Been warned to avoid/second-look at places that have mostly IMGs. Does it apply to FM?

[hsk013]

The general advice I received was that if a program consists mainly of IMGs (or even DOs), there is a reason for that. To how much extent does it apply to FM?

Mayo Rochester FM this year did not have any USMD (which is weird because historically, the program took a lot of USMD). Do personality and fit matter more than marginal differences in academic performances? Or did Mayo Rochester's FM program just went downhill over the past few years? It's hard to imagine there weren't qualified USMDs who applied to Mayo, or those who did all ranked it low on their list.

I noticed that many FM programs that previously took some DOs and IMGs had taken a lot more USMD this year. But Mayo seemed like it was doing the opposite (and Mayo is regarded as one of the best places - not sure about FM, though).

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[Animalcules]

This is so dumb that I'm on the fence of even answering. These FMGs and DOs likely have much better CVs than you, so they were ranked to match.

 

[hsk013]

Sorry, I didn't mean to offend anyone. I was genuinely curious with COVID and virtual interviews affecting this year. No doubt those who matched at Mayo Rochester were stronger and better-fitted candidates than me. I have nothing but respect and wish them the best.

 

[Animalcules]

Match at the best program you can. Judge them by quality, schedule, future opportunity. Don't be swayed by stereotypes. I'm confident that Mayo can pick their candidates and does not rely on FMGs/DOs falling to them.

 

[FutureDoctor5000]

The general advice I received was that if a program consists mainly of IMGs (or even DOs), there is a reason for that. To how much extent does it apply to FM?

Mayo Rochester FM this year did not have any USMD (which is weird because historically, the program took a lot of USMD). Do personality and fit matter more than marginal differences in academic performances? Or did Mayo Rochester's FM program just went downhill over the past few years? It's hard to imagine there weren't qualified USMDs who applied to Mayo, or those who did all ranked it low on their list.

I noticed that many FM programs that previously took some DOs and IMGs had taken a lot more USMD this year. But Mayo seemed like it was doing the opposite (and Mayo is regarded as one of the best places - not sure about FM, though).

Are we seriously having this convo in 2021? There was a DO who matched CT surgery at U Mich... come on now

 

[FutureDoctor5000]

Sorry, I didn't mean to offend anyone. I was genuinely curious with COVID and virtual interviews affecting this year. No doubt those who matched at Mayo Rochester were stronger and better-fitted candidates than me. I have nothing but respect and wish them the best.

The world doesn’t owe a USMD or DO anything, stop asking such **** questions. If NYU or MGH IM or derm was suddenly all DO or img the next match would you question it? Also news flash the match is a complicated system, it doesn’t mean that the program didn’t interview enough USMD’s it just means that the DO/IMG got ranked higher and the DO/IMG subsequently ranked that program higher thus more matched. People also don’t blindly rank programs based on doximity rankings ahahah and it’s more based on location and fit.. maybe the USMD that’s interviewed there found other programs to be better fits, it’s partially also just based on pure luck.

 

[cj_cregg]

I'm a current FM resident. This is not a dumb question, and I think it's pretty clear you're not intending to be insulting towards IMGs/DOs.

The reason people are telling you to be wary of programs with lots of IMGs is because generally, it is harder for IMGs to match to highly desirable programs compared to US grads. This is NOT a knock on IMGs and their abilities, just a statement that many people/programs are biased to prefer US grads. Not saying it's right or wrong, it's just the way it is. US grads are more likely to match overall, have to apply to/rank less programs to get the same result, and so can be more selective in where they apply and rank. Generally, more desirable programs are going to fill with US grads, and less desirable programs will have less US grads applying/ranking highly and therefore less US grads matching. Some would argue that in certain specialties, this is also true of DOs to a lesser extent.

The question then is WHY the program is less desirable. It could be the quality of training, it could be the culture (e.g. malignant program), or it could be something as benign as location. For instance there are not many US grads who are going to be willing to live in more rural areas when they have other options, but there are still some outstanding programs in rural areas. Maybe you want to be in a rural area, so that's not a downside for you, and it'll be a great fit. So I do think it's worth doing a little extra research if you see a lot of IMGs in a program, but it shouldn't necessarily be a deal breaker if there's other stuff you like about the program.

With regards to DOs - family medicine is very DO friendly, and there are lots of excellent programs with a high percentage of DOs. I wouldn't worry about that.

ETA: Also, regarding "the best places" for FM - you'll find that the majority of strong, full-spectrum FM programs are at community based hospitals rather than big academic centers like Mayo. I am not familiar with Mayo's reputation specifically but that is generally the case.

 

[FutureDoctor5000]

Who is it? Umich only allows 3 DO schools to rotate at their hospitals

I don’t think that’s true anymore since the merger, they are from PCOM and I don’t think PCOM was one of those 3 DO schools. U mich has gotten much more DO friendlier since the merger, IR and urology matches the last few years as well as many anesthesia.

 

[Sleepingdoc]

The general advice I received was that if a program consists mainly of IMGs (or even DOs), there is a reason for that. To how much extent does it apply to FM?

Mayo Rochester FM this year did not have any USMD (which is weird because historically, the program took a lot of USMD). Do personality and fit matter more than marginal differences in academic performances? Or did Mayo Rochester's FM program just went downhill over the past few years? It's hard to imagine there weren't qualified USMDs who applied to Mayo, or those who did all ranked it low on their list.

I noticed that many FM programs that previously took some DOs and IMGs had taken a lot more USMD this year. But Mayo seemed like it was doing the opposite (and Mayo is regarded as one of the best places - not sure about FM, though).

Stop this nonsense, are you in high school, still stuck in premed phase???... Please grow up

 

[Banco]

Are we seriously having this convo in 2021? There was a DO who matched CT surgery at U Mich... come on now

That's awesome - saw this person on the interview trail, incredibly impressive.


Now that programs are posting their rosters, I see this year for surgery a bunch of IMGs in top academic program categorical positions - Pitt, UTSW, BIDMC to name a couple.

 

[FutureDoctor5000]

That's awesome - saw this person on the interview trail, incredibly impressive.


Now that programs are posting their rosters, I see this year for surgery a bunch of IMGs in top academic program categorical positions - Pitt, UTSW, BIDMC to name a couple.

Img or carribean grads?

 

[Banco]

Img or carribean grads?

IMG

 

[Lawpy]

Are we seriously having this convo in 2021? There was a DO who matched CT surgery at U Mich... come on now

Yeah agreed. Many FMGs have insane apps so they deserve to match at top places and a lot of DOs are matching very very strong. I don't even get the anti DO bias here.

But i will say if a program has way too many Carib grads, that's a major problem.

 

[Redpancreas]

Yeah agreed. Many FMGs have insane apps so they deserve to match at top places and a lot of DOs are matching very very strong. I don't even get the anti DO bias here.

But i will say if a program has way too many Carib grads, that's a major problem.

Agreed. While I think it's often wrong to apply heuristics to schools and try to look at each individual's path, Carribean graduates are kind of in a class of their own. With graduates raised abroad doing medical school in the country they were raised in who come here and amongst DOs, there is not shortage of qualified candidates. Amongst Carribean graduates, however, they unanimously chose a more convenient but riskier path. I will say though that anecdotally the system seems to be onto that already. I helped 10 people in SOAP and they were all Carribean graduates who failed to match FM.

IMG = Caribbean
FMG = Foreign Medical Graduates

If you try to distinguish with a IMG vs. FMG with a google search you'll get a bunch of SDN and Redditors asking what the difference is. The loose/quasi-consensus seems to be IMG is someone who graduated medical school outside their country of citizenship whereas an FMG is someone who graduated medical school in their country of citizenship. Too many people interchange the terms or use one term for both categories (ex. AAMC uses IMG only). I personally think it would be too hard to keep track of these terms and have them actually mean anything. Illustrating the point through an example, what would you call a foreign born individual raised in the US, who goes back to their country of birth to do medical school and comes here for residency? By strict definition they would be a FMG given they were born in the foreign country and trained in that foreign country and come here...but effectively they were raised here making their path more similar to a US IMG.

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In terms of the overall thread, if we're all being honest, US/MD : Total Resident ratio is still an indicator of competitiveness of a residency program given that school reputation/prestige is still major selection factor for a majority of residencies. It does not, however, say anything about the quality of residents in the program which is what you implied which is why your comments caught so much flak. If we're being honest, being a DO in the system's still a lot harder than an M.D. come match time but I do think with the merger and wider acceptance of D.O.s in the academic community, there has been an opportunity for more DOs who achieve great things to get what they deserve moreso than before. To ignore the US MD bias and say it's 2021 though is a bit of a fantasy just like it would be silly to ignore the top tier school bias.

 

[24blue8]

What about the opposite? In Psychiatry I've seen programs go from mostly IMG/FMG and DO to all US MD in a few cycles. I don't think the programs got "better" but the perceived appeal by US MDs changed and who knows what the applicants based that on. So I would definitely consider whether or not the programs are "unappealing" bc of rumor or some misperception. Many top ranking programs would be considered "IMG sweatshops" if they suddenly lost their match list and had to soap a bunch of non US MDs based on their workload, the furnishings, the salary and the teaching. But because of the name on the building and something slightly arbitrary like Doximity ratings they're considered prestigious.

 

[Osteosaur]

I am very curious about what makes a "good" FM program to go to.

I was advised by one attending that I should look for unopposed to learn the most. Is there anything else to consider?

 

[7331poas]

The world doesn’t owe a USMD or DO anything, stop asking such **** questions. If NYU or MGH IM or derm was suddenly all DO or img the next match would you question it?

Of course I would question it. If it suddenly became the norm that US MDs are displaced from programs then it should alarm any premed entering this profession and accepting debt.

The match rate has progressively fallen from 96% to 92% this year for US MD Seniors. How far does it need to fall, and how many programs do US MDs need to be displaced from for there to be "questions"?

 

[FutureDoctor5000]

What about the opposite? In Psychiatry I've seen programs go from mostly IMG/FMG and DO to all US MD in a few cycles. I don't think the programs got "better" but the perceived appeal by US MDs changed and who knows what the applicants based that on. So I would definitely consider whether or not the programs are "unappealing" bc of rumor or some misperception. Many top ranking programs would be considered "IMG sweatshops" if they suddenly lost their match list and had to soap a bunch of non US MDs based on their workload, the furnishings, the salary and the teaching. But because of the name on the building and something slightly arbitrary like Doximity ratings they're considered prestigious.

What psych programs are you talking about? I am seeing more US MD AND DO at university psych places and less IMG/FMG overall. A record number of DO’s matched psych.

 

[iforget2]

I am very curious about what makes a "good" FM program to go to.

I was advised by one attending that I should look for unopposed to learn the most. Is there anything else to consider?

I believe it also depends on what your goals are once you're done with residency. For example, if you plan to go rural then a program like JPS would be great, but if you're planning on doing outpatient at a big city then an unopposed program might give you skills you may not use after residency.

 

[cj_cregg]

I am very curious about what makes a "good" FM program to go to.

I was advised by one attending that I should look for unopposed to learn the most. Is there anything else to consider?

Agree with above - a good FM program is the one that teaches you the stuff you want to do with your career. A good program for someone who wants to work in a rural setting doing primary care, deliveries, and coverage for a critical access hospital is very different from a good program for someone who wants to do private practice primary care in a big city with lots of specialists.

 

[Redpancreas]

Agree with above - a good FM program is the one that teaches you the stuff you want to do with your career. A good program for someone who wants to work in a rural setting doing primary care, deliveries, and coverage for a critical access hospital is very different from a good program for someone who wants to do private practice primary care in a big city with lots of specialists.

I'm not FM so take this with a grain of salt but when I was considering applying I figured I was looking at places. There are two spectrums of residency applicants. One is someone looking for a stepping stone to fellowship while another's doing their terminal/core of their training. FM is the latter. Therefore, I would think that one would choose a FM residency based on what they train you to do hence when you graduate you can actually do that and make money. From anecdotes I've heard, physician recruiters/practices do not recruit based on a tier/prestige of training program but perceived fit.