Objectives: The present study aimed to determine the perceived barriers faced by Saudi medical graduates while applying for residency or fellowship programs in the USA and to determine any factors working against them. Study Design: A cross-sectional survey study was conducted online in 2013. The study population consisted of 230 Saudi medical graduates doing residency or fellowship programs in the USA. Results: The majorities of the respondents were male and were less than a year into their training program outside of Saudi Arabia. The most frequently reported challenge of finding a residency position was the United States Medical Licensing Examination (USMLE), a lack of clinical experience in the USA before residency, and a lack of research experience. The majority of the participants who reported these challenges had not attended any training programs in Saudi Arabia. The least frequently reported challenge was a high-Grade Point Average (GPA) and specific personal opinions. Conclusion: The results are significant and suggest that the major challenges faced by the surveyed participants while applying for residency or fellowship programs in the USA are related to the licensing exam and a lack of clinical and research experience. Moreover, these challenges appear to be more marked among participants who had not attended any training programs in Saudi Arabia before applying for residency or fellowship programs in the USA. Nevertheless, efforts should be made to facilitate the application process and support Saudi medical graduates as they apply for these programs.