Non-US IMG with a repeat year but good scores?

[Imgdocco]

Hi guys,
I want to apply for next years match and need your help determining the significance of a single failed exam (pre-clinical 1 failed attempt, successful remediation, but delay of 6-8 months in total academic time). A short run through of the profile:
Non-US IMG (visa required)
YOG 2020
Step 1: 250+
Step 2: 255+
3 PUBMED indexed research publications (co-author)
2 months of electives, 3 months of observerships. (specialty specific)
I know this probably doesn't matter as much, but following the failure (again, 1 subject, failed by 1.5%, successfully remediated on second attempt. Subject was Pre-Clinical) there were no more failures in ANY subject, with an immediate rise of over 15% over-all raw percentage evidenced on transcripts. Its bothering me that this delay will come up on the MSPE, and I want to figure out, through your opinions, just how screwed I really am. Not that screwed? Dead in the water as a non-US IMG hoping for anesthesiology? Please help me out!

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[coffeebythelake]

Hi guys,
I want to apply for next years match and need your help determining the significance of a single failed exam (pre-clinical 1 failed attempt, successful remediation, but delay of 6-8 months in total academic time). A short run through of the profile:
Non-US IMG (visa required)
YOG 2020
Step 1: 250+
Step 2: 255+
3 PUBMED indexed research publications (co-author)
2 months of electives, 3 months of observerships. (specialty specific)
I know this probably doesn't matter as much, but following the failure (again, 1 subject, failed by 1.5%, successfully remediated on second attempt. Subject was Pre-Clinical) there were no more failures in ANY subject, with an immediate rise of over 15% over-all raw percentage evidenced on transcripts. Its bothering me that this delay will come up on the MSPE, and I want to figure out, through your opinions, just how screwed I really am. Not that screwed? Dead in the water as a non-US IMG hoping for anesthesiology? Please help me out!

what have you been doing in the off-year? Aside from mediation of 1 subject

 

[Imgdocco]

what have you been doing in the off-year? Aside from mediation of 1 subject

Hello, thank you for your response. This was way back in my first year of med school, I think all I really did after learning that i'll have to remediate was start a research project that eventually landed me my first publication and study med school stuff to get better for the exams going forward. I don't think I could have done much else at the time and my life circumstances were pretty...unique... and needed tending to as well at the time.

EDIT: I think I should add that as an IMG i'm at a school where pre-clinicals are divided into two sections over the span of 2 years, and then theres 3 years of clinicals + some more advanced pre-clinicals. Its in the first section of the pre-clinicals where I failed one module.

 

[coffeebythelake]

I speak based on my experiences as a foreign student who went to an American medical school. I think your stats and scores are competitive, but understand that it is much more difficult as a foreign graduate applying than American grads. Anesthesiology overall is not super competitive, I don't know why you have been unable to match. Did you do rotations in thr USA and have good LORs? Did you apply broadly enough? Are you geographically limited in your application? Are you going for the easier to obtain J1 visa (vs H1b)? Are there any other aspects of your application that might raise red flags?

 

[Imgdocco]

Oh, I'm sorry for not clarifying. I haven't as yet sat for a match because I was hoping to accumulate more USCE (I only have 2 months of it, and 1 US LOR) and hopefully give and pass step 3 as well to show that I'm not a liability that'll fail boards when the time comes because of that one pre-clinical failure on my record. When I do apply, I have a list of 127 or so programs (basically anyone who would offer a J1, H1, or either/both) that I will be applying to and I have no geographical preference, but do have H1 preference. I don't think there are any other components of my profile to raise a red flag because I made sure to change my study habits and got into the top 10% of my class consistently thereafter. I guess I'm more so just worried that as a non-US IMG, the journey is already hard enough as it is, especially for something like Anesthesiology, so I'm trying to strategize both my approach to the failure in my application and interview, and also plan out how much back-up I need to be applying to in-case that one failure has somehow sunk me. Sorry if this sounds overly neurotic.

 

[coffeebythelake]

Oh, I'm sorry for not clarifying. I haven't as yet sat for a match because I was hoping to accumulate more USCE (I only have 2 months of it, and 1 US LOR) and hopefully give and pass step 3 as well to show that I'm not a liability that'll fail boards when the time comes because of that one pre-clinical failure on my record. When I do apply, I have a list of 127 or so programs (basically anyone who would offer a J1, H1, or either/both) that I will be applying to and I have no geographical preference, but do have H1 preference. I don't think there are any other components of my profile to raise a red flag because I made sure to change my study habits and got into the top 10% of my class consistently thereafter. I guess I'm more so just worried that as a non-US IMG, the journey is already hard enough as it is, especially for something like Anesthesiology, so I'm trying to strategize both my approach to the failure in my application and interview, and also plan out how much back-up I need to be applying to in-case that one failure has somehow sunk me. Sorry if this sounds overly neurotic.

I think you have a good chance for success here by applying broadly. I would concentrate on middle of pack programs, have a few lower tier ones, and a few higher tier "reach" ones. Programs will almost certainly ask about reason for remediation and taking an extra year so be prepared for those questions on the interview. There will be scrutiny... Its not difficult to score highly on board exams when you have lots of extra time to study for them. Programs in less desirable places may also ask why you are applying there. If you are not white, I urge you to review the geographic area of the program and take that into consideration. Violent crime is pervasive in certain inner city areas. Also racism is deeply rooted in American culture and certain states might not be a good fit. J1 is definitely much easier to get, the H1b visa is expensive and not many programs sponsor them.

 

[Imgdocco]

Thank you for your response, I appreciate you addressing the issues I didn't even think of yet. I will probably be placing IMG heavy locations highly after a couple of reach programs, but I'm pretty willing to go anywhere. Do you think stating the H1 preference would be a bad idea even if I follow up with saying I'll be willing to take the J1 too if it came to that? My reasons for the remediation are pretty much too much workload and a death in the family just prior to the first examination, and I'm hoping the PD's would be able to see that I dont intend to use it as an excuse or a crutch by looking at my performance after the failure. I'll be applying about 2.25-2.40 years after graduation, depending on if they count till application or till joining the program. Would that be seen as a red flag as well? Even if I did volunteering+research+some clinical work at the time?

 

[coffeebythelake]

Thank you for your response, I appreciate you addressing the issues I didn't even think of yet. I will probably be placing IMG heavy locations highly after a couple of reach programs, but I'm pretty willing to go anywhere. Do you think stating the H1 preference would be a bad idea even if I follow up with saying I'll be willing to take the J1 too if it came to that? My reasons for the remediation are pretty much too much workload and a death in the family just prior to the first examination, and I'm hoping the PD's would be able to see that I dont intend to use it as an excuse or a crutch by looking at my performance after the failure. I'll be applying about 2.25-2.40 years after graduation, depending on if they count till application or till joining the program. Would that be seen as a red flag as well? Even if I did volunteering+research+some clinical work at the time?

Explain why you are out and what you did during that time. Just don't make it seem you wasted your time. Keep up with your medical school knowledge base.

Many middle tier IMG heavy programs only sponsor J1. Think about it from their perspective. If they have loads of IMGs applying to their program happy to take J1, what incentive do they have to pay thousands of dollars, extra resources and time to sponsor an H1b for you? Applying for an H1b especially when the program hasn't sponsored many before and not familiar with the process, can be fraught with hiccups and delays. In my opinion, you will have a better chance getting H1b with top tier programs that want the best applicants, have done it plenty of times before, and are willing to pay for it.

Do more research and figure out the best strategy for you. Not bad to think about H1b but know it is tough for a foreign national IMG. Be OK with J1 with a waiver after. Waiver doesn't mean going to middle of nowhere. Lots of places are undeserved including some bigger cities.

 

[Imgdocco]

Explain why you are out and what you did during that time. Just don't make it seem you wasted your time. Keep up with your medical school knowledge base.

Many middle tier IMG heavy programs only sponsor J1. Think about it from their perspective. If they have loads of IMGs applying to their program happy to take J1, what incentive do they have to pay thousands of dollars, extra resources and time to sponsor an H1b for you? Applying for an H1b especially when the program hasn't sponsored many before and not familiar with the process, can be fraught with hiccups and delays. In my opinion, you will have a better chance getting H1b with top tier programs that want the best applicants, have done it plenty of times before, and are willing to pay for it.

Do more research and figure out the best strategy for you. Not bad to think about H1b but know it is tough for a foreign national IMG. Be OK with J1 with a waiver after. Waiver doesn't mean going to middle of nowhere. Lots of places are undeserved including some bigger cities.

I'm definitely OK with a waiver job, but having trolled silently around SDN I have come across horror stories of people not being able to secure those waiver jobs and then being told to return to their country for the 2 year wait time. I dont know how much water those stories actually hold since im not even in the system yet myself, but I figured trying for an H1B would be a good bet in that circumstance. I would also kind of like to do a fellowship though, and I believe a J1 is miles ahead in terms of acceptance to programs than an H1B, if any do those fellowships (pain or peds anes) in the first place. I will also be trying to get more US Clinical experience before I hit that 2.25 year gap milestone, currently I'm sitting at around 1.5ish.

EDIT: following/during the waiver, are non-US IMG's eligible to apply for an H1 or some other immigration intent visa?

 

[coffeebythelake]

It is possible to go from J1 waiver to permanent resident but it is more complicated then with H1b. Best to talk to an immigration attorney about that

 

[Imgdocco]

It is possible to go from J1 waiver to permanent resident but it is more complicated then with H1b. Best to talk to an immigration attorney about that

Alright, thank you for all your help. Do you mind if I PM you if I have something else to ask in the future? Getting an attending's opinion on some aspects of the field or the match in general could really help.

 

[coffeebythelake]

Alright, thank you for all your help. Do you mind if I PM you if I have something else to ask in the future? Getting an attending's opinion on some aspects of the field or the match in general could really help.

That's fine