am trying to give you points that would help your mindset to think about yourself as the person that has the chance of being one in that 4,222 number. All IMG put together is 7,376. Are you still wondering why you cannot match?

I want you to shift from, “I can’t match” into “I have a chance at being one out of 7,376 people.” That is a large denominator. You are the only numerator in your story. I believe you can match. It may require changing your mindset about how you failed Step 1. It may require changing your mindset about how you did not perform well on Step 2. It may require changing your mindset about actually applying into surgery even though you have been feeling like you are not competitive enough. It may be that this is a time where you are actually going to a conference. You are actually going to show up at the radiology conference, walk up to programs and talk to them. Because you are believing in yourself that you will be that one person out of this large thousands of doctors that match. I am trying to not sell you the dream but trying to show you how that dream is possible, if only you will persist.

Let’s look at some specific data. We have looked at case studies for 2020. Let us look at specific data and numbers. Each specialty again is going to be different. I am going to minimize this so that you can see specifically what we are referring to here.

This table is really pretty. I like it. Anesthesia, this table is in alphabetical order. So you can take a screenshot or whatever you want to do, that is fine. Now looking at this table, let us start from “A” to “I”. Let’s look at the number of positions, just in some specific specialties. Look at anesthesiology, 1,370 positions existed. This is case study data from 2020. That means if a new program opens in 2021, that number of positions could increase. Say that program offers four or five spots because that number can go to 1,375 in 2022. If there are 10 new programs that offer 10 spots each that can also go up exponentially. Number of positions is a number of places that are available for people, doctors, or medical students to match into, whichever category that you fall into. US IMG versus non-US IMG.

I excluded all the US medical school data because it is not important for the purpose of this course. Look at Anesthesia, for example, we had 58 US IMG matched into anesthesia, 78 non-US IMG matched. I can guarantee you that in these numbers, you will see there are actually more non-US IMG that match into anesthesia.

That having been said, these people probably had rotations with anesthesia. They took a fourth year rotation, three, or two with anesthesiologists. They saturated themselves amongst anesthesiologists. They spent a great deal of time as far as US clinical experience with anesthesiologists. They got letters of recommendation from people that were actually board certified in that specialty. Maybe one or two out of three were from anesthesia folks. They spent a great deal of time in surgical rotations or observerships. They may have publications of research. Those are things that I would think about.

Going down to look at dermatology with 31 positions in the entire match, not a whole lot. Out of that, non-US IMG took up two of those positions. I would be glad to be that one out of two. Again, it is not impossible but fairly competitive. It does not mean you shouldn’t try. It just means you have fewer spots that you are looking at. That is what when people say about competitive programs, really what they’re talking about is the number of spots that are available.

Go down to family medicine, 4,662. Actually, interesting, categorical internal medicine is almost twice that number. Family medicine, 787 US IMG matched and 405 non-US IMG matched. Internal medicine, 8,600 plus spots, so more non-US IMG matched.

When people ask me, “What is IMG friendly?” I think you should look at the spots that exist. The number of positions that exist and the number of IMG that match into it. That is how you tell an IMG friendly specialty.

Medicine preliminary, this means PGY1 only. Meaning that person matches into a medicine preliminary spot still has to figure out where they are going to for the next two, three, four or five years of residency. IMG are leveraging that. My presumption is that these IMG are applying into fields like radiology, dermatology. They are doing their preliminary so that the next time around they are going into their specialty residency.

Medicine-primary care has 430 spots. Mostly IMG matched into that. What I am trying to show you here is you can look at something like medicine-dermatology, where there are only six physicians and say, “Okay, well, no IMG matched in there.” Probably, if I wanted to do dermatology, I could reframe my mindset by doing a medicine residency then doing a dermatology residency or I could do a medicine-preliminary then reapplying into dermatology based on the number of spots because they are limited. This is just a different strategy. If I wanted to do emergency medicine with 2,665 positions across the country, 155 for US IMG and 30 for non-US IMG this year. These are not fixed numbers and fluid. They are going to change each year. This is just a case study for one year.

Let us look at some other specialties, interventional radiology, 38 positions across the country. In this one year, two people were US IMG and four non-US IMG that matched.

Going down into neurological surgery, more non-US IMG matched into neurological surgery than US IMG. 12, that is almost twice the number of US IMG. It is a small, low power study but still if you are wanting neurological surgery, this is your chance to say, “Hey, last year 12 non-US IMG matched into it. What do I need to do to be in that?” I will tell you they are big on research, bench research publications. And really, who you know in the neurological world can take you a long way because mentorship goes a long way in neurological surgery.

Let’s look at OB. OB had 1,443 positions. 36 went to non-US IMG and 58 to US IMG. Orthopedic surgery, people say, “Oh, IMG never matched into ortho.” Look at that, 14 IMG in total. 5 of them are US IMG, 7 are non-US IMG. It is really about what you are fixated on at this point.

Pathology, 603 spots, but they gave 232 of those spots to non-US IMG and 54 to US IMG in the year 2020.

Pediatrics, another great specialty with more spots, 2,864 positions available in the match. 222 were given to US IMG and 340 to non-US IMG that matched. What I am trying to share with you here is I’m trying to show you that it is possible. You can run through this list. You can pause the screen right here and study these numbers for whatever specialty that you are interested in. 

Neurology in 2019 was one of the most IMG friendly specialties. In this year, they are still quite up there, but not as high as some of the other ones or as high as the world of previous years. Neurology last year matched tons of non-US IMG. For this year, they have done the same but the numbers are not near as high as they were the year before. That again tells you that these things change. You can not nail down what is considered as an IMG friendly program but you can at least figure out the programs that ranked and matched more IMG.

Let us look at the total PGY1, like we said, 34,264 out of those numbers. These are the total of IMG that matched into them. Let’s talk about surgery as well. So  1,174 surgery preliminary PGY1, categorical surgery has 1,536. Again, several IMG you can tell that are matching into surgery preliminary PGY1. They are doing that because they want to come back around the following year to get into a PGY2 categorical surgery. That is another way if you want to apply into surgery, you should look into both categorical and preliminaries.

Looking at those numbers, psych was another one that had a higher IMG rates in that year 2020, again with 1,858 spots.

Our positions were available in the match. 164 went to US IMG. 129 went to non-US IMG. Plastic surgery, 180 spots matched in total, so not a whole lot but even at that you have three US IMG and 6 non-US IMG. I have a very extensive podcast episode on Dr. Stanley Ogu, who is a plastic surgeon. He really talked about how he went into plastic surgery, it’s on my  IMG Roadmap Podcast. He talked about how he went into plastic surgery. He didn’t go in through the traditional route, which a lot of IMG always forget that you can always match into one specialty and receive additional training in the others. He went into general surgery first, then did a plastic surgery fellowship. I know people that have gone into internal medicine first then gone back and done dermatology or emergency medicine. You can always start in one place and still end up in your desired destination.

Based on that data, the summary of the most IMG friendly specialties of that year in 2020 has not really, spoiler alert, has not changed because the specialties that we consider IMG friendly are really just the specialties that have the most positions in the match. By virtue of anything, if you have the most positions in the match, you are going to accept more doctors in because you have more positions.

I talked to a urologist who actually, urology does not participate in this, they have a different match. They don’t use the ERAS. They have to go through the American Urologic Association to get into the match, but I talked to both a urologist and an obstetrician again through my podcast. They actually said that they believe, “Because IMG focus on applying into what is considered IMG friendly and I am a family medicine. They miss out on the opportunity to actually match into what they really desire, which is urology, OB, or neurological surgery.” If you have good scores and you have a desire to shoot for the stars, please go for it. Don’t let the data hold you back because you just never know if you are going to get an interview. What if you get the interview and then you match? Like our case study in the first section of our course, she mentioned matching in a specialty where she did not really feel she had the strongest portfolio for. You will never know until you try.

Anyhow, let us go over the data on the summary of what we’ll consider most IMG friendly specialties for that year. The spoiler here is it is very similar to the data for last year or the year before, and the year before, and the year before. The reason being that there are more positions in the match for these specialties. The data is similar.  According to the Data IMG Friendly Specialties for that 2020 cycle, this was the top 10 IMG friendly specialties at that time, which means in a few years, if there is more physicians that open up for peds, neurology, for example, that could become what we consider an IMG friendly specialty. You could always do neurology then do a fellowship in pediatric  neurology.

You could still get to your end point by going through a different route. Internal medicine was number one. Again, it had the most positions given to IMG. It had the most positions in the match in general. Family medicine was number two, pediatric, psych, pathology, surgery surprisingly. The number of surgery prelim was actually more than neurology. Surgery categorical follows right after neurology, emergency medicine and then anesthesia. If you are one person, because you can’t be two doctors, it is just one of you. You are thinking what are my odds of getting into Anesthesiology? One out of 136 based on 2020. If you have 2019 data then you look at that and you look at 2018. That number changes.

What I am trying to tell you is that I want you to believe in yourself. I want you to believe that you can hit one of these positions and make it yours. That is really what I am trying to sell you. I am trying to sell you the idea that the denominator is actually larger than you think. I want you to ditch that scarcity mindset. The mindset that makes you feel like you do not have a chance and there are no positions for you. I want you to think differently about it and realize that you actually do really stand a chance.

Moving into part two, the process. Isn’t this such a very stressful season to be thinking about the one thing that can completely change the trajectory of your life? Think about all the things that you can do when you do match. When a person matches, I don’t look at it only as the opportunity to train in that specialty. I look at it as an opportunity to pursue our higher purpose. Some of us, our purpose is entwined in medicine, in healthcare, and in improving health. But some of us, our purpose is way beyond that, it is providing for our families and taking care of our loved ones. I really want to encourage you as you move on in this module that you are not alone when you feel stressed and overwhelmed with what is going on. You are not alone. I am here to really help you navigate this process and demystify it for you, so that you can shed that heavy weight off your shoulders and see yourself as somebody that is actually going to match in the next cycle. That is what I’m here for, to encourage and inspire you guys. That being said, I digressed.

Let us move right into part two. The process is really tedious and that is what I was explaining before. But people have made it. I have made it to the other side. Several IMGs have made it to the other side.

If you are still doubting you should be listening to IMG Roadmap Podcast, which just really gives insight as to people that are continuing to win this thing. I want you to really have that kind of level of faith that you can make it. The big question is besides giving you motivation and making you feel good. I want to know how far are you willing to go for your goals? Are you willing to risk everything to get what you want? Are you willing to set aside everything as you have known it to move across the country for what you want? Because sometimes one of the limitations to finding and matching into a program is that we are not willing to let go of our present situation. We are not willing to let go of our current circumstances. We are not willing to move away from our families for two years or three years. We are not willing to leave our home and our comfort zone. Some of you watching this are thinking, “There is no way Dr. Lum, like I am an IMG, meaning I am from another country and I have already moved this far. Location does not bother me.” You will be surprised if you tell yourself things like, “I do not want to go to Wyoming, I want to match but do not want to go to Wyoming or I do not want to go to the middle of nowhere.”  Those things that you are saying are telling you, your subconscious mind, that you are not willing to go just about any length to match.

You are telling your subconscious mind, “I will match. I will only go if it is like big city or whatever.” So I really want you to think about this seriously as to, are you willing to go to a rural program? Are you willing to go to the middle of nowhere? It is only a 3-5 year sacrifice. A lot of us are going to live well into our seventies. Our medical careers are going to spend decades. Some of us will be doctors for 20, 30, 40, or 50 years. What is three years of sacrifice in the grand scheme of things? I want you to answer that question for yourself. 

Limitations during the program search, number one is finances. Finances really hold a lot of us back. Unfortunately, there is actually a study that showed that finances was one of the biggest reasons why some students perform lower on the USMLE compared to others. Students that had financial issues tend to perform lower on Step 1.

That is because my presumption is the stressors that are added on the person. Usually when people want to do anything to match, it may involve going to do an observership in another town or it may involve buying a plane ticket to fly into the states to shadow at a hospital for six weeks where you are not really touching patients. You are not sure what kind of letter you will get from it. You are not sure if it is really going to add to your portfolio but you are sacrificing and taking the risk.

In those circumstances, the only thing I will tell you is there is no way to be sure. There is no certainty in any of this. This is all about taking one big risk and just believing in yourself. I keep using that word “believe” because believing in yourself would help you leave your comfort zone and be who you want to be. Believing in yourself would help you leave your comfort zone and become who you want to be. 

Sometimes it is a big sacrifice but it is what is necessary. These things do tie up, I know IMGs who have shadowed a work that is research facilitators at hospital for 1, 2, or 3 years before getting the opportunity to match in there for residency. Actually, I know an IMG who had multiple failures in Step 1 and Step 2. This person went to the state of New York and received a limited license to practice because New York is one of those states that would admit an IMG into their state to practice with a limited license, but you work as a physician assistant or an intern. There is always somebody supervising you. You do things like admissions but always have to check out your cases with an attending. She did that at this program in New York that actually was affiliated with the residency program.

She did that for I want to say, two years before she was able to be offered an interview and a position in the program, then she eventually matched there. Now she is pursuing fellowship. I am just sharing that to tell you that it is possible.

Back to the limitations, the reason I am pointing out these limitations is not to tell you what you already know but so that you can start to think about different ways to overcome them and that you know that you are not alone. 

Finances, for example, when I was a medical student, and I have shared this previously. But when I was a medical student, I was so low on finances. I had no money basically. My parents were supporting me. It was a very difficult time because they barely had enough for themselves. Because of that, I stayed in one hospital. I did all my core rotations there and most of my electives there. My CV did not have a whole lot of diversity so when it came to looking for programs and applying into programs in that area. It is kind of limited to myself to the midwest because I felt like that is where I am located. I could pay the rent for the midwest. I only knew life in that setting, so I did not go far south. I did not go far northeast. I did not even look west. I was limiting myself based on my current situation. I was not seeing far into the future or I was not ready to dare to move across the country.

In that season, I only got family medicine interviews even though I applied to internal medicine and family medicine. When I look back, my CV was rich in family medicine because that location that I was in as a student and did all my course had a family medicine program. So all my letters came from the same hospital, the same academic center that is known for family medicine programs. It is no surprise that if someone was reviewing that in Kansas, for example, they would look at that and say, “Oh, she did focus on family medicine through our medical school. She definitely wants to do family medicine, not internal medicine that would make me unappealing to a family medicine program.”

This is just an example for you to see how the limitations that we put on ourselves can really hold us back in the grand scheme of things. Because when you limit yourself to a certain area and your application is getting reviewed across the country. They are thinking, “This person does not want to move. This person wants to stay in that area because they have done everything in that area. This person does not want to apply into this specialty because they have limited themselves based on their geography or based on their finances to only take the opportunity that is close to them.” This is my call to you to open up to opportunities that are outside of your sphere of influence or close to where you are at.

Sometimes people may have family issues. They may have proximity. They want to be close to home. They do not have the time to invest into the research. Because in this video, actually in this module, your next section, I will be walking you through specifically how to search. This searching is time consuming, it is and that is the truth. You have to set aside time to search because you cannot just blindly wait for September 1 and just apply. I think you need to do your research now so that when September 1 comes around, you already have a list of who you are targeting. 

Resources, of course, which is what we talked about, for example, even in this course, I wish I could offer this course for free, but there are so many things that come into recording it, editing, videography, which makes it to where the small price I put on it still ends up meaning a whole lot for some people, for others like yourself, you have sacrificed because this is important to your future. Hopefully your eyes are being open to things that you could do differently.

So knowledge of geography, lack of assistance, these are just some things that I want you to start to think about. What are some ways that I can fix these problems in my life? What are some ways that I can navigate these issues? Because there is always a way. If you look, you will find. If you are looking for the answer, you will find it. Remember that quote in the first section? We keep seeking, we will find. How far are you willing to go for your goals? This is just again another map of the states. I really just want you to just look at it for a second. Are you willing to leave New York and go down to Texas to train for three years? You should be. You should start to talk to your family about moving with you. You should consider talking to other IMGs who have moved and moved back. You can always go back. 

Location, location, location is important because there are some locations though that are known to be IMG friendly. It does not mean that outside of these locations, you would match. What that means is these places historically have proven themselves to be IMG friendly. I want us to look at that. I want us to also consider that even rural locations are IMG friendly. Some big cities and some rural cities are IMG friendly. I would say some big cities are IMG friendly. All rural towns are IMG friendly because they are short of physicians and you need to capitalize on that shortage by showing up.

Let’s look at some locations and then specialty’s the next thing. We have talked about in the first part of the video. The specialties that are IMG friendly are IMG friendly because they have more spots. That is it. They are not IMG friendly for any other reason but that does not mean you should not apply to a specialty that is not on that top 10 list. Because you are afraid, you should apply there.

Then I do recommend that you have a plan B when it comes to specialty, I recommend applying into one specialty. There are two ways to look at this. You can apply into one specialty and exhaust your options. Meaning, if there are 200 programs that you are eligible for, you apply to all of them in one specialty, if you want to risk it. And, “Oh, if you have a plan B, then you can apply into one specialty for 75% of the programs that you are applying to and 25% into plan B specialty.” That is up to you, whatever specialty you are interested in, you can say, “I am going to put in 75 programs in plan A, 25 in plan B with specialty B or for 100 in my plan A and 25 in my plan B.” However you choose to make it, I know a lot of IMGs have done this, and a lot of people have matched through that process, maybe falling into their plan B or even falling into their plan C. I interviewed an OBGYN, which OB was not her first choice. She fell into it as I think it was her plan D or something, because she wanted to match into medicine. Either way, I know people who have interviewed at both. They will interview. I have actually one of our roadmapper, somebody that just graduated this course and matched in the most recent year. She applied into EM and IM. She got tons of interviews in EM, fewer in IM. She ranked all these programs and matched into IM. It is odd, but she is happy with her outcome because she was ready to specialize in either one of those, and still even with that, she can still apply into an EM fellowship. There is always a way around it.

Key steps to remember, like I mentioned before, you are going to determine your two tough specialties that you are willing to train and practice in. You are going to determine what states you want to apply into as an IMG. As I said, stay open, keep it wide open and do apply to all top 10 states. I will talk to you about the top 10 states in the next few slides. Go to the match website and determine how many programs are available in each state. I will walk you through some of those samples.

The other thing that I want you to become familiar with in your search process is FREIDA. That is the American Medical Association of Residency and Fellowship database. It is really where all the data, all the programs are and which ones take IMGs and which ones do not. This is the time consuming process that I was talking about.

So everybody on this course, right after this class, I want you to go right after this class and sign up to FREIDA if you have not yet done so. I want you to begin to see through, get your highlighter out, look for IMG friendly programs and highlight them, and highlight them, and highlight them because that is where you are going to target. Because when you highlight them, then you go to their website and you see what the requirements are. What scores are they looking for? What requirements are they looking at? Look at their prior residents. What schools did they match into? I want you to create a tailored list for your your specialties. For example, I am applying into internal medicine. I go on to FREIDA’s website, I look up all the IM programs. I keep an Excel spreadsheet of all the programs, their contact information and the scores, “If I meet their score requirements, get some of them on my Excel spreadsheet.” Then I say, “I live in the state of Kentucky. I will go to the match website, which is the NRMP.” Each year they have a form that they release, which is where I got the data for the prior part of this lecture. It was from the NRMPs’ website. They have super specific reports. They put out the number of spots in each specialty but also go into state specific information. You can find state specific information for 2018-2019, even further back in the years as you go, 2020 and so on and so forth. You will find on there, there will be programs that you can reference to in order to know how many people in that state matched into whatever you are interested in.

Then that gives you an idea as to, “Maybe I should focus on this state because in these last two years, if they gave a hundred opportunities to IMGs, maybe I would stand a chance there as opposed to another state that has not given opportunity to IMGs for years.”

I want you to really think about creating your own Excel spreadsheet and going through this research. This is time specific. This is a time consuming process. Absolutely, because it is person specific, everybody has a different specialty. I could not include the details in this course. Because my case study may not fit anybody watching. Again, key things to remember, group according to states, use FREIDA and use the data on the NRMP’s website. The links to that will be included in the notes as well.

Do not avoid role programs or non-IMG friendly states because you can make an IMG friendly program. I really want you to take this seriously. Listen to me. You can make an IMG friendly program. You could be the first IMG to match in your program. I matched into a program that receives IMGs but it is not in the most IMG friendly state, which is Kentucky. What I noticed is in Kentucky, rural Kentucky is short on physicians and they are open to IMGs. You can create an IMG friendly program. 

This is just a screenshot from the American Medical Association website about FREIDA. You can find your perfect residency position online using www.freida.com. You can search by specialty, state, keyword, or institution. You can compare your USMLE or COMLEX-USA score and learn if you qualify for an interview. You can save the results in your dashboard, organize, compare, and analyze programs of interest. You can use FREIDA, you have to be a member of the American Medical Association. They have an IMG section as well. The NRMP website is another great source of information. Again, this is the easiest typing in NRMP website in your browser, and you find out the different reports that they have.

Just a summary, this is data from 2019. This is state specific data. This is a case study from 2019. This is the match of 2019. This means these people applied in September of 2018. According to the people that started residency in June of 2019 what we know is in each state, these are the number of IMGs that were admitted to train there.

We were talking about, for example, Kentucky, they give 24 spots to US IMGs and 30 to non-US IMGs for a total of 54. That may feel like a low number, but it is probably because not a lot of IMGs are applying into Kentucky anyway. Because they are thinking it is in the middle of nowhere. The next thing, Idaho had 12 slots for IMGs. Again, who is applying to Idaho, very few people. Delaware is a very small state, but did offer 7 positions to IMGs. Again, people are not looking there. Alabama, 84 positions to IMGs. Alaska did not offer any, I reserve my comments on that but you can probably guess why. Maine offered 12. Indiana offered 52. Illinois, which is one of the more IMG friendly states, offered 348 positions. California offered 341 positions. Arkansas, who would have thought of Arkansas, 104 positions. Sometimes we are just not looking in the right place because we want to only match into certain types of states. Georgia, which is Atlanta, Georgia they only had 180. You would think there would have been more spots given to IMGs in that year. Look at Florida, 540. So that almost tells me I am looking at 300 US IMGs, 241 non-US IMGs. A lot of times Florida is friendly to IMGs, especially if they are from the Southern American countries or Central America, because they have a huge Spanish population. These people speak Spanish. That is something to remember. Iowa has 41 spots. Again, some people may shy away from applying to Iowa, but this could be your go to. Maryland only 76. Michigan, huge 551, Michigan has a lot of programs. It is cold out there but very IMG friendly. So focus on those states. 

For example, if I was interested in anesthesia, I would be looking at all the anesthesia programs in Michigan because I can see that they have a high IMG– In this one year in 2019, they matched a large number of IMGs. If I was looking at that same specialty again, I would look at New Jersey. I will look at Massachusetts but based on my scores I may not qualify for some of these. I will go look at what is that one program in Montana? Do I qualify for that one? What was that one program in Maine or those 12 spots in Maine? Do I qualify for it? Then I will put my money there instead. 

Another slide just showing different states. Tennessee, 65 spots. Again, not a very common state people think about. New York, 1,436, New York is pretty big, it is the number one IMG friendly state for obvious reasons. You should definitely apply to New York but should not disregard your Oklahomas, your Carolinas and your Tennessees because people are not looking there so what you are missing out on is getting crowded in these big cities. West Virginia is another one. Let us see if we have West Virginia data, they had 80 spots but a lot of people would shy away from that, especially in the Northeast. If you apply in the Northeast, definitely send some apps down to West Virginia. DC had 99, a very small state, but 99 IMGs match into there. Texas, Utah, Vermont, Puerto Rico. Just to give you some more insight on this. The point of this is I want you to put together a few things on your Excel sheet. You are going to keep yourself a running sheet of the programs that you are eligible for after your FREIDA research and the states that you are going to target the highest after your NRMP research. Then you put that together.

That is one way of doing things. If you don’t want to go that route, then there are easier ways to do it. I can show you that as well. If I have not otherwise stated this, you can create an IMG friendly program. You could be that IMG that’s in Maine. You could be that IMG. I know a lot of Canadians that may live on the border, a lot of them may be good candidates for those in Maine, Vermont programs, even non-Canadians, that could be you. I just want you to remember that even if you don't see, I didn’t call your specialty, or I didn’t call your state on here, I want you to really consider still reframing your mindset, doing the work and doing the research.

Back to part three, IMG friendly States. In this section, we will walk through some of the data from the previous years. We will look at some of the data in the late 20-teens, ‘17, ‘18, ‘19, and ‘20. Let us get right into it. In 2018, these states are considered the top 10 IMG friendly States: New York, Florida, Michigan, Pennsylvania, New Jersey, Texas, Illinois, Ohio, California, Massachusetts. Like I mentioned before, you can create an IMG friendly program.

The importance of knowing these states is if you have limited resources and finances, you definitely want to focus on these states. If that is not your concern after putting in your scores and such, you realize that you do not qualify for half of the New York programs based on scores. Then you should definitely look into those other states that are not known to be IMG friendly such as West Virginia, Virginia, Kentucky, Kansas, the Midwest, even the South and further out West. Depending on really how much you are allocating into programs. I definitely think that IMGs should focus on IMG friendly states. Remember that these IMG friendly states are IMG friendly states because they are metropolitan and cosmopolitan states. They have a huge influx of immigrants across the board. They have large international airports. There are bigger cities that generate tons of revenue for the US, there is a lot more diversity. That does not mean that you can’t go ahead and train in a traditionally non-IMG friendly state and then return to whatever state that your family is located in. Just something to consider there.

In 2019, IMG friendly States, we have New York, Florida, Michigan, Pennsylvania. New Jersey came up a little bit higher there that year. Did it 1, 2, 3, 4, 5. Over here, it was one, two. It still actually says the same. Texas, Illinois, Ohio. Let us look at 2018. Ohio was a little bit further down. It was 6, 7, 8. Over her it was 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. It was the last on the list for the top 10. Each year again is fluid. It looks like in that year California was a lot higher than it was in the previous years. Massachusetts definitely gives more opportunities than Ohio in this one year.

Their position on the list just varies back and forth but they are still considered IMG friendly. You have to also remember a majority of programs like we looked at Michigan. Michigan had tons of positions. New York has even thousands of positions in the match. Same thing with Florida was the one that had 500 plus IMGs that match because they have more positions.

Another thing to consider is focusing on the States that have the highest positions as well. States with the lowest number of IMGs in 2018 had Alaska, Colorado, Maine, Delaware, it’s also a very tiny little state. Montana, Wyoming, Vermont, Utah but they still had IMGs match there. It was just not as high as the other ones. Colorado, Maine. Wouldn’t you want to be one of the seven that matched in Colorado? You get to spend three years or four years in Colorado, but that is it. You get to explore a new place. I would want to be one of, as far as not matching, I would rather be one of the eight in Utah than not having any opportunity at all. It is just for three years. Just some things to consider. You could definitely put your money out here as well, as far as where to allocate your resources. If you are limited on your budget as to how many programs to apply into but then focus on those top 10 that I gave you. 

We will move into another section. In this section, I will touch more so on what I call, this is the easy way out. It is using other techniques to figure out what is IMG friendly and where it is IMG friendly.

The first thing we will look at is looking at programs based on their alumni. We will reference back to where people from your school have matched. If you are in a school in Pakistan right now, your alumni, people that graduated from your school have matched into programs across the country, you may want to start there with that list, because if they give that personal opportunity, they are more likely to give you an opportunity. Definitely reach out to alumni that you find when you are doing your research, and send them an email, cold emails. I am a fan of cold emails. I get them all the time and I respond. I think other people, the doctors that get them will respond. Definitely reach out and ask them, “Hey, I saw you matched here. I am interested. Any tips for me? Should I do anything different? Is there an opportunity for me to come observe?” You can use the same templates that I put up in the observership section. Always tweak it, make it personal. You want to make these templates personal.

Search program websites, of course. Blank search or using a filtering resource. Let us talk about this a little bit. Filtering resources are websites that provide opportunities for IMGs to figure out what programs they are eligible for. This is basically if you choose to skip everything in the prior section of this module and say, “Hey, I do not have the time to do my own research, fine and fair, but you may pay your price.”

You may choose to pay the price of signing up for a resource like matcharesident. The reason I strongly recommend this is that you can put in your applicant type. You can put in your USMLE Step 1 score, Step 2 CK, US clinical experience, visa sponsorship, and time of graduation. They really help you to figure out what your options for matches are. How this can help is you do not have to wait until September 1 to sign up for a matcharesident. You can sign up right now. The reason I would recommend knowing or getting your list early from them is because you can use that to also target your requests for observerships.

For example, if you are currently watching this and say you are watching it in the month of March. If you go on out and put your applicant type, your years of US clinical experience, or the lack thereof, your US Step 1, Step 2, your visa sponsorship, your time from graduation, you calculate your matches for neurology. It will pull up the number of programs that you are eligible for based on your score that can vary. You can tell you are eligible for 70 programs. What that means is you can go through the websites, don’t trust the filtering resources to do the work for you. You still have to go through the website. It skips a step for you and allows you to go through each website and then look at the specifics. Then you email those program coordinators because you have several months. You have April, May, June, July, August, before September. You have five months. You never know who is going to give you the opportunity to come shadow or observe for one month. That could be your way of showing up and letting them know about you building a one-on-one likability factor with them. In turn, they give you an interview and they like you. Then they want to rank you.

Definitely something I strongly recommend, if you use the code, “IMGROADMAP15”, you get 15% off your list. I think the list of the prices vary but somewhere around 70 or 75 US dollars. You can get a good discount by taking this course and using our discount code.

By personal experience, target programs where you did your rotation. This is key. Important. Especially for IMGs that are in medical school in the Caribbean. You want to target programs that you have experience with where you did your clinical rotations and observerships because they know you. This is why as a third year student when you show up, you really want to be present. You want to be participating. You want to get good letters. Because if these people have a program they are more likely to invite you for an interview before they invite somebody they have never met. 

Programs in your area, your state where you share ties. Ties are such a big thing, because most programs want to retain their graduates. They want people that will continue to come into the workforce in that area and make that area better. Everybody has a sense of wanting to improve their home. If you live in Texas, for example and you live in the Dallas area. Just by virtue of living in that area and you know the area, chances are programs in that area want to match people like you as opposed to taking somebody from Wyoming who may have some trouble adjusting. They may feel more comfortable with you, so capitalize on that. I want you to use that to your advantage. During your rotations, ask about the requirements to match at the programs and establish a working relationship with attendings that you meet.

Definitely, as I mentioned in another module, you want to focus on how to win friends and influence people. How do you win somebody's attention? How do you build a relationship with them? By doing the little things, the body language thing, showing up, helping that person achieve their own outcomes. Usually when I want something with somebody, I help that person achieve their outcomes. Right now, I don’t know what I want from you, but you are taking this course. I am helping you achieve your outcomes. That makes me feel better. I don’t know why but it makes me feel better to see you succeed because I went through the same pain that you are going through. I went through the same process that you are going through. I wish I had a course like this to show me the ropes. Unfortunately, there wasn’t one so I created one so that you do not have to feel alone and you can look up to other people and say, “Hey, these people have done it. They had limitations. They had problems just like I did but here they are.” You want to establish a working relationship with people by using those same techniques. Talking to people, figuring out where are they from? What do they like? What do they not like? What makes you have some commonality with them? Definitely capitalize on that.

The last slide, the SOAP program is another way people find programs to match into. According to the AMA in 2018, 200 IMGs found positions through the SOAP, so not a whole lot compared to the thousands that applied while nearly 9,000 went eligible. That is the problem. The SOAP is very competitive. We want to avoid not getting to the point of needing to SOAP for a match but if we do, there is still a possibility that you can match through that.

That brings us to the end of this section. I just want to share with you some other results. These are doctors that took the course last year in one capacity or the other. They all matched into residency in the 2020 cycle, I am just so proud of them. I really want this to be some encouragement for you. You may not see the color of your skin here, but there were others as well from different racial backgrounds that took this course. I just don’t have their pictures at this point in time. Definitely I am overwhelmed by their joy, the smiles on their faces. This person actually collaged her picture and with her match offer. I am so proud of them. I am trying to sell you one thing again. I am trying to tell you it is possible. Do not give up. Do the right things and listen to people who have been where you are at. Follow every step of this program, step by step. Don’t miss out on any homework. Don’t miss out on doing the work on your own. Heed to this advice and we’ll definitely see you on the other side of your MD.

So I'm going to show you how you can use the NRMP's data in finding states where IMGs have previously matched. The reason this is beneficial is it helps you with triaging, especially if you're going for a super competitive specialty. You can identify, hopefully, the program where IMGs have matched in the prior years. So let's start. I'm going to type in here NRMP data reports. Okay, let's put in the word match. And this you can do on any Google browser. And we can put in All right, so when you get on the screen and you put this keywords in Google, it gives you the NRMP's website. You can click on it and it takes you to the main residency match data and reports. The report that I want us to look at is this one that's titled 2023 Match Results by State, date, specialty, and applicant type. This is where you can know what applicants IMGs and what aren't. Click on that. It opens a PDF, right? And this PDF is obviously they clearly say on here reproduction is prohibited without written permission. So we're not reproducing the document. I'm just going to show you how to analyze the document. So it starts off with, with Alabama as a first date. And it is, oh, gosh, several pages long. And it ends all the way in alphabetical order. I know this is giving you a seizure right now. It ends with Wisconsin. Oh, I'm sorry, Wyoming. So now let's say I'm interested in dermatology. Right? We know dermatology is so super competitive for US grads and even more competitive for IMGs. And so you can do control F on your keyboard. And you can type in dermatology. Right? And search. And it gives you 67 matches. So you can now start cruising through the document state by state, identifying where IMGs matched dermatology in the year 2023. So dermatology. PGY2. PGY2. So this means the person had already completed a prior PGY one year, maybe as a transitional or a preliminary medicine, or a preliminary surgery or a PGY one in another specialty. Now, if you look at that, it gives you two dermatology definitions. Now, for example, AL did not match any IMG. So US IMGs are on this tab right here. Non US IMGs or other are indicated here. So for example, PGY2, AL had zero. Now, if you keep going on your dermatology search, which My computer allows me to go next, so I can keep scrolling through this document really fast like this, looking to scan through for my specialty of interest to see where there was a dermatology match for an img. And this is just the starting point. So over here, if you keep going, Colorado didn't have any. California didn't have any. Connecticut had one right here, one US IMG that matched in Connecticut. What does that mean? That means now on my spreadsheet, which you've been given in the course, you will have Connecticut as a state that you want to look into. When you're looking at your dermatology match. Doesn't mean you're not going to look at Alabama anymore. It just means you're going to prioritize, for example, having a specific personal statement for this dermatology program in Connecticut that matched on img. So how are you going to know the specific program? Now you can look and see and tell. Okay, first of all, they match the PGY2 dermatology, meaning this person already completed a PGY1 year. And in the state of Connecticut, they had 10 positions open for that specialty. And nine went to US grads and one went to IMGs. So what that really tells you is, okay, now I'll go into Frida and I'll find all the dermatology programs in Connecticut and then I'll find their individual website. And I'll go through their website and eventually you'll fall on the one that has the student or the graduate with their school on it. Now, Mark, you. If you are reviewing this right, like close to March, what you'll find is you may not have. You may not have access to the exact resident or the exact school because maybe they haven't updated the website just yet. Now, keeping on with the search, we keep going down that list and again, we're just using dermatology as a case, but it could be for any specialty. You can do this. So when you go through DC, there was nothing there for us. When you come into Florida, for example, you have img. List here. Okay, so 000. So maybe not in Florida this year. But in the past there's been IMGs that are matched in Florida in dermatology. So you're just using the prior year data to kind of get an understanding of who ranked an IMG during that prior year in your specialty of interest. Because if they rank them, then obviously that's how they made it Or they considered them is another option. So PGY2 Durham in Georgia. Nothing for the IMG here. Lets keep going now. And it doesn't mean if you don't see a program that automatically it's always going to be IMG unfriendly. Right? That's not what this means. This is just a way that you can use to strategize to say what states had ranked or considered IMGs in them. And then I go back into Frida or Residency Explorer and find the specific program or the list of programs and target each of them to find the specific ones that had an IMG in them. So you keep going down that list. And we're now in. What state are we in? We're now in Illinois and we're going ahead looking for where we see record of a match in that state. Now in Louisiana, Massachusetts. So it looks like Massachusetts had two PGY2 IMG matches. So what that means is these people already completed one year somewhere else and applied in. And let's go to keep going down Michigan. We don't see any PGY2. So we keep scrolling. We're looking for PGY1 or 2. So PGY2 in Minnesota, they had one img. So I can already infer by this information that if you're applying into like a super competitive specialty one, maybe having a PGY one year backup is a good idea. All right. So keep going down. Oops. It looks like we had one there for medicine, internal medicine, dermatology. So combined program. There was one img. Again, that's Minnesota. So the person who's interested in derm can then have Minnesota and Connecticut on the top of their list of places to network with or look for opportunity. And you can do this all the way down to Wisconsin. No, Hampshire had one IMG over here for a PGY2 position. So you're seeing a trend there is that the IMGs are really getting in as a second year resident, meaning they've completed a one somewhere else in another specialty. So do. Okay, that's Dio, New Mexico. And you can do this process over and over again for all your specialties of interest. However, I usually recommend one maximum two specialties because the more applications you do, the less targeted your application becomes. So again, New York State, which is a generally IMG friendly state. Right. Matched one US IMG into their PGY2 slots. And then looks like this would be non US IMG. So one US IMG and one non US IMG. And you could do this process over and over and over again, all the way down to Wisconsin. All right, so I just wanted to give you an idea of how you can use this data now for a specialty such as internal medicine, which has the most residency spots. What you may notice is if you go in the search bar again and you do internal medicine, what you end up finding is there are some states that are just going to have a majority of IMGs, right? So if you take internal medicine, for example, and you look at Alabama starting with them, well, they really didn't have a whole lot of opportunities for IMGs in that particular state. However actually, let's go back. No, they did. I made a mistake there. So internal medicine, PGY1, I was going to say. That's. That's weird. German SMPGY1. 169 positions throughout the state and 50 went to IMG. So that's a pretty good, you know, 50 out of 169 went to IMGs. So that just gives you perspective. If you look over here, internal medicine, PGY1 link or row, you can see again, 196. So this is for the state of Arizona. Yeah, Arizona. 196 positions for PGY1. And how many went to IMG? So that's the third column from, right? 1, 2, 3, 4. So 31 went to non US IMGs. And 18 went to US IMGs. And so that gives you perspective. Then you can go on Alabama, on Frida and say, what are the PGY1 positions open in Alabama? Right? And you get that list and you start to piece through each individual website and you'll find out, okay, they've had prior img matches, or they are likely to have been one of the programs that offer these 50 positions. And you could do that for any specialty across the board. I hope you find this helpful in your program search.

So in the prior video we talked about utilizing the NRMP's data. So let's go back into it and I'll show you another method that you can use to find NRMP's list. So what programs are available in what state? Okay, so let's go to NRMP data reports. And again, it brings you to this main residency match data and reports page. We you can bookmark on your computer at this point because you're going to be coming back to this website many times in the future, just given the state of what you're pursuing, which is residency. Now, in this section, when you go on the same page, we just previously reviewed the result by specialty and applicant type. Now let's go over program results. 2019 to 2023. All right, so if you click on here, this will give you the number of positions offered and field for all the programs that participated in the match for the past five years. The only thing is, it doesn't give you specifics on IMGs versus non IMG information. again, we're just using this to find programs that are available in the state that we're interested in. For example, IMGs, most of us are going to apply broadly, meaning we're going to apply not only in our local state or states we have family or affiliations in. We're going to apply across the country. But this is going to at least give you an idea when you're not sure what programs are where. Again, everything on NRP is in alphabetical order from Alabama all the way to Wyoming. So Alabama, for example, they give you the name of each academic program or academic center. Academic centers are centers where there is a residency program associated. So it starts with Baptist Outreach Services Alabama. And that only has a family medicine program. They had eight positions, and it looks like every year since they filled their eight positions at least from 21 to 23, if you keep going down, you'll find the next program again in alphabetical order. Brookwood Baptist Health and Brookwood apparently has more than one residency specialty. They have multiple. And so what this could do for you is let's say you are from Alabama or you have family in Alabama or you want to be in the you can come on here and again, use your control to find your internal medicine, let's say, and start to search the document. Okay. Or we could do Family Med. That's just a family. And you can start to search a document and it will give you a highlight of all the family medicine programs which gives you 441 matches. Now, you're not going to apply till 441 programs, but at least it allows you to be able to say, okay, if I have a geographic preference, then in my geographic preference, which you get that preference list from. Frida for example you can use that geographic preference list to come on here and highlight the family medicine programs that are available in the state of Alabama. And this gives you, for example, Montgomery has a family medicine. Birmingham doesn't have a family medicine program listed on here. Centerville Cahaba Medical Care has, like, four family medicine programs. And the key is you can apply to all four family medicine programs for Centerville if you're interested, because they have separate NRMP codes, meaning that they're ranked by different individuals, they're different separate programs, even though they're all under Centerville. However, what makes them stand out is there's a rural program, there's an urban program, and then there are two other programs that are based on their location. So if you're specifically saying I'm interested in rural medicine, then you may be a better fit for this one. However, you could apply to all four. And if you keep going down using Alabama as our case study you'll find Crestwood East. Alabama doesn't have a family medicine, so it's not highlighted because, again, that's what we're searching for over here. And you can keep going down through every single state if you want, or you can find the state that you're interested in. So let's say New York, for example. So if we start with New York, it's going to give us, let's see, it's going to give us everything in New York. So let's just go New York by state. Okay, looks like I bypass that. may have pressed too many things on my screen froze. Lets just refresh the page here. Okay, so back to beginning with new Enter. We're searching for New York as a state. All right. Okay. My computer's having a seizure today, but okay, so New York allows you to find each again program in that state for every single specialty. But because your interest now is emergency medicine in New York, for example, you'll be able to find each program that has an emergency medicine residency. So Albany Medical center, for example, has an emergency medicine residency, and they have 12 positions. Okay, now because you know this information, you go on Albany, you go on Google, and you're going to open a new tab, for example, and you're going to type In Albany Medical Center, Emergency Medicine Residency. And through that search, you'll find them. They actually have an Instagram page, which is great because if you're networking, that's where you're going to start. But then you click on here. The main thing we want to know is, are there a program that says no IMGs, or are they open to IMGs? And on their, on their website is where you're going to find that program. Links. Meet us. Let's see if they give us information on the Meet us page. You can read the word from the program director. You can tell, you know, read more about the residents and the faculty there and where they come from. But this would be where you start your search and saying, hey, should I be, you know, would this be on high on my list or low on my list while just looking through it right now, A lot of them are US grads, but doesn't mean unless they expressively say that, that they do not accept IMGs. Okay, but again, going back to our original form, that's just one center. You can keep going down that list and you'll find Arnold Ogden Medical Center. And it gives you all the programs that they have, which for them looks like they have im, fm, Psych and whatnot. Again, if I was an EM aspirant, I will come down to Bassett and I'll skip Bassett because they don't have any Cooperstown, doesn't have any residencies in emergency medicine. But then I'll see Brooklyn Hospital. Okay, Brooklyn Hospital has emergency medicine residency. That's the NRMP code for that specific program. And the only way you can translate this code is by being logged into NRMP to see what program is designated that specific code. However, if you don't have access to NRMP yet, then sometimes it's hard to get that information. But EM will give you all the number of programs. So this is a program that suffered in 2023, for example, because they had eight spots and they only matched three. So they had open spots. We don't know at the time you're reviewing this video whether they still have an open spot, but that's something you want to look into. Is like, okay, this program had open spots. Why? Right? So you're going to type them into Google and you're going to find them. And you do this again for any specialty you're interested in. And you keep going down the list. Especially for a state like New York, that's a high energy friendly state, you keep going down that list and you can determine, okay, what programs am I going to put high on my list versus not. And then getting this information also allows you a gateway to contact each individual program that you're interested in based on your search here, and speak with them or ask them more information about their program or what you could do. In regards to what your application coming up this cycle.