The three types of program
University-based programs sit in academic medical centers. Community-based, university-affiliated programs are run by community hospitals with a formal link to a university. Community-based programs are run by community hospitals on their own. Military and other settings are left out of the comparison.
| Type | Programs | Positions | IMG share | Share of all IMG positions | J-1 | H-1B | Applicants per position | Median interview rate |
|---|---|---|---|---|---|---|---|---|
| University-based | 2,235 | 16,870 | 13% | 24% | 85% | 22% | 85 | 16.9% |
| Community-based, university-affiliated | 1,970 | 13,328 | 34% | 51% | 67% | 11% | 136 | 14.2% |
| Community-based | 953 | 5,460 | 41% | 25% | 54% | 5.9% | 148 | 13.8% |
Where IMGs actually train
A higher IMG share does not mean more IMG positions. Because university programs are larger and more numerous, they still hold about 24% of all estimated IMG first-year positions, and university-affiliated community programs hold about 51%. Writing off university programs means writing off a real part of the positions IMGs fill.
- University-based24%
- Community-based, university-affiliated51%
- Community-based25%
IMG-friendly does not mean easy
Community-based programs receive about 148 applicants per position, against 85 at university-based programs. If every adviser says "apply to community programs", community programs get every IMG application.
Specialty by specialty
| Specialty | University-based | University-affiliated community | Community-based |
|---|---|---|---|
| Internal Medicine | 19% | 56% | 59% |
| Family Medicine | 17% | 28% | 38% |
| Pediatrics | 18% | 37% | 49% |
| Psychiatry | 8.9% | 20% | 26% |
| Neurology | 25% | 38% | 40% |
| Surgery | 11% | 17% | 20% |
| Emergency Medicine | 6.5% | 21% | 23% |
| Anesthesiology | 5.7% | 14% | 19% |
What this means for your list
- Start with visas. If you need one, university and affiliated programs give you more options.
- Do not skip university programs: they hold a real share of IMG positions and get fewer applicants per seat.
- Treat high-IMG community programs as competitive: apply to them, but do not build a list only from them.
- Compare visa sponsorship in detail in visa sponsorship by specialty, and see where positions are in the best states for IMGs.
Sources
- ResidencyPrograms.io program data for the current application cycle, refreshed October 26, 2026. Program type is the institutional setting each program reports to ACGME. IMG share combines US IMGs and non-US IMGs among current residents.