AMGs before IMGs in the match?

[PSamP]

So just curious, I met a couple of IMGs on the interview trial. All stellar, non matched. Is there a blatant discrimination against IMGs? Are AGMs always considered > to IMGs, if they have the same stats?
Thanks

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[GingyKhan]

IMG graduate here who just couple matched into cat. surgery and anesthesia (fiance). For me, it was always about trying to kill the STEPs because if that could get me in the door to meet with the PD's and an interview then I knew I had a great chance to match. But to answer your question then I would say 100% YES on your question (it's just the way **** works).

 

[PSamP]

IMG graduate here who just couple matched into cat. surgery and anesthesia (fiance). For me, it was always about trying to kill the STEPs because if that could get me in the door to meet with the PD's and an interview then I knew I had a great chance to match. But to answer your question then I would say 100% YES on your question (it's just the way **** works).

Congrats! May I ask of your stats? Did you feel any discrimination?

 

[mvenus929]

I think we had 2 IMGs match in our upcoming class. And I know of an AMG who didn't match here despite ranking it #1. So, it depends, but generally IMGs are not looked at as well as AMGs.

 

[PSamP]

I think we had 2 IMGs match in our upcoming class. And I know of an AMG who didn't match here despite ranking it #1. So, it depends, but generally IMGs are not looked at as well as AMGs.

What field are you in?

 

[tatsuchi]

OP, aren't you the poster who first lied that he was ranking Optho (except that Optho match is through the SF Match and had already happened at the time), then came out it was Rads at three "big" places (the names of the three were not consistent)?

And now you're suddenly curious about IMGs and their match rates.

What exactly is your game?

 

[J ROD]

OP, aren't you the poster who first lied that he was ranking Optho (except that Optho match is through the SF Match and had already happened at the time), then came out it was Rads at three "big" places (the names of the three were not consistent)?

And now you're suddenly curious about IMGs and their match rates.

What exactly is your game?

I believe I read on here that this is a shared account between several folks who wish to remain......

But, they are violating the TOS.

 

[gyngyn]

So just curious, I met a couple of IMGs on the interview trial. All stellar, non matched. Is there a blatant discrimination against IMGs? Are AGMs always considered > to IMGs, if they have the same stats?
Thanks

It's called a filter.

 

[PSamP]

I believe I read on here that this is a shared account between several folks who wish to remain......

But, they are violating the TOS.

Ok the thing is the account was on hold and threatened and now it's only a ONE MAN SHOW, everyone else was kicked out. So now it's not violating anything. I'm just interested about IMG stats, some of my best friends are IMGs. FYI I did not match in radiology, and I'm now going for McKinsey... (EDIT I'm abashed)

 

[Law2Doc]

It's not blatant discrimination to prioritize people who have satisfactorily completed the US rotations that best mirror experiences in US wards. Intern year is a very steep learning curve already. Having had a toe in the water in a US rotation helps, at least early on, and probably more than you realize. The practice of medicine isn't exactly fungible. Though diseases are similar, (prevalence may not be), more importantly patients have very different rights and expectations here, documentation requirements and EMRs are different here, we have different drugs in the repositories here, and so on. So you are starting from a very different place as an IMG, and though you may be brilliant, the first six months are going to go much worse for you. And first impressions are pretty important. So it's not discrimination for the PD to pick a more lackluster US grad who knows the ropes over an IMG who maybe has a higher ceiling. The Step scores simply aren't always as important than not getting a lot of 3 am calls in July because the IMG intern doesn't know how to interface with an irate US patient.

 

[Law2Doc]

Ok the thing is the account was on hold and threatened and now it's only a ONE MAN SHOW, everyone else was kicked out. So now it's not violating anything. I'm just interested about IMG stats, some of my best friends are IMGs. FYI I did not match in radiology, and I'm now going for McKinley...

McKinsey... If you are going to make up a story you would do better learning the name.

 

[Goro]

1000% agree with my learned colleague.

Quoting the exceptionally sage @gyngyn:

"The pool of US applicants from the Caribbean is viewed differently by Program Directors.

The differential diagnosis (the potential etiology) for this finding is not pretty. It includes: Institutional Actions, parental pressure, egotism, weak judgment, inability to delay gratification, poor research skills, gullibility, high risk behavior...

This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to take risks too! So some do get interviews.

A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!"

It's not blatant discrimination to prioritize people who have satisfactorily completed the US rotations that best mirror experiences in US wards. Intern year is a very steep learning curve already. Having had a toe in the water in a US rotation helps, at least early on, and probably more than you realize. The practice of medicine isn't exactly fungible. Though diseases are similar, (prevalence may not be), more importantly patients have very different rights and expectations here, documentation requirements and EMRs are different here, we have different drugs in the repositories here, and so on. So you are starting from a very different place as an IMG, and though you may be brilliant, the first six months are going to go much worse for you. And first impressions are pretty important. So it's not discrimination for the PD to pick a more lackluster US grad who knows the ropes over an IMG who maybe has a higher ceiling. The Step scores simply aren't always as important than not getting a lot of 3 am calls in July because the IMG intern doesn't know how to interface with an irate US patient.

 

[rokshana]

It's not blatant discrimination to prioritize people who have satisfactorily completed the US rotations that best mirror experiences in US wards. Intern year is a very steep learning curve already. Having had a toe in the water in a US rotation helps, at least early on, and probably more than you realize. The practice of medicine isn't exactly fungible. Though diseases are similar, (prevalence may not be), more importantly patients have very different rights and expectations here, documentation requirements and EMRs are different here, we have different drugs in the repositories here, and so on. So you are starting from a very different place as an IMG, and though you may be brilliant, the first six months are going to go much worse for you. And first impressions are pretty important. So it's not discrimination for the PD to pick a more lackluster US grad who knows the ropes over an IMG who maybe has a higher ceiling. The Step scores simply aren't always as important than not getting a lot of 3 am calls in July because the IMG intern doesn't know how to interface with an irate US patient.

this is may be true for the FMG, educated and possibly trained and practiced in the another country, but then this argument would not fly for the offshore student that has done their 3rd and 4th year clinical rotations in US hospitals (never mind having been born,raised,and educated in the US for everything else)...

more goes into it than just USCE (though this is an important factor)...but it is the stigma that is attached to anything that is not USMD...if you labeled the same ERAS application and the only thing you changed was the origin or type of degree (US-IMG, FMG, DO-yes DO), the one that will always get the interview will be the USMD...the rest will depend on the PD's experience with people with the other label...some will prefer the IMG, others the DO and still other the FMG...

 

[mvenus929]

What field are you in?

Since you evidently can't guess from my signature... Peds.

 

[Xorthos]

I think it's program specific. Some programs are IMG friendly, some are not. Depends on the program director.

 

[Law2Doc]

this is may be true for the FMG, educated and possibly trained and practiced in the another country, but then this argument would not fly for the offshore student that has done their 3rd and 4th year clinical rotations in US hospitals (never mind having been born,raised,and educated in the US for everything else)...

more goes into it than just USCE (though this is an important factor)...but it is the stigma that is attached to anything that is not USMD...if you labeled the same ERAS application and the only thing you changed was the origin or type of degree (US-IMG, FMG, DO-yes DO), the one that will always get the interview will be the USMD...the rest will depend on the PD's experience with people with the other label...some will prefer the IMG, others the DO and still other the FMG...

As I've said on other threads, a number of the US rotations set up by community hospitals for offshore schools are "Lite" versions of US rotations (certainly the few I have seen were this, but more importantly a lot of US PDs have this impression). So this is a reason for prioritizing people with "true" US rotations, even over the offshore crowd. When a school is paying cash for rotations and the students give feedback based on how much "fun" they had and how little call they had to do, you can't hope for it to be otherwise. People choose the more chill rotation because PDs will assume that's what they had anyway, and they report back to their classmates that they didn't work hard for a high pass, so it becomes a never ending cycle. And the community hospitals don't want to do anything to not get rave reviews and end this gravy train. I note again the "swag bags" full of coffee mugs and T shirts some of the community hospitals I've rotated through give offshore students.

 

[thehundredthone]

So just curious, I met a couple of IMGs on the interview trial. All stellar, non matched. Is there a blatant discrimination against IMGs? Are AGMs always considered > to IMGs, if they have the same stats?
Thanks

I don't get why this comes up so often. There are more applicants than spots. Thus some applicants will not match. Some of those will be 'stellar', a majority will have particular reasons why they were not ranked highly by the places they interviewed at. We will never be privy to those details and hence everything you hear is conjecture. Think of it as a medical analogy, will this information change your decision making if you're already an IMG? You'll still apply and go through the process, if you want to match into a residency program. Expectations should be tempered regardless of these factors.

this is may be true for the FMG, educated and possibly trained and practiced in the another country, but then this argument would not fly for the offshore student that has done their 3rd and 4th year clinical rotations in US hospitals (never mind having been born,raised,and educated in the US for everything else)...

more goes into it than just USCE (though this is an important factor)...but it is the stigma that is attached to anything that is not USMD...if you labeled the same ERAS application and the only thing you changed was the origin or type of degree (US-IMG, FMG, DO-yes DO), the one that will always get the interview will be the USMD...the rest will depend on the PD's experience with people with the other label...some will prefer the IMG, others the DO and still other the FMG...

As I've said on other threads, a number of the US rotations set up by community hospitals for offshore schools are "Lite" versions of US rotations (certainly the few I have seen were this, but more importantly a lot of US PDs have this impression). So this is a reason for prioritizing people with "true" US rotations, even over the offshore crowd. When a school is paying cash for rotations and the students give feedback based on how much "fun" they had and how little call they had to do, you can't hope for it to be otherwise. People choose the more chill rotation because PDs will assume that's what they had anyway, and they report back to their classmates that they didn't work hard for a high pass, so it becomes a never ending cycle. And the community hospitals don't want to do anything to not get rave reviews and end this gravy train. I note again the "swag bags" full of coffee mugs and T shirts some of the community hospitals I've rotated through give offshore students.

“Every system is perfectly designed to achieve exactly the results it gets” - Don Berwick, IHI. I don't see why it's surprising that a graduate from a school that meets the criteria set up by the LCME and carries the (for the lack of a better term) street cred of a USMD would be considered preferable. I don't discount the fact that the appraisal of schools and students is pretty questionable at times across all systems - the curriculum at allopathic schools is not uniform in the least, some rotations and certain times of the year are as much of a joke for allopathic medical students as they supposedly are for USIMGs. However, that's the system that was set up, and that's the reward for 'making it' in the system. There will always be artificial constructs to differentiate the 'superior' from the 'inferior', change is slow. Maybe with the steady increase in the number of allopathic medical schools more potential students will be afforded the opportunity to move from coach class FMG/IMG to AMG (although there's still the battle of "top X" vs unranked medical school within that subclassification).

 

[rokshana]

“Every system is perfectly designed to achieve exactly the results it gets” - Don Berwick, IHI. I don't see why it's surprising that a graduate from a school that meets the criteria set up by the LCME and carries the (for the lack of a better term) street cred of a USMD would be considered preferable. I don't discount the fact that the appraisal of schools and students is pretty questionable at times across all systems - the curriculum at allopathic schools is not uniform in the least, some rotations and certain times of the year are as much of a joke for allopathic medical students as they supposedly are for USIMGs. However, that's the system that was set up, and that's the reward for 'making it' in the system. There will always be artificial constructs to differentiate the 'superior' from the 'inferior', change is slow. Maybe with the steady increase in the number of allopathic medical schools more potential students will be afforded the opportunity to move from coach class FMG/IMG to AMG (although there's still the battle of "top X" vs unranked medical school within that subclassification).

in the grand scheme of things however it is pretty presumptuous of us to think that just because a school is foreign (domiciled, school in their country that has standards that need to be met form their version of the LCME), that it is inherently inferior in being able to educate a person to make them a fully qualified doctor and that they would be very amenable to be be trained...trained in anyway one can see fit...to become a doctor in the US, UK, Europe, China, India, etc...where ever...are you going to say that the #1 student from HMS and the bottom ranked person from the bottom ranked USMD school are the same quality even though they hold the same US MD degree? Yes, its hyperbolic, but its just an example...there are great USMD just as there are USMD that you would not let take care of your plants...and there are FMGs (and even IMGs) that are better than some USMDs...just because the happenstance of birth or stupidity in college( i confess i am of the latter) shouldn't seal your fate to become a doctor.

 

[rokshana]

As I've said on other threads, a number of the US rotations set up by community hospitals for offshore schools are "Lite" versions of US rotations (certainly the few I have seen were this, but more importantly a lot of US PDs have this impression). So this is a reason for prioritizing people with "true" US rotations, even over the offshore crowd. When a school is paying cash for rotations and the students give feedback based on how much "fun" they had and how little call they had to do, you can't hope for it to be otherwise. People choose the more chill rotation because PDs will assume that's what they had anyway, and they report back to their classmates that they didn't work hard for a high pass, so it becomes a never ending cycle. And the community hospitals don't want to do anything to not get rave reviews and end this gravy train. I note again the "swag bags" full of coffee mugs and T shirts some of the community hospitals I've rotated through give offshore students.

but your point was the lack of exposure of FMGs to the US healthcare as an issue..."lite" or not, they are in US hospitals, seeing US patients, so they ARE being exposed tot he US system...nevermind that with the exception of TWO years abroad, they have lived their whole lives in the US...they are well assimilated tot he US culture (since you know, they are a product of the US culture)...

and PLEASE tell me where these hospitals are...because I never saw that kind of swag...but certainly saw the USMD students that rotated (yes I rotated with MSSM, NYMC, and UMDNJ students) with and the US med students that were on my services as residents with all sorts of perks...paid housing, paid transportation, meal card without limit, etc...if i had to pick between a "swag" bag and free rent and food...

 

[thehundredthone]

in the grand scheme of things however it is pretty presumptuous of us to think that just because a school is foreign (domiciled, school in their country that has standards that need to be met form their version of the LCME), that it is inherently inferior in being able to educate a person to make them a fully qualified doctor and that they would be very amenable to be be trained...trained in anyway one can see fit...to become a doctor in the US, UK, Europe, China, India, etc...where ever...are you going to say that the #1 student from HMS and the bottom ranked person from the bottom ranked USMD school are the same quality even though they hold the same US MD degree? Yes, its hyperbolic, but its just an example...there are great USMD just as there are USMD that you would not let take care of your plants...and there are FMGs (and even IMGs) that are better than some USMDs...just because the happenstance of birth or stupidity in college( i confess i am of the latter) shouldn't seal your fate to become a doctor.

It is absolutely presumptuous of us. My point was not that it is understandably viewed as inherently inferior, since I spoke of that being an artificial construct. My coach class adjective was sarcastic. However, it is not surprising. Unfortunately, for the rhetoric filled public and politicians, stating that "our citizens' jobs must be protected" is more important than "our patients must receive quality healthcare" (if the anecdotal argument is to be made, plenty of patients speak about how much they like their foreign physicians). It's a political issue, and all the politically set up committees end up having one main goal - to consolidate power in the name of maintaining standards and regulating quality (see ABIM, LCME, etc - it's no different across the world).

On the bright side >94% of AMGs match, and I daresay almost all of them are capable of providing at least average healthcare. They, and most IMGs/FMGs that match (which, all said and done is a heartening proportion compared to elsewhere in the world) are at least at the same minimum standard that the system requires. And that's the purpose of the system. The human factor is what causes variability - some PDs want the best and brightest and are willing to recruit IMG/FMGs if they fill that bill; some want to maintain popularity among AMGs and thus restrict themselves to recruiting thusly; some have programs viewed as undesirable and need residents so that they don't get shut down, and so they fill their ranks with whatever they get their hands on.

The happenstance of birth 'seals your fate' in so many ways, this is just one. Should one be afforded the opportunity (if they are able) to break out of those constructed shackles? Absolutely. Will they all meet great resistance (sometimes crossing legal and ethical boundaries) from those who are in the favourable positions that these individuals seek to reach? You can count on it. Can those of us that did manage to succeed, do whats necessary (change public perception first) to bring about some reform? It's uncertain, but we can keep plugging away at it at whatever level of influence we're able to create.

 

[GingyKhan]

Congrats! May I ask of your stats? Did you feel any discrimination?

Step 1 >250 Step 2 >260 for cat. surgery (I didn't have any research done but I had 4 great LORs from University based hospital surgeons).