IMG Headshots:
ECFMG, MyIntealth, and ERAS Photos for International Medical Graduates
(information updated August 2026)
If you're an international medical graduate working toward a US residency, your application process asks for more than one photo, and each one answers to a different specification. The identity photo for your MyIntealth account. The application photo that reaches residency programs through ERAS. Often a passport photo somewhere along the way, since this process runs on travel documents. Most guidance treats these as three separate research problems. This page treats them as what they are: one set of requirements a single well-planned session can meet completely.
The photos your application actually asks for
Three photos come up on the IMG path, at different stages, with different rules.
The first is the identity photo for your ECFMG MyIntealth account, required at account establishment, before USMLE registration and everything that follows. The second is your ERAS application photo, the one residency programs see, which follows AAMC's specification but reaches ERAS through a route specific to IMGs, covered below. The third isn't an application requirement at all, but it follows this population everywhere: an actual passport photo, for the travel documents this entire process depends on.
The MyIntealth identity photo
ECFMG publishes the full requirements directly. The photo must be a clear front view of your full face only, with your face centered, a natural expression, and your eyes open and looking directly ahead. It must be in color, on a plain, light-colored background, and of good quality, not blurry, not too dark or too light. It must have been taken within six months of submission, be high enough resolution to print on the Intealth Identification Form, and be a JPG/JPEG file of 1 MB or less. A photo that misses any of these is rejected and must be resubmitted, which stalls your account establishment and everything queued behind it.
This is an identity photo, not a portrait. It does the same job a passport photo does: confirm that you are you. The rules exist so a reviewer can match your face to your documents without a single question.
Your ERAS photo takes a different route than everyone else's
US medical graduates upload their own photo into MyERAS. You don't. As an IMG, your ERAS photo is submitted through ECFMG, which uploads it on your behalf, and that route carries its own formatting rule: JPEG only, at a maximum of 150 KB. The broader AAMC specification still applies, 2.5 by 3.5 inches at 150 dpi, face centered, head and shoulders, but the PNG option available to US graduates isn't part of the ECFMG route. A correctly formatted JPEG is the only safe answer.
Unlike the identity photo, this one is a real professional photograph. It's often the first thing a program director sees, and it stays attached to your name through every stage of review and interview. What makes an ERAS photo work, beyond the file numbers, is covered in depth on the ERAS headshots page.
One exception carried over from that page: Emergency Medicine and Obstetrics & Gynecology no longer use ERAS. Both apply through ResidencyCAS, which requires its own photo with requirements published inside the application portal. If you're applying in either specialty, confirm the current specification directly through ResidencyCAS.
The passport photo, while you're at it
MyIntealth account establishment also requires a scan of your passport's biographic page, and between visa applications, travel, and document renewals, few populations need current passport photos more often than IMGs. Passport photos follow their own federal specification, different from both photos above, and the passport photos page covers those requirements in full, including why AI-edited photos now carry rejection risk.
The practical point: if you're already in front of a camera under controlled lighting, producing a compliant passport photo in the same sitting costs nothing extra in time.
Have a Question ?
Frequently Asked Questions
Note: information updated August 2026 from EMFMG, AAMC, ResidencyCAS websites.
For latest requirements, check those websites directly.
What are the MyIntealth photo requirements?
ECFMG requires a clear, full-face front view with a natural expression and eyes open, in color, on a plain, light-colored background, taken within six months of submission, saved as a JPG/JPEG of 1 MB or less, at a resolution high enough to print on the Intealth Identification Form. Photos that miss any requirement are rejected and must be resubmitted.
Can I use the same photo for MyIntealth and ERAS?
They're different photos doing different jobs. The MyIntealth photo is an identity photo, built to match you to your documents. The ERAS photo is a professional application photo that programs see throughout the season, with its own size and file rules. One session produces both, but as separate files, each composed and formatted for its own purpose.
Do I upload my own ERAS photo?
No. US graduates upload their own photo through MyERAS, but as an IMG your photo is submitted through ECFMG, which uploads it on your behalf.
My photo was uploaded. Why can't programs see it?
Uploading is only half the step. Once ECFMG processes your photo into MyERAS, you still have to assign it to your programs on the Additional Documents tab of MyERAS. Until you do, the photo sits in your account and programs see nothing. It's a commonly missed step, and an easy one to check.
Does the ERAS photo have to be a JPEG?
For IMGs, yes. The ECFMG route accepts JPEG only, at a maximum of 150 KB. The PNG option in AAMC's general specification applies to US graduates uploading directly, not to photos submitted through ECFMG.
Why was my ECFMG photo rejected?
The most common causes are background problems (patterned, dark, or shadowed instead of plain and light), photos older than six months, low quality or blurry files, faces that aren't centered or fully visible, and files in the wrong format or over the size limit. The requirements are narrow enough that a photo taken casually, without controlled lighting and a proper background, fails more often than it passes.
Do Emergency Medicine and OB/GYN applicants use ERAS?
No. Both specialties now apply through ResidencyCAS, which has its own application system and its own photo requirements, published inside the applicant portal. Confirm the current specification there directly.
I'm doing an observership in Connecticut.
Can I book a session before I apply?
Yes, and that's the ideal window. If you're in the state for clinical experience, research, or an observership, a session can be scheduled near you, and the finished files stay valid for submission as long as they're within ECFMG's six-month rule for the identity photo at the time you submit.
Can you photograph me if I'm still outside the US?
No. Sessions happen in Connecticut. If you're still abroad, the requirements linked throughout this page are everything a local photographer needs to produce compliant files, and they're worth sharing with whoever takes your photo.
Can I get a passport photo in the same session?
Yes. Passport photos follow their own federal specification, covered on the passport photos page. Mention it when you book and it comes out of the same sitting.