Starting residency after 10 years of med school

[steveklenee]

Hello Guys,

I am in a unique situation and would appreciate some guidance.

I graduated from a top med school outside the US in 2002. Since then I did some research and then came to a top 3 medical school in the US for a PhD in Neuroscience which I will be finishing next year with a first-author paper in Nature. So I have done exceptionally well in research but now I want to start my residency in Neurology.

I never gave my Steps. I can give them in the next 6-8 months easily. So my plan is to apply for the 2014 match. I never did any clinical electives in the US because back then I never thought that I would one day want to do residency. Now I am fed up of working with mice and want some real human contact and relevance to my work.

Any thoughts on this please?

Thanks much

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[curlygirlie106]

I think you will be fighting something of an uphill battle, but, then again, nothing is impossible.

Things that are working against you. You still have to study for and take all three Steps... and get your scores back. Getting them all done in 6-8 months would be ambitious. Step 1 is oriented to the basic sciences with Steps 2 and 3 being clinical in nature (Don't forget the CS, too, which has sometimes been a stumbling block for international applicants). Being out of med school for 10 years could make Steps 2 and 3 a little more difficult than you might anticipate. A lot of the knowledge needed for them is "use it or lose it," so I hope that the gap in your clinical exposure doesn't make things too difficult on you.

Another thing hurting you is your lack of US clinical experience. Many programs require at least a few months of US clinical experience prior to applying to their programs, no ifs, ands, or buts. I don't know how you'd get that clinical exposure now that you're out of med school (Not saying it's impossible, but I have no clue how you'd go about setting that up for a accreddited rotation).

Also, you need to be aware of visa issues- many programs will only consider applicants who already have approved visas, and even in those circumstances, only specific types of visas.

With regards to the programs you want to go to, it's good to aim high, but it's important to be realistic. Some programs, especially the competitive ones, tend to favor US MD applicants, making you the underdog from the get-go. You need to consider a wide range of programs. Have a few "reaches" but have safety programs that are known to take IMGs with extenuating circumstances. There are plenty of such programs out there that aren't in Timbuktu.

Best of luck to you!

 

[steveklenee]

Hi,

Thanks for the reply. I am still going to go for it. Nothing is impossible as you said. IMG or not, I only know a handful of neurologists who have ever published first author in Nature. So that is something going in my favor. I think I am good enough to get high 90s in my Steps.

For clinical exposure, I'd either go to UK or just tag along with a clinician here. A fellow Phd student, also an IMG and out of med school for 10 or so years like me, did the same last year and matched at Northwestern. He did not have any decent publications. There is no way I am going to Northwestern or the likes after publishing in Nature.

I will keep you guys posted on this. I am sure this is possible.

 

[curlygirlie106]

There is no way I am going to Northwestern or the likes after publishing in Nature.

Um. Ouch.

One more thing that might be beneficial to you... a touch of humility.

 

[Head]

Is your goal to stay in academics or to forego research completely after your residency training? If you plan to stay in academics, it's true that a Nature paper will put you way above most of your IMG counterparts. If you plan to quit doing research and just practice neurology, I'm not sure it will help you that much.

I would be careful not to be too selective with your application process just because you have a Nature paper. Some of the top programs don't seem to ever take IMG's. Also, I'm not sure what you're like in person, but it's important not to come across too cocky during interviews. Based on that last post you may need to work on reigning things in a little.

 

[soulofmpatel]

think I am good enough to get high 90s in my Steps.

I think this is going to be your stumbling block.

"90s" incorporates three digit scores from as low as around 90/218, and event a 99 can have a 3 digit score as low as 236, which is certainly lower than the average matriculating step I/II score at "top" programs.'

The term "90s" isn't even in the vocabulary of US grads

I would imagine that trying to take step I/II when you are so far out of clinical education would be very difficult.

I would recommend taking the steps, getting your scores, and then setting realistic goals.

The only reason to not to attempt the steps is if you would only want to do a clinical neurology residency if you could go to MGH...in which case you should realistically understand that your chance of matching at MGH is <<50%

 

[steveklenee]

Thanks for the replies.

 

[Shufflin]

First, we don't care what med school you came from if it's not in the US. So don't flatter yourself. If you couldn't get accepted to a US med school that says something.

Second, you should aim for excellent training, not the "top 10." All you think about from overseas is MGH and Yale. Grow up. This isn't college. Here in the US you receive excellent training at most neurology residencies, including Northwestern.

Third, I hope you don't end up at Northwestern, because we're too good for you. Wherever you do end up, your "objective" should be to find some humility.

Fourth, let's see if you can even pass Step 1 and Step 2. Then let's talk.

 

[Striaterminalis]

oh wow you published in nature???? WHO GIVES A RATS AZZ...residency is a like a family and you def. need to tone that little accomplishment down a bit or else I assure you your fellow residents and some attendings are not gonna like ya much.


Oh yeah, and pass your freakin boards before you start knocking great institutions...Good God I've had it with this thread

 

[Mattchiavelli]

I think you will have to explain well why you should do a residency when you seem to already have a pretty good research career going. Also neurology residency in the states is still pretty IM heavy and you'll have to get through a full general medicine year before you even get to the neurology. Intern year is teh suck.

 

[burs0028]

I agree with the other posters. No one but you thinks your nature publication will get you into residency. Your program director is gonna care a lot less about a Nature publication than a clinical neurology paper; the former demonstrates you can think scientifically and conduct research (skills not necessarily useful at the patient's bedside).. "Plays well with others" counts a lot more when you're seeing your 8th consult of the night. Pass your boards, get some relevant clinical experience, and if clinical neurology is still your dream job, then start thinking about which institution would be the best fit. Ruling any place out because their reputation is not elite enough for you is stupid. I'm sure there are Northwestern trained docs on staff at Harvard just as there are Harvard trained docs on staff at other institutions. The further you get in education the less dependent your success is on where you are and more on who you are and how hard you are willing to work. Luck always plays a role too...in both directions.

Try harder to avoid alienating your peers. You sound like a total tool from your posts when you do that.

 

[danielmd06]

Your primary concern here should be the USMLE steps, which I wager may be quite challenging for you so far out of medical school and will include four separate and lengthy tests:

USMLE Step 1
USMLE Step 2 CK
USMLE Step 2 CS, and
USMLE Step 3.

First author publications in well recognized journals will aid you in your residency hunting endeavors I think, as many of the more erudite neurology training locales favor abstract scientific achievement. But I reiterate my first statmeent as the key to completing your high reaching goals.

Good luck.

 

[typhoonegator]

The worlds of clinical neurology and academic neuroscience are not as intertwined as you seem to think they are. That Nature paper would be helpful if you were finishing fellowship and trying to start a lab. It does essentially nothing to demonstrate your skill as a clinician.

There will be some programs that will swoon at your publication record and let it overshadow any weaknesses in your application. Partners (since you dragged MGH into the discussion) will not be one of them, and you can be assured I know something about that. If you are so enamored with the trappings of an early career in neuroscience, perhaps you should consider striving for an independent research career over clinical training. Get yourself a K-08 and try to build towards an R-01. You will find it difficult to maintain field relevance and remain active in publication and peer review when you're spending 80 hours a week in the hospital. That Nature paper will tarnish quickly as the years go by.

If, however, you are truly interested in becoming a physician, then you should strongly consider an attitude adjustment. No one in clinical neurology owes you anything, and you have significantly more to prove than the graduating MS-4 (from Northwestern, perhaps) who, at 25 years of age, has one sad case-report to his/her name but has the reassurances of medical training in the USA and a portfolio of competitive USMLE scores.

 

[Jorje286]

You seem to be more interested in where you'd go rather than a certain career path. If I were you, I'd dig deeper into my motives so not to face a harsh reality check later down the road.

 

[tkim]

There is no way I am going to Northwestern or the likes after publishing in Nature.

Shows that you've been with mice too long.

 

[lewstools]

Um. Ouch.

One more thing that might be beneficial to you... a touch of humility.

I think that attitude pretty much goes to character. There are enough snotty, trenchant, arrogant folks to go around. Stick with research. You do not seem like a human to human quality person. In fact, you sound like a putz. I don't care if you studied at Maurices Academy of Wig design, you've got a crappy attitude-and that, pretty much defines you.

 

[lewstools]

Shows that you've been with mice too long.

....in their cages.

 

[steveklenee]

Whats up with the hostile responses? very sad.

 

[Jorje286]

Whats up with the hostile responses? very sad.

To be honest, I'm more amused.

You don't want to be a neurologist unless you train at Harvard or another top 5? Can you not see how ridiculous that sounds? And trust me, the Harvard faculty have much higher standards than that and could pick up that very easily when they quiz you on your motives.

 

[steveklenee]

I didnt know aiming high was a crime. Arent you being too sour? Some of you guys have issues.

To be honest, I'm more amused.

You don't want to be a neurologist unless you train at Harvard or another top 5? Can you not see how ridiculous that sounds? And trust me, the Harvard faculty have much higher standards than that and could pick up that very easily when they quiz you on your motives.

 

[Jorje286]

I didnt know aiming high was a crime. Arent you being too sour? Some of you guys have issues.

Oh come on now. You know very well that the point I'm getting at is not that you want to go to the best place (which everyone does, duh), but the fact that you're vying exclusively for that.

One would think that if you're really interested in being a neurologist, training at a freakin worldclass institution like Northwestern would not stop you from being one.

You're free to abide by my advice or not, but imo being a physician demands more commitment than sticking with an MGH-or-none approach. As I said in my earlier post, if your motives are iffy, it can get bite you in the ass in the future.

 

[El Dooderino]

I'll let my neurology friends at Partners know to avoid the FMG with a Nature pub. Should narrow it down pretty nicely. You have a crap attitude

 

[tkim]

I didnt know aiming high was a crime. Arent you being too sour? Some of you guys have issues.

Still. Not. Getting. It.

 

[tkim]

I'll let my neurology friends at Partners know to avoid the FMG with a Nature pub. Should narrow it down pretty nicely. You have a crap attitude

Or, you could look at his username = fo shizzle name.

 

[steveklenee]

Are you for real? passing out threats? What residency programs, if any, are you from? Let me talk to your directors.

Have you considered that the way things are and if you remain in academia, and no matter where I go for a residency, I will be your boss or the very least be reviewing your papers and grants? You must be joking. In academia, the big dog is the one with the better papers and bigger grants. If MGH has to ask you for advice on recruitment instead of using their interviews etc, then its really not the program I thought it was. I doubt they will listen to you and by the way there are other FMGs with Nature papers. May be we should talk about why FMGs are publishing in Nature? It seems like that is the issue that is bothering you guys.

Most likely you guys are still medical students or residents in a ****ty program. No wonder you are hanging out at this forum. If you are a resident and "busy", shouldnt you be immersed in patient care, moonlighting, writing crappy "case-reports"?

 

[tkim]

Are you for real? passing out threats? Are you kidding me? What residency programs, if any, are you from? Let me talk to your directors.

Have you considered that the way things are and if you remain in academia, and no matter where I go for a residency, I will be your boss or the very least reviewing your papers and grants? You must be joking. In academia, the big dog is the one with the better papers and bigger grants.

Your replies reek of inferiority complex.

On the other hand, if your future is private practice then save us the trouble. No one will know you and no one cares who you are.

This is unacceptable behavior. Most likely you guys are still medical students or residents in a ****ty program. No wonder you are hanging out at this forum. If you are a resident and "busy", shouldnt you be immersed in patient care, moonlighting, writing crappy "case-reports"?

Heh.

 

[Jorje286]

I will be your boss or the very least be reviewing your papers and grants?

Such academic integrity there, buddy.

 

[steveklenee]

Don't worry highly unlikely that I will review case reports...not my cup of tea.

 

[typhoonegator]

Sniping back and forth does not serve the purpose of this thread.

To the TS, please refrain from ad hominem attacks in the future, as they are a violation of the TOS and can result in restriction of privileges and/or account closure.

This thread has clearly run its course. Closing.