be frank and blunt with me on this

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akshay1

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Greetings Doctors,
I am a final year medical student here in India and I gave my step 1 a year back and did not pass. Although I am going to start my 1 and only elective that i got in Pathology in a week i would want to know what are my chances of getting into a Pathology residency?
I can afford to do residency in India too. The only thing that worries me is that I don't want to waste time in application process. I mean if i don't match in my first attempt it would be horrifying. Can anybody tell me what should i do to improve my cv and after becoming a graduate from my home school what should i do to boost up my cv. I have spoken to a few seniors who are trying for the 2014 match but not in pathology have told me to do research elective for a year and then apply. I am really confused and low on confidence.

I would really appreciate your advice.
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akshay1 said:
Greetings Doctors,
I am a final year medical student here in India and I gave my step 1 a year back and did not pass. Although I am going to start my 1 and only elective that i got in Pathology in a week i would want to know what are my chances of getting into a Pathology residency?
I can afford to do residency in India too. The only thing that worries me is that I don't want to waste time in application process. I mean if i don't match in my first attempt it would be horrifying. Can anybody tell me what should i do to improve my cv and after becoming a graduate from my home school what should i do to boost up my cv. I have spoken to a few seniors who are trying for the 2014 match but not in pathology have told me to do research elective for a year and then apply. I am really confused and low on confidence.

I would really appreciate your advice.
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A research elective will not help at all. Sure it is better than nothing. If you are to do research, I would do research with the Chair but still no guarantees. You can't possibly do anything within a one month elective.

Failing Step 1 is a huge red flag on your application. It is up to you whether you want to continue on with all Steps and then not matching. That would be seriously depressing. You really have to think about the possibility of passing all Steps and not matching.

There are many IMGs in Pathology but with a failure on Step 1, chances of matching in a Path program are against you. Have you passed Step 1? If not, if it takes you multiple attempts on Step 1 and then Step 2 you can forget about matching as a IMG. I would pass all Steps before even thinking about applying. No program wants someone to match into their program and can't pass Step 3.

Sorry to be so negative but I think i am being realistic. You need to pass Step 1 with high scores as a IMG with no further failures.

Having gone through the interview season several times, there are a boatload of IMGs (no pun intended) applying for Pathology. The funniest thing was when a IMG told us he was applying for both internal medicine and Pathology.
 
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I just gave my step 2 cs since i am here in the usa.. i will be giving my step 1 and 2 when i go back. i am definately going to try my level best to get a good score on both the steps for sure. apart from the steps is there anything i should be doing to improve my cv or increase my chances to do pathology residency here in the usa? what if i do my residency in india and then apply for pathology residency here.. will that help?
 
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You asked for bluntness, so I'll do so. Failing step 1 will make it extremely difficult, if not impossible, to get into a pathology residency in the US. Program directors do not want people to fail the boards, and failing step 1 is predictive of that outcome. Your English skills seem fine, so it's not a language issue. There are so many IMGs with strong board scores. I do not think a step 1 failure is something that can be overcome without extreme difficulty.
 
A lot of the NY programs are IMG heavy and will take anyone who walks through the door and is willing to be the late-night PA. The Step 1 failure will make it more difficult, but if good graduates stay away from the NY programs, the programs will still need gross-horses so you'll get in. Don't give up. The race to the bottom is your friend.
 
mlw03 said:
You asked for bluntness, so I'll do so. Failing step 1 will make it extremely difficult, if not impossible, to get into a pathology residency in the US. Program directors do not want people to fail the boards, and failing step 1 is predictive of that outcome. Your English skills seem fine, so it's not a language issue. There are so many IMGs with strong board scores. I do not think a step 1 failure is something that can be overcome without extreme difficulty.
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I totally agree with mlw's advice. Don't waste your time doing research in the USA. You will waste a year and still not match anywhere. If you really want to end up working/living in the USA it makes much more sense to do 2 years of training as a Pathology Physicians assistant. I know some foreign trained MDs who have done this because they couldn't get into residency. There are a few training programs on the East Coast of the USA. For example, the University of Maryland has one. Pathology PAs earn around $80,000-100,000 per year (which isn't that much less than what some academic pathologist's are earning, and there is no need to spend 4+ years in residency/fellowship) and jobs are fairly easy to get. The only issue for a foreign trained MD would potentially be the visa issue. However, this would be an issue if you came to the USA for residency too. Given that PAs are in demand, I imagine that you could find somewhere willing to provide you with an H1B visa to facilitate your work as a PA. However, this is something you would need to investigate carefully before making a decision to train as a PA.
 
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I didn't know you could take or pass step 2 without passing step 1.
 
jp123ok said:
I totally agree with mlw's advice. Don't waste your time doing research in the USA. You will waste a year and still not match anywhere. If you really want to end up working/living in the USA it makes much more sense to do 2 years of training as a Pathology Physicians assistant. I know some foreign trained MDs who have done this because they couldn't get into residency. There are a few training programs on the East Coast of the USA. For example, the University of Maryland has one. Pathology PAs earn around $80,000-100,000 per year (which isn't that much less than what some academic pathologist's are earning, and there is no need to spend 4+ years in residency/fellowship) and jobs are fairly easy to get. The only issue for a foreign trained MD would potentially be the visa issue. However, this would be an issue if you came to the USA for residency too. Given that PAs are in demand, I imagine that you could find somewhere willing to provide you with an H1B visa to facilitate your work as a PA. However, this is something you would need to investigate carefully before making a decision to train as a PA.
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So what do you suggest? Should I do a pathology residency in India and then apply for residency in pathology in USA or do a pathology physician's assistant and then apply for residency? This year almost 30 pathology program seats were unfilled. So don't you think if I apply for the match I might get one ??? I had a crisis during my exam. So failed. I don't think I'm dumb. I would really appreciate some feedback.
 
Do Step 1 again. If you pass and do well, you might have a shot. If you fail or do badly, pack it in and go home.
 
MagicalTrevor said:
Do Step 1 again. If you pass and do well, you might have a shot. If you fail or do badly, pack it in and go home.
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This is probably the best advice I can give you. You will need to retake the exam and score very well to have any shot at a US residency in pathology. In my opinion, doing a path residency in India first will not make a difference.

Your writing suggests a tone of desperation, and for that I am sorry, but you asked for honest opinions. You mentioned the 30 unfilled spots, but my guess is that, no, you would not get one of those spots. Most programs would rather have no resident than a bad resident, especially ones that do not need residents for cheap grossing labour. I'm not saying you would be a bad resident, but that will be the perception after failing step 1.
 
Agree with above on this. I write separately to add that the 30 spots available were pre-scramble...I'm going to bet that those spots probably filled post-scramble, if they were even available at all. Not to physically assault a dead Equus sp. here, but I really, really don't think the chances of matching in path given a Step 1 failure are good in the U.S. It would be a tough gig to get for a U.S. grad with a Step 1 failure, I think, much less an IMG. Again, not to say that you'd be a bad pathologist, but rather to say that the current system is slated against IMG's (hence the loss of "pre-matching"), and with hundreds of IMG's trying to fill a relatively small amount of spots, I think a board failure would eliminate your application from consideration of most programs. I am aware that the perception on this forum is "anyone with a pulse can get a path residency", but I think the match this year - when the numbers become available - will demonstrate that across the board, it is becoming much more difficult to get a residency in most specialties (Path included). Best of luck to you, though.
 
Having failed Step I at some point is not the end, but it is a significant obstacle. However, you must eventually pass Step I before you're going to get into a residency program -- I doubt anyone will even offer an interview without yet passing Step I...interview offers tend to go out based on Step I scores, and if you have no score or only a fail, BZZT. Doing a rotation in the U.S. is only going to help if you also pass Step I. Doing a research year, even in pathology, only -might- help with certain programs, and again only if you also pass Step I. Passing Step I with a good, very significantly improved score will be a bigger help than doing any kind of rotation or research of any length in the U.S. or anywhere else.
 
akshay1 said:
So what do you suggest? Should I do a pathology residency in India and then apply for residency in pathology in USA or do a pathology physician's assistant and then apply for residency? This year almost 30 pathology program seats were unfilled. So don't you think if I apply for the match I might get one ??? I had a crisis during my exam. So failed. I don't think I'm dumb. I would really appreciate some feedback.
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You asked for honesty so that is what I will give you. I suggest that you forget about doing residency in the USA. With a fail on Step 1 your chances of getting a residency spot somewhere are very poor even if you repeat the exam and do well. If I were you I would either go into a PA program in the USA with the intention of working as a PA or do residency in India with the intention of staying in India. Either way, I would forget about residency in the USA.

Program Directors view IMG residency applicants the way most people view the last few pieces of bruised fruit at the supermarket - they look them over with disdain and try to choose the best of the bad bunch. Once you have a fail on step 1 you are on the bottom of this already undesirable pile...
 
"Pathology PAs earn around $80,000-100,000 per year (which isn't that much less than what some academic pathologist's are earning, and there is no need to spend 4+ years in residency/fellowship) and jobs are fairly easy to get."

Totally agree. Why bother to beat your head against the wall when you can earn a decent living AND work fewer hours AND have less responsibility? Some PAs make more than academic pathologists.
 
Kilgoretrout 65 said:
"Pathology PAs earn around $80,000-100,000 per year (which isn't that much less than what some academic pathologist's are earning, and there is no need to spend 4+ years in residency/fellowship) and jobs are fairly easy to get."

Totally agree. Why bother to beat your head against the wall when you can earn a decent living AND work fewer hours AND have less responsibility? Some PAs make more than academic pathologists.
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Although being a pathologist is a lot more interesting than being a pathology assistant. I suspect that most people go into pathology because of actual intellectual curiosity, so I doubt that an interest in pathology really implies an interest in being a PA.
 
Enkidu said:
I suspect that most people go into pathology because of actual intellectual curiosity, so I doubt that an interest in pathology really implies an interest in being a PA.
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I'm sure that people go into pathology for a myriad of reasons, one of which is intellectual curiosity. If we are being honest though, I expect that the more common reason is that they want to be doctors but realize during medical school that dealing with patients sucks...

In any case, if the poster wants to be a pathologist then doing residency and then staying in India to work is an option. Trying to get a residency spot in the USA will almost certainly not work and, since this person seems interested in working in the USA, I was trying to offer a viable alternative career involving pathology. I would also point out that working as a PA is not completely devoid of intellectual stimulation!
 
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@jp123, Couldn't agree with you more.
 
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