Another IMG in the US thread(sorry, but I can't find what i'm looking for)

[circepix]

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Hey guys, I have a few big questions for you. First of all, background info: I am MedStudent who is not a US citizen. I am currently working on taking Step 1 USMLE, and I wanted to know a few things about the roadblocks that I know are being put up against IMGs practicing in the US.

That being said, I have read so much about how difficult it is for IMGs to actually get to practice in the US, and how a lot of them do not get interviews even if they have super high scores because of visa problems and the fact that their education is unclear to the employers, and also the fact that a lot of IMGs have a very thick accent.

I would like to know:

1. is it necessary for an IMG to do some clinical rotations/shadowing before applying for a residency spot? Is it necessary, or just beneficial? If yes, then how long would the rotation/shadowing have to go on for? Keep in mind that I could only come during summer for about 2 months every year. And would I need a letter or recommendation from a US doctor to apply for residency Match?

2. I've been speaking English since i was 4 years old and i do not have an accent. I have read a lot of posts where it said that the accent is a major communication problem and a main reason for an IMG being turned down. If i do not have this problem and I get very high Step scores, would I have a better chance of getting a decent spot? Factoring in the visa problem and the whole "we don't know what level of education you have" thing, what would my chances look like?

While I know that there is no way for you to give me specific information because it varies from program to program, please feel free to speculate, I want to get a general opinion, I am not looking for hard fact. I just want to have an idea of what to expect. I feel like things are looking so very grim and unclear right now for me, and I wanted to know if there really is little hope or if maybe there is a way to overcome or at least compensate in some way for these shortcomings that I really can't delete(like the fact that i am simply not a US citizen)...Also, there is someone in my family(my aunt) who is a doctor in the US. she also went there through the whole USMLE thing. Is there anything she could do to help my situation?

Thank you guys!🙂

 

[circepix]

almost 300 views and nobody can even tell me if i need a US doctor's letter of recommendation to enlist for residency? come on it's a yes or no question.....please?🙁

 

[molten]

almost 300 views and nobody can even tell me if i need a US doctor's letter of recommendation to enlist for residency? come on it's a yes or no question.....please?🙁

Without a U.S. LOR, it's going to be harder.

 

[NotAProgDirector]

No one is answering your questions, because they are hard to answer.

Having US experience is not required by law, but in practice it makes your application much stronger. Getting experience is not easy, as it is not straightforward to get rotations in the US. Simply shadowing someone (like your Aunt) is OK but not what programs are looking for. Experience in another westernized country (England, France, Germany, etc) is better than experience elsewhere.

Speaking English well will help. How much is anyone's guess.

In the end, it will depend on your Step scores, what field you're applying to, and what type of US experience you can get.

 

[circepix]

Thank you. Well I don't imagine it will help too much but I guess it is an advantage over others, and I'll take what I can get. 🙂 My aunt said she could speak to some doctors where she works to let me shadow them during summer. I realize it's not as good as doing an actual rotation, but, again, I'll take what I can get if it's not pointless. Well, I'm from Eastern Europe(oh God now everyone is imagining a 3rd world Russian-speaking country, I can just feel it ), so it would be way harder for me to get into the Western European medical system to get some experience, because I don't know anyone and the programs at my school that usually allow for this kind of things are pretty corrupt so yeah... My problem is that I want to apply for a Surgery position(I haven't decided what kind yet) and as far as I know that's a very competitive program...

If i get very high USMLE scores, how much would that compensate for my lack of field experience? Just tell me what you think, I'm not looking for exact statistics here. Ballpark it. And also, what would my chances be in those conditions(strong USMLE scores, somewhat minimal contact with the US medical system)? And then, what kind of scores would I need as an IMG, for surgical programs?

Also, if I do manage to get a LOR from a doctor I've shadowed for a longer time(I'm not talking just a few months once I'm talking like every summer for the next 4 years), would that count for something? I know it doesn't compare to LORs from professors and doctors you've rotated with and stuff, but I mean would that be taken into consideration even slightly?

Thank you for your previous replies btw. 🙂 You've helped me a lot so far I'm hoping you can answer these as well. 🙂

 

[circepix]

No one is answering your questions, because they are hard to answer.

I know, I really know that it's hard to say anything because every program is different and every hospital is different, but I just want a general opinion, I'm not going to take everything at face value, I realize that it's not fact, just opinion. I don't mind if people answer even if they are not sure...It would really help me figure out a plan...like what my target score should be and what programs I have a shot at etc...I have no one to teach me these things and I'm completely alone in what I'm doing. I'm not making excuses, I'm just pointing out that this forum is pretty much my only contact with US doctors/residents/students etc and I figure you guys know more than I do at any rate. 🙂

 

[Ronin786]

USMLE scores matter a lot. Its one of the most important factors on the application, but there are a lot of other factors that are in play as well. As for the US letter, it will depend on what the author writes.

If he says "circepix watched me take care of patients" its not going to mean as much as if it says "Circepix actively managed patients and was an amazing person". Also the field of the Dr. matters. Its going to be preferable to be in the same specialty you're applying to.

 

[circepix]

USMLE scores matter a lot. Its one of the most important factors on the application, but there are a lot of other factors that are in play as well. As for the US letter, it will depend on what the author writes.

If he says "circepix watched me take care of patients" its not going to mean as much as if it says "Circepix actively managed patients and was an amazing person". Also the field of the Dr. matters. Its going to be preferable to be in the same specialty you're applying to.

That is very good to know, thank you very much. Well from what I understand it would be difficult for me to interact with patients as a simple observer? Is there a chance that if the doctor in question feels comfortable enough he might let me help in not-necessarily-medical ways(I don't expect him to let me start a central line or something, obviously). I don't know what ways those would be, but they would obviously have to be things that wouldn't affect the patient too much...like checking in on him, or taking the patients for xrays or stuff like that. I don;t know, would that be a possibility? 🙂 I think it's a sort of childishly hopeful question, but I can't think of anything else right now so I might as well ask.

 

[Ronin786]

Why don't you just apply for clinical rotations in the US? You're still a med student and even though it's difficult, there are numerous programs that offer electives if you apply in a timely manner and have all your paperwork intact.

Thats going to be your best bet at getting meaningful patient interaction, US experience and letters of recommendation.

 

[circepix]

I didn't know I could. I'm not even sure how I would go about doing that. Is there a link or something you could reffer me to? I'd search on Google but I'm not sure what to search for. Thank you!

 

[shan564]

Search for something like "international visiting medical student clerkships." There are a lot of choices. Your chances will be much better if you've finished Step 1. You only really need 1-3 months of rotations so that you can get your 3 rec letters. The standard here is that you can usually get a good rec letter if you work under an attending for 2-4 weeks as a visiting med student.

The hospital's policy usually changes from year to year, so given that you're still 4 years out, it's hard to make any firm plans. But if you've finished Step 1, you'll probably be able to find a rotation somewhere. You'll be expected to be in your final 2 years of med school. If you do 3 months by the summer of the year before you apply for the Match, that'll give you enough time to get your rec letters in line by the deadline (September).

As a visiting student, you'll have actual responsibilities that allow your supervisor to assess your ability. You'll do initial intake assessments, follow/examine patients every day, etc. This will give the attending the ability to write a rec letter that contains the basic information that they need. The basic purpose of the US clinical rec letter for an IMG is to say "I've seen this student, and I can say with fair certainty that he's easy to get along with, is able to function in the US medical system, is capable of coherently presenting a patient, is interested in learning, is reliable/hard-working, and is at least on par with the medical students that we see in the US." Your supervisor will only be able to say those things if you did a standard US med student clerkship - you can't get that from shadowing/observing, research, volunteering, working as a patient care tech, or one of the many other areas in which you can work in the medical system.

If you can afford it, there are also agencies that will help you find a rotation. They usually cost $1200-2000 for a 4-week rotation. I know of a couple of agencies - American International Clinical Group and ChicagoClerkships. I'm not endorsing either of them, but they do exist.

If you have 3 strong US rec letters, a score of 230-240+ on Step 1, and a score of 240-250 on Step 2, I'd say that you have a pretty good chance of getting interviews in surgery.

At this stage in your career, your #1 goal should be getting the maximum possible score on Step 1. Then you can focus on finding a rotation and getting rec letters.