Dr. Joyner’s Blog: IMG Task Force

Byron Joyner, MD, MPA

We continuously seek ways to help our community improve. As such, we constantly search for ways to help others be better. When a concern is raised, confusion looms or definitions are vague, we seek solutions. Sometimes the solutions are simple. Other times, solutions are complex. During these times, solutions are best discovered through the wisdom of the crowd. Historically, we have gained this wisdom by gathering members of our GME together in time-limited, goal-focused task forces.

This month, Gabrielle Pett, Senior Director of Business Affairs, GME, and Sarah Wahlster, Program Director, Neurocritical Care Fellowship, report out on the excellent work of a GMEC International Medical Graduates (IMG) Task Force. I’m very pleased to share with you their report of how the GME community can better support our IMGs.

One of the most important values of the UW GME Strategic Plan is People, which includes recruitment and retention of residents and fellows and fostering a supportive clinical learning environment. This strategic value includes recruitment, retention, and support of international medical graduates (IMGs). IMGs are valuable contributors to the physician workforce and enrich our learning environment. They also enhance diversity in education and bring lived experiences and unique perspectives on global challenges in healthcare and solutions to address health care disparities to our community.

IMGs make up 25% of the US physician workforce and represent a substantial proportion of applicants to residency programs and fellowships. Over 12,000 IMGs have participated in the NRMP Main Residency Match each year since 2022, and during the most recent NRMP Residency Match, 60.8% of the 16,052 IMGs participating in the Match matched to PGY-1 positions. At a local level, barriers to recruitment of IMGs have resulted in a substantially lower percentage of IMGs matching into UW residency programs compared to programs nationally. IMGs represent 8.1% of UW residents and fellows for the 2025-2026 academic year.

UWSOM programs have sought guidance from the GME Office on recruitment and support for IMGs. In December 2023, Dr. Joyner, chair of the UW Graduate Medical Education Committee (GMEC) charged a time-limited IMG Task Force, to develop best practices and resources for residency and fellowship programs to reduce barriers to recruitment of IMGs, develop resources to improve support for IMG trainees at our institution, and identify measurables outcomes to report to GMEC annually. Members of the task force included faculty, residents, fellows, and program administrators across departments. The task force met 1-2 times a month over a 14-month period. During this time, they conducted surveys of program directors and current IMG residents and fellows, reviewed literature on IMGs in the US health care system, developed two sets of resources for programs and trainees, and identified topics for future consideration.

Best Practices for Recruitment and Supporting International Medical Graduates

The survey of program directors identified variability in recruitment strategies, concerns with visa restrictions, and challenges with supporting IMGs in their transition to US GME. Recommendations for programs included:

Recruitment Strategies

• Having clear eligibility policies and requirements, including any specific requirements for IMG applicants.
• Identifying alternates to grant funding for positions to open program eligibility to  foreign nationals requiring visa sponsorship.

Application Review

• Use of holistic reviews and alignment of applicants to stated program aims.
• Including US clinical experience in eligibility policies if required and encouraging programs to consider alternative experiences.

Work Authorization and Visa Sponsorship

• Highlighting existing visa resources for programs.

Support for IMGs

• Encouraging newly matched IMG residents to complete the EHR learning module developed by FAIMER/Intealth and for programs to request Epic support from the UW Medicine ITS Practitioner Liaison Specialists (PLS).
• Tailor orientation content for foreign national and IMG trainees to help with the transition to US GME.
• Identify mentors early on, conduct early check-ins.

Foreign National and IMG Resources

Foreign National and International Medical Graduate (IMG) Resident and Fellow Resources: This new page on the GME website covers topics unique to foreign national and IMG physicians and serves as a resource for incoming/current residents and fellows and programs.

The task force concluded its work with the presentation of the final report to GMEC in April 2025. While members of the task force expressed satisfaction with the progress made to address barriers to recruitment and support of IMGs, they agreed that this was a first step and recommended evolving the task force into a standing advisory group to continue the momentum, expand on the initial work, and take on additional projects identified early on as topics of importance. These include:

• Hosting community building activities
• Participating in Intealth’s new IMG Well-being Day activities (May 30, 2025)
• Expanding visa options and J-1 waiver support
• Identifying best practices for mentorship
• Evaluating options to develop clinical experiences
• Identifying tools to provide more meaningful observership experiences
• Continue to build on the recommendations in the Recruitment Best Practices guide and Resource site
• Present recruitment outcomes data for annual reporting to GMEC

We would like to thank the members of the task force for their input and dedication over the past year and are excited to continue working with many of the task for members – and others interested in engaging in this work – to address some of the recruitment and retention challenges identified for programs and departments, and to better support our IMG community.

Program Directors

• Sanaz Behnia, MD, Program Director, Nuclear Medicine
• Al Merati, MD, Program Director, Laryngology
• Cary Paine, MD, Program Director, Nephrology
• Kathryn Pepple, MD, Program Director, Uveitis
• Elina Quiroga, MD, Program Director, Vascular Surgery
• Claire Sandstrom, MD, Program Director, Emergency Radiology

Department Faculty

• Carlos Delgado, MD, Associate Professor, Anesthesiology and Pain Medicine
• David Evans, MD, Professor, Family Medicine and Director, Family Medicine Residency Network
• Nathalia Jimenez, MD, Professor, and Vice Chair for Equity, Diversity and Inclusion, Anesthesiology and Pain Medicine
• Ken Steinberg, MD, Professor and Vice Chair for Education, Medicine
• Demet Toprak, MD, Associate Professor, Pediatrics

Residents/Fellows

• Hussein Abdille, MD, Resident, Internal Medicine
• Seifu Abera, MD, Fellow, Cardiology
• Shiv Bhandari, MD, Chief Resident, Internal Medicine
• Dominique Feterman, MD, Clinical Assistant Professor, Rheumatology
• Sofia Jaramillo Quiroz, MD, Fellow, Geriatric Medicine Research
• Usman Nabi, MBBS, Fellow, Pediatric Radiology
• Eduardo Sanchez, MD, Acting Instructor, Infectious Diseases
• Nico Stafforini, MD, Resident, Vascular Surgery

Program Administrators

• Joanna Ames, Program Administrator, General Surgery
• Paula Last, Program Administrator, Nuclear Medicine