Advice for first-year student

[shan564]

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Hi

I'm a first-year medical student, and I'd like to start gearing my CV in the direction of radiology. I realize that my USMLE score will probably be the most important thing - I can't predict that yet, but I was hoping to take care of everything else in the meantime. In case it's relevant, my MCAT score was 35 (13 PS, 12 BS, 10 VR)... I've read that there's a correlation between MCAT scores and eventual Step 1 performance, so I figured I'd mention it.

Here are some questions:

1. I'm a US citizen at the University of Sydney in Australia; is that relevant? I'm allowed to do two clinical electives in the US (as part of my curriculum), but they won't be in radiology.

2. I have a BS in chemistry with minors in medical physics, radioenvironmental sciences, and biology. Is there any chance that my undergrad degree might help/hurt me?

3. I have a little bit of research experience, and should have at least 5-6 publications by the time I finish med school. However, none of these publications are in rads. I'm planning on pursuing some rads research during med school (i.e. full-time during the summers, helping out during my clinical years); how much time/energy should I devote to that?

4. This December/January (our "summer vacation" in Australia), I've set up an "observership" at Washington University in St. Louis (I grew up in St. Louis, and that's where my parents live). I'll try to get involved in some research while I'm there. Is there any benefit to spending a lot of time at WashU as opposed to any other school (including U.Sydney)? I know that WashU has a great reputation, but at the same time, I think that I might be better off building contacts at a school where I'm more likely to get admission.

5. I'll probably do a clinical elective in radiology during 3rd/4th year, but it will be in Australia. I realize that American electives are more beneficial than any international electives, even if it is a developed English-speaking country with a superior healthcare system. Is it possible to set up an "extra" informal elective that I can complete during my summer break in the US?

6. In Australia, we graduate in December rather than May. So, I'll finish med school in December 2012, and I'll start residency in summer 2013. Will it help my application if I spend those few months doing random radiology-related research/coursework/clinical electives/etc? I figure that I'll probably apply for residencies before that, so it may not be as valuable on my CV...

And the big question:
6. I took some master's-level courses in medical physics before I started med school. If I take one extra course every semester, I think I might be able to graduate with a master's degree in medical physics along with my medical degree. Is it worth it? Would I be better off spending the time studying for the USMLE or working on a research project? If I do the master's, will it matter that it's from the University of Sydney (which has a great medical physics program) rather than somewhere in the US?


Thanks for the help! Any extra advice would also be greatly appreciated.

 

[goremachine]

Why are you in medical school in Australia if you got a 35 on your MCAT? I would seriously look into starting allopathic school in the states. It will make it infinitely easier for you to get a radiology residency.

 

[InternationlDoc]

Re: your tagline in your avatar - ofcourse Australia > USA; the unemployment rate is like 0% (exaggerating but you get the idea)

 

[synapse lapse]

Agree with above, at this point your biggest hurdle isn't going to be your steps/grades/research, it will be your IMG status. Why didn't you go to an american medical school with that MCAT? Also, Wash U has what is probably the most competitive/"best" radiology residency in the country (Mallinckrodt), so personally I would spend time at a much less competitive school if I were in your position. Anyhow, the biggest problem is being an IMG, and as such you will need stellar scores and a lot of luck to get in.

 

[shan564]

Long story short, an American med school is not an option.

I've heard/read that the biggest issues for IMGs are rec letters and immigration - if I can get good rec letters in my clinical electives in the US, will IMG status still be my biggest hurdle?

If so, am I better off looking at a different specialty?

 

[Neuronix]

If Australia > USA, why not stay there?

 

[docmd2010]

I'm a DO, and i'm going through this process right now...

let me tell you, i feel i have a strong application, i have been fortunate to have received 7 interviews thus far, although the places that are giving me interviews aren't super good programs. as a US trained MD, with a similar app, i strongly feel i would be getting interivews at these really good programs.

with that said, your future goal of becoming a radiologist is attainable but it will be very tough. however, you need to start your work now. get involved in research, NOW. try and find someone, (preferably a radiologist) that puts out papers more than he sh*ts. you will need extensive amounts of publications (probably 8-10) to even have a shot at a really good US rads program.

you're right-you need to kill step 1, step 2, and maybe even step 3. Ideally, 250+.

work really hard in your medical school classes. be in the top 5.

all the above, is certainly not easy, but if u do the above, you will no doubt match to a good program.

i hope this helps!

 

[Labslave]

Long story short, an American med school is not an option.

I've heard/read that the biggest issues for IMGs are rec letters and immigration - if I can get good rec letters in my clinical electives in the US, will IMG status still be my biggest hurdle?

If so, am I better off looking at a different specialty?

Although it's not a death sentence, a good number of rads programs won't look at IMGs period (they just don't have to). Others look at apps from IMGs only after MDs and DOs from the states have been evaluated. Even for the ones who are "IMG friendly," they interview a far greater number of applicants from US allopathic schools.

No matter how you shake it, you're going to have to be better than your US counterparts at every step of the way if you want to get into a good program here in the States. Although letters of rec could potentially be an issue, that worry pales in comparison to the IMG label on your app.

If there's a legal reason why you couldn't attend med school here, that might follow you for residency apps, too. I really can't think of too many other reasons why you wouldn't be able to stay here with that MCAT score (hell, if your GPA is low, you'd be much better off doing a post-bac program and rocking out than going to med school in Australia).

I apologize for the negative tone of this post, but you deserve to know what you're up against. If you're truly passionate about radiology, I wouldn't let any of this stuff deter you from trying your best and applying. It's just one helluva' hill to climb. Good luck.

 

[synapse lapse]

If Australia > USA, why not stay there?

Good point. Why not just do radiology in Australia?

 

[Taurus]

Just to echo what others have said, your biggest hurdle is your IMG status. You need to crush steps 1 and 2, have great LOR's, and be a publications freak. If you're just average, your chances are slim to none, especially in 2013 when the number of graduating US MD's will make it really difficult for any non-US MD to match into coveted specialties like radiology. I wouldn't bother with WashU or the master's in medical physics. Neither will help you much and if anything a waste of time. Focus on the USMLE and research. Your best bet will be to stay in Aussieland. I hear the women are hot and they have nude beaches.

 

[shan564]

Thanks to everybody for the frank advice. Please don't hesitate to tell me I'm doomed - I'd rather know what I'm in for, rather than getting sugarcoated euphemisms. Just to answer some of the questions you guys asked, in case it's relevant:

-Yeah, it was my GPA. I didn't trust myself in a post-bac, especially considering that there was no guarantee that I'd get in even after that.

-The "Australia > USA" thing is just something I put up a couple of months after I got here because I was excited about the novelty. In fact, there's really not much difference.

-Another long story short, staying in Australia probably won't be an option for bureaucratic reasons.


I actually want to get into nuc med in the long run. I'm under the impression that it's almost impossible to get into nuc med without first doing radiology - am I wrong? Or is there another way for me to get in?

It sounds like my chances are pretty bleak. I've always wanted to do radiology, but that's not etched in stone. If I were to get a 240-250 on step 1 and step 2, would I be likely to get in somewhere? If not, I'd like to know early so that I can start doing research and building contacts in other fields.

 

[docmd2010]

dude.

if you really want this, australia IS gonna be soooooooo much harder than an american MD. suck it up-go to a post-bac program, boston Univ. has a real good one. kick some asss while you're there. live in a square room with no tv, study 24-7. get a 4.0 there. with that-no question you'll get in with a 35. you're obviously smart, u can do well. take a year off and do post-bacc, you'll thank yourself when it comes time to applying for residency with a US M.D. behind your name.

i'm serious, whatever your issues are, work through them, and come to the states and do a post-bac.

 

[synapse lapse]

Totally agree with above, do a post-bacc! There is NO REASON to do medical school abroad with your MCAT. Hell, there are even some post-bacc that guarantee you interviews/amdmissions if you meet minimal requirements (don't know much about these, others can advise). Nuc med is not a highly desired field as you are limited to one modality and most radiologists aren't very interested in it, but I don't kow what chances an IMG has in the field (again, maybe others have an opinion). Anyhow even if your GPA was 2.5 you could rock a 4.0 on a post-bacc and still probably get in somewhere if you applied to enough schools.

 

[Scrub MD]

1. I'm a US citizen at the University of Sydney in Australia; is that relevant? I'm allowed to do two clinical electives in the US (as part of my curriculum), but they won't be in radiology.
.

Rad electives would help, but stick your head in the rad dept and let them know your interested.

\

I have a BS in chemistry with minors in medical physics, radioenvironmental sciences, and biology. Is there any chance that my undergrad degree might help/hurt me?.

After you're in medical school, undergrad doesn't matter.

3. I have a little bit of research experience, and should have at least 5-6 publications by the time I finish med school. However, none of these publications are in rads. I'm planning on pursuing some rads research during med school (i.e. full-time during the summers, helping out during my clinical years); how much time/energy should I devote to that?.

Research and pubs are good, rads>nonrads, devote 5 hours/week (or just enough to keep you interested, getting pubs and still rocking classes and boards.

4. This December/January (our "summer vacation" in Australia), I've set up an "observership" at Washington University in St. Louis (I grew up in St. Louis, and that's where my parents live). I'll try to get involved in some research while I'm there. Is there any benefit to spending a lot of time at WashU as opposed to any other school (including U.Sydney)? I know that WashU has a great reputation, but at the same time, I think that I might be better off building contacts at a school where I'm more likely to get admission..

Letters and contacts at WashU are good, get to know someone well and they may be able to help you out down the road somewhere else.

5. I'll probably do a clinical elective in radiology during 3rd/4th year, but it will be in Australia. I realize that American electives are more beneficial than any international electives, even if it is a developed English-speaking country with a superior healthcare system. Is it possible to set up an "extra" informal elective that I can complete during my summer break in the US? .

Yes, just contact your school and the visiting school.

6. In Australia, we graduate in December rather than May. So, I'll finish med school in December 2012, and I'll start residency in summer 2013. Will it help my application if I spend those few months doing random radiology-related research/coursework/clinical electives/etc? I figure that I'll probably apply for residencies before that, so it may not be as valuable on my CV....

You will still apply the September before you start residency (Dec-July will be your time off, too late to put on application but can still talk about during interviews.

And the big question:
6. I took some master's-level courses in medical physics before I started med school. If I take one extra course every semester, I think I might be able to graduate with a master's degree in medical physics along with my medical degree. Is it worth it? Would I be better off spending the time studying for the USMLE or working on a research project? If I do the master's, will it matter that it's from the University of Sydney (which has a great medical physics program) rather than somewhere in the US?.

I would spend the time studying for classes or boards and research.

All in all, it sucks that you are in medical school in Austrailia and trying to come back to the US. It is tough for anyone to get into rads, especially IMGs, any US medical school would be better than Austrailia (unless you want to stay there, which wouldn't be so bad). Even with your GPA, I think you could have got in somewhere or did something to get in here (MD or DO).

 

[smq123]

I actually want to get into nuc med in the long run. I'm under the impression that it's almost impossible to get into nuc med without first doing radiology - am I wrong? Or is there another way for me to get in?

Isn't there a separate nuclear medicine residency? 😕 I would imagine that nuclear medicine isn't terribly competitive, either.

 

[penguin24]

Isn't there a separate nuclear medicine residency? 😕 I would imagine that nuclear medicine isn't terribly competitive, either.

Yes, Nuc Medicine is a separate 4 yr residency (as opposed to the 5 yr Dx Rads). It is easier to get into, but there are less job opportunities for it.

Another road to take is getting into Dx Rads, then completing a 1 yr fellowship in Nuc Meds.

Both these routes will let you practice Nuc Meds, but the latter option allows you to do all other types of Rads as well, so that would be better; however, it would also be the harder route to take.

 

[HamOnWholeWheat]

Dude, nuc med is infinitely easier to get into than rads. It is its own residency, and its notorious for filling with IMG's (even the almost-top programs). If anything, a lot of IMG's use it as a foot-in-the-door way of getting a Diagnostic Rads spot, not the other way around. If you want nuc med, I'd say you have a great chance of getting it, provided you don't fail anything or bomb step I.

 

[shan564]

Dude, nuc med is infinitely easier to get into than rads. It is its own residency, and its notorious for filling with IMG's (even the almost-top programs). If anything, a lot of IMG's use it as a foot-in-the-door way of getting a Diagnostic Rads spot, not the other way around. If you want nuc med, I'd say you have a great chance of getting it, provided you don't fail anything or bomb step I.

Hm... I guess I was wrong to think that I have to do rads first to get into nuc med.

When I googled "nuclear medicine residency", most of the programs were fellowships for people who have completed radiology, or they required at least a year in internal medicine. Nuc med also wasn't listed in the NRMP data for average USMLE scores by specialty.

So here's my new question - do you guys know where I can go to find more information about getting into nuc med without doing radiology first? I've always been particularly interested in nuc med anyway, so if it's "infinitely easier" to get into, I might be better off focusing my resources on nuc med rather than radiology...

 

[Taurus]

Nuc med is a 3 year residency (used to be 2 year until a few years ago) if you match directly into it or 2 years if you're coming from another residency. Be aware that nuc med jobs are harder to find and much lower paying than rads. That's because most rads can read nuc studies but not vice versa. Therefore, most groups would simply hire a rad who can read everything vs. a nuc med who can only read nuc studies.

You can try to go the nuc med route as a back door into rads. I've seen this happen a few times.

 

[shan564]

Nuc med is a 3 year residency (used to be 2 year until a few years ago) if you match directly into it or 2 years if you're coming from another residency. Be aware that nuc med jobs are harder to find and much lower paying than rads.

I'm aware of the lower pay; I'm fine with that. As far as finding a job - does that mean that there's a chance that I wouldn't have a job altogether? Or does it just mean that I can't be as picky about where I want to go? I grew up in Missouri, so I wouldn't mind living in that area if I couldn't get into a more glamorous place.

Any idea about what sort of USMLE score might get me into nuc med?

 

[Taurus]

I'm aware of the lower pay; I'm fine with that. As far as finding a job - does that mean that there's a chance that I wouldn't have a job altogether? Or does it just mean that I can't be as picky about where I want to go?

You will have to go wherever you can find a job. There are jobs but not plentiful like rads.

 

[shan564]

I guess I can live with that.

Any ideas about the approximate range of USMLE scores that might make me competitive for a nuc med program?

 

[penguin24]

I guess I can live with that.

Any ideas about the approximate range of USMLE scores that might make me competitive for a nuc med program?

Well, NRMP Charting Outcomes of the Match 2009 releases avg Step 1 scores for the major specialties, but Nuc Meds isn't on the list (probably b/c it's such a small field). Diagnostic-Radiology has an avg Step 1 of 238. The avg Step 1 for all US medical students is around 222.

Thus, as a rough estimate since there are no published data, I would say Step 1 avg for Nuc Meds is around 225. As long as you're a solid candidate you will likely get a nuc meds residency.

 

[shan564]

Well, NRMP Charting Outcomes of the Match 2009 releases avg Step 1 scores for the major specialties, but Nuc Meds isn't on the list (probably b/c it's such a small field). Diagnostic-Radiology has an avg Step 1 of 238. The avg Step 1 for all US medical students is around 222.

Yeah, that's why I was asking... I've studied that list in detail, but I think nuc med isn't on the list because they usually go through ERAS rather than NRMP. I spent some time looking for data, but in its absence, I figured I'd have to ask people for their personal experience.

Thus, as a rough estimate since there are no published data, I would say Step 1 avg for Nuc Meds is around 225. As long as you're a solid candidate you will likely get a nuc meds residency.

Cool, thanks... that's what I was looking for. Thanks for the advice.

 

[smq123]

Yeah, that's why I was asking... I've studied that list in detail, but I think nuc med isn't on the list because they usually go through ERAS rather than NRMP.

By the way, you can't "go through ERAS." You either go through the NRMP match, the osteopathic match, or the San Francisco match. ERAS is just an application service.

 

[umang]

Radio is insanly difficult for IMG s to get into. I have step1 269, step2 263, US PhD in Neuroscience with 11 publications. But did not get any iv call from rads.

 

[krust3]

Radio is insanly difficult for IMG s to get into. I have step1 269, step2 263, US PhD in Neuroscience with 11 publications. But did not get any iv call from rads.

so what's the flaw in your app then? are you a non-U.S. citizen? something's definitely amiss here....

 

[umang]

so what's the flaw in your app then? are you a non-U.S. citizen? something's definitely amiss here....

I am an indian medical graduate. graduated in 2004. did phd from 2004-2008 in USA and right now doing neuroradiology research in USA at a University program. more than 20 presentations in neuroscince national and international conferences. More thn 5 awards. GPA during PhD was 4.0. I guess being Indian citizen makes it tough.

 

[smq123]

I am an indian medical graduate. graduated in 2004. did phd from 2004-2008 in USA and right now doing neuroradiology research in USA at a University program. more than 20 presentations in neuroscince national and international conferences. More thn 5 awards. GPA during PhD was 4.0. I guess being Indian citizen makes it tough.

You're also >5 years out from med school graduation. Most program directors get nervous when they have someone who graduated med school so long ago and has had ZERO clinical experience since. That's another huge thing working against you.

 

[DOCTORSAIB]

Radio is insanly difficult for IMG s to get into. I have step1 269, step2 263, US PhD in Neuroscience with 11 publications. But did not get any iv call from rads.

The kids has some sick stats though and has made major contributions to the field of radiology already. If I was a low-middle tier rads PD I'd interview this kid in a heartbeat. As long as the personality checks in, I'd rank him high.

 

[umang]

You're also >5 years out from med school graduation. Most program directors get nervous when they have someone who graduated med school so long ago and has had ZERO clinical experience since. That's another huge thing working against you.

I graduated from med school 6 years ago but since last six months, I am actively involved in patient care at a reputed US hospital and have strong letters from US physicians. It really sucks to see people with much less scores even when they are FMGs are getting calls and I am being left out. Just because i graduated 6 years ago. Why they dont see I have done PhD and have significant accomplishments in this 6 years?

 

[Radsonly]

I graduated from med school 6 years ago but since last six months, I am actively involved in patient care at a reputed US hospital and have strong letters from US physicians. It really sucks to see people with much less scores even when they are FMGs are getting calls and I am being left out. Just because i graduated 6 years ago. Why they dont see I have done PhD and have significant accomplishments in this 6 years?

umang: I cant believe this. When did you apply this season. Was there any red flag in your transcript or application. i am at 5 years from grad and am a FMG. Dont have stellar scores like you. This makes me feel that this is my last chance. OMG can you throw some light on details of your application? And how many places did you apply. With your credentials I would expect invites from top notch programs (UCSF, PENN, MIR, Hopkins). I know of FMGs with US PhDs getting invites in such places. i dont see a reason why you should not. Unless something terribly wrong with your app...

 

[umang]

umang: I cant believe this. When did you apply this season. Was there any red flag in your transcript or application. i am at 5 years from grad and am a FMG. Dont have stellar scores like you. This makes me feel that this is my last chance. OMG can you throw some light on details of your application? And how many places did you apply. With your credentials I would expect invites from top notch programs (UCSF, PENN, MIR, Hopkins). I know of FMGs with US PhDs getting invites in such places. i dont see a reason why you should not. Unless something terribly wrong with your app...

I dont see any problem with my application. Program coordintors told me that my application is very compeitive and i have been put on hold. Eventually i got rejected. I applied in 20 pgm on sept 10 and 40 more programs in october middle. I submiteed my strong lors. I will be meeting with a program director to seek some advice and will know what was wrong with my application. how many invites did u get? did u do radio in ur home country? may be other fmgs have scored more than me. Or may be my sop is horribly bad.

 

[Radsonly]

dude. 20 is too less and sept 10 is obviously very late. And 40 more in October is a waste of money. you should have applied on the first of sept. Applied to about 100 programs and got 11 interviews. am an IMG with 250+ scores. 7 research articles (including posters, abstracts etc). Has an observership (not in rads) and an externship besides a research assistantship, which obviously is not as competitive as yours. You obviously applied late. And most IMGs will not have scores like yours... Wish you the best for this season.

I dont see any problem with my application. Program coordintors told me that my application is very compeitive and i have been put on hold. Eventually i got rejected. I applied in 20 pgm on sept 10 and 40 more programs in october middle. I submiteed my strong lors. I will be meeting with a program director to seek some advice and will know what was wrong with my application. how many invites did u get? did u do radio in ur home country? may be other fmgs have scored more than me. Or may be my sop is horribly bad.

 

[Radsonly]

And I did not do a back home residency in radiology...

I dont see any problem with my application. Program coordintors told me that my application is very compeitive and i have been put on hold. Eventually i got rejected. I applied in 20 pgm on sept 10 and 40 more programs in october middle. I submiteed my strong lors. I will be meeting with a program director to seek some advice and will know what was wrong with my application. how many invites did u get? did u do radio in ur home country? may be other fmgs have scored more than me. Or may be my sop is horribly bad.

 

[umang]

And I did not do a back home residency in radiology...

Oh! That might be the pblm. I guess I have to prepare for next year. Have u been working in USA all these years and at a big uni. My PhD is from mediocre uni. but i did have more than 40 publications (including abstracts, posters, presentations)

are u from europe? i heard being european is easy compared to being indian? I heard but not sure if it is true.

 

[umang]

And I did not do a back home residency in radiology...

are u blackjack?

 

[Radsonly]

Nope. Where did you get that name from? Thank you for the PM...