International medical graduates coming to the United States for a radiology residency face unique challenges. Obtaining a diagnostic radiology residency for an international medical graduate is an uphill task as the threshold requirements are higher. One major disadvantage is that this group usually needs US clinical experience. This can be overcome by having high scores and multiple publications. Another unique challenge for an international medical graduate is trapezing through the never-ending mire of visas and green cards. Not all visas are created equal, and some offer unique advantages. It would help to keep an employment-based green card in mind while navigating residency. Publishing extensively during residency would help procure an employment risk green card later in one’s career.