This analysis reveals significant differences in residency structure and trainee experiences in India and the U.S., suggesting implications for future reforms.
Residency training in India and the United States differs substantially in admissions, structure, oversight, work conditions, and graduate outcomes. India's postgraduate entry relies on high-stakes centralised exams (NEET-PG and INI-CET) with complex counselling rounds and persistent challenges like seat-blocking and asynchronous allotment, whereas the U.S. uses the algorithmic National Resident Matching Program (NRMP) for transparent, rank-based placement. Regulatory frameworks also diverge: India's National Medical Commission is evolving standardisation and recently emphasized full-time residency with “reasonable working hours,” yet enforcement and protections remain variable; the U.S. ACGME mandates structured curricula, milestone-based competency assessments, and capped duty hours to safeguard trainee well-being. Clinical exposure in India tends toward high patient volume with less uniform didactic support, while U.S. programs balance moderate caseloads with formal education and feedback mechanisms. International medical graduates, including many from India, form a signicant portion of the U.S. physician workforce, navigating ECFMG certication to enter GME. This comparative landscape highlights trade-offs between experiential breadth and standardised support, informing aspirants and policymakers
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Acharya et al. (2025) studied this question.
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