Navigating the UCLA International Medical Graduate (IMG) Program: Requirements and Opportunities
The University of California, Los Angeles (UCLA) International Medical Graduate (IMG) program is designed to address the critical need for more bilingual and bicultural Latino family physicians in California. This article delves into the requirements, structure, and outcomes of this innovative program, offering insights for prospective applicants and stakeholders interested in addressing healthcare disparities.
Addressing Healthcare Disparities through the UCLA IMG Program
Latinos in the United States have grown to 63.7 million, representing 18.9% of the total population and making up the nation’s second largest racial/ethnic group after non-Latino White individuals. By 2050, one in four Americans will be Latino. More than two-thirds of Latinos report speaking a language other than English at home, highlighting the diverse language needs of this group. Latinos with limited English proficiency face barriers to receiving high-quality medical care and report lower satisfaction with provider communication than English-speaking patients. Patients who are matched with language-concordant physicians are more satisfied with their medical care, bond with their physician, and receive a higher quality of care.
Despite efforts to increase diversity in the physician workforce, only 6% of practicing physicians in the United States and 6.8% of board certified family physicians identify as Latino. A shortage of Latino resident physicians also exists. Efforts to address this need have focused on early exposure programs, pathway programs, advocacy for increased primary care residencies, and expansion of international medical graduate (IMG) placements in workforce shortage areas. IMGs are physicians who completed medical education outside the United States and includes both US-born individuals who choose to attend medical schools abroad and individuals who are foreign-born and educated. Research shows that IMGs born in Latin American countries are likely to choose their practice locations based on ethnic matching. Among board certified family physicians, 23% are IMGs, and this percentage mirrors the national estimates of IMGs among all physicians. IMGs play a critical role in addressing health care shortages and maldistributions, and also the need for bilingual physicians. In fact, many states have implemented novel IMG programs to address areas with physician shortages.
Program Overview
Developed in 2006, the preresidency training IMG program is designed to prepare more family physicians to practice in medically underserved California communities. The program, cofounded by P.T.D. and M.B., aims to accomplish this goal by recruiting international medical graduates and providing them with a rigorous professional education and hands-on clinical experiences to compete and match in a California family medicine residency program. A graduate of the program (B.S.C.) is now the program director.
The UCLA IMG program requires full-time participation, residence in Los Angeles County, no outside employment, English and Spanish language fluency, and US citizenship or permanent resident legal status. The program is currently free of tuition or fees, covers educational expenses, and includes a small stipend.
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Eligibility and Application Requirements
To be considered for the UCLA IMG program, applicants must meet specific eligibility criteria and application requirements. These include:
- Educational Background: Successful applicants will have obtained a Bachelor’s degree from a US or Canadian institution by completing at minimum 3 years of undergraduate coursework or have obtained a graduate degree from a US or Canadian institution.
- Medical School Recognition: In accordance with California’s most pressing needs and the availability of Family Medicine residency openings in the state, applicants must have graduated from medical schools recognized by the Medical Board of California. The Medical Board of California also requires that IMGs have a Postgraduate Training Authorization Letter (PTAL, or “California Letter”) to be eligible for a medical residency position in California. To be eligible for a PTAL, IMG applicants MUST have received their medical school education, and graduated from, a medical school recognized and approved by the Medical Board of California.
- Residency Status: Applicants must be citizens, permanent residents, DACA recipients, or California residents. Applicants who do not satisfy one of these requirements will not be considered.
- Language Proficiency: Applicants must be bilingual Spanish/English.
- Residency Commitment: Applicants must agree to reside in the Los Angeles area for the duration of their participation in the program.
- Employment Restrictions: Applicants may not undertake outside employment, either full-time or part-time, during their participation in the program.
- Post-Residency Commitment: Finally, you will be contractually committed to working in a medically-underserved community in California for 24-to-36 months beyond completion of a Family Medicine residency. No exceptions are currently being made to these requirements.
Curriculum and Training
The curriculum was developed to support participating IMGs to successfully prepare an application to a California family medicine residency training program by providing a clinical hands-on experience in underserved clinical settings and opportunities to learn the language and culture of US medicine.
Prior to passage of Assembly Bill 1533, state law prevented IMG trainees from participating in supervised clinical contact with patients because they weren’t recognized as residents or medical students enrolled in a school of medicine. As a result, initially the curriculum also focused on how to best prepare participating IMGs to successfully pass the United States Medical Licensing Examinations (USMLE) and improve professional-level English oral and writing skills.
Through passage of California legislation in 2012, the California Medical Board authorized the following program requirements to allow participants to receive hands-on clinical instruction: (a) graduation from a medical school recognized by the California Medical Board (recognition by the World Federation for Medical Education and the Foundation for Advancement of International Medical Education and Research); (b) Educational Commission for Foreign Medical Graduates (ECFMG) certification; (c) passing score for the USMLE Step 1 and 2; and (d) permanent legal US residency status.
The state medical board also requires clinical instruction to take place at health care facilities operated by UCLA or other approved UCLA-designated teaching sites with a formal affiliation agreement. Finally, faculty at UCLA or faculty affiliated with UCLA are required to provide the clinical instruction and supervision.
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During their training, participants perform patient interviews, conduct assessments, develop treatment plans, draft clinical notes, and present cases to licensed supervising UCLA faculty physicians. This hands-on experience is like that of a medical student involved in patient care while adhering to the medical board supervision and training standards. The curriculum includes a required medical English course. In 2009, the clinical curriculum increased from 8 weeks to 12 weeks (6 weeks hospital and 6 weeks primary care); and in 2010, the outpatient curriculum expanded to include the core concepts of the patient-centered medical home. Participants also are required to complete a course and obtain HIV specialist (American Academy of HIV Medicine) certification. Within the program, clinical training does not exceed 16 weeks of clinical instruction, and all clinical experiences are in underserved settings at UCLA affiliates.
Upon completion of the program, UCLA program directors provide a letter of recommendation for family medicine residency match applications.
Program Outcomes and Success
The UCLA IMG program has demonstrated remarkable success in preparing its graduates for family medicine residency programs. A study of program graduates from 2007 to 2024 revealed impressive outcomes:
- A total of 177/204 (87%) participants completed the UCLA IMG program and entered the match.
- All graduates 177/177 (100.0%) that have applied and entered the National Resident Matching Program matched in a family medicine residency program.
- A total of 172 (97%) matched in California programs and 5 (2.8%) matched out of state.
- Family medicine board certification was verified for 152/159 (95.6%) of those eligible.
The program has placed 177 graduates into US family medicine residency programs. All graduates 177/177 (100.0%) that have applied and entered the National Resident Matching Program matched in a family medicine residency program. Of these, 172 (97%) matched in California residency programs and 5 (2.8%) matched in out of state programs. Among program graduates that matched, 157/177 (89%) completed residency training and 18/177 (10%) were in training. The majority of those eligible for medical licensure had a verified medical license (98.8%). ABFM board certification was verified for 152/159 (95.6%) of those eligible. Less than 10% of those that completed residency also completed an ABMS sponsored fellowship.
Graduates of the UCLA IMG program have successfully matched into various family medicine residency programs, with a significant number joining UCLA, Riverside, and Clinica Sierra Vista in Kern County. Nearly half (45%) of these graduates are serving in the rural San Joaquin/Central Valley agricultural regions of California, addressing a critical shortage of primary care physicians in these underserved communities.
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Significance and Impact
The UCLA IMG program addresses the critical need for more bilingual and bicultural Latino family physicians in California, where Latinos are the largest racial/ethnic minority group and a large percentage of the population speaks Spanish. The UCLA IMG program represents a model pathway program for IMG physicians to seek residency training, ABFM certification, and help mitigating health disparities that arise from the lack of primary care access in underserved areas.
Without IMG pathways to practice and other medical education innovations, research has estimated that 92 years of a doubling of matriculating Latino medical students would be required to correct the deficit of Latino physicians. The UCLA IMG program recruits and trains IMGs already residing in the United States-citizens and permanent residents.
Application Process
To apply to the David Geffen School of Medicine at UCLA, prospective students must navigate a multi-step process:
- Primary Application: Submit the primary application through the AMCAS application portal. Prior to submitting an application, you must request that a complete set of official transcripts be forwarded directly to AMCAS by the registrar of each school you have attended. Official transcripts are not required for work you have taken the previous term (e.g. if the application is submitted in the summer, previous spring official transcripts are not required). Your application will not be processed until all required official transcripts are received by AMCAS.
- Secondary Application: After the primary application is submitted and reviewed, applicants may be invited to complete a secondary application. The Secondary application fee is $100.00. Updates to your application will only be accepted when you submit your Secondary Application. On the Secondary Application, you may choose to select the "Dual Consideration Option" to also be considered for the Traditional MD Track.
- Recommendations: Recommendations are submitted through the AMCAS application portal.
- AAMC PREview Exam: The AAMC PREview exam is required for Traditional MD Program Track applicants. Your AAMC PREview exam score does not expire.
- MCAT: Ensure that your MCAT scores are submitted by the final deadline. The earliest MCAT exam date accepted is January 1, 2021, and the final deadline for MCAT score submission is October 31, 8:59pm (Pacific Time). MCAT scores may take up to six weeks to be issued. Plan accordingly to ensure your scores are received by the October 31 deadline. If you plan to retake the MCAT, submit your application once your new score is issued.
- Interview: Following a comprehensive holistic review of both the application and secondary application, select applicants are then invited to interview.
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