Looking for some advice for IMG

[KeepComfortable]

Dear guys and gals,

Hello! I'm in somewhat dire need of advice about FM residency applications as an IMG. I never really planned on coming to the States, but unfortunately I fell in love with an American girl, so... here I am.

I graduated from a decent school in the UK in 2012 (usually top 10 world ranking, not sure if that means anything for application in the US?) with a MBBS and BSc. I've worked 2 years full time (as a physician) in the UK in a variety of fields including 4 months in General practice which I really enjoyed. I spent another 2 years mostly doing part-time locum jobs in general medicine and have good contacts with my attendings from that period.

I have taken my Step 1 USMLE and did pretty poorly, 211, mostly due to my inability to really sit down and read anything, plus the fact that its basically all irrelevant nonsense (no, i'm not bitter at all!) Currently prepping for Step 2 CK which I think will be easier given my clinical experience and getting 85%+ in practice exams without having really opened my book/ started revising yet.

I /think/ my CV looks okay right now despite the bad score, with a 3 publications (I have 6 with my name on but 3 were pretty low quality so I'm keeping off my CV), a presentation and a few other things. I would appreciate someone taking a look at it if that's not too much trouble? Will post it if anyone wouldn't mind!

So the problems I'm facing right now are that I've literally /just/ come to the US in the past week and I personally don't want to apply for residency right now - I was hoping to take my time with the CS and CK exams (although realistically I could do them by Christmas), as well as gain some clinical experience in the US and possibly do a medical-related job for a year (are those in reasonable supply?) I'm also not sure if I should be aiming just for observerships or if its possible to get anything else as a postgrad? I did a 6 week observership at Mass General (and Mass. Alzheimer's Research group) in end of 2011 if that means anything at all.

My current plan is to try and find somewhere in NY that might let me get some clinical experience - would it be better to try and find a hospital or a medical practice, given my intent to apply for FM? Any advice on how to go about this besides spam emailing everything I find on google? Also, any personal opinions on applying for residency now or waiting a year and just making sure all my junk is sorted? How badly would it affect may application to have a delay?

I know I've asked a ton and I appreciate your time for sifting through my clutter, any feedback at all would be greatly appreciated!

Many thanks

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[cabinbuilder]

I think you need to see if you can get a meeting with a residency director and have them help you look at all the steps you need to work as a physician in the US. I don't think most on this website would even know what the hurdles are unless they have forged that trail before. Not sure what type of medical job you would qualify for currently in the US. May want to talk to a hospital physician recruiter to see what their take is on your situation to figure out what you need to be doing and what is available job wise in your current situation.

 

[Natividad Resident]

Some questions for you:
1. Other than observing at MGH in 2011, do you have any exposure to the health "system" in the US?
2. Do you generally know what "primary care" means in the US?
3. Do you have any exposure to primary care in the US as a patient, which would probably show you how different the UK GP model is?
4. Why do you want to work in US primary care?
5. Have you considered IM instead? If not, why not?

Your long post lacks any indication that you actually want to practice primary care in the US. I'm concerned that "I met a girl" is going to fail you as a motivator when you find out what US primary care means. You may not love the NHS, but you'll be disgusted by the US alternative "model."

Meanwhile:
1. In NY you are competing with enormous quantities of FMGs who also want to practice medicine in the US. Other US states are more approachable.
2. To wit, there are IMG-friendly jobs in Missouri et al that you won't find on the east coast. Google "Missouri IMG".
3. You won't get "doctor pay" in the US, despite your UK education, prior to being licensed to practice in the US. The UK is no "nicer" about this.
4. Getting a visa to work is a major problem, if that's not already apparent. Employers will do crazy things to get a visa for a licensed physician. Employers have no motivation to go crazy for you, not for several years. You have to find an employer who wants your unique skills more than those of the local citizen/greencard labor force, or is so in need of labor that they'll do paperwork to get yours. Missouri is desperate to recruit future physicians. NY is not.
5. I disagree with the otherwise brilliant CB on how to approach getting a US residency. You are one of about 10,000 FMGs who try to break into the US residency match every year, 50% of whom are successful. (Page 15 here.) I would consider it a miracle if a residency director or recruiter wants to spend time helping you figure it out.
6. An initial step, to at least move things along, would be to relentlessly pursue volunteering in whatever hospitals are near you. You may find that your immigration status is a problem even as a volunteer. But just getting yourself into a clinical environment on any terms necessary will get you next to the people who can actually help you figure this out - other FMGs.

I don't see a problem in waiting to get in the match, not in terms of harm to your candidacy. What I don't see is a way for you to make a living in NY, meanwhile.

Best of luck to you.

 

[cabinbuilder]

I wasn't trying to get him into a US residency, I was just brainstorming a few ideas as to where maybe to start the process since this is out of my expertise. Hospital recruiters spend most of their days on the phone. I would suspect one would find 20 minutes to give some insights and ideas since hospital systems hire foreign grads all the time. They know what it takes to be able to work in the US. That's all. Thanks for the compliment though.

 

[Natividad Resident]

I wasn't trying to get him into a US residency, I was just brainstorming a few ideas as to where to start the process. Hospital recruiters spend most of their days on the phone. I would suspect one would find 20 minutes to give some insights and ideas since hospital systems hire foreign grads all the time. They know what it takes to be able to work in the US. That's all. Thanks for the compliment though.

Yeah I was thinking just now that he could play the British accent for some attention...

 

[KeepComfortable]

Thanks for the replies!

Unfortunately you've kind of hit the nail on the head - I'm not in love with the American healthcare system and I do find it repugnant in quite a few ways. That said, I actually do love general practice and enjoy developing relationships and interacting with my patients. I don't have any other experience with the American system, nor have I been a patient here. Kind of why I asked about the observership/ clinical exposure options to be honest.
I'm keeping my mind open to all ideas and avenues right now, including moving out of medicine - but while I'm doing that, I'm going to pursue this line of enquiry.

The visa isn't an issue for me, that side of things is basically already handled. I also agree that I would be shocked if anyone gave me the time of day to help me through my queries - hence why I've come to you good people
I'm quite set on NY or at least some place close by because my fiance already has a job in finance here. Money isn't too much of an issue - I made a decent amount doing locum work and she pulls in enough for the both of us right now. I have no illusions as to the kind of pay I'd receive in non-clinical work, though to be honest, starting as a doctor in the UK on 32k pre-tax annually is what I'm used to anyway.

So you would suggest volunteering as opposed to something more formal like an observership? I have looked into clerkships but I'm not sure I actually fulfill the necessary criteria right now.

And not to sound like an ass about it, but I do have a glorious accent. Phone interviews in the US (at least in the past) have been ridiculously easy haha

 

[Natividad Resident]

So you would suggest volunteering as opposed to something more formal like an observership?

Yes you need formal clinical experiences, but hospital volunteering should be a very fast way to get access to people who played the game and won. You're pushing a stretcher or holding up an obese leg for casting by a resident with an accent thicker than yours and you say "hey I'm a British doc hoping to match, can you fill me in on how to get X?" You tell me if you think there's a faster way to get into those conversations...unless you already have contacts? Generally you have to go through an application process & an orientation, and generally there's an expectation that you'll stay for some months, and these shouldn't deter you. If you're able to get a volunteer gig in an academic hospital, you'll be where all the useful stuff is.

You should of course also be using any connections you have from your med school to get inside.