Any IMG sucess stories here?

[Pollicis]

Hi,

Are there any IMG's having great success in getting interviews or matching in GS, especially in some top programs? It would be great to hear your story. I'm looking to match in the northeastern part of the USA. Step 1 248/99, taking step2 next summer. Any info would be greatly appreciated.

thanks,
Pol

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[ESU_MD]

first, congratulations on your board scores. and your decision to enter the best profession in the world.

I am a pgy-4 at a top notch community program. I matched on the 1st try- no prelim yr. have excellent fellowship leads in progress. I am EXTREMELY fortunate, and lucky. Most of my IMG classmates have had to endure multiple prelim years and repeat years in crappy programs or pursue other less competitive fields like ER or anesthesia. ironically, when i was applying for surgery, ER was "hot" and off limits to IMG's- it all goes in cycles.. be in the right place at the right time

surgery is much more competitive nowadays. an IMG would have no chance at all at my program. i am confident my application would be laughed at now. i am a black sheep without a doubt.

advice:
apply widely, aim high-
I was fortunate enough to get interviews at alot of places back then. even some university programs (big names). but probably only because the dumb secretary didnt realize my school was "foreign", remember- 4 yrs ago surgery was slightly less competitive

while your usmle score is good, it is almost expected for img's to score this well on the boards if they are going to get invited to interview for surgery. actually your numbers may only be avg (for img's)- believe it or not! getting anything less than 250 is weak for an IMG.

in my opinion, you should try to follow up with even better numbers on step 2 prior to applying. the rationale being anyone can get lucky once, but 2 superior scores are not by chance. don't be afraid to take them because you dont want to get a lower score and screw yourself. you have to be positive and confident.

try somehow to get a letter from someone known at where you are applying. dr joe bigshot's at community general wont get you anywhere as an IMG

consider your contingency- rank a really good prelim LAST as your backup. someplace that has a history of promoting prelims and/or a strong PD who will ensure helping you get a spot if you do a good job. I ensure you that an IMG will not scramble into anything- since there will likely be no categorical spots.

above all else- believe in yourself. do not get discouraged. if you really want surgery, you will get it if you persevere.

ESU

 

[drenthu]

great post!!!!! Thanx a lot for ur encouraging post.
i have a decent CV and good no of calls but the problem is either they are categorical at small community programs or prelim at top notch programs(top 5). wut shud be the best way ??? wut are the chances of fellowship from community hospitals. i know the rate of conversion at top notch is low but i have seen it happening and they have img maybe couple in cats so wut do u say??

 

[Pollicis]

Thanks ESU for the reply. Do you mind if I PM you with some questions?

Pol

 

[Winged Scapula]

You might reconsider taking Step 2 a little earlier.

Some programs require it of applicants, especially IMGs and assuming you do well, its another bonus on your application.

Besides, you mention taking it next summer - unless you are in the Southern Hemisphere, I would presume next summer you will be in residency in the US and most will have expected you to take it before you start your residency. Time off, especially during internship, is precious. You don't want to start off on the wrong foot by asking for time off to take the test when all of your AMG colleagues will have taken it before medical school graduation.

 

[Pollicis]

Hi Kimberli,

Thanks for the note. I'm actually in my 2nd last year of med school, so next summer, I'm planning on doing Step 2 CS and CK, and two 4-week electives. I'm really looking to match into a categorical GS program in the northeast USA (NY preferably), but all this talk of GS becoming even more competitive over the years makes me nervous. Is a Step 1 score of 248 / 99 really not that competitive for IMGs??? 🙁

 

[Blade28]

I wouldn't limit yourself to one particular state, that's for sure!

 

[Winged Scapula]

Hi Kimberli,

Thanks for the note. I'm actually in my 2nd last year of med school, so next summer, I'm planning on doing Step 2 CS and CK, and two 4-week electives. I'm really looking to match into a categorical GS program in the northeast USA (NY preferably), but all this talk of GS becoming even more competitive over the years makes me nervous. Is a Step 1 score of 248 / 99 really not that competitive for IMGs??? 🙁

Ahh...thanks for the clarification. I had assumed you were applying THIS year.

As for scores, while many FMGs have phenomenal scores, this is generally assumed because they will take a year or so off to study for the test. This is not true for IMGs, who have variable amounts of time off to study, just like AMGs.

Therefore, I would say for an IMG your score is excellent and certainly would be competitive. There is no way you'll know whether or not you'll match unless you try.

 

[teratogen]

Hello,

Does being a Canadian citizen IMG studying medicine in Europe make any difference? (I'm in Ireland). Thanks

 

[SLUser11]

Hi Kimberli,

Thanks for the note. I'm actually in my 2nd last year of med school, so next summer, I'm planning on doing Step 2 CS and CK, and two 4-week electives. I'm really looking to match into a categorical GS program in the northeast USA (NY preferably), but all this talk of GS becoming even more competitive over the years makes me nervous. Is a Step 1 score of 248 / 99 really not that competitive for IMGs??? 🙁

It's competitive for sure, it's just not a SURE THING like it maybe used to be. According to the NRMP "match outcomes" from last year, which you can find at nrmp.org I think, IMGs with your step 1 score matched 47% of the time.

Don't get too discouraged....being an IMG is a big red flag on your app that you can't change or control.....but there are plenty of other factors yet to be determined in your application that you CAN control.

 

[Winged Scapula]

Hello,

Does being a Canadian citizen IMG studying medicine in Europe make any difference? (I'm in Ireland). Thanks

Well, yes and no.

Yes, because in some instances programs prefer candidates who are North American, speak English as a first language and have studied medicine in a First world country.

No, because IMGs who study outside of their country are viewed as being "not good enough" to gain entry into medicine in their own country. ie, this is the conventional wisdom regarding Americans who go to the Caribbean for medical school). This is contrasted to the true FMG who trained outside of the US because he/she trained in their home country; there is no assumption that they couldn't get into a US or Canadian school because of course, they never tried.

And finally, yes it can make a difference because some American faculty realize that entry into a Canadian medical school is exceedingly difficult and that many good quality candidates are forced to study outside of the country.

Hope that clarifies everything for you!🙄

 

[drbruce]

"while your usmle score is good, it is almost expected for img's to score this well on the boards if they are going to get invited to interview for surgery. actually your numbers may only be avg (for img's)- believe it or not! getting anything less than 250 is weak for an IMG."


I shouldn't worry about your USMLE score. Unless the scoring system has changed recently, 250 is still considered excellent, 2 s.ds above the mean value. The average grade for FMG who passed the USMLE was just slightly above the mean value achieved by AMGs - about 215-220 (i cant quite remember)

I would be very surprised if you don't match with a score like 248 in a general surgery residency. You could probably even match with 230, just as long as it is above the mean value.

 

[Pollicis]

so...are there any other IMG's out there with interviews/matches at some upper level hospitals?

 

[Celiac Plexus]

"while your usmle score is good, it is almost expected for img's to score this well on the boards if they are going to get invited to interview for surgery. actually your numbers may only be avg (for img's)- believe it or not! getting anything less than 250 is weak for an IMG."


I shouldn't worry about your USMLE score. Unless the scoring system has changed recently, 250 is still considered excellent, 2 s.ds above the mean value. The average grade for FMG who passed the USMLE was just slightly above the mean value achieved by AMGs - about 215-220 (i cant quite remember)

I would be very surprised if you don't match with a score like 248 in a general surgery residency. You could probably even match with 230, just as long as it is above the mean value.

The mean step I score for matched "us senior" applicants was 222. Contrasted with ortho which was 230, and plastic surgery which was 231, general surgery is less competitive. There is no data specifically for imgs. Keep in mind though, as a "non-us senior", a step I score of 250 is outstanding, but is not a guarantee of success. It is interesting to note that of the 9 "non-us seniors" who applied to general surgery last year, and who achieved a step I score between 250 and 260, 5 went unmatched.

According to the NRMP, last year the number of US seniors applying to general surgery was 1522. The number of available positions was 1051. That means 471 us seniors were shut out. The new data for this year has not been released, but my institution has received more applications than last year, and in spite of raising our step I cutoff, we have even more qualified applicants than last year. At the very least, the process will be at least as competitive as last year. And this is where imgs may have difficulty matching. With so much interest in training positions, program directors look for reasons to screen applicants out. Img status may be used as a reason to screen out an application. So I think img status is a lot more concerning than a step I score of 250.

That said, an img can still match in general surgery. But I advise the img to focus his/her efforts on cultivating relationships with specific programs of interest. Audition rotations are very helpful because if you do a good job, and are well-liked, you will have the advantage of being a known quantity. Combine being a known quantity, with excellent letters of recommendation from well-known surgeons, and phone calls on your behalf, and you will raise your chances of a successful match. Oh, and you're step I score of 248 won't hurt either.

Best of luck. Where there's a will, there's a way.

 

[CattleprodSurg]

The dirty little secret in surgery is that anywhere from 10 - 20 % of residents will drop out, fail, transfer to other specialties, get sick and stop working, become crazy or simply get fired for bad performance.
This was published in a recent article by the ACS.
The prelim positions are geared to fill these posts.
Prelim surgery is not a good option for American grads but is a great position for FMGs. During your time you will have an opportunity to outshine some of the more marginal performing residents and take their positions when the axe falls.
The ACS stats support this as does personal experience.

Good luck all FMGs

 

[Leukocyte]

Prelim surgery is not a good option for American grads....

Why?😕

AMGs who do not match this year, can do a prelim. year...and apply next year. If they do well, they would be even more competetive than the FMGs who did the same.😕

 

[CattleprodSurg]

True. But you have a better chance of matching categorical than a superstar FMG even if you are not as smart, well published, academically acomplished or have better clinical or social skills.

 

[dopetown]

Prelim surgery is ... a great position for FMGs. During your time you will have an opportunity to outshine some of the more marginal performing residents and take their positions when the axe falls.
The ACS stats support this as does personal experience.

So is the best strategy then is to apply to a butt-load of programs everywhere including prelim so that you have a backup?

What if you land a prelim spot, do your one or two years, but couldn't secure a categorical spot? Are you more competitive for the next cycle of matching?

If you match to a categorical, do you start from PGY-2 or do you start all over from PGY-1?

What determines how many prelim years (one or two) you do?

Thanks!

 

[Winged Scapula]

So is the best strategy then is to apply to a butt-load of programs everywhere including prelim so that you have a backup?

I don't know if that's the best strategy, but its the most common one. You do need to have a back-up plan in case you don't match. And I would rank Prelim spots below the Categorical to maximize your chances of matching to a Ca spot over the Prelim.

What if you land a prelim spot, do your one or two years, but couldn't secure a categorical spot? Are you more competitive for the next cycle of matching?

Perhaps. If you do well and get good LORs from your intern program, it may increase your chances. But its a tough road - essentially a year-long audition.

Although there is a new rule coming down the pike, starting next year I believe, which states that you cannot be BE/BC if you have been at more than 3 residency programs during your general surgery residency. Therefore, residents who have had to switch from program to program every year may find themselves in a real bind, as other programs don't want to graduate non-BE/BC residents - it looks bad for them and does a disservice to the resident. Therefore, you may become 'tainted" goods and won't get another shot if you haven't become a Categorical by PGY3 and have mad to change programs.

This means more than ever you need a Plan B if you don't get what you want early.

If you match to a categorical, do you start from PGY-2 or do you start all over from PGY-1?

Well, you won't start over as a PGY-1 (which just implies the number of years you are past graduation), but some programs may require you to redo your intern year as a PGY-2. There are no hard and fast rules, essentially depends on whether or not a program has an available 2nd year space for you and they want to offer it to you. If they don't, then its likely you'll repeat your intern year. Academic programs with people moving in and out of the lab more often have open spots than community programs.

What determines how many prelim years (one or two) you do?

- whether or not the program has space for you as a Categorical
- whether a program likes you and wants to invest in you as a Categorical
- how well you do as a Prelim

etc...again, no hard and fast rules - I have seen people spend 3 years as Prelims before getting Categorical spots, I have seen people spend 3 years as Prelims and never get a Categorical spot (and drop out, of course) and I've seen others (from my own program) do exceptionally well as a Prelim and be offered a categorical 2nd year spot. So it really just depends on a number of factors.

Thanks![/QUOTE]

 

[misyel]

Do these rules apply to DO students as well?

 

[Death]

True. But you have a better chance of matching categorical than a superstar FMG even if you are not as smart, well published, academically acomplished or have better clinical or social skills.

What's that supposed to mean? Is the american system so unfair as to overlook a FMG despite of having an all around better credential than an american grad? While I know and understand the bias towards american grads in competitive branches , this comes as a surprise. I am concerned because i am going for MPH or may be MS [ waiting for confirmation , app process complete] in one of the top institutes in states ,and I took this route just so that I wanted to make myself more competitive , add some research to my CV, get American LoRs etc. So this rather baffles me as to my possible chances of matching.

 

[Celiac Plexus]

What's that supposed to mean? Is the american system so unfair as to overlook a FMG despite of having an all around better credential than an american grad? While I know and understand the bias towards american grads in competitive branches , this comes as a surprise. I am concerned because i am going for MPH or may be MS [ waiting for confirmation , app process complete] in one of the top institutes in states ,and I took this route just so that I wanted to make myself more competitive , add some research to my CV, get American LoRs etc. So this rather baffles me as to my possible chances of matching.

Well, program directors like to be fair and judge applicants on an even field. US med students have a fairly consistent educational experience, and take tests, are judged on their clinical skills, etc... under roughly equivalent conditions. Part of the FMG bias stems from the fact that clinical experiences, and educational experiences of fmg applicants is widely variable. To illustrate this, I will give the example of the USMLE step I score. Many FMG applicants spend 1, or 2, or even more years studying for just this single test. US students all take it at roughly the same time: between their didactic, and clinical education. Even though an fmg gets a 250, on step I, and the US applicant gets a 235, which is more impressive knowing that the FMG spent 2 years specifically studying to beat the test, and the US student spent about 4-6 weeks to specifically beat the test?

Further, clinical skills evaluations are very different from country to country. In some countries, medical students aren't permitted to touch the patients, and in others, they are expected to care for almost every aspect of their care. And there are cultural differences as well that are taken in to account. The United States has its own set of cultural norms which may or may not jibe with the FMG's own, and program directors tend to be very aware of this. They do want diversity in theur programs, but they don't want someone who is ill-equipped to mesh well with the other residents, and faculty.

That's just a couple of reasons for the "FMG bias". That said, there are still FMGS in every branch of surgery, and if you are dedicated, you will find a way. As I recommended before though, cultivate relationships with programs of interest. This will be much more valuable to you than the standard shotgun approach.

Best of luck.

 

[maverick_pkg]

hey i disagree with the 1-2 year thing. some do take 5-6 months, but you have got to remember that most FMGs give it after their med school by which time they would have forgotten most of anat, physio, biochem etc, at least that stuff which doesnt help in the 3rd/4th year. so more time would obviously be required.

also, especially in step 2 ck FMGs are at a significant disadvantage, as the test tests how medicine is practised in US. for example questions dealing with the next step. so many FMGs require 2 months to read american textbooks to get a hang of the american system

my 2 cents!

 

[Pollicis]

I wrote step 1 in the summer between preclinical and clinical years. I can say for sure that it was harder for me than most of my north american friends because they really don't teach the basic sciences to the same standard here as they would in canada/usa. I basically had to teach myself micro/biochem/beh. sci etc. I still ended up with a good score, and I hope the PD's can recognize that... 😕

 

[mohelgamal]

I am an IMG who went through step 1 with two month of on and off study and got 241/97. how do you rate that.

But the most important lesson I learned is, for an IMG, applay to places who take your kind. in other word if you are indian search for a program who has indians. if you are an arab go for programs that take arabs and so on. I am egyptian and guess what. all the programs that I was invited too had egyptian resident. it is simply that they have tested your medical education and found it good

 

[Blade28]

Understandably, there's going to be a bias when US grads are ranked against IMGs. Likewise, if US grads applied for residency spots overseas (England, India, Hong Kong, wherever), there'd be a bias there also.

 

[Blade28]

Understandably, there's going to be a bias when US grads are ranked against IMGs. Likewise, if US grads applied for residency spots overseas (England, India, Hong Kong, wherever), there'd be a bias there also.