Unique couples match: USIMG + US med student

[cleansocks]

Hi,

I would like advice and/or impressions for the following situation:

I'm a 3rd year med student attending a US med school. I am planning to couples match w/ my girlfriend of many years who is in her final year of a 6 year medical program in Prague, Czech Republic.

About her: She's an American citizen but has Czech family and went there for family + financial reasons. She plans to take a year off and do research and complete step 2 while I complete my fourth year. Minimal research experience prior to the year off. She recently completed and honored three away clerkships at my institution in IM, EM, and ID. She wants to do EM.

About me: MD/MBA, no science research but lots of projects, work, poster session, and possibly research paper for MBA. I am undecided but want something with 1. good hours as attending and 2. procedures. I am currently waivering between ortho and anaesthesia.

We are both good students; we both each got 256 on step 1, and will likely complete our years having honored all of our clinical courses. We want to be in Western US (especially CA, CO) unless some sort of incredible opportunity presents itself on the East Coast where I am now. We do not want residency at my institution. We MUST live in the same city.

So to reiterate, I would like any advice or impressions from those familiar with couples match, IMG's, PD's, etc. Thanks in advance.

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[Blade28]

Though you two have impressive stats, I worry a little since you're being so specific in your criteria for residency programs.

For example, applying to only Ortho programs in California (there are 10) and Colorado (only 1!) would be risky, IMHO. I don't know how the rest of your app looks (letters of recommendation, MBA research, etc.), but I do know that most MS-IVs applying to Ortho apply VERY widely and broadly.

Out of curiosity, how do you both know you'll get honors in the remaining clinical rotations?

As an IMG, your girlfriend needs to apply widely as well, despite her excellent Step 1 score (which obviously helps). IIRC, there's also only one EM residency in Colorado.

And I hate to bring this up, and feel free to ignore this question if you want, but do you two have solid long-term plans? The couples match is usually more geared towards those who are engaged/married. Just something to consider.

 

[cleansocks]

To answer your 2 questions: we're just confident about the rest of the rotations; nothing's guaranteed of course. Her and I have been in a long distance relationship for 6 years. It would have been impossible without long term plans.

Thanks for reply; I too am worried about having to apply too broadly, which is why i'm strongly considering less competitive anaesthesiology (also interests me of course). Is EM hard to get into for solid IMG's? I know anything's hard to get into for IMG's.

On a semi-unrelated note, she got 3 LOR's from attendings here in the US. Does anyone know how many she needs to submit total and of those how many should be from her own institution vs US docs?

Thx

 

[gng930]

It's tough to make a call until she completes her Step 2 exam. Being a U.S. citizen, CS shouldn't be much of a problem, but a poor CK score supercedes a fantastic Step 1 score for IMGs IMO. If she scores close to her Step 1 score, EM is very doable. In CA specifically? That brings up another issue other than the fact that it might be the most difficult state to get into in general.

CA is notorious for putting IMGs through all kinds of hoops to practice there. All of the UC programs will want the PTLA by 12/1/2008 (assuming you're going for 2009 match). Will she graduate on time? Remember that processing can take months (first for the ECFMG cert then the actual PTLA). Without the PTLA, her options are cut down to about half (although admittedly the easier half)
.

 

[NotAProgDirector]

On a semi-unrelated note, she got 3 LOR's from attendings here in the US. Does anyone know how many she needs to submit total and of those how many should be from her own institution vs US docs?

Thx

All of her letters should be US letters. So the answer is 3. The fourth letter will need to be the PTLA, as mentioned above.

 

[cleansocks]

Thx for replies.

Do others agree that step 2 is super important even for IMG's with great step 1 scores?

I will research these "PTLA" (initial google search reveals percutaneous transluminal angioplasty =) and "EFIMG cert's" that I admittedly know nothing about.

Good to know the LOR's should all be by US docs. However, it seems strange to me that programs want nothing in that regard from her own well respected albeit non-American institution.

 

[jeeb75]

The PTLA is actually PTAL (Post Graduate Training Authorization Letter). This is a requirement for IMGs to start a residency in California. American grads do not need this.

Here is the link for the CA Medical Board http://www.medbd.ca.gov/

Here is an article on an IMG getting PTAL http://usmlein.com/usmle/?page_id=74 .

The EFIMG cert is actually ECFMG certificate. This is received when an IMG complete Step 1, Step 2CS, Step 2CK and verification of credentials from medical school. Information can be found at www.ecfmg.org .

Step 2 score is important for IMGs. Also, many IMGs are taking Step 3 before residency and some programs prefer if it is done when they look at IMGs.

 

[cleansocks]

Thanks for the links.

It looks like the PTAL should take about 3 months if we can get her into CA at some point for the top-secret FBI fingerprint scan, 6 months otherwise =/. Maybe when she takes step 2 CS which could be done in LA she could get the fingerprints at that point?

Gng930 above mentioned that we need the ECFMG before (presumably for) the PTAL. Is this the case? I could not find this requirement in the article link or in the IMG instructions provided by the CA medical board website. Also, the FAQ on the ECFMG website is exceptionally vague for how long it should take to process the application once all the necessary documents are in. Does anyone know how long it takes?

She graduates in July 2008. We'd want to start applying for the coming cycle. So if ECFMG processing time is negligible, it should take ~3.5 months for the PTAL from that point assuming we fingerprint scan in CA. That being the case, it seems to me she would have to have completed the step 2 CK by no later than July 1st (due to 4-6 week grading time), and preferably sooner, to get the PTAL in by Dec 2008.

So this is the timeline I'm seeing:

Step 2 July 1st ----6 weeks---> Results August 15th, Apply for ECFMG and PTAL ----3 to 3.5 months---> December 1st.

Would appreciate any answers to Q's I ask above and analysis of this timeline. I hope I'm wrong about when she has to take step 2 b/c this would require her to fly back to the US before graduating (expensive) and to study for the step 2 during her final core rotation.

 

[jeeb75]

Delays for PTAL usually occur due to the medical college taking time to verify documents and if the fingerprints are done outside of California. To speed up the process, do the live scan in CA if possible. Also, make sure the medical college sends in the documents (L2 and L5) quickly.
My PTAL took 2 months. I made sure my medical college sent in the paperwork right away and as I live in CA I did the live scan fingerprints.
Also, send in form L1 as soon as possible as the processing time countdown starts from when you send this form in.

Also, the best thing to do is call the CA board. I am sending you a PM with a direct number to the lady in charge of licensing at the medical board.

 

[gng930]

Sorry for any inaccuracies in my post, but I think everyone else has caught them all. I'm a MS-4 myself so I haven't gone through the process first hand. After looking again, I don't think the ECFMG certificate is required, but the diploma still would be. I've been told that for a US-IMG like myself, I am safe as long as I collect L6 forms properly throughout my rotations and start filing the other paperwork if, and when, I match into a CA program. Not sure if the process is any different for your GF, but the guidelines I follow were written up for St. George's graduates who are U.S. citizens.

http://www.valuemd.com/st-georges-university-school-medicine/6411-california-issues.html

 

[cleansocks]

So I have a couple of questions about the PTAL that the CA board representative I spoke with was, for a reason beyond my comprehension, unable to answer.

1. Apparently official processing of the PTAL app begins as soon as the L1 forms and the application fee are submitted. Can official processing of the L1 forms begin without having obtained a diploma and/or step 2 scores or are one (or both) of these required? I notice that on L1 it asks you to list medical school graduated from, diploma obtained, year of graduation as well as tests taken and scores obtained. SO I'm wondering if the official processing of the apps can begin even if these sections lack step 2 results and graduation status.

2. On average it takes 60 business-days to complete processing for the application. If I submit the L1 forms and fee, then near the end of that 60 business-day average (say 50 business-days later) I turn in the rest of the information needed to complete the app, can I still expect the entire processing to be complete around 60 business days or will it be significantly delayed?

3. Also, she said that she has "no idea" when the PTAL needs to be completed and implied, but did not say specifically, that this deadline is program specific. Is that correct? I can't say I have much confidence in this person's mental faculties.



I really need answers to these Q's to figure out how late my GF can take the step 2's and still apply to residencies in time. Any help greatly appreciated.

 

[NotAProgDirector]

So I have a couple of questions about the PTAL that the CA board representative I spoke with was, for a reason beyond my comprehension, unable to answer.

1. Apparently official processing of the PTAL app begins as soon as the L1 forms and the application fee are submitted. Can official processing of the L1 forms begin without having obtained a diploma and/or step 2 scores or are one (or both) of these required? I notice that on L1 it asks you to list medical school graduated from, diploma obtained, year of graduation as well as tests taken and scores obtained. SO I'm wondering if the official processing of the apps can begin even if these sections lack step 2 results and graduation status.

2. On average it takes 60 business-days to complete processing for the application. If I submit the L1 forms and fee, then near the end of that 60 business-day average (say 50 business-days later) I turn in the rest of the information needed to complete the app, can I still expect the entire processing to be complete around 60 business days or will it be significantly delayed?

3. Also, she said that she has "no idea" when the PTAL needs to be completed and implied, but did not say specifically, that this deadline is program specific. Is that correct? I can't say I have much confidence in this person's mental faculties.



I really need answers to these Q's to figure out how late my GF can take the step 2's and still apply to residencies in time. Any help greatly appreciated.

If the PTAL office couldn't answer these questions, I'm not sure that anyone here can either. Still, I would expect the answers to be:

#1 and #2 - I doubt they will begin processing anything until your application is complete. I would assume that the 60 day clock begins when all documentation is received. Remember that 50 business days = 10 weeks!

#3 - Others have mentioned that many CA programs require the PTAL to consider an offer for interview. Hence, you need it really early in the process, hopefully before Nov 1st to be the most competative.

 

[cleansocks]

If the PTAL office couldn't answer these questions, I'm not sure that anyone here can either. Still, I would expect the answers to be:

#1 and #2 - I doubt they will begin processing anything until your application is complete. I would assume that the 60 day clock begins when all documentation is received. Remember that 50 business days = 10 weeks!

#3 - Others have mentioned that many CA programs require the PTAL to consider an offer for interview. Hence, you need it really early in the process, hopefully before Nov 1st to be the most competative.

So the earlier one applies, the more competitive they are? Is this always the case?

 

[NotAProgDirector]

So the earlier one applies, the more competitive they are? Is this always the case?

Yes, as it shows you are organized, taking this seriously, and have your wits about you. Applying on Sept 1 is not really any better than Nov 1, but after Nov 1 it looks like you just weren't trying hard.