Sorry about the confusing thread title. What I mean to ask is this: Let's say an IMG and a US Grad are both vying for Residency spot X. Let's further say that Residency spot X is somewhere in the middle of the spectrum on the range of competitiveness (i.e. both applicants have a decent shot at it). Now, theoretically, let's say that the IMG and US Grad both have IDENTICAL credentials... same board scores, same LORs, same clinical evals, same performance on their interviews. Now, if this is the case, I'm sure the PD would choose the US Grad... understandable enough. What I'm curious about is to what degree would the IMG have to improve his aforementioned credentials to gain that edge over the "mediocre" US grad for the PD to pick him over the US grad. I know this is tough to theorize and even tougher to quantify, but being an above average to stellar IMG, your advice/opinions would be invaluble to me in deciding on where and what to apply to. Thanks very much.