 In effect, taking regular administrative delays into account, and with residency programs starting around July, there is a gap of at least half a year for IMGs between graduation from medical school and beginning of a residency program.Those IMGs who have passed the necessary USMLE exams and obtained the ECFMG certification can then apply to U.S. residency positions via the NRMP and ERAS.USMLE exam scores are considered in the matching process for entering a residency program.