Why IMGs Should Think Like Chess Masters, Not Lottery Players

“In Chess, as it is played by masters, chance is practically eliminated"

– Emanuel Lasker

I was recently watching a documentary about chess grandmaster Garry Kasparov, and something struck me about how he approached each game. While his opponents were often focused on the next move or two, Kasparov was thinking 15-20 moves ahead, considering not just his strategy, but anticipating his opponent’s responses and preparing counterstrategies. He wasn't hoping for his opponent to make mistakes – he was systematically creating conditions that would lead to his eventual victory.

This got me thinking about the stark difference between two types of IMGs I've encountered throughout my career: those who approach their medical journey like chess masters, and those who approach it like lottery players.

The Lottery Player Mentality

You've probably met them – IMGs who pin all their hopes on getting lucky. They study for Step 1thinking, "If I just get a 260, everything will work out." They apply to 200+ residency programs hoping, “Someone will surely take a chance on me." They attend every conference and networking event thinking, “Maybe I'll meet the right person who'll open doors for me."

Don't get me wrong – high scores, broad applications, and networking are all important. But when these become your primary strategy, you're essentially buying lottery tickets and hoping your number gets called.

The lottery player mentality is seductive because it requires less strategic thinking. It's easier to say "I’ll work really hard and hope for the best" than to deeply analyze the landscape, understand the real challenges, and create multiple pathways to success

The Chess Master Approach

Chess masters think differently. They don't hope their opponent will make mistakes – they create systems and strategies that work regardless of external circumstances. They study not just their own moves, but their opponent's tendencies, weaknesses, and likely responses.

For IMGs, thinking like a chess master means understanding that your "opponent" isn't malicious – it's a complex system with predictable patterns, preferences, and bottlenecks. The American medical system has clear preferences: it favors certain scores, experiences, and credentials. Understanding these patterns allows you to develop winning strategies.

Let me show you what this looks like in practice:

Lottery Player: "I'll take Step 2, hope for a high score, and then see what happens."

Chess Master: "I'll analyze the score distributions for my target specialties over the past 5 years, understand which programs historically accept IMGs with my background, identify what additional qualifications successful IMGs in my situation have developed, and create a 3-year plan that systematically addresses each requirement."

Lottery Player: "I'll do some research and hope it leads to publications."

Chess Master: "I'll research which faculty members at accessible institutions are actively publishing in areas that interest me, analyze their recent work to understand their research trajectory, and reach out with specific, valuable contributions I can make to their ongoing projects."

The Power of Multiple Pathways

Chess masters always have backup plans. If their primary strategy gets blocked, they seamlessly shift to alternative approaches. They're playing multiple games simultaneously on the same board.

Successful IMGs I've worked with operate the same way. They don't just pursue one specialty – they develop competencies that make them attractive across multiple related fields. They don't just build relationships in one institution – they systematically cultivate connections across different geographic regions and practice settings.

Here's a real example: An IMG I mentored wanted to pursue cardiology but understood the extreme competitiveness. Instead of putting all his eggs in that basket, he spent two years developing expertise in cardiac imaging, heart failure and preventive cardiology. He built relationships with interventional cardiologists, heart failure specialists and with family medicine physicians who manage cardiac risk factors. When cardiology fellowships didn’t materialize immediately, he secured a strong internal medicine position at a hospital with a robust cardiac program. Three years later, that relationship and demonstrated expertise led to the cardiology fellowship he originally wanted.

Was this luck? Absolutely not. It was strategic positioning that created multiple pathways to his ultimate goal.

The Compound Effect of Strategic Thinking

The beautiful thing about thinking like a chess master is that your moves compound. Each strategic decision creates new opportunities that lottery players never see.

When you systematically build relationships, those relationships refer you to other opportunities. When you develop expertise in underserved areas, you become valuable to multiple types of programs. When you understand the underlying patterns in residency selection, you can position yourself advantageously regardless of changing circumstances.

I've seen IMGs with modest Step scores secure competitive residencies because they thought strategically about their application. I've also seen IMGs with stellar scores struggle because they relied on those scores to do all the work.

How to Start Thinking Like a Chess Master

1. Study the Game, Not Just Your Moves Don't just focus on your USMLE prep – understand the entire residency selection process. Read program websites carefully, analyze match data, understand what successful IMGs in your situation have done differently.
2. Think in Systems, Not Just Goals Instead of saying "I want to match into internal medicine," think "I want to become the type of candidate that internal medicine programs actively recruit."
3. Create Multiple Win Conditions Identify several pathways that could lead to your ultimate career goals. If your dream is to practice cardiology, what are five different routes that could get you there?
4. Play the Long Game Chess masters sacrifice pieces early to secure better positions later. Sometimes the best immediate opportunity isn't the one that serves your long-term strategy.
5. Study Your "Opponents" Understand what residency programs really need, what challenges they face, and how you can be a solution to their problems rather than just another applicant hoping for consideration.

The Reality Check

Does this mean lottery players never win? Of course not – sometimes people do get lucky. But chess masters win consistently, regardless of external circumstances. They create their own luck through systematic preparation and strategic thinking.

The IMG journey is challenging enough without leaving your success to chance. You have more control over your destiny than you think, but only if you're willing to think several moves ahead and play the long game.

"The pawns are the soul of chess: they alone form the attack and defense."

– François-André Danican Philidor

Your daily decisions, networking efforts, research contributions, and skill development are your pawns. Move them strategically, and they'll create the conditions for your ultimate success.

Are you ready to stop buying lottery tickets and start playing chess?

M.Soliman