Another poll: "What are" you guys?

[Knicks]

Poll.

EDIT: and do you guys think there is a major difference b/w the 1st two choices with regards to passing Steps 1 & 2 and getting into a residency?

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[Knicks]

32 votes, not 1 person addressed the question in the above post.

LoL

 

[tacrum43]

To be honest, yes, there is clearly a difference. US grads have a much higher pass rate and much higher match rate (at least for most specialties).

However, non-US grads can do well on the USMLE and can get some pretty good residencies. There's just a lower percentage who are able to do it.

 

[agranulocytosis]

I am going to assume you are referring to Caribbean schools in the poll. I'm a caribbean student but a US citizen (read: failed US applicant), and it is the rule rather than the exception that people from non-US schools have a tougher time scoring well on the step 1. There are the few that got their acts together after messing up in undergrad, but the majority that I know of still remain on the lower end of the spectrum.

My school has not had one single match in any of the competitive residencies (like ortho, derm, rads, or plastics). Majority have matched into FM, IM with a surprising few getting into OB/Gyn and Anes. I think only 2 have matched gen surg. Maybe it comes down to board scores, perhaps it's an issue of name recognition, either way it's tough for FMG to match into the desirable residencies.

I've even heard from upper-classmen from my school that certain elective rotations won't even take applications from caribbean students.

 

[DrFraud]

I am going to assume you are referring to Caribbean schools in the poll. I'm a caribbean student but a US citizen (read: failed US applicant), and it is the rule rather than the exception that people from non-US schools have a tougher time scoring well on the step 1. There are the few that got their acts together after messing up in undergrad, but the majority that I know of still remain on the lower end of the spectrum.

My school has not had one single match in any of the competitive residencies (like ortho, derm, rads, or plastics). Majority have matched into FM, IM with a surprising few getting into OB/Gyn and Anes. I think only 2 have matched gen surg. Maybe it comes down to board scores, perhaps it's an issue of name recognition, either way it's tough for FMG to match into the desirable residencies.

I've even heard from upper-classmen from my school that certain elective rotations won't even take applications from caribbean students.

I also go to a Caribbean School, and my observations thus far are a little different. There is as wide a difference between programs and students in the Caribbean as there are in the states.

At my school, I am a slightly above average student in my class as far as my GPA, and my school has done more than an adaquite job of preparing me for shelf exams, comps, the NBME forms, and Step 1.

We have a history of students getting 99/240+ on step 1 (although not as frequently as with a U.S. programs), and placing students in competative programs including neurosurgery, radiology, and derm (again, not as frequently as a U.S school)

Going to Wayne St. is not the same as going to Hopkins, and neither is going to the American U. of Anguila the same as going to St. Georges. The better know schools in the Caribbean like SGU, Ross, AUC, and Saba have a history of having students who do very well on Step 1, performing well in rotations, and getting competative residencies. I personally felt very prepared by the faculty at my school for taking step 1.

I know this might surprise a few people, but I can say one difference that I have noticed so far between students that I have met at U.S programs and at my school is that I have met a few students who attend and who have struggled at U.S. programs who I am fairly certain would have failed out at my school but have been allowed to slip through...

 

[Knicks]

^^ hmmm, interesting analysis, quite interesting indeed.

 

[ZonaRidicularis]

z

 

[agranulocytosis]

I also go to a Caribbean School, and my observations thus far are a little different. There is as wide a difference between programs and students in the Caribbean as there are in the states.

At my school, I am a slightly above average student in my class as far as my GPA, and my school has done more than an adaquite job of preparing me for shelf exams, comps, the NBME forms, and Step 1.

We have a history of students getting 99/240+ on step 1 (although not as frequently as with a U.S. programs), and placing students in competative programs including neurosurgery, radiology, and derm (again, not as frequently as a U.S school)

Going to Wayne St. is not the same as going to Hopkins, and neither is going to the American U. of Anguila the same as going to St. Georges. The better know schools in the Caribbean like SGU, Ross, AUC, and Saba have a history of having students who do very well on Step 1, performing well in rotations, and getting competative residencies. I personally felt very prepared by the faculty at my school for taking step 1.

I know this might surprise a few people, but I can say one difference that I have noticed so far between students that I have met at U.S programs and at my school is that I have met a few students who attend and who have struggled at U.S. programs who I am fairly certain would have failed out at my school but have been allowed to slip through...

I agree with you on all points. There have been caribbean grads matching well, and the numbers are continuing to grow. I guess my perspective was more on the individual level than on the school level. A few in my class have scored >240 so far, and a lot of the smart ones in my class have yet to take it yet so the number will probably be higher still. The school did say our class was the brightest to step foot in the halls of SMU yet, and the classes continue to get brighter.

But for every success story, there are 4 not-so-lucky ones out there that just weren't able to cut it (as has been my experience at least).

There's a lot of debate as to whether or not so-and-so school in the carib is better than the other, but I think it just boils down to the population of students that attends that school, and the better students to begin with will attend those better schools. But I think med school is pretty universal all throughout the globe - this crap is hard and it takes a certain kind of person to be able to make it through alive.

 

[MedLover25]

I know this might surprise a few people, but I can say one difference that I have noticed so far between students that I have met at U.S programs and at my school is that I have met a few students who attend and who have struggled at U.S. programs who I am fairly certain would have failed out at my school but have been allowed to slip through...

I actually had a few friends of mine who go to US (MD & DO) Schools come down to the Caribbean to visit me (I go to one of the "big four"). After going to class with me for one day they turned to me and their mouths dropped. they couldn't believe how much work gets thrown at us everyday, and my friends go to good schools (and are good students).

Not to mention that going to school in "the caribbean" doesn't mean you're sitting at the beach drinking a pina colada in one hand and holding robbins in the other.

 

[Knicks]

I actually had a few friends of mine who go to US (MD & DO) Schools come down to the Caribbean to visit me (I go to one of the "big four"). After going to class with me for one day they turned to me and their mouths dropped. they couldn't believe how much work gets thrown at us everyday, and my friends go to good schools (and are good students).

Not to mention that going to school in "the caribbean" doesn't mean you're sitting at the beach drinking a pina colada in one hand and holding robbins in the other.

 

[Hayat]

It is common sense that students at American schools are more likely to do well on their country's board. And I am sure they will have a very difficult time passing the German board, right?

The guys who study abroad, like my self, have to accommodate twice. Once to our foreign school system and take on medicine. Then we have to adjust our selves all over again for the American boards. Believe me, it is not that easy.

Medicine is not taught the same way around the world. Of course some systems are better than others. But it is out of our hands. We have to succeed according to the systems that we are in.

Over here, where I am studying, they do not teach: Genetics, Behavioral Science, no more than a couple of pages of molecular biology, their take on biochemistry is different that the American. My school's approach to basic medical sciences is anything but clinical. Our exam styles are different. Most questions are short and long essays, etc.


It is quite tough for us. Please understand that.

 

[Knicks]

In the 2nd option in the poll, maybe I should've specified "off-shore" as meaning "Caribbean", as they emulate the U.S. system a lot better than other countries.

Mods, can you adjust option #2 in the poll? Thanks.

 

[DrFraud]

I agree with you on all points. There have been caribbean grads matching well, and the numbers are continuing to grow. I guess my perspective was more on the individual level than on the school level. A few in my class have scored >240 so far, and a lot of the smart ones in my class have yet to take it yet so the number will probably be higher still. The school did say our class was the brightest to step foot in the halls of SMU yet, and the classes continue to get brighter.

But for every success story, there are 4 not-so-lucky ones out there that just weren't able to cut it (as has been my experience at least).

There's a lot of debate as to whether or not so-and-so school in the carib is better than the other, but I think it just boils down to the population of students that attends that school, and the better students to begin with will attend those better schools. But I think med school is pretty universal all throughout the globe - this crap is hard and it takes a certain kind of person to be able to make it through alive.

It was actually a point of mine that med schools are different (as well as the students) with regard to the question raised by the op, and you can not neccessarily group all U.S. programs into one catagory and as they can vary quite a bit and so do off-shore programs.

I don't think for a second I could compare what I had in terms of my training as being equil to an upper tier U.S. program, but you can't group together an average U.S. program with an upper tier U.S. program either.

Simply put, the training that a student receives at a school like St. Georges is not equal to all Caribbean Schools even though students at other schools in the Caribbean (and the people who run these programs) will try and blur the differences.

I don't think that you can compare all Caribbean grads as equal, as there is a significant difference between the various programs, with the most reputable I mentioned in my prior post - and this is exactly the same with U.S. programs too.

Its basically my opionion, and it could change somewhere down the line, but this is partially based on meeting the students for the past two graduating classes at my school, that a solid student (using grades, step scores, work ethic, LORs, etc) who comes out of one the 'big-4' caribbean schools is somewhat equivilant to a solid student from an average U.S. program it tems of opportunities for residency placement.

 

[GynGuy1983]

It was actually a point of mine that med schools are different (as well as the students) with regard to the question raised by the op, and you can not neccessarily group all U.S. programs into one catagory and as they can vary quite a bit and so do off-shore programs.

I don't think for a second I could compare what I had in terms of my training as being equil to an upper tier U.S. program, but you can't group together an average U.S. program with an upper tier U.S. program either.

Simply put, the training that a student receives at a school like St. Georges is not equal to all Caribbean Schools even though students at other schools in the Caribbean (and the people who run these programs) will try and blur the differences.

I don't think that you can compare all Caribbean grads as equal, as there is a significant difference between the various programs, with the most reputable I mentioned in my prior post - and this is exactly the same with U.S. programs too.

Its basically my opionion, and it could change somewhere down the line, but this is partially based on meeting the students for the past two graduating classes at my school, that a solid student (using grades, step scores, work ethic, LORs, etc) who comes out of one the 'big-4' caribbean schools is somewhat equivilant to a solid student from an average U.S. program it tems of opportunities for residency placement.

I concur with most of what you said.

As a U.S. citizen, non-Caribbean trained physician (I graduated from an EU university not in Poland, lol), I've seen the difference between the big 4 island schools compared to the other programs. I'm not trying to put down anyone's school, as a good, solid medical education can be achieved through hard work, without the need for state of the art facilities that American med schools provide, but there are discrepancies. I have seen the correlation between the better students coming from AUC, Saba, St. George, and Ross, as opposed to the other programs offered to Americans. From what I've come to understand, there are a fair number of the graduates from the big 4 that obtain pretty solid residencies that run the gamut from orthopedics, pm&r, radiology, ob/gyn, general surgery, with the majority in FP or IM.

In my opinion, it shouldn't matter where you went to school, but rather, how well you did on your exams. Whatever happened to the most qualified person getting the job? Enough of this b.s. oligarchy! Whatever happened to the meritocracy that we once had here?

 

[Knicks]

..........In my opinion, it shouldn't matter where you went to school, but rather, how well you did on your exams. Whatever happened to the most qualified person getting the job? Enough of this b.s. oligarchy! Whatever happened to the meritocracy that we once had here?

*Slowly clapping*

 

[peter90036]

how well you do on exams?!?

those have nothing to do with the real world where you have to deal with people and situations.

 

[GynGuy1983]

how well you do on exams?!?

those have nothing to do with the real world where you have to deal with people and situations.

I totally agree that standardized testing may not be the best barometer to determine medical skill and knowledge, but how can you say that simply because you went to school in the U.S., you're a better clinician than someone from anywhere else in the world? Why does the American grad who gets the 215 get the better residency than the IMG who received a 230? Who's to say that the IMG is not the more qualified of the 2 applicants based on scores alone?

Imagine you applied the same mentality to any other field or even time period of that matter. Picture Albert Einstein being forced to watch a bunch of clueless American trained physicists trying to build an atomic bomb, as he's too busy teaching high school physics to the masses. That makes a lot of sense No wonder our educational system is falling by the wayside, we're too stuck up on the fact that whatever is done domestically is the best. Unfortunately, that no longer holds true, nor should we continue to perpetuate this xenophobic ideal that only American trained physicians know what they're doing.

The last time I checked, people are still living in the rest of the world, and paradoxically, they even live longer than Americans. Until America's standard of care meets that of the rest of the developed world, please keep the American trained physician propaganda to yourselves.

Ahh, nothing like a rant before bed. Much better.

 

[ZonaRidicularis]

z

 

[TerpMD]

I totally agree that standardized testing may not be the best barometer to determine medical skill and knowledge, but how can you say that simply because you went to school in the U.S., you're a better clinician than someone from anywhere else in the world? Why does the American grad who gets the 215 get the better residency than the IMG who received a 230? Who's to say that the IMG is not the more qualified of the 2 applicants based on scores alone?

Imagine you applied the same mentality to any other field or even time period of that matter. Picture Albert Einstein being forced to watch a bunch of clueless American trained physicists trying to build an atomic bomb, as he's too busy teaching high school physics to the masses. That makes a lot of sense No wonder our educational system is falling by the wayside, we're too stuck up on the fact that whatever is done domestically is the best. Unfortunately, that no longer holds true, nor should we continue to perpetuate this xenophobic ideal that only American trained physicians know what they're doing.

The last time I checked, people are still living in the rest of the world, and paradoxically, they even live longer than Americans. Until America's standard of care meets that of the rest of the developed world, please keep the American trained physician propaganda to yourselves.

Ahh, nothing like a rant before bed. Much better.

I think you bring up a good point here about the double standard for IMGs. This thread is probably talking about US vs Carribean mostly, not abroad however. Still, there is a double standard and I think in some ways it's similar to that whole "in state-out of state" thing where you need to be a better applicant if you come from somewhere else. That said, it certainly doesn't mean that the IMG is not as good or better. I will say it doesn't suprise me though- why are medicines not approved in the US that have been used for years elsewhere around the world- cause we have to put them through our own special process. Why don't we switch to metric? I could go on and on.....

 

[hj0517]

Speaking of the 'real world' and treating 'real patients' you will do much better if you know your stuff - and thats just how it is. We call our residents house officers in the UK and it is beyond a joke how much difference actually knowing something as a house officer makes in treating and dealing with patients. And as a med student I can tell if i'm with a joke of a house officer (and I don't know much).

The real world real patients line is pulled by hundreds of pre-clinical students each year, it just doesn't work like that.

I was in medical admissions last week and saw a tetralogy and a Russell Silver syndrome in the same day...

 

[peter90036]

Exams are important my friend... it weeds out the lollygaggers (yea I said it) who might end up killing someone just because they don't know their basic sciences.

Sorry my friend, but exams & interviews don't weed out what they're supposed to weed out: people who don't care, people who don't want to work in residency, etc. I have at least 3 stories of extreme (at least 10% of residents i'm "in contact" with).

95-99's, and as PGYs: No notes, wrong notes, wrong meds, no meds, no list of dz w/ pt, no followup on labs, etc etc, 1 outright said he doesn't care what happens to the patients.

 

[DrFraud]

In my opinion, it shouldn't matter where you went to school, but rather, how well you did on your exams. Whatever happened to the most qualified person getting the job? Enough of this b.s. oligarchy! Whatever happened to the meritocracy that we once had here?

Actually, I would say it does matter where you go to school. A candidate with a 215 and completing a degree at Yale, Harvard, Hopkins, or UCSF simply can not be compared with someone with a 215 from The American University of Antigua. The training and education simply is not the same.

Its conceiveably possible that the doc from AUA will turn out better than the doc from Harvard with an identcal step score, but if it were me having to choose, I would lean toward the Harvard grad unless there was something very unique and outstanding that the AUA grad brought to the table.

 

[ZonaRidicularis]

z

 

[GynGuy1983]

Actually, I would say it does matter where you go to school. A candidate with a 215 and completing a degree at Yale, Harvard, Hopkins, or UCSF simply can not be compared with someone with a 215 from The American University of Antigua. The training and education simply is not the same.

Its conceiveably possible that the doc from AUA will turn out better than the doc from Harvard with an identcal step score, but if it were me having to choose, I would lean toward the Harvard grad unless there was something very unique and outstanding that the AUA grad brought to the table.

I'm not denying the fact that people that are trained at the Ivy League level are probably on the higher end of physicians out there, but keep in mind that you're comparing a school that was solely made for students that were denied admission to American schools (AUA). Why not bring up actual, internationally recognized medical colleges like Heidelberg, Cambridge, Oxford, University of Edinburgh, AIIMS in India, that are well-represented in the international community in terms of research and the advancement of the sciences.

As it's been reiterated, knowledge is the key to being a good physician, and the test is adequate in determining whether or not you would be a competent physician. Note that I said competent, not great. Like in any other field, some will excel, some will fail, and most will be content with the level at which they're at, but you personally make that decision.

Let me remind everyone that at the end of the day, we, as physicians, are still human, regardless to what accord others may hold us to. Doctors may understand the consequences to their health better than others, but that doesn't mean you won't see an obese, alcoholic doctor, complaining of dysuria and warm joint pain that apparently all started after partaking in a medical mission to Thailand. Hmm, I wonder what he was doing. . . No, a doctor would never do such a thing

 

[DrFraud]

I'm not denying the fact that people that are trained at the Ivy League level are probably on the higher end of physicians out there.......


As it's been reiterated, knowledge is the key to being a good physician, and the test is adequate in determining whether or not you would be a competent physician. Note that I said competent, not great. Like in any other field, some will excel, some will fail, and most will be content with the level at which they're at, but you personally make that decision.

ok, I think were getting a bit off topic. Were not discussing better/worse physicians. I understand in part what you are trying to say, and I am very understanding, but the thread is about whether where you go to school, what country, tier, Ivy, or whatever, makes any difference in terms of residency and board scores...

 

[Knicks]

^^ correct, albeit these tangents that you guys went on were quite interesting.