Question about IMG competence and future practice possibilities

[jku89]

So I know that Derm and Plastics are hard to match into, but what really irked me recently was looking at the match list for Derm and Plastics in the last two years: it appears that two IMGs have matched in Derm and Plastics respectively, both after waiting for more than a decade doing research, churning out 1-3 mediocre publications in low-impact journals and then getting lucky by matching in plastics or derm. Both are graduates of a foreign (Asian) medical school. Non-US citizens.

I guess what I wanted to know is, how common is it for an IMG who graduated in 1998 to match into a competitive residency spot 15 years later? Even a monkey can be trained to do mediocre research and publish in a random journal. Its sad that they are being accepted over US grads with much more recent experience, better credentials and a better understanding of cultural mores and bedside manner.

Now that these 2 IMGs have matched, what are the chances that they will actually get to stay in the US permanently so that they can practice here? A quick look at the the IMG stats shows that we have 1,000 IMGs from one country alone - how many of these IMGs actually stay here permanently to practice? 100? 50? Even less? How many will get green cards upon completing their residency? Just curious. Thanks.

Are there residencies that don't accept any IMGs? Fields that have close to ~0 IMGs currently practicing in the US? I would love to practice in a field that is at least somewhat exclusive and not open to being outsourced anytime soon. Also, I don't particularly like the idea of a specialty being saturated with IMGs from other countries -- in fact, I am surprised others don't see how unpalatable that idea really is. It would be a horrible situation for all parties involved.

Also, is it fair to say that IMGs from non-Carib/non-European/Australian medical schools who graduate near or at the top of their class are equal to a US allopathic grad in competence? Or perhaps better?

I would tend to disagree vehemently; not just because of the poor infrastructure and dismal state of teaching in these schools (outdated teaching modalities, horrible professors, ancient books, no emphasis on contemporary learning tools) but because of the fairly low standards for admission- they base the admissions decision solely on the results on a single examination, disregarding every other objectively measurable metric available for the applicant, not to mention things like social skills, commitment for and passion for medicine, and demonstrated interest in the field. Plus these people take a couple years to prepare for this examination, and they still don't get anywhere near the perfect score (but still get in).

I wanted to get opinions from other people on the board: have you had experiences that would corroborate the aforementioned? Any dissenting opinions? Thanks!

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[SouthernSurgeon]

Why would you get so cranked up over a couple of extremely rare anecdotes of people who obviously went the extra mile (often working for years as an unpaid lab assistant) to get a residency?

If you want fields that have close to zero IMGs...you already named them.

In other words...TL;DR :troll:

 

[Shjanzey]

What got you so worked up about IMGs? They have a harder road than US grads. The ones that match deserve it.

 

[jku89]

What got you so worked up about IMGs? They have a harder road than US grads. The ones that match deserve it.

A discussion with a PD about the merits of IMGs; he/she stated repeatedly that they were simply "fodder for unwanted residency spots" and "clueless about US culture and the like."

Of course, I have my own opinion, but would like to get others' as well.

 

[jku89]

Why would you get so cranked up over a couple of extremely rare anecdotes of people who obviously went the extra mile (often working for years as an unpaid lab assistant) to get a residency?

If you want fields that have close to zero IMGs...you already named them.

In other words...TL;DR :troll:

What about RadOnc?

 

[DYT]

IMGs have historically filled spots that people like you do not want to go into including IM, Peds and FM. There has always been a shortage of physicians in the United States and IMGs have taken care of this.

I do not think it would matter a lot if one or two applicants land a quite competitive residency.

For all that matters, many/you would have been forced into IM to supply the nation with more internists had it not been for IMGs.

 

[jku89]

IMGs have historically filled spots that people like you do not want to go into including IM, Peds and FM. There has always been a shortage of physicians in the United States and IMGs have taken care of this.

I do not think it would matter a lot if one or two applicants land a quite competitive residency.

For all that matters, many/you would have been forced into IM to supply the nation with more internists had it not been for IMGs.

That's an excellent point. I see what you are saying -- but what is your opinion on the competency issue? And what about market saturation, outsourcing and cultural misunderstandings? Are there any statistics on the number of green cards/permanent residencies given out to the IMGs who come here for training?

 

[DermViser]

So I know that Derm and Plastics are hard to match into, but what really irked me recently was looking at the match list for Derm and Plastics in the last two years: it appears that two IMGs have matched in Derm and Plastics respectively, both after waiting for more than a decade doing research, churning out 1-3 mediocre publications in low-impact journals and then getting lucky by matching in plastics or derm. Both are graduates of a foreign medical school. Non-US citizens.

Uh, I don't know what you consider a "low-impact journal" but the IMGs who do nearly a decade of derm research (I don't think it's that bad by the way - unless you're counting from the date of graduation from their med school) aren't just sitting around doing nothing waiting to get a position handed to them. They do years of research - many times it is in a basic science laboratory, so publications don't come quickly at all, and many of them are fully trained board certified dermatologists in their home country and they use the same textbooks that we do here. They do this by the way, completely UNPAID and can't even obtain a medical license bc it usually requires at least one year of internship. Many of them have families with children.

Edit: Was about to give a more comprehensive answer and correct your post regarding the IMGs who matched into Derm last year, but then realized you just joined today, with this being your first post, hence your intention is quite obviously to inflame and troll. I also highly doubt a Derm PD would discuss with you how IMGs are useless. Congratulations and welcome.

 

[Shjanzey]

I know plenty who have matched into Surgery, Neuro, IM, EM, and other specialties...or are these the unwanted specialties now?

Not sure why their competence is called into question. They have to pass the USMLE, and then apply and be accepted by a residency program before moving on. Plus the fact that they had to learn English, get up to snuff on our system in the process usually means they had to put in more effort.

If it were me, I would be pissed if I heard those comments, especially after putting in all that effort that should prove I am just as qualified as anyone else.

 

[jku89]

Uh, I don't know what you consider a "low-impact journal" but the IMGs who do nearly a decade of derm research (I don't think it's that bad by the way - unless you're counting from the date of graduation from their med school) aren't just sitting around doing nothing waiting to get a position handed to them. They do years of research - many times it is in a basic science laboratory, so publications don't come quickly at all, and many of them are fully trained board certified dermatologists in their home country and they use the same textbooks that we do here. They do this by the way, completely UNPAID and can't even obtain a medical license bc it usually requires at least one year of internship. Many of them have families with children.

Edit: Was about to give a more comprehensive answer and correct your post regarding the IMGs who matched into Derm last year, but then realized you just joined today, with this being your first post, hence your intention is quite obviously to inflame and troll. I also highly doubt a Derm PD would discuss with you how IMGs are useless. Congratulations and welcome.

I'm sorry if I came across as a troll -- my intention was simply to garner opinions from other medical students and AMGs. I was simply genuinely concerned about market saturation, outsourcing, uncalled-for competition and potentially lower quality of patient care. But painting all IMGs with the same brush is stupidity, I realize as much; however, one has to wonder as to whether their credentials really hold up muster the vast majority of the time -- particularly in cases such as this, when he/she is 15 years out of medical school and only just matching in a (very) competitive residency after a fairly poor research outcome.

 

[Shjanzey]

I'm sorry if I came across as a troll -- my intention was simply to garner opinions from other medical students and AMGs. I was simply genuinely concerned about market saturation, outsourcing, uncalled-for competition and potentially lower quality of patient care. But painting all IMGs with the same brush is stupidity, I realize as much; however, one has to wonder as to whether their credentials really hold up muster the vast majority of the time -- particularly in cases such as this, when he/she is 15 years out of medical school and only just matching in a (very) competitive residency after a fairly poor research outcome.

Many people who come here after being out of med school for 15 years have been practicing in their own country before making a transition here. I know a physician who practiced neurosurgery for 20 years before coming here, passing steps and redoing residency. That guy is a beast, and has bigger balls than most people I know.

 

[W19]

The purpose of this thread is to complain about 2 IMG that matched into derm! Lol...

 

[jku89]

I know plenty who have matched into Surgery, Neuro, IM, EM, and other specialties...or are these the unwanted specialties now?

Not sure why their competence is called into question. They have to pass the USMLE, and then apply and be accepted by a residency program before moving on. Plus the fact that they had to learn English, get up to snuff on our system in the process usually means they had to put in more effort.

If it were me, I would be pissed if I heard those comments, especially after putting in all that effort that should prove I am just as qualified as anyone else.

I understand what you are saying... but arguably, getting into medical school itself is the hardest part -- the rest of the journey is a mere cakewalk in comparison. Although it is hard to do well in medical school as well - and people who could have failed in a US curriculum aren't weeded out either. These IMGs get to circumvent the insanely competitive US admissions process and thus save themselves a whole lot of heartache (the kind that weeds people out) - not to mention the culture shock that comes with being in a foreign country and culture that can definitely affect patient outcomes. And what about things like personality, motivation, and other intangibles? AMGs have a really hard time matching not just because of the Steps, but a whole host of other factors-- factors that don't even come into play for IMGs who don't have a similar medical education system in their home countries (AOA, leadership, etc)

 

[DermViser]

I'm sorry if I came across as a troll -- my intention was simply to garner opinions from other medical students and AMGs. I was simply genuinely concerned about market saturation, outsourcing, uncalled-for competition and potentially lower quality of patient care. But painting all IMGs with the same brush is stupidity, I realize as much; however, one has to wonder as to whether their credentials really hold up muster the vast majority of the time -- particularly in cases such as this, when he/she is 15 years out of medical school and only just matching in a (very) competitive residency after a fairly poor research outcome.

How would an IMG filling a residency spot have anything to do with market saturation, outsourcing, and uncalled-for competition and potentially lower quality of patient care? If you look, the IMGs that end up getting into Derm and doing their residency all over again are more likely to stay in academic medicine to contribute to the specialty, so if anything, they are more than making up it in terms of taking an American's spot.

 

[DermViser]

The purpose of this thread is to complain about 2 IMG that matched into derm! Lol...

Who put in a decade of research being someone's lab monkey - so that's 10 years of lost opportunity cost and income, but they're somehow the bad guys.

 

[Wordead]

I understand what you are saying... but arguably, getting into medical school itself is the hardest part -- the rest of the journey is a mere cakewalk in comparison. Although it is hard to do well in medical school as well - and people who could have failed in a US curriculum aren't weeded out either. These IMGs get to circumvent the insanely competitive US admissions process and thus save themselves a whole lot of heartache (the kind that weeds people out) - not to mention the culture shock that comes with being in a foreign country and culture that can definitely affect patient outcomes. And what about things like personality, motivation, and other intangibles? AMGs have a really hard time matching not just because of the Steps, but a whole host of other factors-- factors that don't even come into play for IMGs who don't have a similar medical education system in their home countries (AOA, leadership, etc)

You think it's easier to match derm/plastics than to get into medical school? Okay dude...

And who gives a flying f about motivation and intangibles yay you're super friendly and volunteered in Haiti doing nothing useful. That garbage is everything that is wrong with admissions anyway.

 

[Psai]

You think it's easier to match derm/plastics than to get into medical school? Okay dude...

And who gives a flying f about motivation and intangibles yay you're super friendly and volunteered in Haiti doing nothing useful. That garbage is everything that is wrong with admissions anyway.

lool
man i've seen some of the people who were rejected from derm. I don't understand how anyone can possibly match

 

[deleted500612]

I understand what you are saying... but arguably, getting into medical school itself is the hardest part -- the rest of the journey is a mere cakewalk in comparison. Although it is hard to do well in medical school as well - and people who could have failed in a US curriculum aren't weeded out either. These IMGs get to circumvent the insanely competitive US admissions process and thus save themselves a whole lot of heartache (the kind that weeds people out) - not to mention the culture shock that comes with being in a foreign country and culture that can definitely affect patient outcomes. And what about things like personality, motivation, and other intangibles? AMGs have a really hard time matching not just because of the Steps, but a whole host of other factors-- factors that don't even come into play for IMGs who don't have a similar medical education system in their home countries (AOA, leadership, etc)

You're overgeneralizing. First of all, if you think getting into medical school in a country like China isn't extremely competitive, I've got news for you...

These guys are probably practicing dermatologists in China with a decade of derm research. For all you know they could have also scored a 270 on step 1. They've also obviously passed English fluency tests, your arguments are all extremely weak and make the unlikely assumption that the candidates are as underqualified as possible. If they matched into derm as IMGs they are probably absolute rockstars.

 

[DermViser]

lool
man i've seen some of the people who were rejected from derm. I don't understand how anyone can possibly match

Assuming your post is referring to stats, it is likely to do more with coming off badly during interviews (acting very stuck up, feeling entitled nd rubbing off badly on people).

 

[tellmemore2020]

You sound a bit sheltered and borderline xenophobic.

 

[graviton]

So I know that Derm and Plastics are hard to match into, but what really irked me recently was looking at the match list for Derm and Plastics in the last two years: it appears that two IMGs have matched in Derm and Plastics respectively, both after waiting for more than a decade doing research, churning out 1-3 mediocre publications in low-impact journals and then getting lucky by matching in plastics or derm. Both are graduates of a foreign (Asian) medical school. Non-US citizens.

I guess what I wanted to know is, how common is it for an IMG who graduated in 1998 to match into a competitive residency spot 15 years later? Even a monkey can be trained to do mediocre research and publish in a random journal. Its sad that they are being accepted over US grads with much more recent experience, better credentials and a better understanding of cultural mores and bedside manner.

Now that these 2 IMGs have matched, what are the chances that they will actually get to stay in the US permanently so that they can practice here? A quick look at the the IMG stats shows that we have 1,000 IMGs from one country alone - how many of these IMGs actually stay here permanently to practice? 100? 50? Even less? How many will get green cards upon completing their residency? Just curious. Thanks.

Are there residencies that don't accept any IMGs? Fields that have close to ~0 IMGs currently practicing in the US? I would love to practice in a field that is at least somewhat exclusive and not open to being outsourced anytime soon. Also, I don't particularly like the idea of a specialty being saturated with IMGs from other countries -- in fact, I am surprised others don't see how unpalatable that idea really is. It would be a horrible situation for all parties involved.

Also, is it fair to say that IMGs from non-Carib/non-European/Australian medical schools who graduate near or at the top of their class are equal to a US allopathic grad in competence? Or perhaps better?

I would tend to disagree vehemently; not just because of the poor infrastructure and dismal state of teaching in these schools (outdated teaching modalities, horrible professors, ancient books, no emphasis on contemporary learning tools) but because of the fairly low standards for admission- they base the admissions decision solely on the results on a single examination, disregarding every other objectively measurable metric available for the applicant, not to mention things like social skills, commitment for and passion for medicine, and demonstrated interest in the field. Plus these people take a couple years to prepare for this examination, and they still don't get anywhere near the perfect score (but still get in).

I wanted to get opinions from other people on the board: have you had experiences that would corroborate the aforementioned? Any dissenting opinions? Thanks!

I really hope this is some kind of an attempt at satire.

 

[Chip N Sawbones]

I understand what you are saying... but arguably, getting into medical school itself is the hardest part -- the rest of the journey is a mere cakewalk in comparison.

That's a funny one! Did you make it up yourself or did someone tell it to you?

 

[DermViser]

I understand what you are saying... but arguably, getting into medical school itself is the hardest part -- the rest of the journey is a mere cakewalk in comparison.

If getting INTO medical school was the hardest part in the entire journey, then people who go into BS/MD programs from high school would be the happiest people ever.

 

[evilbooyaa]

I'm all for IMG bashing, but even this is 2extreme4me.

 

[drcrispmd]

I guess someone did not get an interview for their first choice residency. Hope you get into a residency with only AMG because you come off as someone who would not work well with the other grads.

I know many FMG and everyone has stayed in the country after residency. Many go into underserved communities to work. I think with one of the visa they get a green card after serving 3 years in an underserved area.