Indian doctors have to get ECFMG(Educational Commission for Foreign Medical Graduates) registration to apply for residency positions in the USA. To obtain ECFMG certification, you need to pass three steps(Examinations). 1)USMLE Step-1: Computer-based test on basic Sciences and can be taken in India. 2)USMLE CK: Physicians Clinical knowledge exam. Computer based and can be taken in India. 3)USMLE -CS: Physicians Clinical Skills exam and taken in the USA. The average time to pass these exams is 2 years. For the Residency application, many other factors like Demonstrated Research ability, Quality of faculty interactions during the interview, Presentation and Interpersonal Skills, Letter of recommendation, etc. go a long way in affecting the outcome of the interview. The USA PG application system is highly competitive and it’s not unusual to see ECFMG certified candidates waiting for years to obtain a match. Moreover, most International applicants are placed in branches like Family Medicine, Pediatrics &Psychiatry due to the intense competition.