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Foreign Trained MD's options in US??? Advice please?

Discussion in 'General International Discussion' started by kokoro, 07.20.08.

  1. kokoro

    kokoro

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    Hi all, I don't know if this has been covered, if so, please forgive me. But basically . . .
    My uncle is currently a top surgeon in Taiwan - he's been practicing for over 20 years and actually is the director of a hospital. He graduated from the National University of Taiwan. Anyhow, his kids were born here in the US and are now relocating here to go to high school. Hence, my question is . . .

    1. What options does my Uncle have to practice in the US? They plan to settle in the San Franciso Bay Area.
    Would he have to take the USMLE's and redo another residency?

    2. I don't think taking the USMLE's and redoing residency is an option for him. Does anyone know of any advanced educational opportunities? Someone suggested trying PA school - it's shorter than redoing residency.

    3. He does have an MPH from UC Berkeley. I don't know if that would help in any programs.

    Thanks all for any advice!
  2. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    It depends on what he wants to do. I'll assume he wants to stay a surgeon.

    Traditionally, the answer to your question was that he could not be BE without redoing his surgical residency in the US.

    Most jobs in the US require at least BE if not BC.

    As of last fall, the American Board of Surgery started giving credit for up to 2 years of foreign surgical training toward BE. The trick is that you must be in a US training program before they will review your application for advanced standing/credit for foreign training.

    For international physicians with outstanding credentials, there is usually a way around these requirements:

    1) he should check with the California Board of Medicine regarding licensure. If he is not eligible for CA licensure, he cannot work in that state.

    2) there are many fellowship programs which do not require BE in general surgery, and this has been a way, in the past, for foreign trained physicians to get into the US medical system. So he might look into training in critical care, burns, etc. (which are not very competitive and may be more open to his background)

    I would try the fellowship option. If he can't get a job with his current training and expertise in the US, doing a fellowship may make him more palatable to smaller hospitals who would like a fellowship trained surgeon but cannot attract a US trained one. If he does general surgery, there is a big demand, although California is a tough state to get a job in...tort reform, lots of competition, low malpractice rates, etc.

    The MPH, from Cal or anywhere, won't make a difference.

    Most large institutions will require that their faculty be at least BE. However, there are, as I alluded to above, exceptions made for foreign trained physicians of high quality. He should start looking at the job listings in the back of US journals and making some contacts.

    If he cannot get a job as an attending surgeon, he may find he can get credentialed as a surgical assist. These guys, especially if they do lots of Orthopedics, can make as much $200K USD per year.
  3. kokoro

    kokoro

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    winged scapula

    thank you so much for your reply. for surgical assitant, do you mean a physician's assitant? this would require further training correct?

    thanks
  4. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    A surgical assistant is someone who is trained to assist the surgeon in the operating room. It is NOT the same thing as being a physician's assistant (PA), although many PAs do assist in surgeries as well as office duties.

    I referred to a surgical assistant because I know several retired surgeons or former family practitioners who do this for a living and do quite well at it. It generally does not require any additional training for someone who is already a surgeon, but each hospital would have to credential you, so the requirements would depend on what they want.

    As you can see, there is no hard and fast rules about how to go about this.
  5. baysouth

    baysouth Junior Member

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    Thank you so much for your response to this question. It is very important to me as my mother, who is a foreign trained Ob-Gyn with ~20 yrs of experience, is going to move to the US (Houston, Texas). Could you please elaborate on the fellowship option a bit more if at all possible? Exactly, how does it work, would you completely skip residency, would you be able to practice medicine freely as a licensed physician, how long does it take, how difficult is it to attain? I know I asked many questions, but it seems that this may be a very good solution for her. Thanks again.
  6. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    The "fellowship option" varies wildly between specialties and programs.

    Ob-Gyn specialties include Gyn Oncology, Maternal Fetal Medicine, Reproductive Endocrinology and Urogynecology. According to the American College of Ob-Gyn, physicians trained outside of the US are not eligible to become Board Certified. This will severely limit your mother's ability to gain employment as many insurance companies and hospitals require this.

    You can read further about the fellowships here: http://www.nrmp.org/fellow/match_name/obgyn/about.html

    She can try and contact some of the participating fellowships to see if they accept physicians who have trained outside of the US; some may not as they are not willing to train someone who cannot become board certified.
  7. baysouth

    baysouth Junior Member

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    Thank you for your response. Perhaps I should clarify some of my background knowledge first. Can an experienced foreign trained MD receive a license to practice in the US without completing a residency program or obtaining Board Certification? If yes, how? And if no what is the best next option available? By best I mean the least amount of time and effort devoted along with the most appropriate compensation and job opportunity? Can she, for example, practice with restrictions at a certain hospital, etc.?

    On a slightly different note, I had the notion that to complete a fellowship in the US you must have initially completed residency training in the US. It seems that's not accurate and that you can in fact skip directly to fellowship training, correct? If so, could she complete a fellowship for another specialty since the ObGyn route seems to be limited based on what you stated regarding Board Certification?

    Many thanks in advance for your answers to both sets of questions above.
  8. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    In general, foreign trained physicians are not allowed to practice in the US without completing residency. Rarely those with "exceptional" abilities can petition the appropriate board for certification without completing a US residency, but that will only happen for internationally famous physicians.

    Fellowship training without a US residency is mostly useless, as WS points out above this does not lead to board certification. The only value is to gain US experience, so that you can then apply for a residency.

    Hospitals do not usually have "limited priveleges" except for residents.

    So:

    1. You should check the rules for licensing in the state where she will be living. Some states allow licensing after 1 year of training, and then a 1 year fellowship would allow her to get a license (but no board certification) and she MIGHT be able to get a job with the license alone. However, many states require 3 years of training for IMG's to be licensed.

    2. Her best option might be in a supporting role -- i.e. as a helper in another physician's office. Unfortunately, this usually requires some other credentail (i.e. a physician assistant or nurse) which again would require going back to school. But, you never know, perhaps a physician would simply hire her to be a "helper" without a specific title.
  9. shan564

    shan564 Below the fray

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    I have a somewhat similar question. I'll use radiology as my example (because I happen to be vaguely familiar with the training process), but it could apply to other specialties as well.

    There are a lot of radiology training programs in the US that will only accept students who have already completed PGY1. Will they consider me if I completed an internship (or maybe PGY2) in Australia (I'm a US citizen)? Many of these residency programs still require 5 years beyond PGY1, which is enough to satisfy the American Board of Radiology's requirements for board certification... but of course, that doesn't matter if the program won't consider me for admission.

    Also... is there any way to complete any part of my training in Australia and still be able to practice in the US? The postgraduate training seems to be much more user-friendly here, so I'd like to do as much of it here as possible. I'd also like to be able to split my time between both countries (maybe 6 months out of every year in each place?), but I wouldn't want to do it if I'd have to repeat my whole residency.
  10. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    It HIGHLY depends on what specialty you choose. Some are more friendly to overseas trained physicians and some are not.

    For example, recently the American Board of Surgery accepted 2 years of residency training to be applied toward US training. However, you must already be in a Surgery residency in the US for it to be accepted and you cannot be Board Certified without training in the US.

    Radiology, on the other hand, does appear to accept foreign residency training to be Board Certified: http://theabr.org/ic/ic_dr/ic_dr_imedgrad.html

    There is NO one answer...your best plan, until you know what specialty you want to do and what their requirements are, is to do at least an intern year in Oz, with the expectation that you would have to repeat it coming to the US.

    Bear in mind that for some specialties if you want to work in both countries, you may have to train in both countries. So choose your specialty wisely.
  11. j77

    j77

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    I am finding myself in the same crossroad. I have finished medical school in Greece, I am currently in the US preparing to take usmle/ecfmg exams. But I find myself having to go back to greece because my position for pediatrics specialty/residency opened up (a year early than expected :eek::mad:) and I think it would be unwise to let that opportunity pass. I know most people will think I am stupid to leave the US. I'm married to a US citizen and I don't want to be living off of her until I pass the exams - also I am scared on what will happen if I dont pass the exams any time soon. I haven' t been the risk taking person all my life and I don't seem to be willing to take that risk right now at 32.

    Anyhow, to get to the point:

    In 4 years I will have finished pediatric residency in Greece (reminder: I have also finished med school in Greece) and I want to return and practice in the US - more specific Illinois.

    I am trying to figure out how it will be possible to practice pediatrics in the US...
    - Do I still have to get ECFMG/USMLE and then a board exam?
    - Just the board exam?
    - Usmle then residency all over again and then board exam?
    - None of the above?
    - - Usmle exams is it gonna be 1,2CK,2CS. or will I have to take 3 as well?


    In looking for info,I got so confused so I asked for guidance for my 'future colleagues'.
    I have contacted Am. Academy of Pediatrics.
    who told me to contact Am. Board of Pediatrics,
    who told me to contact Illinois Medical Board (www.idfpr.com. havent contacted them yet - still looking for an email contact option on their website.

    As you understand, I dont think I have the stamina to finish in one lifetime two medical schools and two residencies :shrug: but I will do it if it is otherwise unavoidable.

    Please let me know what you know/ think of this subject.
    If there is another state that it would be easier to get licensed and work as a pediatrician, i will seriously consider it as an option.

    Awaiting your input.

    Thank you all,
    John.
  12. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    To practice medicine in any state in the US, you must be eligible for a medical license.

    The requirements for an Illinois medical license are here: http://www.idfpr.com/dpr/apply/forms/md-ex.pdf

    You must pass the USMLE, be ECFMG certified AND have at least 6 years of undergraduate education. It is not clear to me whether or not you attended college before medical school, but note that Illinois requires 2 years undergrad and at least 4 years of medical school.

    Board certification is not a requirement, as of yet, to practice medicine at the state level.

    To take any Board examination, you have to have a valid, unrestricted medical license.

    If you plan to exclusively practice abroad (which it doesn't sound like you do), you must provide documentation of such and a foreign equivalent of a medical license.

    To take any Board examination, you have to be Board Eligible.

    The American Board of Pediatrics requires the following to take the exam:https://www.abp.org/abpwebsite/publicat/certboi.pdf

    1) ECFMG certification from a WHO listed school
    2) 3 years of Pediatric training in an ACGME program in the US or a program approved by the Royal Canadian College of Pediatrics

    OR

    3) Waiver of Accredited Training
    The ABP has established requirements for a physician who has had at least 3 years of general comprehensive pediatric training in programs not accredited by the RRC or RCPSC (ie, international training or training in accredited osteopathic programs in the United States) who wishes to apply for a waiver of training. The interested physician, department chair or program director must write to the ABP before training begins to receive approval for credit for this training.

    The individual must provide documentation of the successful
    completion of at least 3 years of general pediatric residency
    training that includes the actual beginning and ending dates of the
    training and that is signed by the residency program director.

    The individual must also provide a copy of his or her medical school
    diploma and ECFMG certificate. Suggested training for those
    who receive a waiver of training under this policy is available on
    the ABP Web site, www.abp.org. Upon review and confirmation
    by the ABP of this information, the individual may have 1 year of
    accredited training waived
    . A full year at the PL-3 level must be
    completed and, in addition, a year at the PL-1 or PL-2 level or a
    training combination at both of those levels. (The training must be
    completed in general pediatrics; subspecialty training may not be
    substituted.)

    The director of the residency program that the individual enters will
    decide at what level the individual may begin residency and whether
    the 1 year of waived training will be accepted by the program.
    Individuals should investigate the licensure requirements in the
    state in which they wish to seek permanent licensure to ensure
    they meet the requirements if they choose to shorten pediatric
    training completed in the United States.

    Thus, to be BC in Pediatrics, you can apply for a waiver to allow ONE year of your Greek residency training to be used, however, you must still train in the US, essentially doing almost two full residencies.


    Step 3 is required for a full and unrestricted medical license in all US states.

    I did not read through all of the requirements for medical licensure in Illinois. You may be able to be licensed, but without repeating at least 2 years of Pediatrics residency, in most cases, you will not be Board Eligible or Board Certified.

    Whether you think being BC is an issue is up to you. All of the hospitals I have privileges at are no longer accepting applications from physicians who are not Board Eligible. Some insurance companies are making the same squawks.

    So tough decision you have. Please read through the links I provided to see what the best option would be for you. Pediatrics is not a particularly difficult match in the US and if your plan is to work here full time, then you should do your residency here.
  13. j77

    j77

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    First of all I would like to Thank you Winged Scapula for giving me a compass to the badly charted territories of this quest I'm embarking upon. I know it took you time to find the information and to copy-paste the needed parts from the necessary websites and I appreciate all your effort. I believe this is the most clear,concise and well organized guide to the issue IMG (MD and specialist) wanting to practice in the US.

    Regarding this, medical school in Greece, it is 6 years. Finish high school, take exams, enter medical school and study medicine for 6 years.

    Other than that, may I wish everyone that they don't have to go through what I will have to just to be able to practice (2 med schools and two residencies within a lifetime)
    Last edited: 07.16.09
  14. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    I understood that. I did not know whether or not you were a Greek national who did all of his schooling there, or someone who went there for medical school alone.

    You've mentioned this twice.

    What do you mean by, "2 medical schools"? You do not have to go to medical school again to be licensed or do residency in the US.

    And as far as 2 residencies go, that depends on you. If you want to work in the US, then it appears you have to do a US pediatrics residency. If you want to work in Greece, I suppose you have to do a Greek residency. Have you investigated whether or not training in the US would allow you to work in Greece?

    IMHO you need to decide WHICH country you want to work in and do your residency there. There is NO need to do two residencies unless you honestly intend to work in both countries (and there is no reciprocity) and frankly, Pediatrics is not a practice which lends itself to traveling frequently between countries to practice.
  15. usmd

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    I'd just like to add my 2 cents. During my education and training in the US, I have run across many IMGs. What I have found is that they all had to repeat at least some part of their training. The best case scenario is for those who have foreign degrees to do their training in the US, whether that foreign degree is MBBS or MD. From what I've seen, it is much easier for US graduates and trainees to go back to their own country without doing extra training in their own country. This is what my IMG friends have informed me in the past. These friends came from the Middle East, South America, Australia, and Africa. And, in my experience, having travelled to various parts of the US, the most IMG-friendly residency programs are going to be located in the Midwest. It may sound boring to many Americans to be in those parts, but I spent a lot of years in those states and enjoyed them. They become very cosmopolitan because of the influx of IMGs.
  16. ajlin

    ajlin

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    Hi all, please answer to me if anyone know procedures with IMG anesthesiologists in USA.
    I am an an anesthesiologist from Europe and I would like to get lisence to work in USA.I am already in USA and live in Washington State.
    Please tell me all about my future effort to be an lisence anesthesiologist here:).Thank you!
  17. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    Physicians are not licensed by speciality in the US. To be licensed, you must take USMLE Steps 1-3. Washington State requires 2 years of graduate medical education to be eligible for the license: http://www.fsmb.org/usmle_eliinitial.html

    Furthermore, the State of Washington requires that your training be done in an ACGME approved residency program (see pages 119-120):http://www.doh.wa.gov/hsqa/professions/publications/documents/credreqs.pdf and that you be ECFMG certified.

    Thus, you must take the licensing exams, get ECFMG certification and enter a US residency program in Anesthesiology to be licensed and potentially practice.
  18. small doc

    small doc

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    Hello there,
    I'm a US citizen IMG considering a neonatal-perinatal fellowship/ subspeciality training in the US after training in the general pediatrics in my home country. Is that possible? If so, how will I go about it?
    Thanks.
  19. santime

    santime

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    Hi SDN
    I m MD in psychiatry from india. Im looking for carrer in same field but want to bypass usmle bc i don't want to go for residency again.I want to fellowship or PhD or any otherway to work in us.please guide to me on courses to seek a job in usa.
    san
  20. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    You cannot bypass the USMLE if you want to work in the US as a physician. They are part of the entire medical licensing sequence and must be taken to get a license to work. All US fellowships will also require that you are eligible for a medical license (ie, have taken the USMLE).
  21. daringdermat

    daringdermat

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    hello there,
    I have finished my MD dermatology from India.
    I may have to move to Texas....to do a research post there (coz i know getting a derm residency is next to impossible!!)...:scared:
    (1) is it necessary to write the usmle?( for only a research post)
    (2) which institute is best in texas?
    (3) do spouses of permanent residents of the US get more preference
    Please reply soonest...
    PS: i am really not keen on doing family med/internal med...which are the easier residencies to get matched for!
  22. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    Probably not but best to ask your potential employer.

    Depends on who you ask. There are several well regarded hospitals (not "institutes") in Texas.

    Preference for residency? Probably not but it might make a very small difference in your application.

    You have to evaluate your goals and the competitiveness of your application. If your goal is to work in the US as a physician, then you will consider whatever you can get in to.
  23. ikbinwittelily

    ikbinwittelily

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    hi, i ve te same question to. i am an asian foreign trained surgeon , graduated in 2007, worked as a consultant for 3 years and now being an surgical incology fellow in india for 2 years.i would like to have further study in head and neck surgery in usa and for that i dont mind to clear usmle to repeat my residency. The program director at mskcc suggested me that better i do repeat it that just taking fellow without residency and i think that makes sense. I ve heard that american board of surg have waiver so i dont need to repeat the entire length of my 5-years general srgery residency. my question is how i process this thing, because i cant find the web about it, shall i process it before submitting doc to program director, shall i process it before interview or shall i process it after i get the residency program.thank u so much for the information
  24. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    The American Board of Surgery may give up to 2 years of credit to those trained outside of the US in approved training programs. This requires, however, that you are ALREADY in a US residency program before applying for such credit. Therefore, you cannot "process" before you get into a residency program and for that matter, the process is done by your program director, not by the resident themselves.
  25. PacificBlue2012

    PacificBlue2012

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    Honestly do you really want to practice in the US over Australia? I graduated USyd, considering all things the overall lifestyle in Australia is better, you will work double the hours, especially in residency, although residency is shorter in the US.

    Also Radiology is brutally hard for IMGs, you will have to do amazing on the USMLE to get a Rads residency.

    Also you might be working on the assumption on what the US healthcare system is like in the past, its getting worse over there, a lot worse.
  26. altap

    altap

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    The fact of the matter is, it would be very hard for an IMG attending to practice her/his craft in the US again. He/She should pass the USMLE Steps 1 and 2 CK and CS in order for him/her to be eligible to participate in the Match. The sad thing is that even after hurdling all of these exams (plus your experience as an attending from your own country) you cannot be certain to match to a residency program. I just wish that the US would be able to support and to encourage these highly skilled, highly experienced and highly educated individuals to take the USMLE and to practice medicine in the US again. With the shortage of physicians in this country it would be a win-win situation for both the IMG attending and the American public. How to go about this? The state (where there is a need for certain attendings) and a residency program in that state or if there is no residency program in that state any residency program in the country, should collaborate (the money for the training should come from the state not from the federal gov't.) and "sponsor" an IMG attending. Before acceptance into such a program, the IMG attending should sign a contract stipulating that he/she should practice in that state (in an underserved area) for at least 5 years. Of course, this should only be done after this has been offered to any US med. graduate. IMHO, the shortage of physicians should not only be fixed on a national scope but also from state to state. Would the federal gov't accede to this idea? Would organized medicine here in the US accede to this idea? I guess, the people of that underserved area and the IMG attending would.
    Last edited: 10.26.10
  27. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    It is not clear that there is a physician shortage in this country. Some research suggests that it's a physician maldistribution (both geographically and by specialty).

    Plus, encouraging physicians from other countries to come here may hurt healthcare in those countries.

    We already have a system whereby people work for some time in underserved areas in order to get training -- J visa waivers.

    States are going bankrupt left and right. I doubt any will want to get into the GME funding business. In fact, once it becomes clear that the expanded availability of healthcare without any new limits is unaffordable, I expect the feds will get out of the business of funding GME (which will allow them some additional breathing room, until costs continue to consume all funding).
  28. Sweegs

    Sweegs

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    In some ways, the US and Australia are similar in terms of their medical workforce problems (distribution etc).

    I'm working on finishing my psychiatry training in Australia currently, with a strong interest in migrating to the US and practice there after finishing my training.

    I do realise USMLE 1 and 2 are vital, for ECFMG certification. It makes sense to speak directly to the people in charge of the specific place(s) I want to live and work in.

    What else do I need to do?
  29. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    Training outside the US/Canada is not accepted in the US. You will need to take and pass the USMLE, and then complete an entire US training program. There are many posts/threads on how international grads can try to get into US training spots.
  30. tlew12778

    tlew12778 Senior Member

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    This is such a useful thread! Thank you to everyone who responded so thoroughly :) I have a question regarding this *possibility* of a waiver credit -- it would only be applicable to the residency training correct? Would a completed US fellowship not count at all (assuming IMG trained specialist completes a direct fellowship in the same speciality in the US)?

    My DH is trying to decide whether or not to apply directly to the match and redo his residency (he is a fully qualified vascular surgeon in Italy) or apply for a direct fellowship. But from what I have read online, he would not be BE after a fellowship and therefore would have little or no job options to work as a vascular surgeon in the US. Correct?

    If the ABS gives the credit waiver, would that shorten the actually residency length or is it merely credit used towards meeting qualification requirements in order to take the BC exams?
  31. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    It is only credit toward a general surgery residency. Fellowship training is not taken into account for the waiver.

    Perhaps. You are not currently required to be BE/BC to work in the US. There are some hospitals which require it for admitting and operating privileges. So the question is whether or not he can get credentialed to do vascular surgery in the US without being BE/BC. I do not know the answer to that question. It would certainly limit his options.

    It shortens the residency length if granted.
  32. drsaahill

    drsaahill

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  33. piyota

    piyota

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    Hi, thank you so much for all the questions and answers here. I have a specific case I need to ask for my dad, since it seems like none of the cases here can be applied.

    My dad is:
    1. An IMG from Vietnam almost 20+ years ago.
    2. He was a general surgeon.
    3. We moved here in 2003, so he has been 8+ years out of practice.
    4. During those 8 years, my dad studied tenaciously for the first 2 years, then my mom managed to stress him about money for every seconds, eloped with her lover and abandoned us (they're divorced), and finally left us with an autistic daughter (my sister is 7 now, and she needs special care). My dad had to care for her and eventually it consumed his time to study greatly). The divorce also greatly affected him so he could not focus on his tests anymore.
    5. He only aims for being a primary care doctor in the US; has no ambition to become a general surgeon.

    The questions:
    1. Should he still try to study hard for the USMLE? We know that his chance is very slim, especially he has complained about consistently scoring 60% on the USMLE. The language problem is insurmountable for a 50 yr-old.
    2. So even if he passed the USMLE without being accepted into any residency program, will he still have any job prospect as a doctor or it's a dead end?
    3. What other alternatives for him if this whole USMLE thing does not work out? What is another career track that closely resembles his previous job as a general surgeon? We are thinking about surgical assistant; does he need to go to school for that or he can waive it with his credentials?
    4. Should he apply for DO school? Must he take the MCAT if he wants to apply?

    Thank you so so much,

    Me
  34. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    I am not certain what "60%" means on the USMLE. If you're talking about a 2-digit score, those are not percents and anything below 75 is failing. If he cannot pass the USMLE, he cannot be a physician in the US. If language is an issue, completing a residency will be cery difficult as there is lots of reading and writing required -- most of it is electronic now, which may also be a problem for an older physician.

    No options. Without a residency, he will not be licensed in any state.

    Surgical assisting is becoming a more regulated field, with credentialing etc. I don't know enough about it to know if he would qualify. If he's been out of practice for >5-10 years, then I doubt it's going to be easy. Unfortunately, everything requires some sort of official certification now -- so you can't be a Physician's Assistant without doing a US training program. He could be a Medical Assistant -- that's basically someone who puts patients in rooms, takes their BP, etc. He would likely need to do an MA training program, but they are very short and easy. If he were to work in a small private office, that might not be necessary.

    Yes, he will likely need the MCAT for all DO schools. I doubt he would find that any easier than the USMLE. And, some medical schools do not allow those with foreign MD equivalents to matriculate.

    I believe that some DO schools allow foreign physicians to start in their third year directly, but only after passing / doing well on the USMLE.

    Honestly, I think this will be a big uphill battle for him. Better to find another path -- like surgical assist or MA.
  35. piyota

    piyota

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    Thank you so much for your answer, aProgDirector!
    Yes, I meant 60 as in his 2-digit score, not 60%; it was late at night, my bad!
    Can you elaborate a little bit more about the DO schools that accept IMG into their third year if they score high on USMLE, please? I googled here and there but found no valuable info.
    Thank you so much!
  36. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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  37. RoodBoi

    RoodBoi

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    Great work guys, on taking the time to put out so much useful info.
    I gotta question, please...
    I'm currently in a UK general practice training programme; it takes 3 years like the US family medicine prog. Is there any possibility that I may be able to get a waiver of some sort (when I'm fully qualified over here) and be able to practice medicine without the whole usmle business? The academy websites do not yield much info.
    Secondly, there seems to be a sort of void in which some general practitioners exist and are certified outside the mainstream they have their own academy and all. Wikipedia wasn't too clear and that academy's website is shut tight like a secret cult- u have to register and await a password before you can even see any info at all on their site.
    Can anyone shed any light on this?
    Thanks a mill.
  38. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    If you want to practice in the US, you must take the USMLE's and complete a US residency. There is no credit for any foreign training, except for Canada.

    There is no such thing as a "GP" in the US, exactly. There is no secret cult. Theoretically, a US med school grad can take the USMLE, complete 1 (or sometimes 2) years of GME training, get a license, and practice as a "GP", which is now loosely defined as a licensed doc who isn't board certified. Such physicians are finding it increasingly difficult to find any employment. IMG's can't do this at all, as in most states you must have 3 years of GME training before able to be licensed (hence might as well finish the whole training program)
  39. Callie04

    Callie04

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    Hi there!

    I need help with my situation, I was a 5th year medical student in mexico (2 months ago) and I just married my bf in the US, I was 1 year and a half to be an MD in mexico and now I don't know what is the best thing to do to become a doctor in the US.:confused:

    If I start studying here, am I going to go through all pre-med and med school years or can I somehow validate my studies to waive some years here??

    Would it be better if I just go back and finish my school in mexico and then I come back and take the USMLE tests? I am a resident now so I dont know if that would help in any way.

    In mexico we go straight from high school to medical school that is 6 years school and 1 year of social service, though u graduate in the end of the 6th year.
  40. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    You basically cannot apply to US medical schools. They will give you no credit for anything done in Mexico, you don't have an undergraduate degree, and simply matriculating to any foreign medical school invalidates you as an applicant to most US schools. Some DO schools, NYCOM in specific, does have a pathway for foreign docs to enroll, but I think you need to have graduated to do that -- and you still have to complete all 4 years of medical school.

    So, your best chances are to finish medical school in Mexico. Be aware that isn't a simple path either. You need to take Step 1 now, do well on it, then do some US clinical rotations (before you graduate from medical school), then take Step 2 (and some US schools might require Step 2 for rotations also), do well on both Step 1 and 2, then graduate, then apply for a residency in the US. You can skip any step in that pathway you'd like, but it will decrease your chances of getting a spot here in the US.
  41. dermadoctor

    dermadoctor

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    Hi!!
    I am a dermatologist from India, relocating for 2 years to the States. I want to continue working in the field of dermatology ......Can anyone please guide me as to what I can do without having to write USMLE?
    Is working as a research assisant the ONLY option?
  42. Scubymedic

    Scubymedic

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    Good Morning everyone, Im new here so please bear with me. Before I get into my questions, let me give a run down on where I come from.

    I am a twenty-five year-old Asian American Post-Bachelorette in Health Science and Physical Medicine and Rehabilitation (pre med) degree from Mercy College, NY. I have worked in the field of healthcare for several years prior to and since college. I have a been a Clinical Practice Manager (4 Years), Wound Care Specialist (2 Years), and even maintain a Certification as a Nationally Registered Emergency Medical Technician (since age 18, 7 years).

    Of all my years, my fondest moments were treating my patients and making a difference in their lives as an EMT and Wound Care Specialist. Three years ago, I decided to start making headway into my personal life goals, and change avenues into public healthcare by changing employers and moving to Phelps Memorial Hospital Center, a mid-level 235 bed medical center located 20 miles north of New York City.

    Since I was young, I have always wanted to be involved in something larger then myself, and make a difference in lives from a larger aspect then most understand. I know however, that goals like these cannot be achieved so by standing still. After working my way into Phelps, I was recently given the opportunity to move into upper administration as a Sr. Quality Analyst reporting to the CMO, CEO, and VP of Quality and Risk Management. As it stands, I am currently now responsible for much of the rules and regulations for the Clinical aspects of the hospital and its day to day operations, including physician analysis, peer reviews, core measures, and risk management. I am a Performance Improvement Council Chair, Stroke Coordinator for our Stroke Center, and Cancer Center Analyst. In addition, my work also includes reporting and associating with the New York State Department of Health, National Institutes of Health, and The Joint Commission.

    Nonetheless even after moving into administration, as you can probably tell from my background, I have longed to be a clinician who works hands on with his patients. My goal is that I be involved on both the administrative policy aspect of patient care, as well as true hands on, personable, and acute treatment of each and every single one of my patients. So I have now decided to go back and move on to medical school.


    Here is my dilemma. It has been 3 years since I graduated pre med. Being a Health Science Major I have taken: A&P1&2, Biology 1&2, Chem 1&2, Microbiology 1, Organic Chem 1, Physics 1&2, Statistics, and Psychology. Additionally, my institution had offered 500 level Anatomy with Cadaver and a separate 500 lvl Physiology with cadaver which I had taken and obtained a B average. My final overall GPA is a 3.1 on a 4.0 scale. However my science GPA is a 2.9 due to my first semester after changing majors into Pre Med.

    My biggest issue is my MCAT score. Not only is it 3 years old, but I scored terrible on it (less then 20). I do plan to retake it after I take a refresher course and a prep course, but I worry that my educational background is too low for acceptance into medical school locally. So heres the issue: My father graduated from the National Cheng Kung University in Taiwan with a PhD. Currently it is one of the most prestigious Universities in Taiwan, and since my father is an alumnus, they are offering me 100% free education minus room and board (which I would live with my family anyway). From what I am told, the Taiwan Education department Mirrors their medical program from US standards, and is even taught in English. I wanted to go there for med school, and come back for a residency. My question is what do you guys think about me going this route? And if it is feasible, which specialization should I pursue (I want to do Family Medicine, General Surgery, Emergency Medicine, or Neurology) that is easier to get into residency here in America.

    Or am I just blowing hot air, and should stay here and deal with it.

    Thanks for all your help.
  43. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    Here's the scoop:

    That school is not well known in the US. Honestly, it's the first I've heard of it. The fact that it teaches "in the style of the US" is nice, but really meaningless overall. So, it's a risk.

    If your GPA is 2.9 and your MCAT is <20, you may have a big problem with the USMLE exam. Remember that on the MCAT you're competing with everyone, on the USMLE you're competing with those who went to medical school (and are presumably "smarter" than those who didn't). If you don't do well on the USMLE, your chances of getting a spot will be bad. Fail it, and they are very bad. Also, it's unclear how well you'll be able to compete against the other students at that school -- if they are the "best and brightest" from Taiwan, you could really be in over your head.

    You'll also need to do some rotations in the US. The more the better.

    The good news is that if med school is free, and you have a free place to live, there really isn't much risk other than the time you'll spend doing this. You can certainly enroll, see how it goes. If you fail out, then no great financial loss. Even if you finish the whole program and can't get a residency, as long as you don't have large loans all you've lost is some time.
  44. pg1976

    pg1976

    Joined:
    07.12.12
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    Hi All,

    This is my first time posting on a forum so please bare with me :). I am a doctor in Greece married to a US citizen and interested in moving to the US (Boston). My wife has completed my paperwork and I now have permanent residency in the US and a SS # therefore I can work there. In Greece, I have completed my pathology residency and I'm scheduled to begin my Oncology fellowship next year. I have the following questions:
    • Will completing my Oncology fellowship in Greece help me and anyway to become an oncologist in the US? Is it worth it to stay in Greece for another 3 years to complete this?
    • I have an oncologist contact in the US and have been told that I can do research in the hospital he works. Will working a research position in the US help me become a practicing oncologist in the states? Will I still need to complete USMLEs even with the research position?
    • Are USMLEs absolutely required in order to practice medicine? I have heard of a few cases where the hospital will take on the responsibility of a foreign doctor practicing medicine in their hospital (does this really happen)?
    • How impossible are the USMLEs to pass? What scores do I need to work for a hospital? After the USMLEs are passed what happens next? Do I begin appling for jobs and hope the best?
    Thank you for any assistance you can provide.
  45. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    Your training in Greece will not count towards anything in the US. You must complete a full US residency to work here. Prior training might make you a more competitive applicant for residency in the US. But, no, in general a 3 year residency in Greece will not make you a more competitive US applicant at most programs.

    A research position/experience in the US might make you a more competitive US applicant. Still, it is much less helpful than US clinical experience (USCE). USCE is difficult to obtain -- you're no longer a student so can't rotate as a medical student, and won't be able to do clinical work without a license -- which requires being hired as a resident. So, lack of USCE --> no match for residency --> no license --> no USCE. Some programs might let you be an "observer", which means that you can only watch and not participate -- whether that is useful or not is debatable. It's probably better than nothing.

    You must take and pass the USMLE to get any training in the US, and ultimately to be licensed. There are no exceptions (except for the DO licensing exams, you cannot take those).

    How hard are the USMLE's to pass? Well, 95+% of US grads pass. Problem is, you don't just want to pass them. Your score will be a very important part of your application, you need the best score you can possibly attain. If you pass, you can't take them again.

    Once you pass the USMLE (Steps 1, 2CK, and 2CS) you then apply in the match for residency. There are many threads about this process for IMG's, you should search them
  46. Daniperu

    Daniperu

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    Hi! this is my first time using any sort of forums so i hope i can get some good answers!
    I am currently finishing my neuroscience undergraduate program. I was planing on attending medical school here in the USA but my grades were not great so i kinda gave up on it. I recently realized that maybe going to a south american country such as Peru, which is were i was born and still have family there, and attending medical school there wouldnt be a bad idea. I looked up medical schools recognized by the medical board of California and some peruvain schools are listed. My question is, If i want to come back and work in the US, what steps do I have to take? and what things would I have to retake again?
  47. lmesina

    lmesina easily amused

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    Hello all!

    I'm a long time member (well, 2 years, which I consider long enough hehe) of SDN. I also pursued an International Medical Education. My situation was that I was in the U.S. Air Force and upon request to separate to attend med school, they approved with the ultimatum that I get into one within 6 months.. this was not enough time for the MCAT/AMCAS process.

    I was in perfect position however; to take the NMAT (Philippine Med School equiv. to MCAT) and apply to the Philippines, my parents' home country. I am a Filipino American.

    What I want to say about going abroad for med is this:

    -For your own sake, don't treat it as a second-hand "I couldn't get into a US school" kind of deal. You're only hurting yourself and your chances of experiencing an enriching physician training education. Try to integrate with the culture and country you're located in.

    -It may be easier since I'm Filipino and I love my countrymen, but I really do my best to contribute to the Public Health situation here in the Philippines, keeping up to date with the Healthcare situation, and their goal of attaining UHC (Universal Healthcare).

    -I believe it is much better to contribute to the country that is providing you with the medical education that for one reason or another, you are not getting from your home country.

    -I'd imagine that it also is infinitely better, to be integrated and involved with the medical situation in the country you're studying in (especially if a third world country with inadequate healthcare).. instead of sitting IDLY by as a med student, who is just there because he/she couldn't get into a school of his/her home country, and just wants to one day ace the MLE's. Imagine what this could do for your personal experience as a physician in training, let alone interviews for residency in your home country.

    We should be genuine, truly be DOCTORs for others, and not just ourselves
  48. smruthi

    smruthi

    Joined:
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    MD/PhD Student
    Hello there
    Im a doctor from India. I have specialised in OB/GYN in India and was practising for 2yrs.
    currently im in US. Im on H4 visa and cannot work here. i intend to stay here for max 5yrs.

    my question
    Is there any add on course/ fellowship/Phd / any other useful programs related to OB/GYN for a foreign doctor?
    The purpose is to learn something over the next 5yrs which may be useful when i get back to India.
    I have no intention of working in US. pls let me know
    Thanks a lot
  49. loveurth

    loveurth

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    Hi guys,

    I found this website that will answer most of international questions and if they are able to they can help you set up all your paperwork to get licensed....check them out:

    www.gotconsult.com
  50. Luisp

    Luisp

    Joined:
    10.29.12
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    Resident [Any Field]
    hi, i´m planning to move to tha states soon, im in my 2nd residence year almost begining third in surgery... i know i have to take the ECFMG/USMLE exam to work in the states... but i dont want to repeat the 4 residence years again...

    is there any way possible that i dont have to do the residence years again??
    im planning to make my speciality in plastic or maxillofacial surgery ...

    please, let me know everything i need to do. thank you

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