Are all FMG's equal?

[Taurus]

If you want to play this little game we call medical training, then you have to understand the rules. The point about why someone would go to a US MD school is residency. If there was no such thing as residency, nobody would care what school you went to. For example, most dentists don't do residency and therefore most people don't really care what dental school they go to. However, if you want to get into a competitive medical residency like derm, ortho, ent, rads, etc, it sure helps to come from an US MD school. It's not impossible to get into one of those specialties as a DO or Carib MD applicant but you have to be much, much better, even to score an interview. And how is the decision arrived at to grant an interview? It's the selection committee headed by the PD, who most often is a US-trained MD. Unless you want to do FM, IM, peds at places most US MD's don't want to do, it's important to keep in mind US MD > DO > FMG when applying to medical school.

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[dragonfly99]

<About residency. DOs are in a much better position than Caribs. Not marginally so. They have their own protected residencies, their own goverining bodies, and Boards. No DO is left without a residency. The whole system, from med school, to residency, to board certification is protected and in place. Gosh, they have their own Hospitals. Carib grads are left with the spoils of the residency match, and in fact, ony 40% of Carribean grads actually match.>

Not sure about the 40% match stat for Carib grads. I do know that I've never met a DO who didn't get a residency...there are very few. Just like there are very, very few US MD grads who don't get a residency. On the other hand, it's not hard to find or run in to either FMG's or US citizen IMG's who trained abroad (including Caribbean) and didn't get a residency. It's like musical chairs and there are a ton of applicants (FMG and IMG). Some are going to get left out each year. If you are in the top of your class then you'll get something...very likely it won't be derm or radiology, but you'll get something.

As far as DO stigma, some patients do stigmatize them, but I don't think most do. My mom was telling me she wasn't sure about them...back in the day 20-40 years ago maybe patients preferred one or the other. I told my mom I wouldn't worry about it...just like any doctor ask around about them and maybe look at where they went to school. I am from the Midwest and I can tell you that there are lots of DO's in practice and they do well. Most are in primary care, but not all. They are common in the South and Midwest. I've worked at two top 30 or so academic med centers and I have run in to the occasional DO - we had one rheumatology fellow and an anesthesia resident (the latter was totally AWESOME doc...both were good actually). One has to realize that while some DO's desire an allopathic residency, they don't all care, or even try for one. They have their own hospital system and their own accreditation systems. What you have going for you training as a DO is the philosophy and probably a primary care bent at most of the schools; if that is your cup of tea then so be it. Some believe in the osteopathic manipulation stuff, and some don't...if you don't you don't have to practice/use it later, I don't think.

I think one has to be careful about the med school one chooses if one decides to go abroad. Folks are going to wonder why you chose to do that, vs. reapply in the US. It might be seen as "trying the easy way out". Having said that, certain MD schools like maybe a few Israeli and Caribbean ones seem to have name recognition in areas like New York. Perhaps in those areas DO's are not as common, or not as recognized by the general public. Students have to think about their own particular situations. Would they rather attend St George in the Caribbean and do rotations in New York, taking a chance on getting a US residency vs. attend a DO school in some small town in the Midwest (assuming those are the only 2 places the person got in)?

Most patients are not savvy enough to know the difference between a DO or MD, and most don't even know how long you go to school to be a physician vs. a nurse or any other profession. They also might not know that a naturopathic doc and a chiropractor don't go to the same type of school, or for the same amount of time. Some patients are smarter and more educated, but you'd be surprised about what people don't know. Mostly they'll just look for a doc by specialty (i.e. OBGyn or a primary care doctor).

 

[dragonfly99]

As far as DO's not getting in to neurosurgery, I think that's a function of several things.

For one thing, that's not the emphasis of most DO schools nor of students who go there. Most of those schools are more primary care focused, at least as far as I know. So probably a DO school wouldn't be the best one to pick for an applicant who has a strong interest in neurosurgery I would think.

Also, some students in DO schools aren't great standardized test takers, and to get into neurosurgery you pretty much need high USMLE scores. I doubt the DO schools teach to the USMLE exam either, as some US and international MD schools do.

I think if a DO student showed up with top clinical grades, 250's on his boards, and had done neurosurgery research and had a LOR from some well known neurosurgery faculty, I don't see why he wouldn't get in neurosurgery residency. It's just that most of the DO students aren't in that situation. For one thing, they probably aren't at schools where there are a bunch of neurosurgeons who could mentor them.

Anyway, most US MD students couldn't get in to neurosurgery either...

 

[jiy76]

I won't presume to speak for everyone, but I can tell you why I think the Caribbean schools are sub-optimal.

Everyone at a Caribbean school is there because they did not get into a school in their home country (generally the US and Canada, hereafter called 'American'). They have poorer GPAs, MCATs, and CVs than do American students. Fine. Let's divide those students into 2 groups: those who weren't serious about their studies and weren't well-prepared for the MCAT, but who are intelligent and dedicated to becoming a good physician, and those whose scores are, um, an accurate reflection of their true ability.

For the first group, the Caribbean schools are a wonderful second chance. All that group needed, once they got serious, was someone to give them a fair shake. They're bright, they're motivated, and they take that second chance and run with it. Those are the people who pass the boards well, approach the wards with enthusiasm, and make good residents.

The second group-- those who truly aren't bright or dedicated enough to make it through medical training-- are what give me problems. The Caribbean schools are famously for-profit institutions. They admit without discretion. They admit for 1-2 years of "premedical" studies, or "half-time" studies, or whatever-- anything to make a buck. People fail, are re-admitted, fail... The schools themselves have *no* incentive to winnow them out (which they could do-- they could have a single entry time, they could conduct real interviews).

And they shaft people on their clinicals. The quality and rigor of your clinical sites varies enormously. Some are glorified observerships, some are slave labor, many award only A+s and As, nothing lower. Again, the schools have little incentive to change any of this. I feel that if you came out of a Caribbean school with good board scores and a solid fund of medical knowledge, you are to be especially commended because it was most likely entirely of your own doing, *despite* the barriers imposed by your school.

OP, I'd take a seat in a "real," national medical school-- one with its own hospitals and its own clinical faculty, who will train students to become residents in its own system-- any day over a for-profit Caribbean school. Whether that means Sackler, or Ireland, or Australia is really up to you (though they're three quite different countries: make sure you'd be happy living there).

Oh, and please let's all avoid the "there's this one guy" fallacy. Yes, there's the brilliant Hopkins grad who hates attending on the wards and just wants to get back to his lab. Yes, a woman from SGU is now attending in rad-onc at Harvard. Yes, that Ross peds resident is so full of warm fuzzies, his patients love him to death. As with any statistical distribution, there will be outliers, but they don't affect trend.

I'm a carib student and I agree for the most part with everything said above. Everything that was mentioned is a part of the carib med school system. Essentially It is up to the student to make it. The people in the second group of students usually never make it through the multiple board exams to become residents so i guess no harm no foul but yes it doesnt look good on the system.Clinicals are what you make of it some rotation spots are great with lots of teaching hands on experience and REAL grades. Some spots are exactly as mentioned above.Carib schools are far from perfect.That being said there are a lot of students from the first group who end up being outstanding physicians that would never have had a chance otherwise.Its a means to an end that a lot of people are grateful for.

 

[LadyGrey]

This has been an interesting discussion to read. I wanted to thank dragonfly99 for the very reasonable comments about DOs.

For a lot of us, honestly, DO was a second chance the same way BlondeDocteur talked about the Caribs. I have some brilliant classmates who couldn't get into an MD program for reasons like age, slacking off in college, or whatever. It is a pretty imperfect process. I was a reapplicant; second time around I added DO schools to the mix, got into my state DO school, and there I was.

I'm going through the residency application process now, and there are a handful of programs (this is EM) that just don't like DOs. They can kiss my @ss, because there are plenty that don't care, and I'm not hurting for interview offers. I did a lot of clinical rotations at a site that also had SGU kids, and I think they have significantly greater obstacles thrown at them than we do, as far as scheduling rotations and as far as residency program attitudes.

BTW, we do have our own neurosurgery programs, 11 of them. So I'd assume most DOs wanting to do it go into those.

 

[Excelsius]

<About residency. DOs are in a much better position than Caribs. Not marginally so. They have their own protected residencies, their own goverining bodies, and Boards. No DO is left without a residency. The whole system, from med school, to residency, to board certification is protected and in place. Gosh, they have their own Hospitals. Carib grads are left with the spoils of the residency match, and in fact, ony 40% of Carribean grads actually match.>

Not sure about the 40% match stat for Carib grads. I do know that I've never met a DO who didn't get a residency...there are very few. Just like there are very, very few US MD grads who don't get a residency. On the other hand, it's not hard to find or run in to either FMG's or US citizen IMG's who trained abroad (including Caribbean) and didn't get a residency. It's like musical chairs and there are a ton of applicants (FMG and IMG). Some are going to get left out each year. If you are in the top of your class then you'll get something...very likely it won't be derm or radiology, but you'll get something.

As far as DO stigma, some patients do stigmatize them, but I don't think most do. My mom was telling me she wasn't sure about them...back in the day 20-40 years ago maybe patients preferred one or the other. I told my mom I wouldn't worry about it...just like any doctor ask around about them and maybe look at where they went to school. I am from the Midwest and I can tell you that there are lots of DO's in practice and they do well. Most are in primary care, but not all. They are common in the South and Midwest. I've worked at two top 30 or so academic med centers and I have run in to the occasional DO - we had one rheumatology fellow and an anesthesia resident (the latter was totally AWESOME doc...both were good actually). One has to realize that while some DO's desire an allopathic residency, they don't all care, or even try for one. They have their own hospital system and their own accreditation systems. What you have going for you training as a DO is the philosophy and probably a primary care bent at most of the schools; if that is your cup of tea then so be it. Some believe in the osteopathic manipulation stuff, and some don't...if you don't you don't have to practice/use it later, I don't think.

I think one has to be careful about the med school one chooses if one decides to go abroad. Folks are going to wonder why you chose to do that, vs. reapply in the US. It might be seen as "trying the easy way out". Having said that, certain MD schools like maybe a few Israeli and Caribbean ones seem to have name recognition in areas like New York. Perhaps in those areas DO's are not as common, or not as recognized by the general public. Students have to think about their own particular situations. Would they rather attend St George in the Caribbean and do rotations in New York, taking a chance on getting a US residency vs. attend a DO school in some small town in the Midwest (assuming those are the only 2 places the person got in)?

Most patients are not savvy enough to know the difference between a DO or MD, and most don't even know how long you go to school to be a physician vs. a nurse or any other profession. They also might not know that a naturopathic doc and a chiropractor don't go to the same type of school, or for the same amount of time. Some patients are smarter and more educated, but you'd be surprised about what people don't know. Mostly they'll just look for a doc by specialty (i.e. OBGyn or a primary care doctor).

Thank you for the good points. A lot of firsts for me, especially about NS. Since it seems that Caribs have already been covered extensively, I will sum up why a DO might not be a good choice:

1. They are focused on primary care and if someone wants to go to NS, for example, it will be very difficult since there might not be any neurosurgeons in the school who could write a good LOR, even if Step 1 scores are high. This will be fine if you are headed for PC, but otherwise, it is not the main function of DOs to focus on specialties.
2. The stigma/bias associated with the degree among some patients and medical communities, even if restricted to certain geographic regions
3. DO schools don't concentrate on USMLE as MD schools do. Therefore, it may be more difficult to get high test scores required for some specialties.
4. Due to the DO school focus, it might be hard to do research there in some specialties like NS.
5. Since most program directors are MDs themselves, they will be more inclined to choose an MD, rather than a DO. And there are already plenty of MDs competing for ROADS residencies.
6. The recommendation letters from DOs, even assuming you can find an neurosurgeon DO at your schools, will not have the same weight as a recommendation from a famous MD neurosurgeon.
7. The perception of how smart you are as evaluated by your LOR writer, such as a neurosurgeon, has an important role in ROADS residencies. Therefore, it is possible that attending a DO school might create a bias that "you were not smart enough for MD" and can be detrimental.
8. As more MD schools are being built while MD residency spots are not being increased as much, it means that there will be more MDs competing for MD spots in the future. Some estimates say that due to the increase, there may be as much as 40% cut in IMG residencies by 2015 to satisfy the demands of US graduates. Since most IMGs go into primary, it is likely that most of these reassigned spots will be allocated to DO students, making DOs even more heavily concentrated in PC.
9. DOs are not recognized internationally and you can't practice in another country if one day you find yourself forced to move somewhere else (or maybe collaborate on an international research).

If I missed something or if something is wrong, let me know.

 

[Brodiewankenobi]

Thank you for the good points. A lot of firsts for me, especially about NS. Since it seems that Caribs have already covered extensively, I will sum up why a DO might not be a good choice:

1. They are focused on primary care and if someone wants to go to NS, for example, it will be very difficult since there might not be any neurosurgeons in the school who could write a good LOR, even if Step 1 scores are high. This will be fine if you are headed for PC, but otherwise, it is not the main function of DOs to focus on specialties.
2. The stigma/bias associated with it among some patients and medical communities, even if restricted to certain geographic regions
3. DO schools on concentrate on USMLE as MD schools do. Therefore, it may be more difficult to get high test scores required for some specialties.
4. Due to the system's focus, it might be hard to do research in some specialties like NS.
5. Since most program directors are MDs themselves, they will be more inclined to choose an MD, rather than a DO. And there are already plenty of MDs reaching for ROADS residencies.
6. The recommendation letters from DOs, even assuming you can find an neurosurgeon DO, will not be worth as much as a recommendation from a famous MD neurosurgeon.
7. As more MD schools are being built while MD residencies are not being expanded as much, it means that there will be more MDs competing for MD spots in the future. Some estimates say that due to the increase, there may be as much as 40% cut in IMG residencies by 2015 to satisfy the demands of US graduates. Since most IMGs go into primary, it is likely that all these spots will be allocated to DO students, making DOs even more heavily concentrated in PC.
8. DOs are not recognized internationally.

If I missed something or if something is wrong, let me know.

1. The two osteopathic schools that have accepted me place over 60% of their grads into non-primary care residencies.

2. I really think you are overstating the bias here. Next year 20% of all medical students are going to be osteopathic students. The more visibility for the profession will likely abrogate any regional bias or prejudice against do's.

3. i assume that says "don't concentrate on the USMLE." Yeah maybe DO's schools should just teach the test. That strategy has produced great doctors at these Caribbean diploma mills.

4. Yeah doing basic science research may be more difficult, but i have seen plenty of opportunities to do research on a translational or clinical level at nearly every DO school (once again FAR more than any Carib)

5. I can't imagine any PD worth their salt taking one candidate over another simply b/c of the initials after their name

6. What if you were an allopathic student trying to get letters for a NS residency and the only one willing to write you a letter was a DO neuosurgeon? Would you turn it down? Didn't think so. Osteopathic students also rotate with MD preceptors, so you are probably just as likley to get a letter of rec written by an MD as a DO.

7. DO's will probably expand the number of their OWN residencies to compensate for the loss of some allopathic spots. You get a DO degree, your going to get a residency spot. WAY more concerned about this if I was an IMG or FMG.

8. This is so overblown b/c how many ppl actually go on to practice overseas (bet its less than 1%). The only major country with any real restrictions is France.

 

[howelljolly]

Mean people suck

 

[tkim]

Thank you for the good points. A lot of firsts for me, especially about NS. Since it seems that Caribs have already been covered extensively, I will sum up why a DO might not be a good choice:

1. They are focused on primary care and if someone wants to go to NS, for example, it will be very difficult since there might not be any neurosurgeons in the school who could write a good LOR, even if Step 1 scores are high. This will be fine if you are headed for PC, but otherwise, it is not the main function of DOs to focus on specialties..

1. 
   
   While some schools require more FM than others, having that requirement doesn't preclude one from specialing.
   
   This part about not having a neurosurgeon at your school to write a letter shows that you aren't in med school yet. Most people do a neurosurgery rotation and get a LOR from their attending. If you go to a school that has a nsg dept or program and have the chair or PD write a LOR, so much the better, but not all schools have nsg faculty.
   
   

   [*] The recommendation letters from DOs, even assuming you can find an neurosurgeon DO at your schools, will not have the same weight as a recommendation from a famous MD neurosurgeon..

   
   See above.
   
   

   [*] DOs are not recognized internationally and you can't practice in another country if one day you find yourself forced to move somewhere else (or maybe collaborate on an international research)..

   
   Care to point me to a list of where USMD's are recognized internationally?
   
   The false assumption that many premeds make is that the USMD is some sort of *magic card* that allows you to practice anywhere in the world. It does not. USMD's and USDO's are appropriately considered foreign degrees by other countries, and while some will grant reciprocity on the degree, most other countries will require sitting for and passing their licensing exams, along with language and citizenship requirements.
   
   Here's our list:
   
   http://en.wikipedia.org/wiki/Doctor_of_Osteopathic_Medicine#International_practice_rights
   
   Ireland, France and Spain are sticking points, but there's a fair amount of representation in the first world countries. Is the DO recognized as widely as the USMD? I'd say no. But to what extent is the USMD accepted internationally no one knows. It's not universal, that's a fact.

 

[Excelsius]

While some schools require more FM than others, having that requirement doesn't preclude one from specialing.

This part about not having a neurosurgeon at your school to write a letter shows that you aren't in med school yet. Most people do a neurosurgery rotation and get a LOR from their attending. If you go to a school that has a nsg dept or program and have the chair or PD write a LOR, so much the better, but not all schools have nsg faculty.
...

Thank you. That's a great point and I didn't know that. I will add that question to the list I am making. However, if I understand you correctly, you are saying that while having an NS department at the schools is definitely better, it is not a necessity because you can do NS rotation at any school and get a LOR that way.

I wasn't too concerned about international recognition, that's why it was at the bottom of the list.

 

[howelljolly]

If you want to go for neurosurgery, or any type of surgery for that matter, you would choose a NS elective. If one isnt offered at your school, you'd do it at another. Point is, your attending on that rotation (wherever they are) would write your letter of reccomendation, not the Chair of the NS at your med school.

Its not a question of nescessity, this is just how its done.

Department Chairs dont write your LOR, your attendings do.

Sometimes, your attending is the Chair.

Sometimes all of the planets allign.

 

[LadyGrey]

[*] They are focused on primary care and if someone wants to go to NS, for example, it will be very difficult since there might not be any neurosurgeons in the school who could write a good LOR, even if Step 1 scores are high.

As was already said, if you want to do allopathic neurosurgery, you will do elective neurosurg rotations at programs which you are considering, and get letters from those attendings or ideally the program director.

This will be fine if you are headed for PC, but otherwise, it is not the main function of DOs to focus on specialties.

Yeah, in theory. In practice all this means that a)you will hear a lot of rah-rah family med talks in your first two years, b) you may have to endure an extra-long family medicine clerkship third year, possibly at the expense of the lengths of things like medicine and surgery.

The stigma/bias associated with the degree among some patients and medical communities, even if restricted to certain geographic regions

Are we comparing this to being a US-trained MD, or an IMG/FMG? Because sure, if you can do the US MD route, by all means do it and spare yourself the relatively minor headache of being different. But don't let preoccupation with DO stigma convince you to go to the Caribbean.

DO schools don't concentrate on USMLE as MD schools do. Therefore, it may be more difficult to get high test scores required for some specialties.

Your board scores are about you and your individual effort to prepare for them. If your school sponsors/requires a prep course, it will be COMLEX-focused. Lesson: don't rely on this as adequate preparation. Some of us who take both actually do better on USMLE than COMLEX.

Due to the DO school focus, it might be hard to do research there in some specialties like NS.

I think it's going to be hard at most medical schools to do neurosurgery research. Most people I know did more basic science-y stuff.

Since most program directors are MDs themselves, they will be more inclined to choose an MD, rather than a DO. And there are already plenty of MDs competing for ROADS residencies.

...but more inclined to choose a DO than an FMG/IMG, in nearly all cases. Not making a judgment, just saying that's how it seems to be.

The recommendation letters from DOs, even assuming you can find an neurosurgeon DO at your schools, will not have the same weight as a recommendation from a famous MD neurosurgeon.

See above. So do neurosurgery electives with Dr Smartypants, MD, and get your letter. None of my letters are from people directly "at my school."

The perception of how smart you are as evaluated by your LOR writer, such as a neurosurgeon, has an important role in ROADS residencies. Therefore, it is possible that attending a DO school might create a bias that "you were not smart enough for MD" and can be detrimental.

I think their perception of your intelligence comes solely from how good you are on their rotation. You can give them a copy of your resume with your board scores listed if you want to enhance their perception, but I really think the letter is about what they thought of your behavior and knowledge as shown directly to them. If you really think someone has a strong anti-DO bias, for God's sake, get someone else to write that LOR.

As more MD schools are being built while MD residency spots are not being increased as much, it means that there will be more MDs competing for MD spots in the future. Some estimates say that due to the increase, there may be as much as 40% cut in IMG residencies by 2015 to satisfy the demands of US graduates. Since most IMGs go into primary, it is likely that most of these reassigned spots will be allocated to DO students, making DOs even more heavily concentrated in PC.

As you yourself said, it is the IMGs who will likely be pushed out first, not the DOs.

DOs are not recognized internationally and you can't practice in another country if one day you find yourself forced to move somewhere else (or maybe collaborate on an international research).

Nothing to add on this one, it was already addressed thoroughly.

 

[dragonfly99]

<If you want to go for neurosurgery, or any type of surgery for that matter, you would choose a NS elective. If one isnt offered at your school, you'd do it at another. Point is, your attending on that rotation (wherever they are) would write your letter of reccomendation, not the Chair of the NS at your med school.

Its not a question of nescessity, this is just how its done.

Department Chairs dont write your LOR, your attendings do.

Sometimes, your attending is the Chair.

Sometimes all of the planets allign. >

Actually, that's not necessarily true. I know multiple folks from my class in medical school got letters from the department chairs in specialties like radiology, anesthesiology and neurosurgery even though the dept. chair wasn't their attending on their rotation. Usually when dept. chairs do this, it is done using an amalgamation of knowledge/comments gleaned from what other attendings have told him about the student, +/- the student's resume and a short personal interview/conversation with the student. A lot of department chairs just don't spend much time being the "ward attending" any more, but at the same time they know that having a letter from someone like a dept. chair is helpful to students trying to get in to a competitive specialty. Therefore, they'll not uncommonly write a LOR for a student even if they didn't directly supervise him/her. Usually if people get a letter like this they'll also get one from the attending who directly supervised them on the rotation.

At any rate, one could do neurosurg. from either a DO or a MD medical school, but in either case I think it would be advantageous to be at a school that actually has a neurosurgery department (and/or reasonably sized division with the general surgery department). It's kind of unfair in a way, but it ends up making a difference sometimes. This is also true of other specialties and subspecialties. For example, if I'm an internal medicine resident at Emory or Duke, which have well know cardiovascular divisions, it might be a little easier for me to get a cardiology fellowship than someone from a different medicine program (even at a similarly prestigious/competitive medical center) that isn't as famous for cardiology. Part of this is probably because of having LOR's from folks more well known in the cardiology world...and/or the programs may just be extrapolating (correctly or not) that the resident from Emory or Duke will have been exposed to a greater number of more complex cardiovascular patients during residency.

 

[womp]

bluealiendoctor,

Having read your post, I have to say you pose the same arguments that every non-traditional caribbean/FMG student who is pissed off about the system states.

The problem is this:

1) You and other students like yourself couldn't get into an American medical school. That in it self speaks volumes. So yea, I would want the person from Joe Schmoe American university over an FMG because at least that person got into a school in their own country. Who cares about the reasons....you couldn't get in.

2) You have to seperate FMG and IMG. I have a lot respect for IMG's who grew up in other countries and went to school in their own homeland before attempting to immigrate to this country. For the most part, they are coming over to give themselves and their families a better life and oppurtunities.

3)American FMG's on the other hand are usually (not always), students who screwed up in undergrad or couldnt do well on the MCAT who use a loophole in our system to get a 2nd tier education outside of our country and call themselves doctors. They write about how we should feel about their loans...they are the ones who choose to go to these overpriced, diploma mills so no, I don't feel bad for them.

4) You talk about board scores being the great equalizer but they are not. It's been discussed numerous times that they are simply a certification exam. So yea if I a med student at Harvard gets a 220 and you go to a caribbean school and get a 260, I'm still going to take the Harvard student because I know they didn't spend 2 years simply studying for the test and another 6 months waiting and studying aterwards. Most american grads spend around 3-5 weeks studying for step 1 and have a curriculum designed not to pass Step I but to teach the essentials to becoming a good physician which is far more than Step I I assure you.

If I had my way, I would let all residency spots be available to american grads and then give what remains to IMG's. FMG's would not factor into the equation.

Your comments are pretty out of line.

Not all US medical schools are equal either and different states have different levels of competitiveness during admission. Every US medical school has decel programs and summer classes for those who can't cut it on the first try (which also reflects a failure in the admissions process). Yet these people are still US medical grads when they graduate. Would you rank them above more capable FMG's too? Based on your comments above, you would. Sub-optimal, indeed.

Just because someone went to a US school doesn't give that person an automatic right to look down on every FMG.

And if you really want to play this game, I went to a top ten university, would it be fair to automatically accept me over some state school grad regardless of my academic performance and dedication?

If you're really good, you don't need to hide behind these false dichotomies you drew. You certainly wouldn't be afraid of a few FMG's taking a sizeable risk themselves to achieve their dreams.

 

[thedrjojo]

No, your residencies show the unjustified system. Again, perhaps you didn't read....a foreign grad who does all his/her clinicals with US grads, has higer board scores, will still not get better chances than the US grad all because of an unjustified bias. People say D.O. is better than going Caribbean yet the ONLY reason one goes to D.O. school is because they couldn't get into an M.D. school. Nobody has chosen D.O. due to its 'holistic' approach in 20 years.....I know you all can clearly see the unjustice here...it's just difficult to allow someone who has out performed you do well so you gotta bring 'em down however you can. The little person who responded 'whaay' is just your typical spoiled, snot nosed kid who's daddy probably paid for everything and is only in this for the money. He/she won't ever stay bedside and ease the mind of the dying, or help an entire family deal with cancer....but hey, he/she went to a US school..so can do no wrong.

I have mixed feelings on this. I am an US student currently rotating at a community hospital with a group of students from SGU and some NYCOM. They are nearly on par with me and my fellow US student on the knowledge base, but where we really outshine them is from our 3rd year... why do I say this? Because I have just spent 8 months at the University Hospital getting my clinical training, where they have spent it at various community hospitals getting their clinical training. University Hospitals attract better residents and better teaching attendings, and have a greater focus on Education. They also give us a stronger clinical background. Couple that with the fact that we are tested with an OSCE at the end of every one of our rotations (save Surgery) where as the SGU students haven't taken an OSCE and are thus at a disadvantage in the clinical skills. During my first two years, besides taking courses that were integrated (Molecular and Genetic Medicine, Integrated Structure and Function, Mind, Brain and Behavior, Infection and Host Response, and Disease Process, Prevention, and Therapy, which were much more clinically based than they were solely subject based) we also took courses called Physian's Core I and II, which had us going into primary care office seeing patients during our first year, and going into the hospital in IM and Peds seeing patients in our second year, plus having lectures from clerkship directors on physical exam and interview skills and taking OSCE's at the 1st and 2nd year level. So I agree at 220 at US school isn't the same as a 220 at a carribean school if it is true you only have the core science courses and 6 months to study for the test, just like a FMG at the 4th year level does not have the exposure of a US grad at the same level. I think for the most part, residency programs and such don't care much about what you did before med school, so in essence you do get a clean slate when you start med school, but being an IMG/FMG puts you at the disadvantage of not being at a University Hospital for the most important 3rd and 4th years of training. And its not just me saying that, the 4th year SubI from SGU on my team who matched OB is the one who really pointed out to me the disadvantage they are put in by not getting the university experience.

 

[Tigerz_Fan]

Mean people suck

Totally agree.

 

[womp]

I have mixed feelings on this. I am an US student currently rotating at a community hospital with a group of students from SGU and some NYCOM. They are nearly on par with me and my fellow US student on the knowledge base, but where we really outshine them is from our 3rd year... why do I say this? Because I have just spent 8 months at the University Hospital getting my clinical training, where they have spent it at various community hospitals getting their clinical training. University Hospitals attract better residents and better teaching attendings, and have a greater focus on Education. They also give us a stronger clinical background. Couple that with the fact that we are tested with an OSCE at the end of every one of our rotations (save Surgery) where as the SGU students haven't taken an OSCE and are thus at a disadvantage in the clinical skills. During my first two years, besides taking courses that were integrated (Molecular and Genetic Medicine, Integrated Structure and Function, Mind, Brain and Behavior, Infection and Host Response, and Disease Process, Prevention, and Therapy, which were much more clinically based than they were solely subject based) we also took courses called Physian's Core I and II, which had us going into primary care office seeing patients during our first year, and going into the hospital in IM and Peds seeing patients in our second year, plus having lectures from clerkship directors on physical exam and interview skills and taking OSCE's at the 1st and 2nd year level. So I agree at 220 at US school isn't the same as a 220 at a carribean school if it is true you only have the core science courses and 6 months to study for the test, just like a FMG at the 4th year level does not have the exposure of a US grad at the same level. I think for the most part, residency programs and such don't care much about what you did before med school, so in essence you do get a clean slate when you start med school, but being an IMG/FMG puts you at the disadvantage of not being at a University Hospital for the most important 3rd and 4th years of training. And its not just me saying that, the 4th year SubI from SGU on my team who matched OB is the one who really pointed out to me the disadvantage they are put in by not getting the university experience.

Mostly agree with this, but not all FMG's are equal (to answer the OP's question). You first started talking about Caribbean students (and specifically SGU) but then generalized your conclusion towards all IMG/FMG's.

FMG's from University College London or Tel Aviv University would have gone to fully legitimate university programs with university hospital clinicals. The clinical education at Tel Aviv University is known to be pretty first rate, as the attendings do the actual clinical instruction, and students are encouraged to get hands on experience and do procedures. These students would arguably be better off than most community-rotating DO's and even many lower-tiered MD's in their clinical exposure.

To treat all FMG's as Caribbean students is a bit intellectually sloppy.

 

[thedrjojo]

I did start by saying i was torn on the issue, but I do appologize, I was generalizing mainly to the carribean schools (and the DO students) I was currently rotating with. I sometimes just go off on tangents on these posts and by the time I reach the end I sound like the insane ramblings of a syphilitic brain.

My only experience with true FMG's is limited to a few of the psych and OB residents whom came from overseas (a few from India, another from some eastern european medical school) and I had mixed reviews. The 3rd year OB resident from India (complete with his MBBS, my first time seeing those letters) was as good if not better than other 3rd year OB residents I encountered, and the intern MBBS and eastern european intern were slightly behind their US counterparts, but likely will catch up with a little experience. The SGU PGY2 in OB I worked with was also probably on par with other PGY2's in the program (besides being a mean, nasty person with a chip on her shoulder because she went to SGU, and let us know about it). But then again, this being a University program, these might have been the cream of the crop from the FMG/IMG's to make the cut at the university program, but who knows.

 

[Dissonance]

People say D.O. is better than going Caribbean yet the ONLY reason one goes to D.O. school is because they couldn't get into an M.D. school. Nobody has chosen D.O. due to its 'holistic' approach in 20 years.

Clearly you are both misinformed and bitter, and I'm using tact when I say that. Also, averages numerically for entrance requirements for Osteopathic schools are pretty close to/ if not equal to some Allopathic counterparts.

I'm certain most people, myself not withstanding, considered various paths to becoming a physician, including offshore routes such as the carribbean at some point during their pre-med journey. No one is attacking you for that.

Point is, the difficulty of matching as an IMG/FMG is not NEW news by any means. So for you to b*tch about that whole idea, when you already knew that you were facing an uphill battle, on a forum primarily frequented by AMG's......



Yeah.

 

[collosalmockery]

How would I fare in the match process if I become an MD from Weill Cornell Medical College at Qatar (WCMC-Q)? No one can guarantee anything but I would like to see if WCMC-Q graduates will be piled along with an IMG from No-Name Indian college?

 

[ResidentMD]

How would I fare in the match process if I become an MD from Weill Cornell Medical College at Qatar (WCMC-Q)? No one can guarantee anything but I would like to see if WCMC-Q graduates will be piled along with an IMG from No-Name Indian college?

No they arent. They match into reasonably decent programs, if they have a comparable CV to an IMG from a no-name med school. The months of USCE (clerkships) are principally the reason why. The name helps too.

 

[thrombin]

great discussion i wanted to know

Do PD's tend to look at grades for FMG's because some schools have a pass fail system where as the Caribbean and other schools have letter grades ie A B C etc. So does it boil down to the Steps to equalize all FMG's or are grades important.

Also which is regarded better doing all your rotations in US hospitals (Caribbean) vs. doing rotations in the country your hospital is located along with 6-8 months of electives in the USA.

 

[thedrjojo]

great discussion i wanted to know

Do PD's tend to look at grades for FMG's because some schools have a pass fail system where as the Caribbean and other schools have letter grades ie A B C etc. So does it boil down to the Steps to equalize all FMG's or are grades important.

Also which is regarded better doing all your rotations in US hospitals (Caribbean) vs. doing rotations in the country your hospital is located along with 6-8 months of electives in the USA.

US experience is paramount, but many of the US Hospitals the Caribbeans rotate at are considered poor quality. I have rotated at several of the hospitals and tried my hardest not to have to go back... luckily these were 2ndary sites for us, only part of the experience to give us a well rounded experience, both University and Community exposure (and these are community hospitals that Carib students rotate at, most of which are populated with private patients that the residents hardly touch, let alone the medical students). To rehash comments back on page 1, US Medical Schools, and probably schools in other countries, focus on more than just teaching to step 1 during the first year. My school had physical diagnosis, ethics, interviewing skills, cultural competency, as well as numerous patient interactions, including an outpatient preceptorship in first year (16 half days), a psych interviewing preceptorship in second year (5 half days), a peds preceptorship (2 half days) and a medicine inpatient preceptorship (5 half days). Plus we have a student run clinic where you can go as often as you'd like, requiring at least 20 (5pm-8pm+ sessions) during the first two years if you want to have the experience count towards a fourth year family medicine elective.

 

[skatertudoroga]

HI, please tell me your thoughts on U Sydney or Flinders U for next year in case I get rejected from american m.d. schools. My main reason for not considering caribbean is that I would find it unbearble to spend 4 years on a tropical island constantly thinking about how I can fail to match instead of enjoying the beach. Thats why I need to be in some "college town". Besides the (potential lack of) ability to go back to usa, how would my clinical experience differ at those schools from some of the other schools under consideration? P.S. I have a very high mcat and slightly low gpa. But mainly got rejected from american schools this cycle because I failed my interviews. Thanks.

 

[Winged Scapula]

HI, please tell me your thoughts on U Sydney or Flinders U for next year in case I get rejected from american m.d. schools. My main reason for not considering caribbean is that I would find it unbearble to spend 4 years on a tropical island constantly thinking about how I can fail to match instead of enjoying the beach. Thats why I need to be in some "college town". Besides the (potential lack of) ability to go back to usa, how would my clinical experience differ at those schools from some of the other schools under consideration? P.S. I have a very high mcat and slightly low gpa. But mainly got rejected from american schools this cycle because I failed my interviews. Thanks.

FYI:

most, if not all, Caribbean schools catering to North Americans require only 2 years on the island. The last two years are spent in the US doing rotations.

Adelaide nor Sydney are not "college towns", (not in the American sense) and although Adelaide is much more suburban around Flinders, it is by no means a walking sort of college town which I imagine you envision.

Why are you doing so poorly at your interviews and how do you know this is why you didn't get in? If your academic record is otherwise good, perhaps you should be working on this skill rather than considering going abroad for school.

 

[skatertudoroga]

wtf.

 

[Winged Scapula]

wtf.

Indeed.

Put the Jaeger down and step away from the "Submit Reply" button.

 

[skatertudoroga]

sorry

 

[skatertudoroga]

FYI:

most, if not all, Caribbean schools catering to North Americans require only 2 years on the island. The last two years are spent in the US doing rotations.

Adelaide nor Sydney are not "college towns", (not in the American sense) and although Adelaide is much more suburban around Flinders, it is by no means a walking sort of college town which I imagine you envision.

Why are you doing so poorly at your interviews and how do you know this is why you didn't get in? If your academic record is otherwise good, perhaps you should be working on this skill rather than considering going abroad for school.

I had 1 interview a year ago and 3 interviews this year. No wait-lists, just flat out rejections. I knew that I did poorly on that interview a year ago, but I thought that my rejection could be partly explained by my poor cGPA. Thats why I entered a SMP program in which I was easily top10%(relative to the med school class). That is also why I was very motivated to get high grades, I thought it would make up for my poor communications skills. Yet I got those rejections when people who had lower stats to begin with and had average grades in the smp might've gotten 1 interview ->1 acceptance. Of course I can try to work on my interview skills. I can even get a "coach" who will prepare me to answer some of those questions. I knew for a long time what questions to expect including "why do you want to be a dr?", "what are your passions?",etc but I never knew how to answer those quesitons. But really if you're not defective you should be able to do at least average on the interview without any preparation. I did so poorly on the interview because I am just not a likeable person. I did not make any real friends in that program.

 

[skatertudoroga]

blondedocteur,
I don't think it fits with your argument. I am not someone who attended a Caribbean medical school. My point was that I COULD HAVE BEEN...very easily. And I don't think I was an academically marginal candidate for medical school...your argument as I understood it was that Caribbean medical schools are ONLY for students whose applications showed they were academically marginal in some way. My argument was that sometimes pretty good applicants who really do have the qualifications just don't get in to medical school in the US. On my 2nd try, I got in to a medical school that is consistently ranked in the top 5 in the US. I did have a slightly higher MCAT score the 2nd time around, and had 1 extra letter of recommendation, but really there wasn't a whole lot of change in my application otherwise. I am sure there were qualified applicants turned away from medical school they year that I was accepted...and I'm sure there are qualified applicants being turned away this year. Medical (and other professional school) admissions is an inexact science at best. I think to make sweeping statements about all student who attend Caribbean schools isn't really helpful. So I think the answer to the original post's ? about whether all FMG's are equal is "No, they are not". However, a lot of people have their suspicions about the quality of the education at a lot of the Caribbean medical schools, and about some of the students who go down there for school.

I think "communication skills" is very much a an academic requirement for medicine. If you had interviews your mcat/gpa are high enough to get in somewhere. While on average 1 out of 3 students gets accepted post interview, some people(me) may have 0% conversion rate and some have >80%. I think for someone like me it is even more dangerous to go to school offshore than for someone who did poorly on gpa or mcat. They can always work harder in med school. But the way to distinguish themselves when they go on residency interviews is to be likeable. Not to mention that impressing attendings duirng your subinternships depends largely on your interpersonal skills. I think the type of IMGs who do well on residency interviews are the type of people who always talk to other students in class(or during recess). The type of people who can always come up with "small talk". Not the type of people who review their syllabus notes or just spend the time looking at some moderately attractive girl or just looking at the ceiling. Btw, many people go to the caribbean with a presumption that they have "connections" back home that while were not strong enough to get them into a u.s. md program are strong enough to get them into a residency if they just do well on usmle.

 

[skatertudoroga]

bump. is there any way to look at the match list for american/canadian students at australian schools the same way you can look up caribes?

 

[NotAProgDirector]

The only place to get this information is from the school themselves. Either they publish it on the web, or they don't. You could contact them to see if they would share it with you. Make sure you ask how many people didn't match at all -- although they may simply not tell you.

 

[MyNameIsAlex]

xxxxxx

 

[docbill]

US experience is paramount, but many of the US Hospitals the Caribbeans rotate at are considered poor quality. I have rotated at several of the hospitals and tried my hardest not to have to go back... luckily these were 2ndary sites for us, only part of the experience to give us a well rounded experience, both University and Community exposure (and these are community hospitals that Carib students rotate at, most of which are populated with private patients that the residents hardly touch, let alone the medical students). To rehash comments back on page 1, US Medical Schools, and probably schools in other countries, focus on more than just teaching to step 1 during the first year. My school had physical diagnosis, ethics, interviewing skills, cultural competency, as well as numerous patient interactions, including an outpatient preceptorship in first year (16 half days), a psych interviewing preceptorship in second year (5 half days), a peds preceptorship (2 half days) and a medicine inpatient preceptorship (5 half days). Plus we have a student run clinic where you can go as often as you'd like, requiring at least 20 (5pm-8pm+ sessions) during the first two years if you want to have the experience count towards a fourth year family medicine elective.

You know you are a making a general statement covering all Carib medical schools, but that it is not alway true. I know a number of people who go to SGU (and AUC) who get to rotate with US Allopathic medical students for every single core rotation and got to do much more than just watch medicine happen.

We can compare to many DO schools who don't even have core rotating hospitals and get to do a large portion of their training in a private clinic and not a hospital. Not to mention less weeks of rotations and less overall core rotations.

Now if you went to an Irish school or something like that. Where the rotation for students are really laid back. They send you out to these little town to a so called peripheral hospitals where you show or you don't show, no one cares.

Yes some schools train you for the USMLEs. What is wrong with that? It is important to have a strong basic science training.

 

[docbill]

I think "communication skills" is very much a an academic requirement for medicine. If you had interviews your mcat/gpa are high enough to get in somewhere. While on average 1 out of 3 students gets accepted post interview, some people(me) may have 0% conversion rate and some have >80%. I think for someone like me it is even more dangerous to go to school offshore than for someone who did poorly on gpa or mcat. They can always work harder in med school. But the way to distinguish themselves when they go on residency interviews is to be likeable. Not to mention that impressing attendings duirng your subinternships depends largely on your interpersonal skills. I think the type of IMGs who do well on residency interviews are the type of people who always talk to other students in class(or during recess). The type of people who can always come up with "small talk". Not the type of people who review their syllabus notes or just spend the time looking at some moderately attractive girl or just looking at the ceiling. Btw, many people go to the caribbean with a presumption that they have "connections" back home that while were not strong enough to get them into a u.s. md program are strong enough to get them into a residency if they just do well on usmle.

Are u serious? I don't even want to start evaluating all the wrong things you said in your post.

As a general note. Good communication skills makes a great physician. Medicine is not only scientific knowledge it is a social field. If you talk to your patient properly and know what to ask (ie have good communication skills) eventually your patient will tell you what is wrong with them.

 

[MyNameIsAlex]

xxxxxxxx

 

[thedrjojo]

You know you are a making a general statement covering all Carib medical schools, but that it is not alway true. I know a number of people who go to SGU (and AUC) who get to rotate with US Allopathic medical students for every single core rotation and got to do much more than just watch medicine happen.

We can compare to many DO schools who don't even have core rotating hospitals and get to do a large portion of their training in a private clinic and not a hospital. Not to mention less weeks of rotations and less overall core rotations.

Now if you went to an Irish school or something like that. Where the rotation for students are really laid back. They send you out to these little town to a so called peripheral hospitals where you show or you don't show, no one cares.

Yes some schools train you for the USMLEs. What is wrong with that? It is important to have a strong basic science training.

Agreed, I haven't seen all the community hospitals that the Carib schools get sent to. I have seen, personally 2 hospitals (Newark Beth Israel and St. Michaels) and 1 clinic (JFK Family Practice) that SGU students rotate at, and our school rotates through a few more (St. Joseph's in Patterson, St. Barnabus, Trinitas for psych, Hoboken University Medical Center [Ross students]) and so speaking from that experience, those are definately second tier hospitals compared to the 4 Academic centers I have had any experience with (University Hospital in Newark, Hackensack University Medical Center, Tisch @ NYU, and Belleview @ NYU).

Yeah, I agree with DO comment, which also contributes to their status below MD as far as the Allopathic match goes. But because their curriculum is regulated by the LCME, they get a bump compared to carib schools.

And the problem with teaching to the USMLE is that those tests test very specific, typically obscure information that is not the entirety of medicine, or even basic sciences (from USMLE, you would think every 3rd patient would have a pheo). Plus, the information is several years old, so it would ignore new breakthroughs or developments that a more open curriculum would not. Granted, I would have preferred my curriculum to be a little more closely guided towards the USMLE's, particularly those that decided to use a shelf exam (which, because of the overlap in topics is a poor decision IMO because 1/3rd of the Biochemistry test wasn't covered in our Biochemistry course but instead was in immunology, or physiology, cell biology, etc, etc, etc).

 

[Law2Doc]

...
And the problem with teaching to the USMLE is that those tests test very specific, typically obscure information that is not the entirety of medicine, or even basic sciences (from USMLE, you would think every 3rd patient would have a pheo). Plus, the information is several years old, so it would ignore new breakthroughs or developments that a more open curriculum would not. Granted, I would have preferred my curriculum to be a little more closely guided towards the USMLE's, particularly those that decided to use a shelf exam (which, because of the overlap in topics is a poor decision IMO because 1/3rd of the Biochemistry test wasn't covered in our Biochemistry course but instead was in immunology, or physiology, cell biology, etc, etc, etc).

The USMLE was never meant to be a yardstick of quality of education or ability. It was meant to be very much a minimum standard. Doing well at this test at the expense of other things is thus not a selling point -- it means you are minimally qualified, like the other 90+% of students who pass the thing. It's the stuff you are supposed to learn that isn't on this test that really determines whether you are more than minimally qualified. A program that puts it's full weight into teaching toward the USMLE misses the bigger picture, the point of med school.

Think of it like the NFL combine. They test prospective draftees on their ability to run fast, jump high, run routes. Yet every year lots of people who can do all these things well wash out of the NFL. Why? Because being able to do these minimum things does not mean you can put it all together into a competitive package, and be a good NFL player. The same goes for the USMLE. It tests the minimum basics, and you are expected to at least be able to pass such a test to get to the next level, but there is more to the next level than these minimum basics.

You often see the offshore/IMG crowd saying "I passed the USMLE, that "proves" I am qualified to be a doctor in the US". But no, it's no different than that dude who runs a 4.4 at the combine -- it proves he is not without potential but it doesn't prove he's going to be any good, or even passably qualified at the actual job.

 

[Shinken]

Yeah, I agree with DO comment, which also contributes to their status below MD as far as the Allopathic match goes. But because their curriculum is regulated by the LCME, they get a bump compared to carib schools.

Actually, no it isn't. Just FYI.

 

[Captopril]

The USMLE was never meant to be a yardstick of quality of education or ability. It was meant to be very much a minimum standard. Doing well at this test at the expense of other things is thus not a selling point -- it means you are minimally qualified, like the other 90+% of students who pass the thing. It's the stuff you are supposed to learn that isn't on this test that really determines whether you are more than minimally qualified. A program that puts it's full weight into teaching toward the USMLE misses the bigger picture, the point of med school.

Think of it like the NFL combine. They test prospective draftees on their ability to run fast, jump high, run routes. Yet every year lots of people who can do all these things well wash out of the NFL. Why? Because being able to do these minimum things does not mean you can put it all together into a competitive package, and be a good NFL player. The same goes for the USMLE. It tests the minimum basics, and you are expected to at least be able to pass such a test to get to the next level, but there is more to the next level than these minimum basics.

You often see the offshore/IMG crowd saying "I passed the USMLE, that "proves" I am qualified to be a doctor in the US". But no, it's no different than that dude who runs a 4.4 at the combine -- it proves he is not without potential but it doesn't prove he's going to be any good, or even passably qualified at the actual job.

wat

 

[McGillGrad]

The USMLE was never meant to be a yardstick of quality of education or ability. It was meant to be very much a minimum standard.

Absolutely true, BUT since it is the only objective criterion, it is used as something that actually tests your relative basic science knowledge. PDs buy into it too.

 

[goosew]

Absolutely true, BUT since it is the only objective criterion, it is used as something that actually tests you relative basic science knowledge.

Well, I've gotten into many-a-debate about this very point itself. I mean, Is it REALLY an objective measurement???

I mean, for it to be a true objective measurement, and such a true "standardized exam", shouldn't every exam have the exact same questions.

By each exam having differing amts. of questions from different subject matters with "alleged" 'standardized level of difficulty'. <-- isn't that a subjective measure in itself??


I can't tell the number of times I've heard "1/2 of the exam is just luck that you're asked the questions you studied properly for since the scope/breadth of knowledge is so vast" (which basically negates the exam from being standardized)

 

[McGillGrad]

I see your point and I agree to a degree.

There are a couple statistical wizards (with math undergrads) who broke down how different tests give a stable score for all who take it. The NBME people include a plus/minus error of about 6 per exam, so they know that you could do differently on any given day within a certain range.

All we can agree on is that step exams are more objective than basic science grades and clinical evaluations. But that's not saying much...lol...

Well, I've gotten into many-a-debate about this very point itself. I mean, Is it REALLY an objective measurement???

I mean, for it to be a true objective measurement, and such a true "standardized exam", shouldn't every exam have the exact same questions.

By each exam having differing amts. of questions from different subject matters with "alleged" 'standardized level of difficulty'. <-- isn't that a subjective measure in itself??


I can't tell the number of times I've heard "1/2 of the exam is just luck that you're asked the questions you studied properly for since the scope/breadth of knowledge is so vast" (which basically negates the exam from being standardized)

 

[goosew]

All we can agree on is that step exams are more objective than basic science grades and clinical evaluations. But that's not saying much...lol...

No disagreement from me..


Although, I've heard rumors of a certain underground push to make the Step1 a pass/fail exam only.

(don't know how true it is, but it'll throw the application process in a tizzy as programs will have to screen applicants differently).

I just don't like the idea that if you're a good student, etc. and have a "bad day" and barely pass the exam, (but DO pass so you're not allowed to re-write it), then it basically throws you out of the running for a number of programs.

(didn't happen to me, but DID happen to a friend of mine.). I'm a ******* and completely deserved my score.

 

[SouthernSurgeon]

Although, I've heard rumors of a certain underground push to make the Step1 a pass/fail exam only.

(don't know how true it is, but it'll throw the application process in a tizzy as programs will have to screen applicants differently).

There will always be a yardstick. If Step I goes away programs will find something else...be it increased weight on shelf exam scores or class rank, or something entirely novel (like I could see the ABIM or the ACS developing specific exams for students entering those fields).

 

[match]

nothing is equal in US. even a recommendation from a PD friend who is not in medical filed may can change your 75 score more than 90 of some one else.

 

[SouthernSurgeon]

nothing is equal in US. even a recommendation from a PD friend who is not in medical filed may can change your 75 score more than 90 of some one else.

Huh?