Psychiatry Residency for an International MD

[PsychMed91]

I'm currently a sophomore doing my premed in Israel. I've discussed admissions to medical school with some users in this forum and it seems that doing an MD degree in Israel, even though it would be considered foreign, would be more efficient. Medical schools in the states don't acknowledge foreign degrees from Israel, and the fact that I'm an American citizen does not help in that matter.
A little bit about me and my choices: Generally, I was always interested in mental illnesses. Ever since I was little (around 13) I used to read about all the disorders and symptoms and many mental disabilities. I started studying psychology this year hoping to become a Clinical Psychologist for two reasons:
1. There is a rumor that psychiatrists don't do therapy but only manage with drugs. As I came to find out, psychiatry therapy is well known in the states.
2. I thought that as a clinical psychologist I'd have enough knowledge to deal with severe mental illnesses. Later this year it came to me that I won't really be able to deal with those subjects as a mere psychologist.

Therefore I decided to become a psychiatrist. I'll be finishing my BSc. in Biology in a year and a half and then I'll attend a medical school here in Israel.

I read about the different residencies and I started to wonder how realistic would it be to admit to an American residency with an Israeli MD degree?
Any information on the subject of admission or any helpful tips would be much appreciated.

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[psychphan]

I do not know about Israel speficially, but as a generalization there are tons of FMGs/IMGs in the field of psychiatry. Someone recently posted a stat on these forums that 30% of practicing adult psychiatrists in the states are FMGs. I believe the stat meant board certified psychiatrist, which would mean they completed US residencies.

 

[nitemagi]

You'd probably fall into a mid-level of competitiveness. You're a step ahead if you have fluency in English, which is a huge barrier for many FMG's, especially in psychiatry where language is a major factor.

 

[PsychMed91]

That's the first piece of good news I've got since I started this new route. English is my primary language and therefore fluent.
So it's settled: I'll do an Israeli MD and a residency in Psychiatry in the states. Anything I should know about the process? Are there any test I should pass in order to admit to an American residency? Will I be able to get into competitive programs like Yale or Harvard?

 

[splik]

you will be fine if you go to one of the schools full of americans like sackler or ben gurion and some US electives. you will of course need to pass the USMLEs. you will be fine for yale and the jewish programs. Harvard does not have a psychiatry residency - there are several programs affiliated with HMS and your competitiveness for any program will depend on your performance during medical school, your US electives and where you did them, your letters of recommendation, your USMLE scores, your extracurricular activities, evidence of commitment to psychiatry, and any research experience and publications.

 

[Darkskies]

you will be fine if you go to one of the schools full of americans like sackler or ben gurion and some US electives. you will of course need to pass the USMLEs. you will be fine for yale and the jewish programs. Harvard does not have a psychiatry residency - there are several programs affiliated with HMS and your competitiveness for any program will depend on your performance during medical school, your US electives and where you did them, your letters of recommendation, your USMLE scores, your extracurricular activities, evidence of commitment to psychiatry, and any research experience and publications.

I was under the impression that it is very difficult to obtain a psych residency at Yale as a DO. Likewise for MGH/Longwood. If that's the case is it really easier as a foreign MD? People on the pre-med forums all say that DO>>FMG/IMG

 

[nitemagi]

I would clarify that it will be possible to get a residency in the US, that does not mean it will be easy, nor that you will necessarily have access to a top program. MGH/Columbia/UCLA are not known to take many FMG's, if any, ever. There are of course rare exceptions. On the other hand there are some programs in the US that are near exclusively populated by FMG's, usually in lesser desired locations. So be prepared for that. Going to school abroad will most definitely make you LESS competitive for any application.

 

[psychphan]

I was under the impression that it is very difficult to obtain a psych residency at Yale as a DO. Likewise for MGH/Longwood. If that's the case is it really easier as a foreign MD? People on the pre-med forums all say that DO>>FMG/IMG

Being a DO who applied/interviewed this year, I feel like I have some insight here. Personally, I see myself as a relatively strong applicant and had PDs on the interview trail tell me my application was very strong (particularly my board scores which were 90-95% national average, or based on previous years match stats data around the 99% for psych applicants). That being said, there were programs that did not offer me interviews, presumably being a DO had something to do with that. 3 of those such programs are the ones you listed in your post, and to my knowledge Yale, MGH, and Longwood have never had a DO in their respective psychiatry residencies (I do believe Yale has had DOs in other specialties but that isn't particularly relevant to the conversation). That being said, I also did receive interviews at a number of programs that I would consider to be top tier, including WPIC/UPMC which arguably is stronger than any of those 3 programs already mentioned. On the other hand, while on the interview trail I spoke with several very well qualified FMGs who did not receive interviews to a number of places that I did. I always thought it was funny the variation in what programs look for in an applicant (or maybe more specifically who their biases are against). In general, conventional wisdom is all other things being equal in an applicant, DO>FMG, and I do think that for the majority of programs this is the case. This however, isn't the case for some programs including Yale, MGH, and Longwood, as it seems you could be the sole author of the DSM-V and not be accepted into their residencies if you are from an osteopathic school.

Other DOs out there, or anyone who is more knowledgeable, feel free to correct me if I am wrong, as I am sure there are stronger DO applicants than I and some of them may have interviewed at those places. But to my knowledge, none have ever matched.

 

[splik]

I was under the impression that it is very difficult to obtain a psych residency at Yale as a DO. Likewise for MGH/Longwood. If that's the case is it really easier as a foreign MD? People on the pre-med forums all say that DO>>FMG/IMG

Going DO is better than going to the caribbean or a US student going to eastern europe for medical school. But most places FMG>>>>DO, if you control for English language. FMGs (except maybe the ones from India many of whom are excellent) are usually coming from the top medical schools in their countries where it is often as or more competitve to get in than in the US. They are usually the best and most determined of that crop. DO students often couldn't get into an allopathic medical schools and they don't have the same reputation as well known medical schools internationally.

Yale has lots of FMGs in its program and tends to oversample foreign applicants.

 

[splik]

I would clarify that it will be possible to get a residency in the US, that does not mean it will be easy, nor that you will necessarily have access to a top program. MGH/Columbia/UCLA are not known to take many FMG's, if any, ever. There are of course rare exceptions. On the other hand there are some programs in the US that are near exclusively populated by FMG's, usually in lesser desired locations. So be prepared for that. Going to school abroad will most definitely make you LESS competitive for any application.

As I have mentioned before my experience as an FMG has been that the most competitive places truly want to best students regardless of whether they be USMDs or FMGs. MGH has 2 FMGs, Columbia has 2 FMGs, Cornell has 1-2 US FMGs, UCLA has 1 FMG, UCSF has 1 FMG. Many of these however are MD/PhDs.Yale, Emory, Duke, Mayo have many FMGs but I fo not consider these 'most competitive'.
[Columbia and Cornell are bizarre - they invite us FMGs for interview but don't sponsor visas!]

I can tell you that it is the so called 'mid-tier' places that don't have any FMGs because they don't want to tarnish their reputation. I got interviews from almost all the places I wanted which are considered to be competitive or elite or whatever. The less competitive programs that I applied to because I was told to have back ups all rejected me!

 

[splik]

Some places may have a preference for DOs over FMGs, that might be as psychphan says if they have had good experience with them in the past. Otherwise they are rightly or wrongly shut out.

 

[splik]

We get a ton of these threads about applying for residency with a foreign degree/as a foreigner. If I Match I promise to post a comprehensive guide of how to match as an IMG (not caribbean mind i think that's a different experience).

If I don't match (and I might get blacklisted after releasing the full list of programs to avoid lol) I promise to post a comprehensive guide of how NOT to match into psychiatry as an IMG.

 

[Swisych]

An advantage you would/will have over your fellow FMG is your American citizenship which allows you to not worry about any visa.
Along with good USMLE scores for all steps (FMG are usually required to pass all 3 before applying), relevant US Clinical Experience is critical (and often required). That should get you good letters of recommendation which are important too.

 

[psychphan]

As I have mentioned before my experience as an FMG has been that the most competitive places truly want to best students regardless of whether they be USMDs or FMGs. MGH has 2 FMGs, Columbia has 2 FMGs, Cornell has 1-2 US FMGs, UCLA has 1 FMG, UCSF has 1 FMG. Many of these however are MD/PhDs.Yale, Emory, Duke, Mayo have many FMGs but I fo not consider these 'most competitive'.
[Columbia and Cornell are bizarre - they invite us FMGs for interview but don't sponsor visas!]

I can tell you that it is the so called 'mid-tier' places that don't have any FMGs because they don't want to tarnish their reputation. I got interviews from almost all the places I wanted which are considered to be competitive or elite or whatever. The less competitive programs that I applied to because I was told to have back ups all rejected me!

Unless they are DOs.

A mid tier place not wanting to take an FMG and an ivy league place not wanting to take a DO are both equal examples of "not wanting to tarnish their reputations" as I am sure there are DOs who are stronger applicants (in terms research experiences, work/volunteer, dedication to the field, personality, and board scores [the only truly objective measure thats equal across the board I might add]) than MDs, either US or FMG, who have matched into those 'elite' places. That's no different than a mid tier place rejecting an FMG. As I said, both are cases of bias. Neither is right, but both do occur.

But I will stand by the original statement that in general, most places would look more favorable on DO applicants than FMGs. That is of course ALL other things being equal, and we both know that ALL other things are never equal.

 

[Leo Aquarius]

...3 of those such programs are the ones you listed in your post, and to my knowledge Yale, MGH, and Longwood have never had a DO in their respective psychiatry residencies (I do believe Yale has had DOs in other specialties but that isn't particularly relevant to the conversation). That being said, I also did receive interviews at a number of programs that I would consider to be top tier, including WPIC/UPMC which arguably is stronger than any of those 3 programs already mentioned...

Really?? UPMC stronger than MGH? Hmmm, interesting.

 

[psychphan]

Really?? UPMC stronger than MGH? Hmmm, interesting.

Arguably, and I'd say it's certainly in the same class. UMPC is far and away the leading program in resource funding in the country, and importantly residents have access to the faculty conducting the research. Add that to the fact that Western Psych is arguably the most impressive University based inpt psych hospital in the country with 300+ inpt beds with specialty units in pretty much everything you can thnk of, meaning the psychopathology you see is excellent. #1 in research plus world class inpt facilities have to make it one of the select few top programs in the country. Sure, MGH is more competitive, name and location...they have both in their favor, and obviously it's a phenomenal program. However, I really don't think it's a stretch to put WPIC in that class.

 

[billypilgrim37]

Pittsburgh is also notable in that the local accent is actually MORE ANNOYING than the local accent in Boston. That should factor into the equation as well.

 

[notdeadyet]

Are you sure you're not thinking Philadelphia? Pittsburgh's accent pales in comparison.

 

[PsychMed91]

Interesting information you supplied. I must emphasize that the degree I'm getting as a FMG is an MD and not a DO. Don't know if it changes anything. Also, it seems like I would have to do some clinical work in the US prior to residency. Sounds logical to me as I'll have to pass the USMLE before sending admissions to residencies.

Also, I'm glad to see that FMG's in the psychiatric field aren't rare. It's just that going to the US right know to do a premed, and then a medical school, doesn't seem realistic at all and a lot for time would be wasted (about an extra three years at least).

My American citizenship would help me as well, and that's an advantage I'll have over the other FMG's.
The salaries of psychiatrist in the states seem so unrealistic though. Can't imagine myself starting to work with an average of 120 grand - It's huge!

I read the post psychphan wrote about UMPC being the best residency to research mental illnesses. Sounds great! My main interest, and the reason I wanted to get into the field in the first place, was to deal with and research severe mental illnesses.

What else should I know about admitting to a residency with a foreign MD? Are there more tests I should complete other than the USMLE? Other things I can do after my degree to ease the process?

 

[digitlnoize]

Interesting information you supplied. I must emphasize that the degree I'm getting as a FMG is an MD and not a DO. Don't know if it changes anything. Also, it seems like I would have to do some clinical work in the US prior to residency. Sounds logical to me as I'll have to pass the USMLE before sending admissions to residencies.

Also, I'm glad to see that FMG's in the psychiatric field aren't rare. It's just that going to the US right know to do a premed, and then a medical school, doesn't seem realistic at all and a lot for time would be wasted (about an extra three years at least).

My American citizenship would help me as well, and that's an advantage I'll have over the other FMG's.
The salaries of psychiatrist in the states seem so unrealistic though. Can't imagine myself starting to work with an average of 120 grand - It's huge!

I read the post psychphan wrote about UMPC being the best residency to research mental illnesses. Sounds great! My main interest, and the reason I wanted to get into the field in the first place, was to deal with and research severe mental illnesses.

What else should I know about admitting to a residency with a foreign MD? Are there more tests I should complete other than the USMLE? Other things I can do after my degree to ease the process?

This is anecdotal, but I went on ~15 interviews (overkill, I know), and they generally went like this:

1. MD Student
2. DO Student
3. MD or DO Student (about a 50/50 split, I'd say)
4. Me (DO Student)
5. FMG
6. Random (usually an MD > DO > FMG)

I had 3 interviews that were Me + 3-4 FMG's. No MD's. ECU (primarily Ross graduates), Carilion (primarily graduates from an Indian medical school that the chief resident went to), and Hershey (Indian and Carribean) come to mind.

Now, I think that there was a healthy supply of DO's at all of my programs, but then again, I only applied to MD programs that I knew were "DO friendly." Meaning, they were known to take DO's in the past (judged by counting at least one, preferably two DO's in their current program).

I recommend that you scour the websites of every psych program in the country. Focus on the smaller towns, or towns in terrible locations. University of Missouri comes to mind as another decent program that takes a good number of FMGs.

If you apply to every FMG-heavy program, and are competitive, you'll stand a far higher chance of matching than if you just apply to Yale, Hopkins, UNC, Duke, and these type places.

Good Luck!!!

 

[psychphan]

I read the post psychphan wrote about UMPC being the best residency to research mental illnesses. Sounds great! My main interest, and the reason I wanted to get into the field in the first place, was to deal with and research severe mental illnesses.

Just to clarify, I specifically said they receive the most dollars for research funding. The 'best place to do psych resereach' would probably be based on what youre specific research interests are. There are a number of excellent programs that have tons of research going on. But that seems to be pretty far in your future at this point. Take it one step at a time, and good luck!

 

[PsychMed91]

I do have plenty of time until my residency begins, and many things can change until than (as far as we know it might be the end of the world soon )

I'll keep on working to make that dream come true. Thanks for your help guys, I'll post again if I'll come up with more questions.

 

[belle54321]

Sorry for my ignorance, but US med schools don't recognize undergrad degrees from Israel?

 

[PsychMed91]

Unfortunately the AMCAS doesn't recognize Israeli bachelor degrees. If they would have it could make my life a lot easier. But then again, there's always an alternative.

You can refer to my other post on the subject in the premed section:
http://forums.studentdoctor.net/showthread.php?t=888055

 

[splik]

I recommend that you scour the websites of every psych program in the country. Focus on the smaller towns, or towns in terrible locations. University of Missouri comes to mind as another decent program that takes a good number of FMGs.

I am sure dig means well but please ignore this. Most people really have no idea re: IMGs if they aren't one and as a result give terrible advice such as the above.

Focus on finishing your undergrad and getting into medical school. Going to medschool in Israel will not be a barrier to getting into a good psychiatry residency if you are a good student. It is not like going to medical school in the caribbean etc. No one can say where you could go because we dont even know if you will get into medical school! If you do very well, get strong board scores, have excellent recommendations, do US electives, do research and get publications, and do lots of interesting extracurricular activities you will be be fine. Now you won't be on a par with those at top US medical schools but that will not be a bar.

 

[digitlnoize]

I am sure dig means well but please ignore this. Most people really have no idea re: IMGs if they aren't one and as a result give terrible advice such as the above.

Focus on finishing your undergrad and getting into medical school. Going to medschool in Israel will not be a barrier to getting into a good psychiatry residency if you are a good student. It is not like going to medical school in the caribbean etc. No one can say where you could go because we dont even know if you will get into medical school! If you do very well, get strong board scores, have excellent recommendations, do US electives, do research and get publications, and do lots of interesting extracurricular activities you will be be fine. Now you won't be on a par with those at top US medical schools but that will not be a bar.

I certainly didn't mean that FMGs/IMGs couldn't go to top schools. Certainly, if you have the stats to get in there, and that's what you're looking for, go for it. I should also add that by "terrible towns," I simply meant "places many people don't want to live." For example, Columbia Missouri looks like a great college town, close to both St. Louis and Kansas City, and I've only heard good things about the program. Certainly not a terrible place to live, but you (and anyone) will stand a greater chance of getting in there, than a program in, say, NYC or San Fran.

But, statistically speaking, if you want to give yourself the best chance of matching, you should also apply to some FMG/IMG heavy programs, since they are the ones with a strong track record of taking non-US students.

Definitely do all the things splik listed there and be as exemplary a student as you can. However, with the increase in US MD class size over the last few years, the spot crunch is coming, and I (and most people) think it's going to hit the FMGs the hardest. Watch for things to be more difficult in the coming years.

NOTHING is impossible. If your dream is Yale Psych (or whatever), then go for it, and if something is stopping you, it won't be where you're from. But, I would still recommend some backups. Better safe than sorry.

 

[cleareyedguy]

I did a quick search at 4 of the programs that are widely considered the most competitive to get into, both because they're good programs and happen to be in desirable cities (alphabetically: Columbia, Cornell, UCLA, UCSF; I looked at a couple others and didn't immediately see a med school roster so left them out). All 4 had at least one FMG, but I didn't see any DO's. The "FMG" tag may not really capture them, however, since Columbia's were from Firenze, Italy, and Bogota, Colombia; Cornell's were from Cornell-Qatar; Oxford, and Sackler in Israel); UCLA's was from Sao Paolo; and UCSF's from Beijing.

This implies that unless a DO has a real "in" or some other outstanding characteristic, odds are slim at these places. And that even "FMG's" are a rare breed unless you happen to have gone to a world class international school.

OTOH, as everyone points out, there are plenty of strong programs that are open to a wide variety of backgrounds. Further, if you take a look at faculties and fellows at these same selective places, DO's and FMG's are indeed more commonly found. I don't, by the way, see that as necessarily weird. People want reassurance at all levels. If you come from a school they don't know, you better get them to REALLY know you. Or, if you go to a residency program that vets you, then you'll be a better candidate later on.

 

[belle54321]

I certainly didn't mean that FMGs/IMGs couldn't go to top schools. Certainly, if you have the stats to get in there, and that's what you're looking for, go for it. I should also add that by "terrible towns," I simply meant "places many people don't want to live." For example, Columbia Missouri looks like a great college town, close to both St. Louis and Kansas City, and I've only heard good things about the program. Certainly not a terrible place to live, but you (and anyone) will stand a greater chance of getting in there, than a program in, say, NYC or San Fran.

But, statistically speaking, if you want to give yourself the best chance of matching, you should also apply to some FMG/IMG heavy programs, since they are the ones with a strong track record of taking non-US students.

Definitely do all the things splik listed there and be as exemplary a student as you can. However, with the increase in US MD class size over the last few years, the spot crunch is coming, and I (and most people) think it's going to hit the FMGs the hardest. Watch for things to be more difficult in the coming years.

NOTHING is impossible. If your dream is Yale Psych (or whatever), then go for it, and if something is stopping you, it won't be where you're from. But, I would still recommend some backups. Better safe than sorry.

Sorry for my ignorance, and don't meant to hijack the thread. but why do so many DO students pursue allopathic residency? As I understand there are more osteopathic schools than 10years ago, are the number of spots not catching up? I understand there may be more career opportunities after an allopathic residency. But are AOA residencies not up to snuff? Psych will be my second residency, and personally, I have never felt threatened by DOs for residency spots. I think there are definitely enough spots for most DO and AMG seniors who want them. On my interview trails, I also met many IMG/FMGs at some top (or to avoid if you ask splik) places-Columbia (not in the "to avoid" group according to most people), Yale, Duke, etc.