Historically, there has been a mutually beneficial relationship between the US healthcare system and International Medical Graduates (IMGs). The US healthcare system has benefited from the diverse backgrounds that IMGs come from, and especially from the role of IMGs in helping with the workforce gap in rural and underserved areas as well as public and community hospitals. Investing in the residency and fellowship training of IMGs and providing support to them not only enhances their ability to deliver high-quality care but also ensures that the needs of varied patient populations are met effectively. In this chapter, we highlight several important aspects of IMG applications for program directors and educators to understand, as well as some unique issues that IMG trainees may face. The importance of mentorship, leadership, as well as acculturation and immigration will also be discussed. Future directions and nontraditional pathways for IMG training and entry into the psychiatry workforce will also be discussed.