Is Neurology IMG Friendly? Match Statistics
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Is Neurology IMG Friendly? Match Statistics and Program Distribution

April 15, 2021

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Introduction

Is Neurology IMG Friendly

International medical graduates evaluating specialty options frequently ask whether neurology residency is IMG friendly in the United States. This analysis examines objective data from the 2025 National Resident Matching Program (NRMP) Main Residency Match, the 2024 NRMP Charting Outcomes in the Match for International Medical Graduates, and the Accreditation Council for Graduate Medical Education (ACGME) program database.

Understanding whether neurology is considered an IMG-friendly specialty requires examining program distribution, match statistics, and workforce demand. Neurology occupies an intermediate position in the accessibility landscape—more selective than primary care specialties such as internal medicine and family medicine, yet substantially more accessible than procedural and surgical specialties. International medical graduates constitute 31.3% of active neurologists in the United States, reflecting the specialty’s historical openness to internationally trained physicians. [1] A comprehensive overview of neurology residency preparation—including training structure, application benchmarks, and strategy—is available in our Neurology Residency Guide.

Neurology Residency Program Volume and Growth

The ACGME lists 202 accredited adult neurology residency programs in the United States for the 2025-2026 academic year [Document 3]. This figure represents a substantial national training infrastructure distributed across 43 states, the District of Columbia, and Puerto Rico.

In the 2025 Main Residency Match, neurology programs offered 932 PGY-1 positions across 159 participating programs, with 925 positions filled, yielding a fill rate of 99.2% [Document 1]. An additional 228 PGY-2 positions were offered across 37 programs, with 227 filled (99.6% fill rate) [Document 1].

Between 2021 and 2025, neurology experienced notable expansion, with 195 additional positions offered—representing a 19.7% increase over the four-year period [Document 1]. This growth rate exceeds that of many other specialties and reflects ongoing efforts to address projected neurologist workforce shortages. Current projections estimate neurologist workforce adequacy at approximately 88.6% in 2024, with only modest improvement to 91.2% projected by 2037. [2]

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    Where Are Neurology Residency Programs Located?

    Applicants frequently search for which states contain the greatest concentration of neurology residency programs. The distribution of programs across states influences application strategy and training opportunities, with programs concentrated in states with large populations, major academic medical centers, and established graduate medical education infrastructure. Applicants can review the full list of neurology residency programs across the United States.

    Table 1: States with the Most Neurology Residency Programs, 2025-2026

    StateProgramsReferences
    New York24[Document 3]
    Texas19[Document 3]
    California18[Document 3]
    Florida18[Document 3]
    Pennsylvania14[Document 3]
    Ohio10[Document 3]
    Illinois9[Document 3]
    Michigan8[Document 3]
    Massachusetts7[Document 3]

    Regional distribution demonstrates concentration in the Northeast and large Sun Belt states. The Northeast corridor—particularly New York, Pennsylvania, and Massachusetts—contains approximately 22% of all programs. Texas, California, and Florida collectively account for approximately 27% of programs, reflecting population growth and GME expansion in these states. States with larger academic health systems and major metropolitan populations tend to support multiple neurology training programs, which partly explains the concentration observed in New York, Texas, California, and Florida.

    Geographic variation in neurologist density is substantial, with nearly four-fold differences between the lowest and highest density regions. [3] States with higher program density offer more potential interview opportunities within a geographic region. Programs in states with documented neurologist shortages may demonstrate particular interest in applicants willing to practice in underserved areas following training.

    IMG Participation in Neurology Residency

    The 2025 Match data demonstrate substantial IMG representation in neurology. Among the 925 PGY-1 positions filled [Document 1]:

    • U.S. citizen IMGs filled 46 positions (4.9%)
    • Non-U.S. citizen IMGs filled 223 positions (24.1%)
    • Combined IMG representation: 269 positions (29.1%)

    This combined IMG share of 29.1% positions neurology among the more accessible non-primary-care specialties. Neurology ranked as the fourth most common specialty match for non-U.S. citizen IMGs in 2025, following internal medicine, family medicine, and pediatrics [Document 1].

    Table 2: Neurology PGY-1 Match Statistics for IMGs, 2025

    MetricU.S. IMGsNon-U.S. IMGsTotalReferences
    PGY-1 Applicants135627762[Document 1]
    PGY-1 Positions Filled46223269[Document 1]
    Percentage of PGY-1 Positions4.9%24.1%29.1%[Document 1]

    These figures are consistent with historical participation patterns in neurology residency training. [4] IMGs disproportionately practice in densely populated, low-income communities with higher disease burden and lower physician density, addressing critical workforce gaps. [5]

    Characteristics of Matched IMG Applicants in Neurology

    Data from the 2024 NRMP Charting Outcomes in the Match provide insight into the profiles of matched and unmatched IMG applicants [Document 2]. The purpose of this section is interpretation of match data patterns rather than prescriptive guidance.

    Matched non-U.S. IMGs demonstrated a mean USMLE Step 2 CK score of 245, compared with 240 for unmatched applicants. Matched U.S. IMGs had a mean Step 2 CK score of 237, compared with 229 for unmatched applicants [Document 2]. These differences are modest compared with highly competitive specialties where score differentials are more pronounced.

    Research productivity differentiated matched from unmatched applicants. Matched non-U.S. IMGs reported a mean of 4.7 research experiences and 13.3 abstracts, presentations, or publications, compared with 3.4 research experiences and 8.8 scholarly outputs for unmatched applicants [Document 2].

    The number of programs ranked emerged as a notable factor. Matched IMGs ranked a mean of 7.0-7.5 contiguous neurology programs, whereas unmatched applicants ranked only 2.5-2.6 programs [Document 2].

    Comparison with Other Specialties

    Contextualizing neurology within the broader residency landscape clarifies its relative accessibility. Approximately one-quarter of the U.S. physician workforce comprises international medical graduates, though representation varies substantially by specialty. [6]

    Table 3: IMG Representation Across Selected Specialties, 2025

    SpecialtyPGY-1 Positions FilledIMG Share (Combined)Relative AccessibilityReferences
    Internal Medicine (Categorical)10,58444.6%High[Document 1]
    Pathology61936.3%High[Document 1]
    Family Medicine4,55231.4%High[Document 1]
    Neurology92529.1%Moderate-High[Document 1]
    Pediatrics (Categorical)2,98828.1%Moderate-High[Document 1]
    Psychiatry2,38014.4%Moderate[Document 1]
    Emergency Medicine3,00314.8%Moderate[Document 1]
    General Surgery1,77412.0%Low-Moderate[Document 1]
    Orthopedic Surgery9292.4%Low[Document 1]

    Neurology’s IMG representation of 29.1% exceeds that of psychiatry, emergency medicine, and all surgical specialties. This positioning reflects neurology’s emphasis on clinical reasoning and diagnostic skills—competencies that translate across training systems—rather than procedural volume that may be difficult for IMGs to accumulate. [1][7]

    Interpreting Whether Is Neurology IMG Friendly

    Several conclusions emerge from this analysis. First, neurology maintains a substantial national training infrastructure with 202 accredited programs offering over 1,100 positions annually across PGY-1 and PGY-2 entry points.

    Second, IMG participation is consistent and substantial. The 29.1% combined IMG share of PGY-1 positions in 2025 reflects historical patterns. IMGs play a vital role in providing greater access to neurologic care, particularly in traditionally underserved regions. [1]

    Third, geographic distribution favors applicants willing to apply broadly. Program concentration in New York, Texas, California, Florida, and Pennsylvania creates regional clusters, but programs exist across 43 states.

    Fourth, the data suggest that neurology programs employ holistic evaluation. The modest score differentials between matched and unmatched applicants, combined with the importance of research productivity and application breadth, indicate that programs consider multiple factors rather than applying strict score thresholds. [8]

    Fifth, position growth suggests continued opportunity. The 19.7% increase in positions between 2021 and 2025 reflects specialty expansion driven by workforce needs projected to persist through at least 2037. [2]

    Conclusion

    Neurology residency demonstrates characteristics consistent with moderate-to-high accessibility for international medical graduates. The specialty’s substantial program base, consistent IMG participation rates, broad geographic distribution, and emphasis on clinical reasoning distinguish it from highly restrictive specialties. While neurology is not the most accessible specialty in U.S. graduate medical education, objective data support its characterization as a realistic pathway for academically prepared international applicants.

    Applicants interested in the full residency preparation process should consult the comprehensive neurology residency guide for international medical graduates.

    Consult with IMGPrep

    Neurology residency training in the United States is influenced by workforce demand, geographic distribution of training programs, and the growing need for neurologic care across diverse regions. Understanding these structural factors is essential for international medical graduates evaluating Neurology as a residency pathway.

    IMGPrep provides individualized advising for international medical graduates pursuing U.S. neurology residency training.

    Consult with IMGPrep to develop a structured strategy for your neurology residency pathway.

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    References

    1. Dall TM, Storm MV, Chakrabarti R, et al. Supply and Demand Analysis of the Current and Future US Neurology Workforce . Neurology. 2013.
    2. Freeman WD, Vatz KA, Griggs RC, Pedley T. The Workforce Task Force Report: Clinical Implications for Neurology . Neurology. 2013.
    3. Silvestre J, Ferdon RJ, Ravinsky RA, Reitman CA. Geographic Disparities in the Supply, Demand, and Adequacy of the United States Neurologist Workforce . Journal of Clinical Neuroscience. 2026.
    4. Hasan TF, Turnbull MT, Vatz KA, et al. Burnout and Attrition: Expanding the Gender Gap in Neurology? . Neurology. 2019.
    5. Lin CC, Callaghan BC, Burke JF, et al. Geographic Variation in Neurologist Density and Neurologic Care in the United States . Neurology. 2021.
    6. Gutmann L, Cahill C, Jordan JT, et al. Characteristics of Graduating US Allopathic Medical Students Pursuing a Career in Neurology . Neurology. 2019.
    7. Mahajan A, London Z, Southerland AM, Khan J, Schuyler EA. Immigrant Neurologists in the United States: The Path of Most Resistance . Neurology. 2021.
    8. Jordan JT, Sellner J, Struhal W, Schneider L, Mayans D. International Issues: Obtaining an Adult Neurology Residency Position in the United States: An Overview . Neurology. 2014.

    Documents

    1. National Resident Matching Program. Neurology Main Match Results and Data 2025 .
    2. National Resident Matching Program. Charting Outcomes in the Match: International Medical Graduates . 2024.
    3. Accreditation Council for Graduate Medical Education. ACGME Neurology Programs List . Academic Year 2025-2026.