Competitiveness of top IM programs

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Handsome88

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Hey all,

I'm an IMG from a top 50, Western European school interested in Cardiology and thus have to match in top 20 IM program (right?). How competitive is to do that relative to other specialties (like Categorical General Surgery)? I'm debating between GS and Cards (don't ask why), I may not want to do General IM and so I'm basically trying to assess which is more difficult to match into: Cardiology (top IM programs) or GS for IMGs?

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I'm an IMG from a top 50, Western European school interested in Cardiology and thus have to match in top 20 IM program (right?).

Im a lowly first year but I have a medical family and I know that this is greatly exaggerated and false sentiment on this forum. Yes it is competitive but just about every single academic university medical system in the states has a cardiology fellowship. Its not that hard to match IM at some university programs and from there its all on you as far as impressing the Program Director and showing an interest in cardiology etc. Do you have a better chance of matching cardiology from MGH unequivocally yes, but do you have to go to hopkins to match at USF cardio-no. I know that this doesnt answer the subject of your post but I thought this might also help
 
Im a lowly first year but I have a medical family and I know that this is greatly exaggerated and false sentiment on this forum. Yes it is competitive but just about every single academic university medical system in the states has a cardiology fellowship. Its not that hard to match IM at some university programs and from there its all on you as far as impressing the Program Director and showing an interest in cardiology etc. Do you have a better chance of matching cardiology from MGH unequivocally yes, but do you have to go to hopkins to match at USF cardio-no. I know that this doesnt answer the subject of your post but I thought this might also help

Agreed. Your biggest obstacle to Cardiology coming from another country is your visa. As in many programs don't deal with them because they do not have to, which also the main problem trying to match into a top 20 IM program for medicine. They also don't need to deal with visas so they don't, unless you're a really stellar candidate (every year the top programs will take at least one superstar candidate per program from overseas). But there is no need to cross bridges before you get to them. It's cheap, relatively speaking, to apply to multiple, multiple programs, if you have the means to go on as many interviews that are offered, you'll easily find a medicine program. From there you'll have to show interest in cardiology, do some scholarly activity in that arena, and you should generally be able to find a spot as long as you're not too picky.
 
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I have been reading this wonderful forum compulsively for a couple weeks now as the current 4th years near glory day and I have been wondering this exact question myself. I feel that I am a 'competitive' candidate, but really don't have an accurate picture of just how competitive I am. I would really appreciate some experienced insight into my position, so thanks in advance. Heres my snapshot:

I am an MS3 at one of the SUNY schools (not giving specifics for anonymity sake, if you really think it makes a difference I will gladly PM), I have an MA in Molecular Biology (1 year program b/w undergrad and med school), 257 Step 1, Honors in every pre-clinical course minus 1 High Pass (and Pass in both ECM courses), Honors in every clerkship so far including Neuro, Medicine, Surgery, and Pediatrics. I have my fingers crossed 24/7 that I make the cut for junior AOA, but I am pretty confident I will be AOA by senior year for sure. I was interested in ENT for a long while up until recently when I realized that IM is really where I belong and I can't wait to start training. On that note, I was involved in an ENT research project between 1st and 2nd year; I honestly have not kept up with it too well as I am not intrinsically motivated for that kind of research but I do know the work and know it is being presented at conference next month. I am cool with doing research, I just haven't gotten involved in a project that I picked myself or am genuinely interested in. I have a pretty decent slathering of other involvements around school from ENT club leadership, free clinic administrative leadership for a year, anatomy teaching to PA/PT over a summer, and helping run the anatomy mock-practicals for the 1st years as a second year. I have a penchant for teaching and have followed through with it pretty well; i was paid staff teaching chemistry at Binghamton when I was doing my Masters.

I have very broad and open interests ranging from Cards>GI>Hospitalist>Intensivist>Heme/Onc. I really am an open book when it comes to what direction I want to head in Medicine. What I do know is that I want to train amongst the best. I am a product of SUNY and every step of the way I have gone with the state option over the high priced private option, even though I had the opportunities. Now is when it counts and I really want to Match at a top 25.

My question: am I actually MGH/BW/Columbia - Cornell/Sinai/NYU material?

Now I know people will tell me, sure, your competitive and will probably get some interviews (right?). But I also know that names from SUNY schools are much fewer and far between on these schools match lists than names from likewise top med schools. I really want to stay in NY for family and life reasons, which makes Columbia/Sinai/Cornell/NYU my ideal picking, but I will obviously be taking my shot at the Harvards, Penn, and Yale also. I don't really see myself going to Baltimore or NC for JH and Duke for the family reasons. I'll obviously have Monte, LIJ, etc... on my list somewhere, but I'd be honestly disappointed to not end up at a tier 1. Am I really taking a crap shoot at hoping I can match in NY or do I have a solid fighting chance?

Thanks for reading my long, self involved post. I really appreciate any insight I can be given because I really need some guidance. I hope to contribute more around these parts now that I have broken the ice, this is a great great place.
 
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My question: am I actually MGH/BW/Columbia - Cornell/Sinai/NYU material?

I put $20 on you getting an interview at most of those places, if not all of them, especially if you nail the AOA.

I think you're fairly well set. Try and round up some recent scholarly work, even if it just a couple of poster submissions to your local SGIM or other meeting(s), and Honor the Sub-I and that should round out your application nicely.

We really need a "what are my chances" thread
 
I have an MA in Molecular Biology (1 year program b/w undergrad and med school), 257 Step 1, Honors in every pre-clinical course minus 1 High Pass (and Pass in both ECM courses), Honors in every clerkship so far including Neuro, Medicine, Surgery, and Pediatrics.

My question: am I actually MGH/BW/Columbia - Cornell/Sinai/NYU material?

Columbia/Sinai/Cornell/NYU my ideal picking, but I will obviously be taking my shot at the Harvards, Penn, and Yale also. I don't really see myself going to Baltimore or NC for JH and Duke for the family reasons. I'll obviously have Monte, LIJ, etc... on my list somewhere, but I'd be honestly disappointed to not end up at a tier 1.

I would be very surprised if you didn't end up in the top tier unless you decide you like another program. I'd recommend only interview at 2-4 backups like Monte, LIJ. Maybe send in 4 apps to backups just to make sure but I think you should get interviews at almost all of those top programs you listed save a few so don't waste your time with too many backup programs. Interviews take a toll on you so don't get worn out interviewing at too many backups. The interviews invites at the back up programs will come first, before the dean's letter and most top tier programs wait until the dean's letter comes out in Nov. It will be tempting to set up interviews at all of your backups but set up only a few and wait until the deans letter comes out before setting up the rest. Within a few days after the deans letter you should know whether you are going to get interviews at your top programs (I'll ruin the surpirse, you will)

I'd recommend you still apply to Duke and JHH. They are excellent programs and it is going to cost you next to nothing to apply to a few more programs. Who knows, you may really like those programs.
 
Im a lowly first year but I have a medical family and I know that this is greatly exaggerated and false sentiment on this forum. Yes it is competitive but just about every single academic university medical system in the states has a cardiology fellowship. Its not that hard to match IM at some university programs and from there its all on you as far as impressing the Program Director and showing an interest in cardiology etc. Do you have a better chance of matching cardiology from MGH unequivocally yes, but do you have to go to hopkins to match at USF cardio-no. I know that this doesnt answer the subject of your post but I thought this might also help

Thank you very much for the post. But that is true only if you are a US IMG. I'm not US IMG and I need some kind of visa too. I looked around on the Cardio forums and people there are having a stressful time and hardships trying to get into Cardiology while having 15+ research experiences (some with 9+ pubs, 10 abstracts...etc). I don't understand how they have all that experience but from what I saw you really need to work your ***** off to get cardio...So someone like me with no research experience as of yet, and no real interest in doing research (but I still have to do few, I have no choice), will have to match at a 1st tier university.

To get back at my question. How many weeks of electives do I have to do to match at a top tier (or a school that gives me high chances at Cards as non US-IMG), I have time during my second year (I will have done core elective in IM here) only, and only 2 weeks after 3rd year. And then the same question goes with GS. I ask that because IMG matching is directly proportional to elective time (most importantly in during last year). Also what about required USMLE scores for top IM and any categorical GS. Thanks!

P.S. I know 2 people who have the same dilemma and so I appreciate the help you can give me!
 
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@ Handsome88 - as an IMG both the duration and quality of elective experience are important. As you say the longer you spend doing US rotations, the better. Many top tier programs will screen you out on the basis of less than (insert any random number from 1-12 months) of hands-on US clinical experience. But some will be willing to waive their own criteria for particularly attractive candidates.

However, it certainly pays to first identify how much elective time your medical school will allow, and then, well in advance, focus on organizing meaningful electives (ideally subinternships, but if not possible, cardiology or other medical subspecialty) at institutions where you want to match. Work hard and make sure you do a fantastic job on your rotation, meet the program director and impress the clerkship director. Do this and this will be your best shot at matching at that institution.

Making meaningful contacts who have a personal interest in recruiting you into their program is crucial to the success of IMGs getting interviews at top tier institutions. The more electives you are able to do (and excel at), the higher the probability of your getting interviews and eventually matching at a great institution.

Also, IMGs who match at great places typically (but not always) have a strong research background - you might want to consider this when planning the next few years...
 
@ Handsome88 - as an IMG both the duration and quality of elective experience are important. As you say the longer you spend doing US rotations, the better. Many top tier programs will screen you out on the basis of less than (insert any random number from 1-12 months) of hands-on US clinical experience. But some will be willing to waive their own criteria for particularly attractive candidates.

However, it certainly pays to first identify how much elective time your medical school will allow, and then, well in advance, focus on organizing meaningful electives (ideally subinternships, but if not possible, cardiology or other medical subspecialty) at institutions where you want to match. Work hard and make sure you do a fantastic job on your rotation, meet the program director and impress the clerkship director. Do this and this will be your best shot at matching at that institution.

Making meaningful contacts who have a personal interest in recruiting you into their program is crucial to the success of IMGs getting interviews at top tier institutions. The more electives you are able to do (and excel at), the higher the probability of your getting interviews and eventually matching at a great institution.

Also, IMGs who match at great places typically (but not always) have a strong research background - you might want to consider this when planning the next few years...

Thanks for the reply.

To be honest, I'm going to allocate most of my elective time back in Canada, so I really can't have more than ~6 weeks of elective time in total in both my final years (4 and 2 in 3rd and 4th respectively). I don't know how much of a chance that will give me to get reasonable LORs. I know it wont get me in John Hopkins or Yale, but I'd settle for anything that gives me a reasonable chance for a fellowship.
Do you think any Canadian experience/LORs count too?
 
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Thanks for the responses, they were reassuring. I guess I just have to keep on keeping on and finish out as strong as I have started. I know I shouldn't be in a rush and that all will come in good time, but I really just want to fast forward to at least september when I will be in my Sub-I and focusing more directly on IM. I am actually looking forward to Psych, but not OB/Gyn so much. O well, we all have to do it. I am really damn excited about this whole process!!! I can't wait to get some more responsibility.
 
Thanks for the responses, they were reassuring. I guess I just have to keep on keeping on and finish out as strong as I have started. I know I shouldn't be in a rush and that all will come in good time, but I really just want to fast forward to at least september when I will be in my Sub-I and focusing more directly on IM. I am actually looking forward to Psych, but not OB/Gyn so much. O well, we all have to do it. I am really damn excited about this whole process!!! I can't wait to get some more responsibility.

Good job hijacking my thread...
 
If you need a visa, you should not waste your time with Columbia. Columbia doesn't give the type of visa that you need to remain in the country after completing residency. They will probably not even offer you an interview b/c of that.

Good luck!
 
Hi everybody, i was wondering, is it possible for an img get into top tier programs like hopkins or yale??? If its possible, how can one improve your chances???

I know its almost impossible,but im just wondering!:p
 
Hi everybody, i was wondering, is it possible for an img get into top tier programs like hopkins or yale??? If its possible, how can one improve your chances???

I know its almost impossible,but im just wondering!:p

Depends on the type of IMG.

Carib or other offshore American nonsense? No.
Top graduate of well respected top med school in your home country? Possibly.

Also, while Yale is a good program, putting it in the same category as Hopkins is silly.
 
Yes, it is absolutely possible! However, it is indeed extremely challenging. Most top programs will take an upper limit of 1-2 IMGs per year, and some will take none, depending on the competitiveness of the AMG applicant pool in your application year. You will be competing for a handful of interview slots (sometimes 1 or none) against a 1000+ pool of IMG applicants, many of whom may have equally strong CVs. As a consequence the interviews you get will be somewhat capricious. You will certainly not receive interview invitations at all of the top-tier programs (unlike many AMGs who post on SDN), but a subset of those may well invite you.

Things you can do to improve your chances:
-go to a top medical school in your home country.
-perform extremely well there. Present your transcript in a way that american program directors can understand and have very strong letters of recommendation from your home institution.
-do elective rotations at US hospitals while you are still a student (the longer the better) and get stellar LORs from your attendings. Do your very best to get an elective at the top-tier institution at which you want to match (this requires careful advance planning). This can be crucial in getting an interview.
-score 250+ in the USMLEs. Most top programs will screen out IMG applicants on the basis of their scores. More than one tope program has told me that they use 250 as a cutoff for IMGs.
-do research. If you are genuinely interested in research and have a strong research background, many more people will be interested in you. Publish!
-get a degree from a top American institution. Ideally a PhD, but a MPH or other degree can also be very useful.
-speak flawless English, acquaint yourself well with American culture and present yourself well at interview. Have a good reason for why you want to move to America and why you are a good fit for the institution.

Most importantly, develop contacts at the institution that you want to go to (eg. by doing an elective, doing research there, getting a PhD from the affiliated university and getting to know professors etc.)

And finally, don't lose hope! It can definitely be done and with determination, planning and hard work, you can do it too! But you will have to demonstrate that you are the best of the best and know that the bar is set higher than for American applicants.
 
Depends on the type of IMG.

Carib or other offshore American nonsense? No.
Top graduate of well respected top med school in your home country? Possibly.

Also, while Yale is a good program, putting it in the same category as Hopkins is silly.

Even as an unabashed Yalie, Hopkins is a cut above - arguably the best program in the country per some on this board. That being said, the Yale/Columbia/Cornell/Chicago/BID/Sinai/Stanford/Penn/Whatever top 10-20 program not named Hopkins you prefer (or ucsf, bwh, mgh) remain a difficult match for IMGs. One or two a year at maximum was what I saw on the interview trail last year, and they are almost always non-American citizens with stellar scores, numerous publications and often an advanced second degree or two.

Instatewaiter can correct me but I think there was one IMG in this year's intern class at Hopkins...pretty much the candidate above with extensive US clinical experience.
 
Even as an unabashed Yalie, Hopkins is a cut above - arguably the best program in the country per some on this board. That being said, the Yale/Columbia/Cornell/Chicago/BID/Sinai/Stanford/Penn/Whatever top 10-20 program not named Hopkins you prefer (or ucsf, bwh, mgh) remain a difficult match for IMGs. One or two a year at maximum was what I saw on the interview trail last year, and they are almost always non-American citizens with stellar scores, numerous publications and often an advanced second degree or two.

Instatewaiter can correct me but I think there was one IMG in this year's intern class at Hopkins...pretty much the candidate above with extensive US clinical experience.

Yup there was an IMG in this years intern class - 2 actually when you consider Cornell in Qatar. Hopkins seems to be very open to IMGs compared to many big name programs. Each year has a few IMGs usually from the UK, Germany or South America. Hopkins seems to have almost always been this way because a lot of our attendings are from foreign countries and came to train at hopkins back in the day.

Next year hopkins class has 3 IMGs- one from Universidad de Panama and 2 people from University College Dublin. The IMGs who match tend to be exceptional interns. These people did extensive rotations in the US, have high scores and blew the program director, away during their interview.
 
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