Suggestions have been made on how to meet the educational challenges of international medical graduates (IMGs) such as learning to do psychodynamic psychotherapy. These suggestions include providing more structured instruction with explicit feedback. More demonstration of interviewing by faculty and more opportunity to do practice interviews are necessary. Language, slang, and accent reduction training needs to be incorporated into the training program. Courses in American culture are essential for IMGs. Focusing on board preparation with special courses might well improve pass rates. Including psychological theory from the start of the residency and discussing the psychological aspects of the doctor-patient and staff encounters in many clinical settings will place the psychological issues on a sounder footing. IMGs could benefit from having a mentor available to discuss both personal and professional issues.