Why the US has the most, not the highest share

The US has the largest number of foreign-trained doctors of any country in the world, but that’s a function of scale, not an unusually high reliance on international recruitment. The OECD notes the US “recruited just 33 foreign-trained doctors for every 100 new medical graduates,” well below the rate of 200+ in some peer countries that lean much harder on international hiring to fill shortages.

• Market size. The US has over a million practicing physicians. Even a below-average foreign-trained share still produces more foreign-trained doctors in absolute terms than 100% of a smaller country’s entire physician workforce.
• Pay. US physician compensation significantly exceeds the UK, Canada, and most of Europe, making it a strong draw for anyone who can clear the entry bar.
• A standardized qualifying exam. The USMLE gives any medical graduate worldwide a defined, merit-based path to prove eligibility, unlike countries with more discretionary credential recognition.
• The residency bottleneck limits entry, it doesn’t drive it. The number of Medicare-funded residency positions has been frozen by federal law since 1997. That cap gates how many international medical graduates (IMGs) can enter US practice each year, regardless of employer demand — it’s a big part of why the US doesn’t lead on share despite being the most financially attractive destination.
• Many “foreign-trained” doctors are American. A meaningful share of IMGs in the US Match are US citizens who trained abroad, often at Caribbean schools that exist specifically to serve applicants who didn’t get into a US medical school and plan to return and practice in the US.

What the 2026 Match shows

The 2026 NRMP Main Residency Match offered 44,344 positions and filled 41,482 (93.5%). Of the roughly 20,934 active US MD-senior applicants, about 1,361 went unmatched. International medical graduates — US-citizen and non-US-citizen combined — filled about 9,684 positions; nearly 3,000 of those were US-citizen IMGs. The non-US-citizen IMG match rate fell to a five-year low of 56.4% this cycle.

Canada is opening new routes for international doctors

Canada’s immigration department (IRCC) says it is making permanent residence simpler for doctors trained abroad. Its page lists three new measures:

• An Express Entry category for doctors with at least 1 year of full-time Canadian work experience as a medical doctor in the last 3 years.
• 5,000 federal spaces reserved in the Provincial Nominee Program, so provinces and territories can nominate doctors who have a job offer or a letter of support.
• Work permits processed in 14 days for doctors nominated by a province or territory, so they can work while they wait for permanent residence.

Family members can be included in the application. None of this replaces licensing: you still need your foreign credentials assessed and a licence from the medical regulator of the province or territory where you will practice. IRCC also cites the Canadian Institute for Health Information: 31% of Canada’s family physicians were trained abroad in 2024, a narrower measure than the share of all doctors in the table above.