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Discussion in 'Re-Applicants [ MD / DO ]' started by BrianK0220, May 2, 2012.
The DO>Caribbean gap is getting bigger due to the coming residency crunch. If you want to do residency and practice in the US, it's much better.
A quick search looks like DOs aren't recognized in Mozambique. However, it's my understanding that if you join an organization like Doctors Without Borders, you can still practice as a physician in countries that don't give DOs equal practice rights with MDs. You just can't go there and set up a practice.
Remember that it might be difficult to swing the 50/50 time share you're planning. The fact that you'll be gone half the year would be a turn-off for many groups, and someone will have to cover your patients when you leave the country. If you tried to set up your own practice, it would be next to impossible to find staff who would be willing to only work half the year.
What's the residency crunch? Is this simply that residency spots are not increasing and medical graduates are? How bad is it expected to be?
I've heard it framed in as many scenarios as possible. From IMG's being competitive with DO's for residency spots to IMG's being shut out of US residency completely.
I think it's going to get to the point where IMG's can expect to have multiple attempts before matching. And I think (but could be wrong) that surgery will be all but off the table at that point as well.
a thousand times yes.
The only reason to go to the Caribbean is to have the MD after your name and if you believe you are a special snowflake who can succeed where 60%+ of your incoming class can't.
You might run into some problems with trying to practice in Mozambique and you will have to fight for it, but then again practicing medicine in any foreign country even with an MD is hard. It's better to know you are pretty much guaranteed a residency as a DO (osteopathic GME exists too!) and you will be much more competitive in ACGME residencies than IMG's will.
Go DO and don't look back.
+10000. Something to think about, there were 3 new DO programs opened this year in addition to all the new MD programs as well that are all US based. So do you get part of the coming residency crunch? As others have said go DO and never look back. The international community is starting to turn around for international locales, and will continue to do so. In answering the question about Doctors without Borders yes DOs are absolutely recognized and warmly welcomed once you complete residency.
Don't worry about the DrPH. The problem with your application is the MCAT, and building on a good graduate GPA isn't going to help that. If you get a 26 or better, I'd expect you'd have several DO acceptances to choose from, and if you can get 30+ you'll be in the running for US MD.
I'd finish out the MPH and throw everything I had at the MCAT. If you have downtime after graduating, get some work experience and try to put some money away.
An MD from a non-LCME accredited school such as SGU or Ross does not give one the same international practice rights as an MD from an LCME accredited school. You will be considered a foreign grad with U.S citizenship.
In general a US DO has greater international privileges than a Foreign Medical Graduate MD.
Sure in the US, a D.O. has greater privileges and less hoops to go through than a FMG MD, but I don't think this is the case in foreign countries especially those who have osteopaths, which are completely different than DOs in the U.S.
SGU is overcrowded anyway.
What extra hoops does a SGU graduate have to go through....to practice in the US. I thought SGU graduates are well repected in the US.
Every FMG has to score higher to match in residency. Many, but not all states have additional post-graduate training rules, for example, requiring 3 years instead 1 year of residency to sit for Step 3.
Secondly, Mozambique is a poor country, there's probably nothing stopping you from actually practicing in that country as a DO, even if the laws say differently. In that part of the world, it's more about who you pay off rather than what laws you obey.
If your goal is to work in Mozambique half the time you might have significant obstacles any route you take.
Doing the occasional DWB trip for a month might be okay, but if you're gone half the year, you leave your US patients and practice group partners holding the bag until you come back. Few groups will hire you and fewer patients will consider seeing a physician who is gone half the year and unavailable to them.
Sounds unrealistic but if that's what you want go for it.
Not difficult at all if you stick with the locums gig, then you can decide when and where you want to be in the US, get a license in that state and work locums for that duration. 3 -6 months is the timeline that many locums sites like to have as commitment. It's also 3-6 months on military bases and Indian reservations in the US. You do not have to join any type of permanent practice or group. Just plan ahead an you will be employed during the time you want to be.
While in general I'd agree with this, ACGME surgery is very unfriendly to DOs. In 2011, 108 FMGs (52 US citizens, 56 foreigners) matched to categorical surgery, as compared to only 28 DOs. Granted, this may be skewed by the number of each applicant type but it seems out of proportion compared to most other specialties, where DOs and US IMGs seem about equally represented.
Numbers above from this report.
Solid advice. Thanks a lot guys.
First of all, the only appropriate comparison is between US IMGs and DOs. FMGs have nothing to do with this because some of them have completed prior residencies in their home countries which is why you see some of them matching into ACGME derm spots, spots in which most DOs and USIMGs would have little chance at matching. You're also neglecting to mention the AOA general surgery slots reserved for DOs. When you examine the match data (which it sounds like you did), you can see that more DOs than USIMGs matched into fields like anesthesiology, emergency medicine and radiology (not ubercompetitive now, rads especially has taken a competitiveness hit the last couple years). More DOs than USIMGs also matched into Ob/Gyn. When you compare DOs and USIMG match statistics, a significantly higher percentage of US IMGs that match end up going into FM. Nothing wrong with family medicine, but it is generally considered the least competitive specialty in which to match, so the fact that USIMGs are matching into this field at a higher percentage than DOs is an indication that some programs prefer DOs to USIMGs.
It's true that at a few places, USIMGs are preferred to DOs (such as hospitals that St. George's affiliates with, and I've heard that Cornell won't take DOs, but will take USIMGs into anesthesia) but these places are few and far between. The empirical data suggests that DOs match better than USIMGs.
You also have the issue of away rotations, which are important for USIMGs that want to match into fields besides FM/IM/peds, and sometimes important in those three specialties as well. I have looked into this, and USIMGs still have to fill out separate forms and apps to do fourth year away rotations. US MD students have access to the online VSAS (visiting student application service), which lets them schedule rotations at hospitals/schools that are participating in the system. DO schools gained access to the system this year for their students (and 90% of participating schools have agreed to let the DO students rotate there), but the USIMGs are still shut out from it, and I don't see this changing anytime soon. Additionally, the paper application route for away rotations is filled with problems as well, because a decent number of programs will not take any foreign medical students for rotations, and that includes USIMGs.
For the next few years when comparing prospects of US MD, DOs and USIMGs in the match, I see it looking something like this:
US MD >> DO >>>> USIMGs
After 2018 or so, when the number of graduating US MDs and DOs equals the number of residency positions, I think USIMGs are in big trouble. I could see the match rate for a place like SGU, which is now maybe 80% (and that's the match rate for those that graduate, so we aren't including the failures and drop-outs), dropping substantially, maybe to 60% or so. Obviously the lower-tier Carib schools will get hit first and go from 25% matches to 0%, but it will affecct SGU eventually. DOs may feel the pain eventually too but the USIMGs are gonna feel it first, and DOs have their own residencies to fall back on (hundreds and hundreds of spots in family practice).
10 years ago this wouldn't have been the case (I would have said that the USIMGs and DOs were equal or maybe given the USIMG a slight edge assuming they were coming from St. George's or Ross), but programs that never used to take DOs (mid-tiers) are now trying them out, and after they take one, they are open to taking more if the first was successful.
You are correct that a number of specialties prefer DOs to US IMGs, and that underscores the point of my post--while DO>IMG in most situations, that may not be the case if someone is trying to match into ACGME surgery (I didn't address AOA surgery in my post because DOs obviously have the advantage there).
I understand that -- my only point was that the availability of the AOA match reduces the number of ACGME gen surg matches. When a DO matches AOA general surgery, they're pulled out of the AOA match. The evidence suggests that most general surgery programs are either willing to take both or are willing to take neither. Believing that USIMGs will still be able to match gen surg at the same levels 5 years from now would be a very optimistic prediction, and I do think that DOs will have an easier time than USIMGs at trying to match into gen surg in the future.
Sorry, what is an USIMG?
A US citizen who studies abroad for their medical education, usually at a Caribbean school.
recalling practicing privelges in various countries it is now Carib MD (38) to US DO (55). 3 years ago DOs were eligible for full practice in 45. this number will grow even more in the coming years.
What does IMG stand for, if anything?
international medical graduate.
Graduating from SGU this year, I can say that we do continue to have a competitive match year, with students continuing to match in catergorical surgery, EM, rads, anes, ect... The current match list can be found on our website which is reported by NRMP back to our school along with self reported pre-matches. As far as our attrition rate; it is closer to 5%. Many students leave for personal reasons as well as academic issues. I would be happy to answer any more questions about our schools statistics, or call us!!
Thus spake the SGU Marketing Department.
Your MD degree is only a phone call away. Operators are standing by...
Look like you slipped there! Nice try though.
And 5%? Come on!
It's hard to make generalizations for all the medical schools in the Caribbean. While some do have very high yearly attrition rates and poor residency matches, there are some that do not. The attrition rate at SGU is 5-7% annually and that has been calculated by class each year. But I can see how it might seem surprising given that there are some medical schools in the Caribbean with real attrition rates 35% and greater. It is important to note, however, that statistically each of these schools performs differently, and it's a bit biased and ignorant to clump them together.
The 60% figure comes from the fact that SGU enrolls ~1000 students a year but graduates only 400-500.
Can you find me a factual published percentage that shows that? There are two classes each year, each class has approx 450-550 students (after a recent increase in the number of students being accepted, the admin has now began cutting back down the size of each class). That means in a given year, yes about 900-1100 students have started at SGU. Each year, about 6% of students successfully transfer to US medical schools. Of the remaining students at SGU, the GRADUATION RATE is 87% (that is 957 out of 1100 students, NOT 400-500). Again, this has been calculated each year. The percentage of those that graduate AND become physicians is 93% (so of 957 students that's about 890 students with residencies or positions back in their home countries). Remember that Caribbean schools have many individuals from the US and Canada but also many other countries where residencies are not always done- some students from our school therefore, graduate successfully and go on to practice in their home countries but cannot be considered to be "accepted to a residency position" since that doesn't exist where they're from. That is why the wording of the 93% statistic is "graduates who become physicians" and not "graduates who obtain residencies." If you'd like, I'll be graduating this month and can take a head count for you to see how many people are graduating from my class But in the meantime, you can find these published stats on the SGU website.
I agree that if you are able to get into a medical school in the US, you should absolutely do it, for many reasons that we all know. I don't believe in arguing against something just for the sake of arguing. If you are going to argue against the stats and performance of Caribbean medical schools do so intelligently and find actual information. Don't go off of heresy and the comments you see from individuals on forums like these that simply have nothing positive to say about other avenues to medicine. Just sayin'
You might run into some problems with trying to practice in Mozambique and you will have to fight for it, but then again practicing medicine in any foreign country even with an MD is hard.
My friend is a fmg and failed step 2 ck and passed on second attempt by one point and got one interview and was accepted to residency... He had a C average in medical school and almost failed a number of courses. He studied in the Caribbean... He just passed step 3 and scored high on the first attempt.
Well, since we are dealing in anecdotes: I am yet to hear any resident or attending to refer to Step 3 as hard. Most often I rather hear "2 months, 2 weeks and numer 2 pencil" as prerequisites for Step 1,2 and 3 respectively.