Is it safe going to Caribbean if you want to practice only family medicine?

[DermViser]

I told you I wouldn't expose anyone. The other one is in his 3rd year I don't know how you call that prelim. But the point was that yes you can match from a foreign medical school and I know many more FMGs that matched last year even in neurology and at other great institutions. But I would not be anymore specific because I hate exposing people.

You said, "But I'm absolutely sure I know one FMG in one program there that matched last year." So that person would now be a PGY-2 Categorical.

---

Members don't see this ad.

 

[DermViser]

Well when I originally said I knew people who matched at Penn as FMGs I don't remember using the word categorical or non categorical, you brought it up.

Yeah, you said he/she was a PGY-3.

 

[DermViser]

Well when I originally said I knew people who matched at Penn as FMGs I don't remember using the word categorical or non categorical, you brought it up. And again, the list you showed is for the current program.

Yes, a prelim there is essentially a dead-end.

 

[Optimist100]

Yes, a prelim there is essentially a dead-end.

That s what you think, you are no prophet to predict the future, and even if you were I would still question the accuracy of your prophecy.

 

[DermViser]

That s what you think, you are no prophet to predict the future, and even if you were I would still question the accuracy of your prophecy.

Okay now you're just trolling.

 

[Optimist100]

Okay now you're just trolling.

That s still what you think. I said I knew people that matched at Penn as FMGs, I never said categorical or non categorical, you brought that up. And you are showing the recent surgery program, when I mentioned the surgery program I never specified the year. I said I knew people who matched last year, that could be any program.

 

[DermViser]

That s still what you think. I said I knew people that matched at Penn as FMGs, I never said categorical or non categorical, you brought that up. And you are showing the recent surgery program, when I mentioned the surgery program I never specified the year. I said I knew people who matched last year, that could be any program.

You said this: "Don't be discouraged by all these posts OP, it's all about the boards, I know people who graduated from African(Nigerian and many others) medical schools and matched into psychiatry and even surgery at Penn . So if you deem yourself capable it is really just a matter of doing well on the boards. And guess what? they are better off than any of us here. They have no loans to repay, African medical schools are almost free, everyone should envy them and seriously consider going to Africa for medical school ."

You were incorrect as prelims will not be board certified in Surgery when they finish.

If they matched last year at Penn - they would be on that list. You're now backtracking.

 

[Optimist100]

You said this: "Don't be discouraged by all these posts OP, it's all about the boards, I know people who graduated from African(Nigerian and many others) medical schools and matched into psychiatry and even surgery at Penn . So if you deem yourself capable it is really just a matter of doing well on the boards. And guess what? they are better off than any of us here. They have no loans to repay, African medical schools are almost free, everyone should envy them and seriously consider going to Africa for medical school ."

You were incorrect as prelims will not be board certified in Surgery when they finish.

If they matched last year at Penn - they would be on that list. You're now backtracking.

The bold statement didn't indicate the year, your list is the list of staff in the current surgery program. The one I know who matched in surgery I have no idea what year he matched. The one I know who matched last year I don't know what program he is in. I hope it's clear now.

 

[DermViser]

The bold statement didn't indicate the year, your list is the list of staff in the current surgery program. The one I know who matched in surgery I have no idea what year he matched. The one I know who matched last year I don't know what program he is in. I hope it's clear now.

 

[RTC19]

I'm just curious if should it be fine to apply to Caribbean medical schools like ross university if looking to do only pediatric/family med/ internal or psychiatry ??
Thank you

In a word, no.

 

[NickNaylor]

I told you I wouldn't expose anyone. The other one is in his 3rd year I don't know how you call that prelim. But the point was that yes you can match from a foreign medical school and I know many more FMGs that matched last year even in neurology and at other great institutions. But I would not be anymore specific because I hate exposing people.

Yes you "can." Unfortunately your argument fails as your n=2 of these "brave men" does not overshadow prevailing trends or statistics.

 

[IlDestriero]

Don't mock this brave man.
He will have the last laugh when we are all working under him when he is Chief of Staff at MGH!

(Maiduguri General Hospital, Borno State Nigeria)

 

[DarknightX]

I know at least four people that went to Ross and did just fine. Everyone keeps blowing the Stigma of IMG out of proportion. If you were never meant to get into medical school you'll still fail in the Caribbean. If you screwed up because of laziness, health, financial etc reasons it's your last chance. If you pass your boards you'll get a residency slot. A lot of ifs

You are so wrong it's not even funny. You have to be a troll. This topic has already been discussed in detail -

http://forums.studentdoctor.net/threads/new-york-times-article-on-caribbean-medical-schools.1089631/

Why don't you read through it and actually try to learn something before you come on here posting your nonsense.

Here's some highlights:

1. Every residency program would MUCH rather have an MD or DO than an IMG. It's just the way it is, and with the increase of medical schools and residency spots NOT increasing, it's only going to get more competitive.

Basically, MD's and DO's have first dibs. IMG's get all the leftovers. You are an IMG if you graduate from a Caribbean school.

2. Competitive specialities are already out of the question if you attend a Caribbean school, that's not even debatable. You're already shut out of Plastics, Derm, Ortho, Optho, and anything else that's relatively competitive. You're gonna be looking at family practice residency in South Dakota, and you'll be damn lucky to get that spot.

The match rate is less than 30% for Caribbean schools and many of those who do match end up in dead end prelim spots. Matching from a Caribbean school is only going to get more difficult as enrollment for allopathic and especially osteopathic schools increases while residency spots stay the same. This has already been pointed out by multiple posters so perhaps you should go back and read through this thread again.

Claiming that if you pass your boards you'll get a residency spot is absolutely false, you can't even say this for US students. Many Caribbean students pass their boards and end up with nothing.

So as it stands now, you have over a 70% chance of spending anywhere from $50,000 to $250,000 and receiving absolutely nothing from it. The odds will only be worse in the future.

3. Some of you premeds live in a fantasy world.
"Like, I scored a 23 on the MCAT and my GPA is 2.7, but I'm still gonna be a great doctor!!! Like, I deserve to go medical school!!!!"

"It doesn't matter that I suck at standardized tests and I have bad study habits; I just know that once I get into medical school everything will work itself out and I'll get a great score on Step 1!!! Like, it's my last chance!!"

"WHEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!"

 

[TheBatman]

You are so wrong it's not even funny. You have to be a troll. This topic has already been discussed in detail -

http://forums.studentdoctor.net/threads/new-york-times-article-on-caribbean-medical-schools.1089631/

Why don't you read through it and actually try to learn something before you come on here posting your nonsense.

Here's some highlights:

1. Every residency program would MUCH rather have an MD or DO than an IMG. It's just the way it is, and with the increase of medical schools and residency spots NOT increasing, it's only going to get more competitive.

Basically, MD's and DO's have first dibs. IMG's get all the leftovers. You are an IMG if you graduate from a Caribbean school.

2. Competitive specialities are already out of the question if you attend a Caribbean school, that's not even debatable. You're already shut out of Plastics, Derm, Ortho, Optho, and anything else that's relatively competitive. You're gonna be looking at family practice residency in South Dakota, and you'll be damn lucky to get that spot.

The match rate is less than 30% for Caribbean schools and many of those who do match end up in dead end prelim spots. Matching from a Caribbean school is only going to get more difficult as enrollment for allopathic and especially osteopathic schools increases while residency spots stay the same. This has already been pointed out by multiple posters so perhaps you should go back and read through this thread again.

Claiming that if you pass your boards you'll get a residency spot is absolutely false, you can't even say this for US students. Many Caribbean students pass their boards and end up with nothing.

So as it stands now, you have over a 70% chance of spending anywhere from $50,000 to $250,000 and receiving absolutely nothing from it. The odds will only be worse in the future.

3. Some of you premeds live in a fantasy world.
"Like, I scored a 23 on the MCAT and my GPA is 2.7, but I'm still gonna be a great doctor!!! Like, I deserve to go medical school!!!!"

"It doesn't matter that I suck at standardized tests and I have bad study habits; I just know that once I get into medical school everything will work itself out and I'll get a great score on Step 1!!! Like, it's my last chance!!"

"WHEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!"

How about you read what I wrote very clearly first, it seems like a good idea.

 

[notbobtrustme]

It's never safe to go to the islands.

 

[ruedjgtc]

Well OP, now that this conversation has been flushed out, you have several choices:

• listen to medical students who won't lose residency positions to IMGs, residents and attendings (those who are gainfully matched), both parties who therefore have no vested bias in advising your against it because we're both not negatively impacted by the issue or your decision

or

• listen to a couple of premeds who have the vested interest of hoping their idea works and may be rationalizing their back up plan, that which defies statistics and all reality on the ground because they "know a guy" (1 or 2 of the minority that actually successfully matched)

Let's be clear, @DermViser and the others aren't saying international programs are universally pieces of crap, we're saying you're inviting yourself to crap chances of matching for several years, if at all. People do certainly match from IMG (US born), however they are the minority. Thus you should be aware that you have a high chance of finishing a lengthy and potentially costly medical education with nothing to show for it except being able to do informercials at 3 AM about penis pills with your MD moniker.

You might be the next House (without the attitude), but if you can't snatch interviews then all you'll do is potentially clean houses. If you want a white coat, try MD with DO applications, hell even NPs have a white coat. If you want to be a doctor then try for US MD & DO. Before trying IMG, search SDN allopathic for people who finished IMG and can't match.


Don't let optimism cloud your rational judgement.

 

[DoctorSynthesis]

You said this: "Don't be discouraged by all these posts OP, it's all about the boards, I know people who graduated from African(Nigerian and many others) medical schools and matched into psychiatry and even surgery at Penn . So if you deem yourself capable it is really just a matter of doing well on the boards. And guess what? they are better off than any of us here. They have no loans to repay, African medical schools are almost free, everyone should envy them and seriously consider going to Africa for medical school ."

You were incorrect as prelims will not be board certified in Surgery when they finish.

If they matched last year at Penn - they would be on that list. You're now backtracking.

You are so wrong it's not even funny. You have to be a troll. This topic has already been discussed in detail -

http://forums.studentdoctor.net/threads/new-york-times-article-on-caribbean-medical-schools.1089631/

Why don't you read through it and actually try to learn something before you come on here posting your nonsense.

Here's some highlights:

1. Every residency program would MUCH rather have an MD or DO than an IMG. It's just the way it is, and with the increase of medical schools and residency spots NOT increasing, it's only going to get more competitive.

Basically, MD's and DO's have first dibs. IMG's get all the leftovers. You are an IMG if you graduate from a Caribbean school.

2. Competitive specialities are already out of the question if you attend a Caribbean school, that's not even debatable. You're already shut out of Plastics, Derm, Ortho, Optho, and anything else that's relatively competitive. You're gonna be looking at family practice residency in South Dakota, and you'll be damn lucky to get that spot.

The match rate is less than 30% for Caribbean schools and many of those who do match end up in dead end prelim spots. Matching from a Caribbean school is only going to get more difficult as enrollment for allopathic and especially osteopathic schools increases while residency spots stay the same. This has already been pointed out by multiple posters so perhaps you should go back and read through this thread again.

Claiming that if you pass your boards you'll get a residency spot is absolutely false, you can't even say this for US students. Many Caribbean students pass their boards and end up with nothing.

So as it stands now, you have over a 70% chance of spending anywhere from $50,000 to $250,000 and receiving absolutely nothing from it. The odds will only be worse in the future.

3. Some of you premeds live in a fantasy world.
"Like, I scored a 23 on the MCAT and my GPA is 2.7, but I'm still gonna be a great doctor!!! Like, I deserve to go medical school!!!!"

"It doesn't matter that I suck at standardized tests and I have bad study habits; I just know that once I get into medical school everything will work itself out and I'll get a great score on Step 1!!! Like, it's my last chance!!"

"WHEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!"

Oh man now people are defending African med schools. I don't understand how people pay off these loans when they can't practice.

Thank you derm viser and darknight for atleast trying to talk some sense into this guy.

 

[CherryRedDracul]

 

[ovenmitts]

Since it's been mentioned a few times in this thread (and I've heard it before), can someone please clarify what it means to be a "preliminary" surgical resident?

 

[RedHuntingHats]

Simple answer again = no. I know several very highly qualified medical students through my research organizations. They did everything "right," but they were not able to match into a US residency. Not even family medicine (surprisingly) - which is why many of them ended up in research or MPH programs.

 

[Winged Scapula]

Since it's been mentioned a few times in this thread (and I've heard it before), can someone please clarify what it means to be a "preliminary" surgical resident?

There are 2 types of Preliminary Surgery residents:

1) Designated (DP)
2) Non-designated (NDP)

The former are residents who require or choose a preliminary year (or two) of surgical training prior to going on to their respective specialties: in my program we had DP for Ortho, Uro, ENT, NSGY and PRS, so intern positions were reserved for those who matched into those specialties and they would spend their first year as a Designated Preliminary surgical intern year in the GS department. Some going into Radiology or other specialties where an intern year was required might choose a surgical Prelim year.

NDP are typically filled by those for whom either the spot isn't "designated" for a certain specialty (we could use those for Rads, for example) or more commonly, for those who did not match into categorical surgical training (training leading to completion of residency and board eligibility).

The reason we are making a big deal about the difference is that there are usually hundreds of Prelim surgery positions available every year; they are not in demand. And yes, many FMGs may find these positions at prestigious institutions. However, they rarely translate into a categorical position at the same institution. Using Mayo Clinic as an example: they have many FMGs as prelim interns, in many specialties and even advertise the assistance they provide in helping the Prelims obtain categorical training. However, you'll note that almost never means *at Mayo*. The same goes for Penn, etc. So seeing an FMG with a prelim surgery residency, even at an Ivy League program, is not considered a coup. The gentleman above from Africa appears to be a "rock star" with an impressive CV and publications. Had he been an American grad, he surely would have matched into a Categorical surgery position. But he didn't (I am however, of the opinion that *he* will be able to swing his Prelim at Penn into a Categorical position somewhere). Its a big deal because the user who brought it up was ignoring the significant difference between a NDP and a DP or Categorical surgery residency. There are very few FMGs who have completed training at places like Penn but our optimistic friend was trying to obscure that point.

Prelim surgery positions are also widely held, and correctly so, as being the graveyard for the careers of FMGs/IMGs. Many toil in Prelim positions for years without any promise of a Categorical position. As a matter of fact, under pressure from the RRC, the American Board of Surgery no longer accepts more than 3 Prelim years toward Board Certification and programs are not allowed to continue someone on as a Prelim for that long; for years, programs would take on Prelims simply to serve as man power, to fill the call schedule but not offer these residents a chance to stay on. If the PGY-3 from UWI shows up as a PGY-4 at Penn next year, then I will be surprised.

 

[Law2Doc]

Agree with WSs explanation of prelim above, but would clarify that in addition to the advanced surgical paths, people going into radiology, rad onc, PM&R, anesthesia, derm, optho and the couple of EM places that require a prelim year all can use a surgical prelim as their intern year. (by "neuro" I assume she meant NS, because neurology generally has to do a medicine prelim). It's not high on most advanced residency people's lists because of the hours, but some people prefer certain locations, hate rounding, or simply enjoyed their surgery rotations in med school more than IM. The residencies like the designated prelims better because they don't need time off to interview and don't ask for help in finding their next step. Non designated IMGs are pure slave labor. They have few career options and so their best bet is often to be unbelievably good such that their current program extends them or talks them up to someone else with a spot. If you string a few prelim years together you can get licensed. If you are a rockstar everybody loves and in the right place at the right time (when someone leaves the categorical program off cycle), maybe you get the spot. But as mentioned you probably win just as often playing power ball/lottery. For most a non designated prelim surgery position just means you get worked hard for a year while you need to continue your residency search.

 

[DermViser]

There are 2 types of Preliminary Surgery residents:

1) Designated (DP)
2) Non-designated (NDP)

The former are residents who require or choose a preliminary year (or two) of surgical training prior to going on to their respective specialties: in my program we had DP for Ortho, Uro, ENT, Neuro and PRS, so intern positions were reserved for those who matched into those specialties and they would spend their first year as a Designated Preliminary surgical intern year in the GS department. Some going into Radiology or other specialties where an intern year was required might choose a surgical Prelim year.

NDP are typically filled by those for whom either the spot isn't "designated" for a certain specialty (we could use those for Rads, for example) or more commonly, for those who did not match into categorical surgical training (training leading to completion of residency and board eligibility).

The reason we are making a big deal about the difference is that there are usually hundreds of Prelim surgery positions available every year; they are not in demand. And yes, many FMGs may find these positions at prestigious institutions. However, they rarely translate into a categorical position at the same institution. Using Mayo Clinic as an example: they have many FMGs as prelim interns, in many specialties and even advertise the assistance they provide in helping the Prelims obtain categorical training. However, you'll note that almost never means *at Mayo*. The same goes for Penn, etc. So seeing an FMG with a prelim surgery residency, even at an Ivy League program, is not considered a coup. The gentleman above from Africa appears to be a "rock star" with an impressive CV and publications. Had he been an American grad, he surely would have matched into a Categorical surgery position. But he didn't (I am however, of the opinion that *he* will be able to swing his Prelim at Penn into a Categorical position somewhere). Its a big deal because the user who brought it up was ignoring the significant difference between a NDP and a DP or Categorical surgery residency. There are very few FMGs who have completed training at places like Penn but our optimistic friend was trying to obscure that point.

Prelim surgery positions are also widely held, and correctly so, as being the graveyard for the careers of FMGs/IMGs. Many toil in Prelim positions for years without any promise of a Categorical position. As a matter of fact, under pressure from the RRC, the American Board of Surgery no longer accepts more than 3 Prelim years toward Board Certification and programs are not allowed to continue someone on as a Prelim for that long; for years, programs would take on Prelims simply to serve as man power, to fill the call schedule but not offer these residents a chance to stay on. If the PGY-3 from UWI shows up as a PGY-4 at Penn next year, then I will be surprised.

So if you do 3 Prelim years, that means if you find a categorical spot, you restart as a PGY-1 categorical, right?

 

[Winged Scapula]

So if you do 3 Prelim years, that means if you find a categorical spot, you restart as a PGY-1 categorical, right?

No, there's no wholesale requirement to do that, at least not in surgery. It's up to the program; if you've met the requirements of the relevant specialty board for training, you can start with PGY4.

 

[Winged Scapula]

(by "neuro" I assume she meant NS, because neurology generally has to do a medicine year

I did; thank you for catching that.

 

[DermViser]

No, there's no wholesale requirement to do that, at least not in surgery. It's up to the program; if you've met the requirements of the relevant specialty board for training, you can start with PGY4.

But how? A prelim's responsibilites are so different than a PGY-2, 3, 4, 5, in terms of knowledge, number of surgeries, etc. Repeating a prelim three times would be repeating PGY-1 three times. How can you then jump to a responsibility of a PGY-4?

 

[Law2Doc]

But how? A prelim's responsibilites are so different than a PGY-2, 3, 4, 5, in terms of knowledge, number of surgeries, etc. Repeating a prelim three times would be repeating PGY-1 three times. How can you then jump to a responsibility of a PGY-4?

Fwiw the people I know who found spots after a prelim either had to redo pgy1 (most common)or were ecstatic to get to go right to pgy2. Never saw anyone jump from pgy1 to a 3rd year position.

 

[DermViser]

Fwiw the people I know who found spots after a prelim either had to redo pgy1 (most common)or were ecstatic to get to go right to pgy2. Never saw anyone jump from pgy1 to a 3rd year position.

I was referring to the the RRC rule that WS mentioned about getting to repeat prelim Surgery for a max of 3 times.

 

[Winged Scapula]

But how? A prelim's responsibilites are so different than a PGY-2, 3, 4, 5, in terms of knowledge, number of surgeries, etc. Repeating a prelim three times would be repeating PGY-1 three times. How can you then jump to a responsibility of a PGY-4?

Obviously most don't.

But it depends on the program. Our Prelims who wanted a surgical career did the exact same rotations as the Categoricals; their "responsibilities" were no different and I'm not sure why their knowledge would be any different (one of the best I ever saw routinely scored 99 percentile on our intraining exams and is now a Surgical Oncologist. Very bright, very talented and the nicest guy ever.) It was true that the Categoricals were often preferred by faculty and tended to be taught more and do more cases, but not many more. The ABS does not mandate a certain number of cases until the Chief year so most would be able to make up any case log deficiencies during their final 2 years.

So this will obviously be a function of the program; if you don't allow your Prelims in the OR then perhaps it will be a problem. But my residency program and my current program treat them the same.

Just to clarify: you cannot do 3 years as a Prelim any more; you must be made a categorical by PGY3 or, if they've done 3 Prelim years must repeat PGY3 to satisfy ABS requirements: http://www.absurgery.org/default.jsp?certgsqe_training

 

[DermViser]

Obviously most don't.

But it depends on the program. Our Prelims who wanted a surgical career did the exact same rotations as the Categoricals; their "responsibilities" were no different and I'm not sure why their knowledge would be any different (one of the best I ever saw routinely scored 99 percentile on our intraining exams and is now a Surgical Oncologist. Very bright, very talented and the nicest guy ever.) It was true that the Categoricals were often preferred by faculty and tended to be taught more and do more cases, but not many more. The ABS does not mandate a certain number of cases until the Chief year so most would be able to make up any case log deficiencies during their final 2 years.

So this will obviously be a function of the program; if you don't allow your Prelims in the OR then perhaps it will be a problem. But my residency program and my current program treat them the same.

Just to clarify: you cannot do 3 years as a Prelim any more; you must be made a categorical by PGY3 or, if they've done 3 Prelim years must repeat PGY3 to satisfy ABS requirements: http://www.absurgery.org/default.jsp?certgsqe_training

So you can only repeat prelim twice?

 

[Winged Scapula]

So you can only repeat prelim twice?

It's actually somewhat more complicated (and I wasn't clear above).

You cannot do 3 Prelim years and move into PGY4 any longer; your status must be changed to a categorical by PGY3. A program can change your status at any time as long as they document that you have met the ABS requirements for categorical residents.

However you can do 3 Prelim years as long as you repeat PGY3 as a categorical. The RRC discourages programs from keeping residents on for this long without making them a categorical; most don't but some have abused this over the years which was the reason for the rule.

When you add in the requirement that you train at no more than 3 programs, it becomes more complicated because if you are repeating years, it doesn't get counted toward number of programs (for some odd reason I still fail to understand).

So....

- no more than 3 programs
- if you repeat the same year at different programs (ie PGY1 at 2 programs), it only counts as 1 program
- if you do PGY1 at one program, PGY2 at a second, it counts as 2 programs
- 3 Prelim years at the same program are not against the "law" but you cannot become a PGY4 unless you are made a categorical during your PGY3 year
- you may do 3 Prelim years at 3 separate programs as long as you repeat PGY3 as a categorical