Restriction to Specific Fields

International medical graduates (IMGs) are an essential component of the US workforce, comprising nearly a quarter of licensed physicians in the USA. The trend of IMGs in training programs in the USA is projected to increase, particularly in primary care specialties such as family medicine, internal medicine and psychiatry. Acceptance into more competitive training programs such as higher tier general surgery programs, surgical subspecialties, dermatology, and neurosurgery requires academic excellence as well as additional measures to improve chances of a successful match. This includes clerkships/observerships and research experience in the USA with the goal of performing well and securing strong letters of support from mentors. Herein, the authors provide a perspective on how competitive some specialties are for IMGs such as surgical subspecialties and dermatology, the obstacles they may face when applying to them, as well as potential solutions to overcome these barriers.