If you have applied to Canadian programs, the American process will feel familiar and also slightly off. The system is called ERAS, the Electronic Residency Application Service, and most of the steps are in a different order from what CaRMS taught you.
The 2027 season is already underway, and some deadlines have passed. We are writing this on 14 October 2026 and checking the dates against the AAMC and ECFMG pages. We are not advisors, and we are not the right people to tell you which programs to apply to.
What ERAS Is
ERAS is the application system that most US residency programs use. You build an application, assign documents, choose programs and submit. Programs then review it, invite you to interview and rank applicants for the match.
International medical graduates apply through the same system, but with an extra step: you need an ERAS token from ECFMG, and ECFMG certification requirements are tied to the match.
The 2027 Timeline
The 2027 ERAS season opened on 4 June 2026. ECFMG distributed tokens to IMG applicants starting 24 June 2026. Applicants could begin submitting MyERAS applications to programs on 2 September 2026 at 9 a.m. Eastern, and programs began reviewing them on 23 September 2026 at 9 a.m. Eastern. The 2027 season closes on 31 May 2027 at 5 p.m. Eastern. [1]
So if you are a current IMG applicant, you have probably missed the earliest submission date. The AAMC timeline page does not say whether that is fatal, and the answer depends on the specialty. Ask programs directly, and read their application policies.
The Token
The ERAS token is requested through MyIntealth, the ECFMG applicant portal. ECFMG lists the token fee at $185 and says it is non-refundable. [2][3] You should plan to apply to at least one participating program before requesting one, because not every specialty and program uses ERAS. [3]
For some specialties, such as emergency medicine and obstetrics and gynecology, ECFMG refers applicants to ResidencyCAS. [3]
Do You Need to Be ECFMG-Certified First?
Not necessarily before you apply, but you do need to meet the ECFMG examination requirements to take part in the match. ECFMG’s token page says IMGs must have passing results or satisfactory completion of the ECFMG certification exam requirements by the NRMP rank order list certification deadline. [3] We cover that in our ECFMG and NRMP guides.
Fees
ERAS charges per program, with tiers by number of programs within each specialty. The AAMC publishes the current schedule and a fee calculator, and its fee page says refunds are not offered for any reason. [4] The figures on the page we retrieved looked out of date to us, so we are not printing per-program prices.
What we can say is that the cost scales with the number of programs you choose. We wrote about the total in our residency application cost article.
The Practical Order
First, make sure your ECFMG account and credentials are in good order. Verification of your medical diploma and transcript is done through ECFMG and is listed at $110 each. [2] Then request your token, register for MyERAS, and begin building your application. Letters of recommendation, your personal statement and your transcript all feed in.
Then decide your program list with real information about which programs accept IMGs and what visas they sponsor. We cover visas in our J-1 versus H-1B article.
Canadians and ERAS
Nothing about being Canadian changes the ERAS process. You apply as an IMG. What does change is the planning around it: you may also be applying through CaRMS, which has its own deadlines, and the two matches interact. We explain how in our article on applying to both in the same year.
The Bottom Line
ERAS is the application system for US residency, and IMGs need an ECFMG-issued token, which costs $185. The 2027 season opened on 4 June 2026, applications could be submitted from 2 September 2026, and the season closes on 31 May 2027.
Check the AAMC and ECFMG pages for current fees and dates, and talk to the programs you are interested in about their IMG policies. Our Resources page lists the official sources.
References
- AAMC. (2026). 2027 ERAS residency timeline for international medical graduates. https://students-residents.aamc.org/applying-residency/article/eras-timeline-img-residency/
- Intealth ECFMG. (2026). Fees. https://ecfmg.org/fees/index.html
- ECFMG. (2026, June 24). ERAS 2027 residency tokens now available. https://www.ecfmg.org/news/2026/06/24/eras-2027-residency-tokens-now-available/
- AAMC. (2026). Fees for the 2027 ERAS season. https://students-residents.aamc.org/applying-residencies-eras/publication-chapters/fees-2027-eras-season