Quite confused

[Caretaker22]

Hey guys,

First off, I would apologize if this is the wrong forum for this, but I figured it seemed the most appropriate to post in as it is the closest match I could make. Im a first year student in a Pakistani medical college which is IMED recognized. I know this stuff is probably a long way off, but I am dead sure that I want to take up a residency in a foreign country. What im confused about exactly, is whether to take AMC for Aus, or the USMLE for USA.

I know there are benefits and drawbacks to both, but I've been leaning a bit towards Australia. What I wanted to ask is, how is the AMC? Can I take it in my 4th year as I could do the USMLE's, or do I have to have my degree in hand to do so?

Also, i've heard getting placed in Aus is significantly harder then getting a residency in the US, and also that if one has completed the USMLE's and is ECFMG [I hope I said that right] certified, they may skip the AMC procedure altogether and apply directly.

Could someone enlighten me about these issues please, and perhaps offer up any other opinions they might have? Thanks a lot

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[neulite30]

Hey guys,

First off, I would apologize if this is the wrong forum for this, but I figured it seemed the most appropriate to post in as it is the closest match I could make. Im a first year student in a Pakistani medical college which is IMED recognized. I know this stuff is probably a long way off, but I am dead sure that I want to take up a residency in a foreign country. What im confused about exactly, is whether to take AMC for Aus, or the USMLE for USA.

I know there are benefits and drawbacks to both, but I've been leaning a bit towards Australia. What I wanted to ask is, how is the AMC? Can I take it in my 4th year as I could do the USMLE's, or do I have to have my degree in hand to do so?

Also, i've heard getting placed in Aus is significantly harder then getting a residency in the US, and also that if one has completed the USMLE's and is ECFMG [I hope I said that right] certified, they may skip the AMC procedure altogether and apply directly.

Could someone enlighten me about these issues please, and perhaps offer up any other opinions they might have? Thanks a lot

I think you've got the right forum. You will, no doubt, get some more detailed responses in the future, suffice it to say I can offer the following now:

As you're aware, these are two entirely different countries. As such, there is little recognition in the early parts of medical training, in either country. Having passed the USMLE and being ECFMG certified makes no difference in Australia. In fact, most of those I interacted with in Australia when I worked there are not aware of these exams.

I don't know about AMC eligibility.

Keep this in mind when deciding: It is becoming increasingly more difficult to get an internship position in Australia (PGY1). You need this before going further. Depending on the "residency" you choose in Australia, it can take from 2-5 years before you BEGIN training. Training itself is another 5 years on.

In the US, you take the highly standardized boards (USMLE) and compete based on merits for a residency position beginning directly after graduation and typically are 4 years in length, typically.

Lastly, you can always go to Australia with your US board certification as a specialist (minus a few hoops to jump through). America does not recognize residency training outside the US and Canada.

Hope this helps.

 

[Caretaker22]

First off, thanks so much for your responses.

I have a few more questions though. I was given to understand that the US residency programs also prefer Americans, then AMG's, then IMG's, for positions?
And if I DO apply to US, what, besides a good USMLE score, would make my CV pop? Keep in mind Im a Pakistani with only Pakistani nationality as yet.

Thirdly, and this is more out of just curiosity, but what scores/application do you reckon an IMG needs to get a position in a surgical residency? I dont mean Nuero, more like, Plastic surgery etc, or orthopedics, and what about something like Anesthesiology? Thanks again!

 

[Caretaker22]

I know electives etc help, and so do research papers [but apparently to a lesser extent], but when/how can one start these electives and which ones are stronger/weaker in this regard?

 

[Caretaker22]

Bump..

 

[neulite30]

A bump after only 2 days?

While SDN can be a wealth of helpful information, try not to rely solely on the posts here. Although you are asking subjective questions, so I guess I can't think of a better information resource out there. So here we go...

"I was given to understand that the US residency programs also prefer Americans, then AMG's, then IMG's, for positions?"

-This is entirely specialty-dependent. Even if I were to be able to answer this accurately, it should not deter you from applying; this is something you cannot change (in the short term). However, this is a big fat "YES" for positions in Australia.

"And if I DO apply to US, what, besides a good USMLE score, would make my CV pop? Keep in mind Im a Pakistani with only Pakistani nationality as yet."

-Good (great, in the case of being an IMG) USMLE scores will keep your application out of the rubbish bin, for the most part. Again, each specialty will be different. As a rule of thumb, have an overall good application (i.e. no red flags or weak areas). And what are these weak areas/red flags I speak of? (no doubt your next question) Things like failing a rotation, failing ANY part of the USMLEs, a questionable LoR, no experience in the field of interest, and (more recently) programs have been dissuaded by LoRs not specific to the field (meaning the applicant is applying to multiple specialties). While this last trend is ok and acceptable in Australia, the American selection committees like to see applicants with some sort of assurance as to the direction of their career. Personally, I believe this is in keeping with the structure of the training schemes across both countries (America vs. Australia). Australia still retains a British-style of post-graduate training (currently in transition), thus reflecting the previous 6-year medical courses where graduates were quite young coming out of medical school and, more often than not, were a bit unsure about what specialty they would like to enter. The American system graduates older doctors who, again for the most part, are expected to be a bit more sure. This is just my opinion...

"Thirdly, and this is more out of just curiosity, but what scores/application do you reckon an IMG needs to get a position in a surgical residency? I dont mean Nuero, more like, Plastic surgery etc, or orthopedics, and what about something like Anesthesiology?"

-Fortunately, the answer to this question can be found in graphs on the NRMP site. The NRMP does (did, as the last pooled data was in 2011) a fantastic job of presenting the statistical probability of matching in a specialty based on contiguous ranks, USMLE scores, publications, etc. (http://www.nrmp.org/match-data/main-residency-match-data/) Don't take it as final, but it gives you a good sense. Not surprisingly, you will need AWESOME USMLE scores to match into surgery. As an IMG looking into plastic surgery? PHENOMENAL.

"which ones are stronger/weaker in this regard?"

-I don't understand this part of your previous question.

 

[thomas pynchon]

Hey guys,

First off, I would apologize if this is the wrong forum for this, but I figured it seemed the most appropriate to post in as it is the closest match I could make. Im a first year student in a Pakistani medical college which is IMED recognized. I know this stuff is probably a long way off, but I am dead sure that I want to take up a residency in a foreign country. What im confused about exactly, is whether to take AMC for Aus, or the USMLE for USA.

I know there are benefits and drawbacks to both, but I've been leaning a bit towards Australia. What I wanted to ask is, how is the AMC? Can I take it in my 4th year as I could do the USMLE's, or do I have to have my degree in hand to do so?

Also, i've heard getting placed in Aus is significantly harder then getting a residency in the US, and also that if one has completed the USMLE's and is ECFMG [I hope I said that right] certified, they may skip the AMC procedure altogether and apply directly.

Could someone enlighten me about these issues please, and perhaps offer up any other opinions they might have? Thanks a lot

You have no chance in Australia as student numbers are at record highs and Australian med students themselves are struggling to get internship. Part of the effect of this is that students from medical schools in other countries have no chance at gaining entry into the hospital system in Australia.

 

[Phloston]

A bump after only 2 days?

While SDN can be a wealth of helpful information, try not to rely solely on the posts here. Although you are asking subjective questions, so I guess I can't think of a better information resource out there. So here we go...

"I was given to understand that the US residency programs also prefer Americans, then AMG's, then IMG's, for positions?"

-This is entirely specialty-dependent. Even if I were to be able to answer this accurately, it should not deter you from applying; this is something you cannot change (in the short term). However, this is a big fat "YES" for positions in Australia.

"And if I DO apply to US, what, besides a good USMLE score, would make my CV pop? Keep in mind Im a Pakistani with only Pakistani nationality as yet."

-Good (great, in the case of being an IMG) USMLE scores will keep your application out of the rubbish bin, for the most part. Again, each specialty will be different. As a rule of thumb, have an overall good application (i.e. no red flags or weak areas). And what are these weak areas/red flags I speak of? (no doubt your next question) Things like failing a rotation, failing ANY part of the USMLEs, a questionable LoR, no experience in the field of interest, and (more recently) programs have been dissuaded by LoRs not specific to the field (meaning the applicant is applying to multiple specialties). While this last trend is ok and acceptable in Australia, the American selection committees like to see applicants with some sort of assurance as to the direction of their career. Personally, I believe this is in keeping with the structure of the training schemes across both countries (America vs. Australia). Australia still retains a British-style of post-graduate training (currently in transition), thus reflecting the previous 6-year medical courses where graduates were quite young coming out of medical school and, more often than not, were a bit unsure about what specialty they would like to enter. The American system graduates older doctors who, again for the most part, are expected to be a bit more sure. This is just my opinion...

"Thirdly, and this is more out of just curiosity, but what scores/application do you reckon an IMG needs to get a position in a surgical residency? I dont mean Nuero, more like, Plastic surgery etc, or orthopedics, and what about something like Anesthesiology?"

-Fortunately, the answer to this question can be found in graphs on the NRMP site. The NRMP does (did, as the last pooled data was in 2011) a fantastic job of presenting the statistical probability of matching in a specialty based on contiguous ranks, USMLE scores, publications, etc. (http://www.nrmp.org/match-data/main-residency-match-data/) Don't take it as final, but it gives you a good sense. Not surprisingly, you will need AWESOME USMLE scores to match into surgery. As an IMG looking into plastic surgery? PHENOMENAL.

"which ones are stronger/weaker in this regard?"

-I don't understand this part of your previous question.

Good post here. Thanks for the input,

 

[Caretaker22]

My apologies if I came off as too eager there
Your post was very helpful, thanks loads for your input. And I meant which electives would be considered strong and which ones weak, but I think I've burdened you enough, i'll research it

 

[jayK]

hi
im in a similar dilemma see. Im a US citizen who happened to have done my medical training in India and i am also looking into going to Australia for doing a residency but im not quite sure if it will be the right decision and i was hoping if someone could guide me on the entire process and the dificulty i will be facing if i choose to go to Australia

thank you

 

[pitman]

hi
im in a similar dilemma see. Im a US citizen who happened to have done my medical training in India and i am also looking into going to Australia for doing a residency but im not quite sure if it will be the right decision and i was hoping if someone could guide me on the entire process and the dificulty i will be facing if i choose to go to Australia

thank you

That's really too broad a question, much of which would have been answered multiple times. You would be better off first checking out the threads on this topic, then come back and ask specific questions.

 

[jayK]

That's really too broad a question, much of which would have been answered multiple times. You would be better off first checking out the threads on this topic, then come back and ask specific questions.

hey thank you for replying
my specific question is
what are my chances of getting into residency in Australia compared to the USA ?
what i mean to ask is how hard will it be?

 

[neulite30]

hey thank you for replying
my specific question is
what are my chances of getting into residency in Australia compared to the USA ?
what i mean to ask is how hard will it be?

The first question cannot be answered accurately. Here are some factors that dictate competitiveness in the respective countries:

Australia:
-citizenship/permanent residence status (must have been born in the country or New Zealand, previously applied and obtained the visa through Skill Select (need completion of internship first, unless you've previously obtained a PR visa through another skill), or married an Australian citizen)
-AHPRA registration (must complete internship in Australia, which includes an Emergency term, Surgery term, and Internal Medicine term. While only three specific terms are required, you must complete one year of hospital training, I forgot how many weeks). Your training MUST have been completed in Australia or New Zealand (while the structure and length of each term in New Zealand may be different than the AHPRA requirements, they are considered equivalent and is sufficient for registration purposes - I called and asked about this a few years ago)
-graduate of an Australian/New Zealand medical school
-AMC exam completion
-availability of qualified Australian/PR applicants in your specialty of interest (if they are present, by policy they must be offered a position ahead of non-citizens/non-permanent residents)
-Letter of recommendation from Australian physicians
-Number of training positions available (intern, PGY1-543) [I'm obviously being facetious with that last part, but the point is you can continue on in general training as a House Officer for the rest of your career - see Career Medical Officer (CMO)]. Just a quick digression: "a medical officer with specialist qualifications who chooses to work in an area outside their specialist qualification." reference: https://www.hwa.gov.au/sites/uploads/Public hospital medical workforce in Australia - Appendices.pdf

United States
-USMLE scores: Steps 1, 2CK, 2CS, 3(for H1B visa I think), ECFMG certification (occurs after you have the following: medical degree from an institution of higher learning found on an approved schools list, passed USMLE Step 1, 2CK, 2CS); expect to spend a few thousand dollars getting this step done, as not only are the exams themselves expensive, Step 2CS is offered only in the US (five cities, to be exact).
-LoRs from US physicians
-Completion of rotations in your field of interest in a US hospital (presumably where one would get the LoRs)
-Publications, presentations, research projects related to your field of interest
-US citizenship
-Less than a few years out of medical school
-Post-graduate degrees
-Interview performance
-Experience in the specialty of interest

These lists mark typical elements of a competitive applicants ERAS application Having deficiencies in one element may not necessarily hinder your chances greatly, but this is very subjective and program specific (i.e. the program evaluating you will determine your competitiveness for their training spots, and hence, replies to an SDN post will not be able to tell you this)

It is important to remember the following with regards to post-graduate training in the two countries:
US: Generally, you apply directly to a specialty in the US. You are locked in to a program for its entire duration (typically 3-5 years, usually 4). It is not looked upon favourably if you switch programs/specialties, although I imagine the latter would be more ok.
Australia: In Australia, you enter general training, typically for a one year duration after which you need to renew your contract; this is also true if you're in specialty training too, I believe. Changing locations, training institutions, or specialties occurs quite regularly there, and thus, is not much of an issue. Of course, the Australian post graduate training scheme is in flux and may start to mimic that of the US in the near future, but it's a slow process.

The second question is very subjective and the answers you receive here will vary widely. You will need to evaluate this on your own.

 

[jayK]

The first question cannot be answered accurately. Here are some factors that dictate competitiveness in the respective countries:

Australia:
-citizenship/permanent residence status (must have been born in the country or New Zealand, previously applied and obtained the visa through Skill Select (need completion of internship first, unless you've previously obtained a PR visa through another skill), or married an Australian citizen)
-AHPRA registration (must complete internship in Australia, which includes an Emergency term, Surgery term, and Internal Medicine term. While only three specific terms are required, you must complete one year of hospital training, I forgot how many weeks). Your training MUST have been completed in Australia or New Zealand (while the structure and length of each term in New Zealand may be different than the AHPRA requirements, they are considered equivalent and is sufficient for registration purposes - I called and asked about this a few years ago)
-graduate of an Australian/New Zealand medical school
-AMC exam completion
-availability of qualified Australian/PR applicants in your specialty of interest (if they are present, by policy they must be offered a position ahead of non-citizens/non-permanent residents)
-Letter of recommendation from Australian physicians
-Number of training positions available (intern, PGY1-543) [I'm obviously being facetious with that last part, but the point is you can continue on in general training as a House Officer for the rest of your career - see Career Medical Officer (CMO)]. Just a quick digression: "a medical officer with specialist qualifications who chooses to work in an area outside their specialist qualification." reference: https://www.hwa.gov.au/sites/uploads/Public hospital medical workforce in Australia - Appendices.pdf

United States
-USMLE scores: Steps 1, 2CK, 2CS, 3(for H1B visa I think), ECFMG certification (occurs after you have the following: medical degree from an institution of higher learning found on an approved schools list, passed USMLE Step 1, 2CK, 2CS); expect to spend a few thousand dollars getting this step done, as not only are the exams themselves expensive, Step 2CS is offered only in the US (five cities, to be exact).
-LoRs from US physicians
-Completion of rotations in your field of interest in a US hospital (presumably where one would get the LoRs)
-Publications, presentations, research projects related to your field of interest
-US citizenship
-Less than a few years out of medical school
-Post-graduate degrees
-Interview performance
-Experience in the specialty of interest

These lists mark typical elements of a competitive applicants ERAS application Having deficiencies in one element may not necessarily hinder your chances greatly, but this is very subjective and program specific (i.e. the program evaluating you will determine your competitiveness for their training spots, and hence, replies to an SDN post will not be able to tell you this)

It is important to remember the following with regards to post-graduate training in the two countries:
US: Generally, you apply directly to a specialty in the US. You are locked in to a program for its entire duration (typically 3-5 years, usually 4). It is not looked upon favourably if you switch programs/specialties, although I imagine the latter would be more ok.
Australia: In Australia, you enter general training, typically for a one year duration after which you need to renew your contract; this is also true if you're in specialty training too, I believe. Changing locations, training institutions, or specialties occurs quite regularly there, and thus, is not much of an issue. Of course, the Australian post graduate training scheme is in flux and may start to mimic that of the US in the near future, but it's a slow process.

The second question is very subjective and the answers you receive here will vary widely. You will need to evaluate this on your own.

thank you so much this was quite helpful

 

[neulite30]

No problem. The 2014 IMG Charting the Outcomes was released today. It has very important information regarding an applicants chances of matching in the US, even broken down into specialty, scores, ranks, and country of medical school.

http://b83c73bcf0e7ca356c80-e8560f4...atch-International-Medical-Graduates-2014.pdf