Are LoRs from US physicians necessary for IMG to get US residency

[bobiest]

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For a US citizen who is an IMG and has decent USMLE scores, is it necessary to for him to obtain LoRs written by US physicians in order to get residency match in the US? If this IMG has not done any clinic rotation in the US, how can he get the LoRs from US doctors? Thanks in advance for your advices!

 

[gutonc]

For a US citizen who is an IMG and has decent USMLE scores, is it necessary to for him to obtain LoRs written by US physicians in order to get residency match in the US? If this IMG has not done any clinic rotation in the US, how can he get the LoRs from US doctors? Thanks in advance for your advices!

You get US LORs by doing US rotations. If you're not doing that, you're putting yourself in a really bad position to get a US residency spot. If your only redeeming quality is that you don't need a visa, you're putting yourself in a really long line with only a relatively few spots at the end of it.

 

[bobiest]

Thanks a lot for your answer! Yes, your answer is still a good advice.

Is there any formal or official rule in US residency match to require an IMG applicant to have LoRs by US physicians and to have done US clinic rotations, or is it just a nice-to-have?

I heard that some US states, e.g., NY, do not allow an IMG to do residency in their states who studied in a foreign med program that included more than 12 weeks clinic rotations outside of the country which the foreign med school belongs to. That means an IMG can only do no more than 12 weeks rotations in the US, if at all. But short rotations might not be long enough for an IMG to get good LoRs from US doctors. If this is true and US LoRs are necessary, then it would almost sound like a trap to an IMG.

 

[gutonc]

Thanks a lot for your answer! Yes, your answer is still a good advice.

Is there any formal or official rule in US residency match to require an IMG applicant to have LoRs by US physicians and to have done US clinic rotations, or is it just a nice-to-have?

There is no ERAS or NRMP rule saying that you have to have USCE and/or US LORs to match.

I heard that some US states, e.g., NY, do not allow an IMG to do residency in their states who studied in a foreign med program that included more than 12 weeks clinic rotations outside of the country which the foreign med school belongs to. That means an IMG can only do no more than 12 weeks rotations in the US, if at all. But short rotations might not be long enough for an IMG to get good LoRs from US doctors. If this is true and US LoRs are necessary, then it would almost sound like a trap to an IMG.

I have no idea who you heard that from, but you need to go and punch that a**hole in the nuts right now. Then go back 20 minutes later and do it again. Repeat until you feel better about the fact that following this advice essentially nuked your Match chances.

I'm sure you've heard of Caribbean schools like Ross, SGU, AUA, right? Guess how many weeks of rotations those kids do in the US? 12? Nope...12+40. That's right...2 whole years. And guess which state has the most USIMGs practicing in it? NY. So whatever you heard (or think you heard) is obviously total horses***.

Sure, 12 weeks (no idea where you got that number, I'm sure it's based on something, but I don't know what and I couldn't possibly care less) isn't as much as 2 years, or 6 months, or whatever. But it's better than nothing. And since most rotations for US med students are only 4 weeks, you could get 3 US LORs from 12 short weeks. That and a fake MSPE from your school that nobody will read anyway and you've got a complete application.

 

[bobiest]

Thanks a lot for the info and the tips! They are very helpful.

About the 12-week rule related to the restrictions on IMGs for doing US residency, I read from this link, http://forums.studentdoctor.net/threads/university-of-queensland-ochsner-clinic-program-recognized-by-all-50-states.881074/. Those Caribbean schools mostly have approvals from the NY state as exceptions to the 12-week rule. The foreign school I have in mind is not on the list of those approved schools. That's why I am worrying about it. However, if a 4-week US rotation is normal for a US LoR, definitely the best way is to do at least three 4-week rotations in the US.

 

[the argus]

There is a 12 week rule in New York but you have the details wrong.

As an IMG, you are not allowed to do >12 weeks of clinical rotations physically located in New York state in hospitals not affiliated with your school. You can do as many weeks of non-affiliated rotations as you want anywhere else in the US, just no more than 12 can be in New York. You can't even really do this anyway, because IMGs must apply for approval from the New York State Medical Board for every single non-affiliated rotation they do in the state, and they would presumably reject your application once you reach >12 weeks. I also believe they ban you from licensure not residency, but I'm not sure about that.

The way the caribbean schools get around this is they have agreements with lots of hospitals to be officially affiliated in the eyes of the New York State Medical Board. Each school has a specific list of hospitals that their students can rotate through without being subject to the 12 week cap. As a Ross student I did 50 weeks of clinical rotations in New York state, 38 of which at "affiliated" hospitals and not subject to the cap, and 12 at "non-affiliated" hospitals subject to the cap.

And to answer the original question, yes you need letters from US physicians. It's not required but heavily recommended.

 

[bobiest]

There is a 12 week rule in New York but you have the details wrong.

As an IMG, you are not allowed to do >12 weeks of clinical rotations physically located in New York state in hospitals not affiliated with your school. You can do as many weeks of non-affiliated rotations as you want anywhere else in the US, just no more than 12 can be in New York. You can't even really do this anyway, because IMGs must apply for approval from the New York State Medical Board for every single non-affiliated rotation they do in the state, and they would presumably reject your application once you reach >12 weeks. I also believe they ban you from licensure not residency, but I'm not sure about that.

The way the caribbean schools get around this is they have agreements with lots of hospitals to be officially affiliated in the eyes of the New York State Medical Board. Each school has a specific list of hospitals that their students can rotate through without being subject to the 12 week cap. As a Ross student I did 50 weeks of clinical rotations in New York state, 38 of which at "affiliated" hospitals and not subject to the cap, and 12 at "non-affiliated" hospitals subject to the cap.

And to answer the original question, yes you need letters from US physicians. It's not required but heavily recommended.

Thanks a lot for your clarification!