2007 match: 20% of gen surg spots filled by FMGs?

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MacGyver

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NRMP says that 823 US seniors matched in gen surg this year for a total of about 1050 positions.

NRMP doesnt say how many US seniors applied to gen surg.

I was under the impression that FMGs generally get the leftovers, but apparently thats no longer the case, or else gen surg is not nearly as competitive as everybody claims it is.

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From looking at my school's rank list, it appears that a bunch of my classmates went for gen surg and didn't match. I don't know their scores or class rank, but I'd venture a guess based on what I do know of them, that they were pretty competitive applicants.

We did have some really excellent matches, however they were mostly in IM, EM and urology. We had 6 prelim-only surgery matches and 4 surgery research matches, with 12 categorical matches. Slightly better than a 50% match rate. And that doesn't count anyone who may have scrambled into something else entirely.

To be fair, the research matches are probably just people waiting on the ACGME to reaccredit the school's own program, and at least one of the prelim-only matches wasn't actually a gen surg casualty. But it still reflects poorly to have so many go unmatched.
 
NRMP says that 823 US seniors matched in gen surg this year for a total of about 1050 positions.

NRMP doesnt say how many US seniors applied to gen surg.

I was under the impression that FMGs generally get the leftovers, but apparently thats no longer the case, or else gen surg is not nearly as competitive as everybody claims it is.

This is a longstanding pattern in general surgery. See http://www.nrmp.org/res_match/tables/table6_06.pdf

Likewise, for the last several years, there have also been many more US senior applicants than GS spots. In the 2005 match (data posted on NRMP site, http://www.nrmp.org/matchoutcomes.pdf) there were about 2.5 applicants for each GS spot (1.5 US seniors + 1.0 all others). US Seniors are either overestimating their competitiveness in a tightening market or would rather change careers than train at programs which FMG's are willing to accept.
 
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US Seniors are either overestimating their competitiveness in a tightening market or would rather change careers than train at programs which FMG's are willing to accept.

I think it's more likely that US seniors are overestimating their competitiveness, since it appears that a substantial number are willing to put their necks out for a prelim year instead of choosing another specialty. I'd bet that every single one of those people would have widened their net if they had any kind of realistic idea of where they stood among the applicant pool. But since the programs fill with FMGs (who knew already that they had an uphill battle and applied widely), they don't have that opportunity. And where do most people get a sense of how competitive they are? From the faculty they talk to and the people they ask for advice.

It's one thing to get good advice and fail to match because you ignored it, but somehow I don't think that's what's happening.
 
I'm never sure how to interpret these numbers, because they talk about US applicants, but Canadian graduates are considered equivalent (all Canadian schools are LCME accredited) and therefore not FMG/IMG status. I know there probably aren't many of us (as there are only ~2000 grads per year and most are staying in Canada for residency)...but I would be interested in where we fall/what our statistics are.
 
I don't think current PGY-1 residents who are looking for a categorical position are included in that statistic, although I am not sure how many applicants that actually represents.
 
NRMP says that 823 US seniors matched in gen surg this year for a total of about 1050 positions.

NRMP doesnt say how many US seniors applied to gen surg.

I was under the impression that FMGs generally get the leftovers, but apparently thats no longer the case, or else gen surg is not nearly as competitive as everybody claims it is.


Remember "US seniors" does not include Independent Candidates, which would include DOs, Canadians, FMGs/IMGs as well as others who have either taken a year off or are switching specialties (ie, the IM PGY1 who decides to switch to surgery).

Unfortunately, the data tables provided to date don't have this broken out. Generally, the annual education issue of JAMA in September will and NRMP will have it posted before then.
 
...And where do most people get a sense of how competitive they are? From the faculty they talk to and the people they ask for advice.

It's one thing to get good advice and fail to match because you ignored it, but somehow I don't think that's what's happening.


I suspect some people are getting bad advice. It is not uncommon to hear, outside (and even sometimes inside) SDN, people talking about how easy it is to match into general surgery. Like attendings with bad fashion sense, there are those whose match information is about 5 years out of date. If they don't directly participate in the match process (meaning interviewing and attending ranking discussions), they likely don't really know what is competitive and what isn't.

Take with a grain of salt.
 
As an FMG who matched into categorical surgery this year, I realized a few things along the interview trail. It's true that many US grads (and FMGs as well) overestimate the strength of their application, not just for surgery but for many other fields as well. I ran into many people who only applied to <30 programs and received <10 interviews who were quite satisfied with what they got. They claimed that this PD from this program told them they were great and will be ranked high and they were sure they would match there. It's like interviewing for a job: BELIEVE NO ONE. Then when people don't match, they are so shocked and disappointed. C'mon people...we are doctors....we are intelligent people. Stop having delusions of grandeur!! This whole process should not surprise anyone. If you are from Harvard with Steps of >240 and excellent recs from well-known people, then maybe ranking more than 10 programs is over the top. Otherwise, in a competitive field, play the numbers.

Secondly, many people who had low scores even had the nerve to say that they don't want to be at such-and-such program because the cafeteria had bad food, parking wasn't free, not enough textbook funds, etc. These factors are largely frivolous in the bigger scheme of things. If you can go to a program that has all these perks, great. But if these perks aren't there, would you not ranked a program and go unmatched for that reason? I'm sure that there will be many more people in the future who will go unmatched because of these reasons and it serves them right.

As for programs filling with FMG's, many PDs don't want to risk having the program on probation due to low board passage rates, which is common in general surgery residency. So they look for FMG's (mostly US-IMG's) with high Step scores (which correlates to high surgery board scores) to boost the numbers. As one PD told me, "My priority is to protect the program first and foremost."
 
So the mantra that I hear constantly on the SDN forums that FMGs only take hte leftovers is obviously a load of crap huh?

This looks like strong evidence to me that FMGs are treated pretty much equal as US grads in the surgery match. Maybe in urology or derm there's more of a stigma against FMGs, but I think the data shows thats not the case in gen surg.
 
I believe what blackdiamond says because I heard the exact same things from 2 PDs from two different surgery programs.....that they would rather have FMGs with higher board scores than a US medical grad with sub-standard scores. Their reasoning was, if the FMGs are capable to doing well in the usmles, then they will probably do well in their ABSITE exams. Failing those surgery boards means the program will probably end up in probation and be scrutinized.....which no PD wants to go through. But having said that, US medical grads obviously still get picked before FMGs if their scores are just a few points below their FMG counterparts. But if a USMG has step scores of like 210 and an FMG has step scores of 240, then I think the FMG definitely has a better chance of matching.

I don't know if this phenomenon occurs in other residencies but I have definitely seen this happen in surgery.
 
I was under the impression that FMGs generally get the leftovers, but apparently thats no longer the case, or else gen surg is not nearly as competitive as everybody claims it is.

So the mantra that I hear constantly on the SDN forums that FMGs only take hte leftovers is obviously a load of crap huh?

This looks like strong evidence to me that FMGs are treated pretty much equal as US grads in the surgery match. Maybe in urology or derm there's more of a stigma against FMGs, but I think the data shows thats not the case in gen surg.

Well, I know that you generally prefer inaccurate generalizations to actual facts, but Pilot Doc's link spells out GS's competitiveness, even using your own crapped out logic:

http://www.nrmp.org/res_match/tables/table6_06.pdf

In there, it says that last year General surgery was filled by 83% US seniors, which according to the pdf file is behind Ortho, derm, and plastics, and ahead of almost everything else.

As for the statement that IMGs are treated equally to US seniors, that's a very obvious and extremely weak troll job.

I believe what blackdiamond says because I heard the exact same things from 2 PDs from two different surgery programs.....that they would rather have FMGs with higher board scores than a US medical grad with sub-standard scores. Their reasoning was, if the FMGs are capable to doing well in the usmles, then they will probably do well in their ABSITE exams. Failing those surgery boards means the program will probably end up in probation and be scrutinized.....which no PD wants to go through. But having said that, US medical grads obviously still get picked before FMGs if their scores are just a few points below their FMG counterparts. But if a USMG has step scores of like 210 and an FMG has step scores of 240, then I think the FMG definitely has a better chance of matching.

I don't know if this phenomenon occurs in other residencies but I have definitely seen this happen in surgery.


I'm sorry, but for most GS residency programs, the US senior with a 210 still easily trumps the IMG with a 240.
 
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It seems to me that most programs that have IMGs as categorical residents needed to fill a spot quickly when another resident left suddenly or unexpectedly, or if they have recently added categorical positions and are wanting to "back-fill." The IMGs are often able to start at any time and can sign outside the match, making it much easier for PDs to get someone right away.
 
I looked at those tables, and they say nothing about how many US seniors participated in the match, they only say how many actually matched. NO conclusion can be drawn from that regarding whether FMGs are getting spots over AMGs.

Unless of course, you assume that AMGs always get preference. And surely the circularity of that logic is obvious.
 
You can't forget that the match does not just take into account what the programs want, but what the students want as well. A lot of US students do not want to go to programs where there already are FMGs or where they may be in the same class as FMGs. I have heard people using that as reason to not rank a program.

Also, you have to consider where people are interviewing - US seniors and FMGs are likely not applying/interviewing at the same places (at least there weren't many at my interviews). I dont think that my home program even interviews FMGs, regardless of board scores. On one of my interviews, the PD said "the most important part of your application is the list of schools you've attended."

Likely, if you compare the rank lists of most FMGs and most US seniors, you will get a VERY different type of list.


Just my two cents... statement of the obvious :p


also don't forget that 5 years ago, gen surg was not filling, so FMGs got spots much easier back then, so obviously they are the senior residents now (again, obvious :p)
 
repeat post.

Hmm, I'm a FMG and I have not heard that US grads chose not to rank a place because there are FMGs, I think that is a pretty stupid reason. Well, if they do, good, then another FMG will have a better chance at matching.
 
Again, I think if they had it to do over, or if there were openings in those programs to scramble into, you might find that they would prefer to match at one of those programs over not matching at all. It's just not clear to many AMGs that those are their choices.

Also, I know a number of people who ended up ranking places where they didn't really want to match.
 
I dont buy the argument that there are weak gen surg programs that AMGs wont apply to. Maybe that was true 10 years ago, but its almost certainly not true in today's climate.

If you can give me a name of such a program, then I'd be happy to look up how many AMGS vs IMGs they have for residents.

I already said that I dont know how many US grads applied for gen surg, because the NRMP hasnt released that yet. But if the anecdotal reports here are true about lots of US grads failing to match, then I think its a good indicator that FMGs are competing with US grads in a way that they didnt before.

Of course the other explanation is that the US grads who failed to match were absolute idiots who chose only to rank top tier programs, only applied to 5 places, etc.
 
IFNGAMMA....Please check your PM
 
I think it's more likely that US seniors are overestimating their competitiveness, since it appears that a substantial number are willing to put their necks out for a prelim year instead of choosing another specialty. I'd bet that every single one of those people would have widened their net if they had any kind of realistic idea of where they stood among the applicant pool. But since the programs fill with FMGs (who knew already that they had an uphill battle and applied widely), they don't have that opportunity. And where do most people get a sense of how competitive they are? From the faculty they talk to and the people they ask for advice.

It's one thing to get good advice and fail to match because you ignored it, but somehow I don't think that's what's happening.


1) Osteopathic Graduates are not considered US Seniors. I am a graduating DO, and matched into a categorical, allopathic general surgery program, university based at that.

2) As for FMG's, i'll tell you what they told me at one University program in the midwest.
"We take one FMG per year, usually from AIMS (all india institute of medical sciences). Those residents have double 99's on their boards. They work hard, are humble, know their stuff, and crush the absite. In my opinion, they are the ideal surgical residents."

There's not too much to argue with there. The indian educational system was founded by the british. All of their classes are taught in english, granted many of them have some problems with english proficiency. You can't argue with numbers, and a lot of times, it's a numbers game.

3) For the most part, every FMG I interviewed with told me that they had applied to EVERY SINGLE GENERAL SURGERY PROGRAM ON ERAS, for both categorical and preliminary. Why would you take a, "graduating US senior" just because he has an MD from the US of A, when you've got a guy who's not going to act like he's entitled to anything with better numbers who's going to work harder?

If I were a PD, I wouldn't discount FMG's (or DO's) just because of where they came from. I'd look at everyone based on standardized comparisons (board scores), see what other people had to say about them (LOR's) and then talk to them and make a decision for myself.

Just one man's opinion.
 
As for the statement that IMGs are treated equally to US seniors, that's a very obvious and extremely weak troll job.


... ...

I'm sorry, but for most GS residency programs, the US senior with a 210 still easily trumps the IMG with a 240.

good thing for IMG's that you're not the one making the decisions.

I heard the same, "protect the program, first and foremost" line from more than a few program directors.

i'd have to disagree with you there. i think that there is a certain stereotype associated with "IMG"

people think "IMG" and think of a non-american born, probably Indian or Asian person with a thick accent and bad fashion sense (i'm indian, before you all start ragging on me).
"IMG" includes a wide variety of people, not all of whom speak broken english. Many of them were born right here, in the US of A, and decided for whatever reason, to go to school outside of the continental US or Canada (or DO school). And so, when this person who is familiar with our culture, speaks perfect english, and can relate to patients, has 240+ on their steps, why would a program director rather select an applicant with an MD from the US and inferior board scores? Doesn't make a whole lot of sense, IMHO.
 
I dont buy the argument that there are weak gen surg programs that AMGs wont apply to. Maybe that was true 10 years ago, but its almost certainly not true in today's climate.

If you can give me a name of such a program, then I'd be happy to look up how many AMGS vs IMGs they have for residents.

I already said that I dont know how many US grads applied for gen surg, because the NRMP hasnt released that yet. But if the anecdotal reports here are true about lots of US grads failing to match, then I think its a good indicator that FMGs are competing with US grads in a way that they didnt before.

Of course the other explanation is that the US grads who failed to match were absolute idiots who chose only to rank top tier programs, only applied to 5 places, etc.


there are some people that wont apply or rank places with FMGs... not every single AMG shares that opinion, so that's why there are not programs without any US grads... that's all. don't know if it's right or wrong... but some people do think that way... i guess it's like the people who refuse to apply to community programs...

i didn't follow this ideology myself... but i have talked to people in my class who do feel that way. i know a couple people who are upset that the program that they matched at has 4 FMGs (not surgery)

ah well... when there are thousands and thousands of rank lists, who knows how it works out... could just be a bunch of drunk monkeys doing the match for all we know :p


:luck: :luck:
 
Why would you take a, "graduating US senior" just because he has an MD from the US of A, when you've got a guy who's not going to act like he's entitled to anything with better numbers who's going to work harder?

Because I'm an U.S. citizen, and my tax dollars, and those of my family and all of my teachers throughout my schooling go to support resident education. And the government will more than make up in taxes and loan repayment the amount it spent to train me. However if I can't get training in a specialty I am competitive for because FMGs are getting those spots, then as a taxpayer I'm hopping mad that my tax money is paying for their education at the expense of mine.

Training in surgery is indeed a privilege, however it's a privilege that FMGs shouldn't have at the expense of U.S. citizens.

And I would have no problem whatsoever with DOs matching in allopathic residencies, if the AOA reciprocated and took allopathic graduates. Either they're equal or they're not. You can't have it both ways.
 
Because I'm an U.S. citizen, and my tax dollars, and those of my family and all of my teachers throughout my schooling go to support resident education. And the government will more than make up in taxes and loan repayment the amount it spent to train me. However if I can't get training in a specialty I am competitive for because FMGs are getting those spots, then as a taxpayer I'm hopping mad that my tax money is paying for their education at the expense of mine.

Training in surgery is indeed a privilege, however it's a privilege that FMGs shouldn't have at the expense of U.S. citizens.

And I would have no problem whatsoever with DOs matching in allopathic residencies, if the AOA reciprocated and took allopathic graduates. Either they're equal or they're not. You can't have it both ways.

I never thought a cookie could be so angry. Bottomline is that regardless of who you are competing with, it all turns out like it is suppose to. I tend to think that many US MDs that did not match were those that did not work hard enough or were too arrogant or uneducated about the application process. If you are a US MD and really want a particular position and work really hard for it, you will always get it.
 
Samoa, let me first begin by saying you look quite delicious and scrumptious. I think most DOs completely agree with you. There should be a combined match and every year this topic is brought up by DO students across the country only to be shot down because the powers in charge do not see it that way since they stand to loose a lot of money and power if the match ever combines.

werd
 
However if I can't get training in a specialty I am competitive for because FMGs are getting those spots, then as a taxpayer I'm hopping mad that my tax money is paying for their education at the expense of mine.

Samoa, NOBODY is saying that a "truly competitive" USMG should not get a spot at a residency program. Infact, I maintain that if there is a USMG and an FMG with similar credentials, the USMG should definitely be given preference just because of the fact that he went to a US medical school. Even in reality, a competitive USMG generally gets what he/she wants and when he doesn't, it is usually because another USMG had better scores than him and ended up taking his spot.....not because an FMG stole it from him. As I mentioned in an earlier post, the only way an FMG can take a USMG's spot is if a USMG had below average usmle scores and the FMG happened to have >230-240 scores. In this scenario, how the hell would you consider the USMG to be competitive with below average step scores......
 
This whole banter back an forth about USMG, FMG, IMG's etc. is kinda funny.

i will give you a view from the outside looking in ... from a more competitive specialty ... the most common problem i see in our non matching students is the over state their worth. they believe what others have said to them and then they expect to match because one or two people of some significants said they were "good" or "will match" ... i have talked about this on one of my blog entries Calls, Lies, and Letters ....

looking at numbers of FMG's IMG's that have matched and trying to figure out why there are so many that have matched is pointless ... those who didn't match ... it was for a reason (bad interview, low scores, poor grads, not enough interviews, not enough programs ranked) ...

looking at many of the FMG's and having worked with them ... many are extremely bright, hard working, motivated, and skilled ... many have already practiced as a physician oversees ... many have done significant research ... they also don't take things for granted ... something many of us who train students notice in today's residents ....The residents and medical students now adays are soft ..... a tongue and cheek thing i wrote voicing some concerns about a trend that i and many of those dedicated to training residents and medical students have noticed

i think there is a misconception that people who have not trained in allopathic american medical schools are not up to par ... there are many USMG from allopathic schools who are below par ...

so ... that is my 2 cents ... i will state for the record i am a USMG from a top 20 school, trained at a well known orthopaedic residency and fellowship (all allopathic) and have held positions at 2 allopathic us medical schools ... i also have been on the resident selection committee at 3 universities ...

that is all i got ... to all those who have match congrats ...
 
Because I'm an U.S. citizen, and my tax dollars, and those of my family and all of my teachers throughout my schooling go to support resident education. And the government will more than make up in taxes and loan repayment the amount it spent to train me. However if I can't get training in a specialty I am competitive for because FMGs are getting those spots, then as a taxpayer I'm hopping mad that my tax money is paying for their education at the expense of mine.

Training in surgery is indeed a privilege, however it's a privilege that FMGs shouldn't have at the expense of U.S. citizens.

And I would have no problem whatsoever with DOs matching in allopathic residencies, if the AOA reciprocated and took allopathic graduates. Either they're equal or they're not. You can't have it both ways.


bottom line--there are more residency spots than there are US MD graduates. That means that in order not to have unfilled spots, they have to allow "others" into the fracas. basically, what you're saying is that if there is a specialty that you're "competetive" for, but there is someone who is more competetive (based on numbers) than you, then you should get the spot by virtue of the fact that you are a US citizen. Honestly, this sounds a lot like affirmative action to me, which is not something I agree with either. If the AMA is going to allow DO's and FMG's into the NRMP match, then the most qualified and most appropriate candidates for the job should get the job. That call is made by the program directors and residency selection committees, bottom line. We all take the same tests, and are all evaluated on the same parameters.

I agree that the AOA should allow MD students into the match; or rather, i'm a proponent of a joint match. The AOA has resisted this for a long time. However, the winds of change are blowing.

We pay taxes for a lot of things--the government gives money to a lot of different programs--what about US citizens who are FMG's?
 
The day that Canada/Europe and the rest of the world has the same open door policy for FMGs that we have here is the day I'll agree that FMGs should compete on an equal basis with the american grads.

Do you guys have any idea how ridiculously hard it is for FMGs to go to CAnada/Europe? The USA has the most liberal FMG policy in the industrialized world, so I'm not going to shed tears for any of them.
 
MacGyver

i think you are miss informed. there is not an open door policy ... all people who come to the us have to under go all of the same training that those in the US do ... this means even if you have been in practice in another country (except Canada and i think maybe the UK) you must first pass all of the USMLE exams as well as the clinical portion ... then they must repeat their residency requirements ... the US policy is by no means open door ... many of the FMG's / IMG's have already completed a residency ... to some this makes them more marketable ... imagine accepting a resident who has already practiced his / her craft ... it makes it so much easier on the attending staff if you already have some of the skill set needed to practice your craft ... so, young padawan ... it is not easy for those from a foreign country to practice in this country ... many actually have worked here in another role before being accepted into residency (research, technical jobs, ect.) ... they are also not offered the opportunities to many of the very prestigious residencies .... many go to the residencies considered lesser by their american counter parts ...

so i guess believe what you will ... but, i don't think the FMG's are preventing qualified residents from obtaining a residency ... it is more likely that the applying resident was beat out by a more qualified resident candidate ... and remember it is just a numbers game
 
MacGyver

i think you are miss informed. there is not an open door policy ... all people who come to the us have to under go all of the same training that those in the US do ... this means even if you have been in practice in another country (except Canada and i think maybe the UK) you must first pass all of the USMLE exams as well as the clinical portion ... then they must repeat their residency requirements ... the US policy is by no means open door ... many of the FMG's / IMG's have already completed a residency ... to some this makes them more marketable ... imagine accepting a resident who has already practiced his / her craft ... it makes it so much easier on the attending staff if you already have some of the skill set needed to practice your craft ... so, young padawan ... it is not easy for those from a foreign country to practice in this country ... many actually have worked here in another role before being accepted into residency (research, technical jobs, ect.) ... they are also not offered the opportunities to many of the very prestigious residencies .... many go to the residencies considered lesser by their american counter parts ...

so i guess believe what you will ... but, i don't think the FMG's are preventing qualified residents from obtaining a residency ... it is more likely that the applying resident was beat out by a more qualified resident candidate ... and remember it is just a numbers game


word up pedi
i'll tell you of three such residents i worked with.

one was a CT surgery/heart transplant attending from India, then the UK. He came here, worked as a research assistant doing heart transplants. Then, he started gen surgery residency. This guy has the neatest handwriting, most comprehensive notes, and when he's on vascular service, the attendings intentionally overbook their cases because it's like having an extra attending on service.
One was a pediatric CT surgeon in the phillipines. seen dozens of TOF, very skilled, technically, from what i hear. i never worked with him.
One guy finished a surgery residency abroad, came here and did a CT fellowship at a VERY prestigious program, then, because he wasn't board eligible in GS, started at a GS program here in the US AS A PRELIM, worked his tail off, and moved into someone else's spot.
If I were a PD, i wouldn't blink an eye before taking one of those guys over some guy from a US school who thinks he deserves a spot because his family pays their taxes.
 
This argument is pretty worthless. We all know that USMGs are shown the appropriate preferential treatment. The only people that are scared of IMGs "taking their jobs" are marginal applicants.

And just to reiterate a previous statement I made, if I was forced to bet money on the match, I'd feel a lot more comfortable with the chances of a US Senior with a 210 Step 1 than an IMG or DO with a 240.


Also, I believe that somebody asked earlier about undesirable residencies where the majority of residents are IMGs: These absolutely exist, and I ran across a bunch of them when I researched programs 2 years ago. There seems to be a large focus in New York (look at a caribbean school's match list and you'll see where I'm talking about), and then small community programs throughout the nation that you've never heard of.
 
This argument is pretty worthless. We all know that USMGs are shown the appropriate preferential treatment. The only people that are scared of IMGs "taking their jobs" are marginal applicants.

And just to reiterate a previous statement I made, if I was forced to bet money on the match, I'd feel a lot more comfortable with the chances of a US Senior with a 210 Step 1 than an IMG or DO with a 240.


Also, I believe that somebody asked earlier about undesirable residencies where the majority of residents are IMGs: These absolutely exist, and I ran across a bunch of them when I researched programs 2 years ago. There seems to be a large focus in New York (look at a caribbean school's match list and you'll see where I'm talking about), and then small community programs throughout the nation that you've never heard of.


Agreed with SLUer....there is no point in arguing about this because a "good" USMG WILL get a spot somewhere.....no doubt about that.....and rightfully so, they deserve it for the hard work they put in. It is the marginal USMG applicants (and you'll know who you are) that keep bitching and moaning about FMGs stealing their spots.

Also, it may be true in some instances that a USMG with a 210 will probably get a spot over an FMG with a 240.....which will never make sense to me. But just because they do so does not make it right. But I guess that's life.
 
Agreed with SLUer....there is no point in arguing about this because a "good" USMG WILL get a spot somewhere.....no doubt about that.....and rightfully so, they deserve it for the hard work they put in. It is the marginal USMG applicants (and you'll know who you are) that keep bitching and moaning about FMGs stealing their spots.

Also, it may be true in some instances that a USMG with a 210 will probably get a spot over an FMG with a 240.....which will never make sense to me. But just because they do so does not make it right. But I guess that's life.

Well let's see if I can help you make more sense of it.

The American grad that scored a 210 did it with two months of study time, the FMG with the 240 most likely did it with 2 YEARS study time, huge difference.

I have met many great FMG's, not saying anything bad about them, just stating that scores between the two are apples and oranges. That 210 American grad may have been able to pull a 270 if he/she studied for 2 years for one test.

Besides that, we all know some great test takers, foreign and American, that are not very good when it comes to taking care of patients.

The above is part of the reasons that it is tougher for a FMG to land a residency spot.

Many programs are very friendly to FMG's, but they have them do prelims so they can see which ones are for real good applicants and which ones are paper and fluf, keep the good ones as categoricals the next year. It's unfortunate that it has to come to that, but it is a good plan IMO with the current discrepancys in study times etc.
 
So most or all of the US grads who didnt match were marginal/subpar then?

Whats all this crap I hear about gen surg applicants being a highly self-selected group? Thats obviously a lie if what you say is true. Cant have it both ways.
 
So most or all of the US grads who didnt match were marginal/subpar then?

Whats all this crap I hear about gen surg applicants being a highly self-selected group? Thats obviously a lie if what you say is true. Cant have it both ways.

Most, not all. There's always a story about a great applicant that slipped through the cracks, but most non-matched US seniors have a couple red flags on their applications.

As far as the crap you're hearing, I'm pretty sure it's the verbal diarrhea coming out of your own mouth.
 
So most or all of the US grads who didnt match were marginal/subpar then?

Whats all this crap I hear about gen surg applicants being a highly self-selected group? Thats obviously a lie if what you say is true. Cant have it both ways.

Nobody said anything about having it both ways. General surgery in the last few years has become one of the more competitive fields. Last year "the big three" in competiveness were Derm, Radiology and Gen Surgery according to the match people themselves in their post match article.

Someone has already pointed out that the only thing counted in that "83%" was GRADUATING US ALLOPATHIC SENIORS. Not the ones that took a year off and did research, DO's, and prelims that matched.

There are many programs that give a deserving prelim a spot every year. Those count "against" that number you are refering to.

I know a girl that didn't match last year due to the military, she entered the match too late for interviews and had to scramble for a spot. She was a good surgery resident and they rewarded her this year with a categorical. They had 5 categorical spots, but according to the above criteria they "only" filled 80% with US allopathic seniors. In truth they filled 100% with US Medical grads since she was from U of Texas but as a prelim she doesn't count.

I would hope that all Surgery programs would have the common manners to offer at least one good prelim a year a spot if they have earned it. They probably don't but the ones that do would also skew that "number" you are talking about.

You are stating yourself that marginal candidates don't match in General Surgery. If they screen out marginal candidates isn't that "selective"?

As long as we are generalizing then yes, the majority of US Seniors that didn't match in GS either were either marginal, had poor interviewing skills, or over estimated their competitiveness by listening to people claim that GS "isn't really competitive" and didn't rank enough programs.

There are also many deserving applicants every year in every competitive field that are screened out due to bad luck, timing etc but as a general rule I would say the majority were as above.
 
Most, not all. There's always a story about a great applicant that slipped through the cracks, but most non-matched US seniors have a couple red flags on their applications.

So what classifies someone as a marginal canidate? And how the heck does one as a marginal canidate have half a hope of a spot?
 
Well let's see if I can help you make more sense of it.

The American grad that scored a 210 did it with two months of study time, the FMG with the 240 most likely did it with 2 YEARS study time, huge difference.

I have met many great FMG's, not saying anything bad about them, just stating that scores between the two are apples and oranges. That 210 American grad may have been able to pull a 270 if he/she studied for 2 years for one test.


well i disagree. am a FMG and studied for step 2 CK which I took in my last year after 1.5 months study time.

Some FMGs do sometimes take upto 6 months as they might be consultants having left their subjects long time back. Imagine yourself studing Biochem, Physio, Anat and Micro 5 years from now. How much would you remember?

Another thing is some FMGs study on a different, generally British system, so it may take them a month to adapt to the different style of questions.

The mean among FMGs is slightly lower than AMGs for a variety of reasons. The top among FMGs would also be about the same as top AMGs. And it is these few top FMGs that manage to get into competitive fields like gen surg, plastics etc. And besides the scores, they have great letters of recommendation as well.

so it is actually orange vs orange, IMHO
 
all things held equal, who has the better chance of getting into a gen surg residency-- a US DO or carib FMG?
 
all things held equal, who has the better chance of getting into a gen surg residency-- a US DO or carib FMG?

interesting question, but it seems to me it's the caribbean FMG. When I was looking through a lot of programs' websites and looking at the roster of residents, very few were DOs and there were a lot more residents from the caribbean schools. And also when I was on the interview trial (I went to 16 interviews), I met a total of 4 DOs while I met many FMGs. So from these 2 observations I would say a caribbean FMG has a better chance.
 
all things held equal, who has the better chance of getting into a gen surg residency-- a US DO or carib FMG?


I would agree with IFNgamma. I had a similar experience. I didn't meet any DO's while on the trail, but did run into several FMG's. While this doesn't answer the question, I think it might hint that FMG's are seen more favorably than DO's.
 
... something many of us who train students notice in today's residents ....The residents and medical students now adays are soft .....

I can't stand hearing things like this; lamentations about how inferior 'nowadays' are to some imagined past full of brilliant doctors living at the hospital 24/7/365. Were there not stupid people back then who managed to float through school or fall between the cracks of their training? Just because some have chosen to question some of the practicalities of medical training that have persisted ONLY in the name of 'tradition' doesn't say anything about that generation's work ethic or intelligence. Let's not forget that we now admit that the way things were back then directly endangered patient's lives (sentence #1 in that oath thing...).

Sorry for the brief off-topic, but I hate that attitude. I am not inferior to someone who was born before me just because of the fact, and the 80-hour work week does not make me inferior to someone who trained without it, and I don't think it is appropriate or intelligent to go around saying so. I am not 'soft'.
 
interesting question, but it seems to me it's the caribbean FMG. When I was looking through a lot of programs' websites and looking at the roster of general surgery residents, very few were DOs and there were a lot more residents from the caribbean schools. And also when I was on the interview trial (I went to 16 interviews), I met a total of 4 DOs while I met many FMGs. So from these 2 observations I would say a caribbean FMG has a better chance of matching into a general surgery residency.

Can anyone verify if this is just anecdotal evidence or actually true? I will be applying to schools in a few months and this information may influence my decisions. Thanks.
 
Can anyone verify if this is just anecdotal evidence or actually true? I will be applying to schools in a few months and this information may influence my decisions. Thanks.

This is certainly anecdotal, but you can check for yourself. Go to the website of a program you are interested in, and look at the roster of residents and see where they went to medical school. You will find very few programs w/ DOs in their program, and if you do manage to find one, the MDs far outnumber the DOs, and out of those MDs, some are FMGs.
 
This is certainly anecdotal, but you can check for yourself. Go to the website of a program you are interested in, and look at the roster of residents and see where they went to medical school. You will find very few programs w/ DOs in their program, and if you do manage to find one, the MDs far outnumber the DOs, and out of those MDs, some are FMGs.

Perhaps you noticed less DO's during your interview trail for the following reasons:

1) DOs only make up 6% of the total physician population in the U.S. And even then, they tend to be more concentrated in certain states (PA, MI, NY/NJ, etc)
2) DOs have their own General Surgery programs.

To the poster trying to decide b/w Caribbean MD vs. US DO, please understand that there is a clear bias against DO's in allopathic General Surgery residencies. I'm not denying that. But as a DO, you have your own residency programs as well as the ability to apply for allopathic programs.

Last time I checked, Caribbean MD's don't..;)
 
DO PCPs don't care if you went to an allopathic residency as well. They tend to refer to their own and there is a much higher percentage of DOs that go into primary care than allopaths.
 
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