Advice for long-term residency roadmap as an IMG

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Mar 11, 2017
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Long time reader, but I rarely post so I apologize if this post is in the wrong section.

I am a Canadian student that will be beginning a 4-year program at an Irish med school starting this September. I am thinking about a career in a surgical specialty. I'm not 100% sure which one but my interest right now is in neurosurgery and my ECs and research experience so far reflect that. I'm trying to figure out the best course of action in terms of setting up my research, observership, ECs and other activities over the next 4 years to tailor to the field I eventually want to match to. But I want to make sure my plan is actually feasible so that I don't waste valuable experiences on a field that will be unobtainable.

I currently have done research in neurosurgery labs, have a publication, and will likely have another by the end of the summer. One of my parents is a neurosurgeon and from observing their experience, I became interested in the field. That being said, I realize that neurosurg is one of the most competitive residencies, even more so as an IMG. If neurosurgery right off the bat is not feasible, I was wondering if there is an alternative path to it - even if it means spending more time.

I have searched through the forums for people in similar situations and it appears as though for an IMG, an easy way to get your foot in the door is to do preliminary surgery internship. I read about cons about this (e.g. some programs offer you little OR experience, risk of not getting into a PGY2 position, etc), but if I want to do surgery, to me it seems like this is actually the path with the highest likelihood of success.

The biggest barrier I can see is getting an initial residency as an IMG. But once I'm in and I work hard, won't I be on level playing ground with AMGs to compete for neurosurg spots? I'm not exactly clear on how the prelim surgery path works, so if it doesn't work this way please let me know.

And if neurosurg in the US is too hard to get into, would you be able to recommend more realistic surgery options? I will also be attempting to match in Canada, though that will also be challenging.

Any advice would be sincerely appreciated!


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7+ Year Member
Apr 6, 2009
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The standard stuff.

Good scores. Good clinical. Good research.

Then get a prelim position. Do well and have some phone calls made.

Also consider if surgery is definitely for you during this entire process

Winged Scapula

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Apr 9, 2000
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Charting Outcomes for the Match will give you the data you need to see what qualities successful applications to Nsgy have:http://www.nrmp.org/wp-content/uploads/2017/04/Main-Match-Results-and-Data-2017.pdf

Last year, out of 218 Nsgy positions offered in the match, 14 went to Non-US IMG (thats you). The document is lengthy but you'll be able to see average Step 1 scores, etc. for each category of applicants.

@statia 's experience is probably more the norm; the difficult in matching to a surgical specialty right out of school, without significant connections, is high. You'll have to decide when the time comes on a Plan B and how long/how much you're willing to do to try and obtain a Nsgy position (yes, I realize you will do *anything* but there comes a point in life when you have to accept that some things are not going to work out, if that should come to fruition in your case).
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