A growing number of US states are easing long-standing barriers for international medical graduates (IMGs), allowing some to practice without repeating full US residency training.
Recent policy changes now enable ECFMG-certified doctors to obtain limited or provisional licenses in multiple states, particularly in underserved areas facing physician shortages.
Traditionally, IMGs were required to complete US residency training after clearing the USMLE before practicing independently. However, since 2023, several states have introduced alternative licensure pathways that recognize prior international training and clinical experience.
These reforms are not universal and come with conditions such as supervised practice or rural service requirements. Still, they signal a clear shift: the US healthcare system is increasingly relying on foreign-trained doctors to meet workforce demands.
Against this backdrop, the 2026 residency match data reflects how international graduates especially from India and Pakistan are capitalizing on expanding opportunities.
See also: Now Doctors Can Come to the USA to Practice Medicine Without the Need of Medical Residency
More than 1,000 Pakistani medical graduates secured residency positions in the 2026 National Residency Matching Program (NRMP), according to APPNA.
This year’s match was the largest in history, offering 44,344 positions to 53,373 applicants, with over 93 percent of seats filled.
Among Pakistani institutions, Dow Medical University in Karachi led with 132 matches, followed by King Edward Medical University in Lahore with 109, and Aga Khan Medical College with 60.
These figures reflect consistent participation from a few high-output institutions rather than a broad-based surge across all medical schools.
Indian medical graduates remained the largest group among IMGs, with nearly 3,000 securing US residency positions in 2026. Pakistani graduates ranked second with over 1,000 matches.
In total, more than 9,000 IMGs including US and non-US citizens matched into residency programs this year. The match rate for non-US IMGs stood at 56.4 percent.
This reinforces a clear pattern: South Asian graduates continue to dominate the IMG pipeline into the United States.
The impact is visible at the hospital level.
At Parkview Hospital in Indiana, 14 of 15 internal medicine residents are international graduates, including 12 from Pakistan. At Baptist Hospital of Southern Texas, all 13 residents in a program are IMGs, with six from Pakistan.
Such trends highlight how IMG-heavy residency cohorts are becoming more common, particularly in internal medicine and community hospital programs.
At the same time, this reliance has sparked policy debates in the US around workforce planning, training standards, and long-term sustainability.
India produces around 92,000 medical graduates annually, far exceeding many countries, and has over 74,000 doctors practicing across OECD nations, nearly three times the number from Pakistan.
This large and steady output translates into a more even distribution of Indian IMGs across US residency programs, rather than concentration within a few institutions.
Over time, this broad integration has positioned Indian doctors as a consistent and deeply embedded part of healthcare systems in the United States and other developed countries.
The 2026 numbers build on strong momentum from 2025.
In 2025, a record 1,061 Pakistani doctors matched into US residency programs the highest ever at the time. The continued high numbers in 2026 suggest sustained participation rather than an exceptional surge.
Indian IMGs, meanwhile, have consistently maintained their lead over multiple years, reflecting both scale and established migration pathways.
Several structural factors explain this trend:
Large medical graduate output in both countries
Increasing familiarity with USMLE and NRMP pathways
Established diaspora networks in US healthcare
Cost-driven migration to foreign medical schools, including Caribbean institutions
It is also important to note that not all IMGs are foreign nationals. Many are US citizens who pursue medical education abroad due to competitive domestic admissions.
OECD data highlights the scale of global migration:
United States: 45,830 Indian and 12,454 Pakistani doctors
United Kingdom: 18,953 Indians and 8,026 Pakistanis
Canada: 2,127 Indians and 1,087 Pakistanis
Total OECD: 74,455 Indian and 25,607 Pakistani doctors
India accounts for 21 percent of foreign doctors in the US, while Pakistan contributes 6 percent.
Despite losing a higher proportion of doctors to migration (10.6 percent vs India’s 7.3 percent), Pakistan still maintains a higher doctor-to-population ratio (1.1 per 1,000 vs India’s 0.7), according to World Bank data.
References:
1. National Resident Matching Program. “Match Data.” Accessed March 30, 2026. https://www.nrmp.org/match-data/?
2. “IMG Friendly Residency Programs, States, Specialties.” Accessed March 30, 2026. https://www.residencyprogramslist.com/img-friendly?
3. Organization for Economic Co-operation and Development (OECD). Health at a Glance 2025: OECD Indicators. Paris: OECD Publishing, 2025.
https://www.oecd.org/en/publications/2025/11/health-at-a-glance-2025_a894f72e/full-report/international-migration-of-doctors_17ff3227.html?