IMG Alternate Pathway for ABR Eligibility

Our four-year alternate pathway was created to allow international medical graduates (IMGs) to complete four years of radiology training and become eligible for certification by the American Board of Radiology (ABR). The IMG Alternate Pathway for Board Eligibility details are on the ABR website. The four years of training must be completed at one institution without interruption. 

Becoming ABR-certified allows an IMG to practice radiology in private practice or any hospital (public or private) in the U.S., provided additional requirements regarding medical licensing and immigration status are also satisfied.

Please note that most states in the U.S. require two years of ACGME-accredited training to apply for an unrestricted license to practice medicine in that state. Therefore, although not always possible, Mallinckrodt Institute of Radiology makes every effort to offer four-year pathway solutions that include at least two years of ACGME-accredited training. Additional ACGME-accredited training can be completed at Washington University School of Medicine in St. Louis or elsewhere after a WashU Medicine four-year pathway (or may have been completed at other academic institutions before joining WashU Medicine). This can also be variable depending on the candidate’s VISA status. 

  • The required four years of training can be accomplished through a combination of annual training in the following programs: neuroradiology, nuclear medicine (two years of training is required), and pediatric radiology
  • The two years of nuclear medicine residency are required to complete the pathway and allow the trainee to fulfill all the requirements to be eligible for the ABNM certification exam.  All inquiries are routed through this subspecialty for approval.  The four-year alternate pathway is no longer available if nuclear medicine does not accept the applicant.   
  • You may request a specific combination of years of radiology training you would prefer, and if possible, we will offer a four-year pathway that aligns with your preferences. However, our training positions are limited, and you may be offered a four-year pathway different from your initial request.  If you agree with the pathway suggested, you will be offered a virtual interview with participating programs. Once all the program directors accept the four-year training plan, the plan cannot be altered by the trainee. 
  • Please note that WashU sponsors J-1 visas for trainees. We do not sponsor new H1-B visas for applicants from abroad but will extend an existing H1-B visa from another institution if a four-year pathway is offered to a candidate.   

Individual fellowship training is not a path to entry into a four-year ABR pathway at WashU.  We require the potential fellow/resident to request and be approved for four years before starting any four-year pathway training at Washington University in St. Louis. For more information about the medical school’s rules regarding four-year pathways, visit the Graduate Medical Education (GME) office.

MIR offers a wide range of helpful resources and competitive benefits for trainees.

The interview process typically consists of virtual meetings with faculty and staff of the participating programs. The candidate’s prior training will be evaluated through the presentation of cases and clinical scenarios. Upon completion of the interview, the program directors will discuss the individual candidate, resulting in either acceptance or rejection.

If an offer is extended, the program directors will present selected candidates to the GME Committee for approval as exceptional candidates. Exceptional candidates have demonstrated clinical excellence amongst peers, leadership qualities, a track record of strong research and scholarly activity, and administrative or volunteer work. If the GME Committee does not approve a candidate, then a formal four-year pathway cannot be offered to the candidate. 

If you are interested in applying, please complete the application and provide the following documentation (PDF copies only;  no JPGs allowed except for professional photo):

  • Current CV  
  • Three letters of recommendation, including a letter from your residency or fellowship program director. Contact information should be a work address, no personal mail.  Please address these to the Program Director. 
  • USMLE Score reports: We require successful completion of all USMLE Steps before an application may be considered for a potential pathway. 
  • Copy of ECFMG certificate 
  • Copy of medical school diploma 
  • Dean’s letter from medical school 
  • Medical school transcripts 
  • Personal statement 
  • Certificate of completion of residency 

Please note that WashU sponsors J-1 visas for trainees. We do not sponsor new H1-B visas for applicants from abroad but will extend an existing H1-B visa from another institution if a four-year pathway is offered to a candidate.   

Please email all inquiries and application documents to Missi Varner, manager of medical education programs.  

Program Director

Rosana Ponisio, MD
Associate Professor of Radiology