any IMG's lurking out there

[trent05]

How did IMG's fair this interview season. I was suprised to only see a few on the trail. If 2/3 of those applying to path are IMG, then where art thou? Okay Deschutes you are Canadian but I consider that only half IMG.

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[stormjen]

I think they got interviews at places where many of us didn't even bother applying. The top IMGs compete with the AMGs of course.

 

[Mrbojangles]

I've met a few at some competitive programs.

 

[yaah]

Yeah, most programs will have IMGs. There are one or two in my program however I don't even think they interviewed any this year, for some reason. However, though, a lot of times the IMGs at big name programs are those with heavy research experience or who have done extensive clinical work here perhaps in another field.

 

[deschutes]

How did IMG's fair this interview season. I was suprised to only see a few on the trail. If 2/3 of those applying to path are IMG, then where art thou?

Part of the reason you're not running into them is that some programs are more IMG-oriented than others. Wayne State for instance has a history of taking 2 IMGs to 1 AMG per year. And I know of only one other person on this forum who interviewed there.

Okay Deschutes you are Canadian but I consider that only half IMG.

Well, that is half the story
I look IMG on paper but sound AMG/CanadianMG in person. I'm quite convinced that I did better during interviews than my app looked because I didn't sound like I was (if you will pardon the expression) FOTB.

Everyone has an accent. It just depends on whether yours is "acceptable"

 

[trent05]

All Img's that I encountered had 99's on both steps. A good USIMG friend of mine had 250's and 260's on the steps and signed at a middle tier program where he did a rotation. If you have good boards I think you will get more interviews at Univ. programs than you can attend.

 

[deschutes]

My Step 1 score was below 220/90, but not by much. I didn't have Step 2 scores at the time of application and still don't. I did have 4 good LORs, though I still think the one I was counting on could have been stronger. One poster at a national meet, and one at the recent USCAP - though that was too late to put in my application.

I got a call from my top ranked program saying "We hope to see you here in July", whatever that meant.

So we'll see on March 14 how much they like me.

Bottomline: You never know till you try.

 

[b&ierstiefel]

My Step 1 score was below 220/90, but not by much. I didn't have Step 2 scores at the time of application and still don't. I did have 4 good LORs, though I still think the one I was counting on could have been stronger. One poster at a national meet, and one at the recent USCAP - though that was too late to put in my application.

I got a call from my top ranked program saying "We hope to see you here in July", whatever that meant.

So we'll see on March 14 how much they like me.

Bottomline: You never know till you try.

Now watch you match at #1. And you will party party party party party. Your friends will go to sleep. But you'll still be rawkin!

 

[PathOne]

I will be going through this process next year. I am a USIMG studying in Australia (U of Sydney) and a US citizen. What kind of board scores are required to get interviews at reasonable university programs?

Also, how important is it to have pathology experience in the US? I can do a rotation in Australia; however, it will be very difficult for me to arrange a rotation in the US (but I can do so if it is essential).

Any other advice?

Barring programs that filter out IMG's in the Match, I think it's hard to overestimate the value of a strong US LoR.

Non-US grades, training and LoR's are basically meaningless for a US PD, because they wouldn't say much about your ability in a US program (except in special cases, like if you already have a non-US specialist recognition or proven research record in path.).

But a strong LoR from a recognized US-trained or -based researcher or clinician can be VERY helpful. In exceptional circumstances, a non-US LoR might also help - I'm pretty sure a letter from Rosai in Milan will come in handy...

But for the IMG, there's basically only three measuring points: Step scores, US LoR's and published research. If they are strong, there's no problem. If not, there's probably choices out there the PD will consider safer, unless the PD happens to be a graduate from the same country as yourself.
- This would at least apply to competitive programs, which most in path is today. Things are different in int med or FP.

 

[deschutes]

Further, all grading is P/F so, unlike the US, there is no butt kissing and jockeying for position during the clinical years.

I'm in a Canadian school which operates on the Pass/Fail system, so I can empathize. I knew working on my grades would not show - and besides, I am not capable of that sort of sustained effort at the books. I took Step 1 halfway through 2nd year - I would like to have aced it, but was more concerned with passing.

So being completely jaded with studying cardiac physiology for like the 5th time, I opted for research, with the goal to publish.

(I still suck at reading ECG's.)

You have one thing working for you, and that is the fact that you are a US citizen. USIMGs do not require J-1 visas - and one can easily imagine that the lack of immigration paperwork is appealing to certain PDs.

 

[Harbster]

I still suck at reading ECG's.

Makes the two of us

 

[b&ierstiefel]

What is ECG?

 

[PathOne]

You have one thing working for you, and that is the fact that you are a US citizen. USIMGs do not require J-1 visas - and one can easily imagine that the lack of immigration paperwork is appealing to certain PDs.

Yes, citizenship creates one less hurdle to overcome, so would certainly be a plus. However, the "IMG friendly" programs (such as NYU) are generally willing to help out, if you're who they want.

The real problem with visa-issues is for the resident, not the program. If you're on a J-1 for medical training you HAVE to leave the US for at least two years after finishing training (there's ways around it, but you'd need to be REALLY careful when applying for a visa). But in general there's NO exceptions for the return requirement, not even if marrying a citizen.
Only way out is to work in "medically underserved areas". Don't know where that would be for path. Napa Valley perhaps (ask LADoc00)?

Anyway, path isn't generally regarded as IMG-hostile, unlike the more competitive specialities, such as Derm. And I think I've read somewhere that something like 50% of docs in NYC are foreign (by birthplace or training) -- seems high, but there ARE a lot, and they've obviously managed to clear all the hurdles.

 

[deschutes]

The real problem with visa-issues is for the resident, not the program.

Exactly. Any perceived potential problems for the program will eventually make themselves felt by the resident.

The exact wording in the J-1 visa requirements is "two years in your country of origin" (i.e. citizenship). This is provided you want to eventually apply for landed immigrant/permanent resident status in the US.

The chair at Iowa introduced me to the concept of the O-1 visa. "O" for "Outstanding". I kid you not. This apparently does away with the two years requirement.

But that seems to be somewhat of a reach. Certainly not something I'd count on.

Especially since (and I quote Dr. Fletcher's Powerpoint here) the ADASP survey from Nov/04 response to the question "Will you sponsor successful candidates for O-1 visa?" showed the following:

With H-1
Yes 72%
No 28%

With J-1
Yes 48%
No 52%

• Only for exceptional candidates: 20%
• Prefer not: 25%
• Institution will not: 20%

 

[PathOne]

Yeah, Sloan-Kettering has TONS of foreigners, especially in research, and are apparently experts at getting special stuff like O-1's. I think you'd need published research for that one, though.

Nice numbers from Chris Fletcher (himself a Brit, who by the way never did a US residency, and thus isn't US boarded. Well, not entirely true. He's boarded in Int Med...)

 

[stormjen]

Out of curiosity, how difficult is it for an AMG trained at a U.S. residency to practice medicine in another country? Say I complete residency and want to move to Canada, or Argentina, or France? I assume it is different for each country.

 

[deschutes]

In broad strokes, I think there are two categories: the countries which have a pretty good set-up of their own (and pay relatively well), and the countries where infrastructure, governing bodies and therefore healthcare are desolate beyond one's imagination.

You would jump through many hoops for the first, and they'd be desperate for you to come to the second.

 

[PathOne]

While the ABPath absolutely refuse to make exceptions for US residency training requirements, it IS possible to get specialist recognition outside the US as a AMG. However, it is a fairly difficult road to travel, and in many instances the decision not only varies from country to country, but from case to case. I personally know of examples where people were required to redo ALL of their pathology training in Europe, even though they had passed US boards.
In fact, there's not even a uniform standard for getting a plain license, except in the UK which has the PLAB.
It's somewhat odd, because I find it really difficult to point to specific differences between training in Europe and the US, but it probably comes down to tradition and politics. If you look outside Europe, the picture is even more blurred. For instance, UK qualifications are basically instantly recognized in Singapore, and partly in Canada and Australia, but those same countries can be very sceptical if your qualifications were optained in say Germany or France.
If somebody really wants you, there's always ways around the bureaucratic red tape, in any country. But if you just want a change of scenery or are moving for personal reasons, it CAN become a major headache.

And on top of everything else, visa and work permit rules are constantly tightened all over the world. It's probably fair to say, that the US today is significantly easier to work in as a foreigner, than it is to go to Europe as an American.