Asking for advice

[Pavel]

Hey Guys,
This forum is a great link for US neurosurgeons and for those who are thinking to become. Thank you very much for the info.

I wanted to ask your opinion.
I am Russian neurosurgeon. Live in Russia. Not a US citizen.
Currently doing USMLE, passed step 1 – 85/209 and 2 CK – 93/229. Take 2CS in a month.
I am 25 y/o. Have about 30 publications in home country, finishing PhD thesis.
What are my chances to get in to NS residency?
Just thinking if it worth it to try it in match 2008
Any opinion will be appreciated.

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[trout]

I think with those scores it might be very hard to match but maybe not impossible. You may want to consider one of the pre-residency fellowships. Many have been successful in securing a spot after them.

 

[Pavel]

thank you for reply, searching both ways now.

 

[drbruce]

Hi Pavel
Interesting situation you are in. At 25 years old, I assume you haven't completed your neurosurgical training yet, especially since you are doing a pHD thesis as well, but I would still apply at any rate as you have nothing to lose and everything to gain. Your list of publications will put you in good stead regardless. I will only go for community programs though.

If you unsuccessful you can try again when you have completed your training and have a few years experience behind you.

What is neurosurgery like in Russia? I have been interested in visiting Russia for a long time now and hopefully will finally get to see the country next Easter.

Incidentally, how does a pre residency fellowship work? I have never heard of them.

 

[Pavel]

Dear DrBruce,
Thank you for encouragement, I will try to apply anyway, but will try to get at least any connections or “points”.
My situation is not very typical. I entered Medical school at 16, graduated with MD degree at 22, after that I went directly to residency in neurosurgery in Moscow. It’s 2 years long. Yeah, big surprise for many non Russian surgeons. Anyway, last year I finished residency and got board certification and license. Went to spinal surgery fellowship and worked for several months in ER, but realized that it’s too hard to both work and study for USMLE. So I am not working right now, just doing MLE and thesis. Unfortunately I have to sacrifice the latter for the former. Next month going to US to take 2CS.
Neurosurgery is really differs here from hospital to hospital. But generally the level of education and skills is low. Unfortunately. There are 2-3 really big (in terms of professionalism) hospitals in Moscow, and 2-3 more in whole Russia. I personally was lucky to get a really good training, especially in spinal field.
Pre-residency fellowship is an option in US. We don’t have it in Russia.
By the way, how come you’re coming to Russia? Just visiting as a tourist?

What do you do? Med school, residency?

 

[drbruce]

As a tourist to begin with but afterwards I would like to return to Russia the following year to get some actual work experience in the rural hospitals outside of Moscow under the auspices of an international christian medical organisation, the name of which I forget. Medical care in different parts of the world is a fascinating subject for me. Perhaps I need to get out more.

Wow, two years for neurosurgery. I suppose you sub specialise from the outset. In the UK it can take 10-15 years after graduation to become a consultant neurosurgeon. Training, however, only takes 9 years; 6 years of neurosurgery, plus 3 years basic surgical training, the rest of the time is spent in limbo, waiting for a consultancy post to come up, which could conceivably take forever. The American system is better - shorter, but far more intense. That I can put up with.

Is neurosurgery a competitive field in Russia?

 

[Pavel]

Neurosurgery in Russia is not really competitive for several reasons. B/c no matter what specialty you are, the average salary in Russia for a surgeon is about $100 a month. Moscow is exception, people in surgery make big money here – $600-800 a month. The most part of the income comes from gratuity payment from patients (under the table).
The most competitive field here in Dentistry, Ob/Gyn and Pharmacy. As to NS, no one wants to work hard and earn nothing. In my case I was born to be NS, just like it.
Stupid country. The more you work – the less you get. Funny, but true.

So, what field you are working? You r from UK?
Hey, let me know when you come, it would be great to talk to you, if you don’t mind. Will give you some survival tips ;o))))
The medical education here is as follows: after high school – 6 year Medical Academy, after you get MD, you go to Internship or Residency (2y) in any specialty. After that you can do fellowship (3y). That’s all. After Internship or Residency (2y) you get license, sertificate and right to practice medicine. Not private practice, we don’t have it here.

 

[drbruce]

$100 a month, wow! Seems so unfair!

I'm still at medical school. Also 25 years old. I certainly won't mind having a chat when I visit Russia, especially if you could show me around the hospitals, that would be great! Of course, not to inconvience you.

I'm hoping to get into either general surgery or neurosurgery. Unfortunately NS is such a small field in the UK and the competition for spots is incredibly fierce. America is the way forward, I'm sure of that.

 

[Pavel]

DrBruce, no problem with giving you a little tour. You won't find a better giude ;o)))
Right now I am thinking about surgery and NS as an options for future match. The chanses are not really high, but I have to try. Once you are in surgery - it's hard to switch to smth else.

 

[drbruce]

Cool, that would be great! Just out of curiosity, what were your bread and butter cases?

 

[Pavel]

I mostly did spinal procedures. Myself I go pedicular screw fixation of lumbar spine, interlaminectomy for lumbar dics herniations, anterior and posterior cervical fusion. CVJ fusion done twice. As to anterior thoracic and lumbar region I only do approaches, decompression and fusion itself is done my more experiensed surgeons.
On the head i did myself only haematomas and couple convexital meningiomas. All the rest only approaches to anterior of posterior fossas for different cases.
Unfortunately I havent been practicing for about a year.

 

[drbruce]

Wow, sounds like they kept you busy. How many hours did you have to work per week during the residency and llooking back on your training, did you have any regrets about entering this field? Sadly many neurosurgeons do from what I hear.

 

[Pavel]

what I tell you, is going to surprise you. NS is considered the hardest field in medicine (no one disagree at this point). That is why NS's have the best hours, in our hospital 6h/day, 2 month/year vacation and 1 year of work counts as 1,5. Sounds good, but in reality it;s different.
I love NS very much, thats why I spent 10-12 h/day there including weekends, i enjoyed it.
That time all I wanted to get skills and experience.
If you work in ER, its way different, hard to bear.
Another REALLY interesting thing about residency, hospital don't pay you,
You pay to the hospital for doing residency there, like you do in Med School.
If you study here, actually in 2 years you do the same procedures, that European NS's do after 5-8 y of training. They throu you to real life pretty quick.

 

[drbruce]

Hmm.. I do want to become a neurosurgeon myself, desperately. Getting a residency placement in the US for a fresh out of school international medical graduate is very difficult. Even with good USMLE grades.

So do you think it will be worth studying in Russia for two years, acquire the necessary surgical skills and then relocate to America.

Apparently many foreign doctors do their post grad training in Russia. There is quite a lot of information available on the internet about this option.

 

[Pavel]

Well, here is the Q for you.

1. You want to be an american NS?
2. or you want to be NS in UK?
3. or You just want to be a great NS despite where you are?

What to do depends of what you want.

Myself, I want to be NS in US, no other option.
Been in states 3 times, and love it there. Besides, neurosurgery there - is a real deal in terms of professionalism.

For option 1 the best for you would be to do the USMLE the best you can and go to US. Apply for NS, if you fail, apply to general surgery and then find your way to NS. That what I am going to do, b/c with my MLE scores chanses to match in NS are dismal.

Going to Russia is wasting of time. I wouldn't advice anybody to go here. There are too few good NS's here. I was lucky to work with one of whose.

When do you graduate from your Med school?
Did you do USMLE yet?

 

[Jackofknives]

Sorry to interrupt, but is it possible to take USMLE outside of US, like in Europe for example? I live in Denmark and have never heard somebody taking USMLE here.

And is there an expiration date for USMLE exams? For instance, if I take USMLE step 1 after 2nd year of med school, will that still count after I graduate, which is 4 years later?

 

[mpp]

I think you have to take it in the states. It is a computerized test but I don't think they offer it overseas.

The timing of the test depends on which state you do your residency in. In some states you need to have all of the steps complete within seven years to get a medical license.

 

[Pavel]

U can take USMLE almost in any country in Europe, and in some of eastern europe and even in middle east. I took step 1 in germany and 2CK in Israel this year. Go to prometric.com and check where you can do it. I am pretty sure u can easily do it in dennmark.
U should do usmle withing 7 year period - if you took step-1, do the rest 2CK and 2CS in 7 years.

 

[neuro2bjc]

Neurosurgery in Russia is not really competitive for several reasons. B/c no matter what specialty you are, the average salary in Russia for a surgeon is about $100 a month. Moscow is exception, people in surgery make big money here – $600-800 a month. The most part of the income comes from gratuity payment from patients (under the table).
The most competitive field here in Dentistry, Ob/Gyn and Pharmacy. As to NS, no one wants to work hard and earn nothing. In my case I was born to be NS, just like it.
Stupid country. The more you work – the less you get. Funny, but true.

So, what field you are working? You r from UK?
Hey, let me know when you come, it would be great to talk to you, if you don’t mind. Will give you some survival tips ;o))))
The medical education here is as follows: after high school – 6 year Medical Academy, after you get MD, you go to Internship or Residency (2y) in any specialty. After that you can do fellowship (3y). That’s all. After Internship or Residency (2y) you get license, sertificate and right to practice medicine. Not private practice, we don’t have it here.

I Paval,
I am a student fromt he United States and plan on becoming a neurosurgeon. Basically I want to help people abroad but the process of me getting a degree is going to take too long. I have looked into medical schools in Russia and want to know whther all schools in Russia offer the MBBS degree like in the commonwealth [this degree is not issued in the states, only commonwealth or former colonies]; also do you know whether I could transfer my credits from an American university to a Russian school for a semester and overload my courseload and get my degree on a faster pace? I know this appears confusing, but basically I want to know whether schools in Russia allow you set your own courseload and overload and get a degree. Thanks for any advice.

 

[Pavel]

Hi,
your situation is complicated, but not too much.
Correct me if I wrong, the MBBS is not recognized in the US.
So your goal is to get MD in order to be eligible for board and state exams?
Actually that what one of my friends did. He's american, couldn't afford study in US. Studied 2 years in Belgium, ran out of $, and transferred to Russian med school - Medical fac of Peoples friendship university. He's got his MD this year, now preparing for MLE. Another options are Med schools in smaller cityes like Smolensk (where I studyed) or Tver. Check it here http://www.tsma.ru/
Technically you can transfer with your credentials at 3-4 year of russian med school. But if you really can do it you'll only find out only after you talk to a dean.
Check this to find out more about russian and other med schools. http://www.valuemd.com/index.php

 

[neuro2bjc]

Hi,
your situation is complicated, but not too much.
Correct me if I wrong, the MBBS is not recognized in the US.
So your goal is to get MD in order to be eligible for board and state exams?
Actually that what one of my friends did. He's american, couldn't afford study in US. Studied 2 years in Belgium, ran out of $, and transferred to Russian med school - Medical fac of Peoples friendship university. He's got his MD this year, now preparing for MLE. Another options are Med schools in smaller cityes like Smolensk (where I studyed) or Tver. Check it here http://www.tsma.ru/
Technically you can transfer with your credentials at 3-4 year of russian med school. But if you really can do it you'll only find out only after you talk to a dean.
Check this to find out more about russian and other med schools. http://www.valuemd.com/index.php

Tahnk you for your help!

 

[mpp]

The MBBS degree is recognized in the US. You still must pass the USMLE exams.

 

[Dr.Cooper]

Hey Hi.....
I'm in 2nd course general medicine studying in Tver state medical academy (Tver, Russia).
I wish to give USMLE and apply for Neurosurgery.
what are my chances for studying in US and What is procedure ?
Actually I am an Indian so i will be first giving MCI screening test after completing sixth course here.
and I really want to become a neurosurgeon.
So can you please help me by advising so as how should I study and how far and hard I have to work for in order to reach my aim.

 

[mmmcdowe]

Hey Hi.....
I'm in 2nd course general medicine studying in Tver state medical academy (Tver, Russia).
I wish to give USMLE and apply for Neurosurgery.
what are my chances for studying in US and What is procedure ?
Actually I am an Indian so i will be first giving MCI screening test after completing sixth course here.
and I really want to become a neurosurgeon.
So can you please help me by advising so as how should I study and how far and hard I have to work for in order to reach my aim.

You need to score very high on the USMLE because foreign medical graduates are fairly scarce in US neurosurgical residencies.

Information in terms of taking it;
http://www.usmle.org/bulletin/eligibility/
http://www.ecfmg.org/