Caribbean School students and the Match

[MonAmiMD]

Guys, I have always wondered:
If Carib students enter the match along with US student, why don't a few Carib students get great residencies as a result every year?
(great residencies= residencies at top/famous hospitals).

I am sure many Carib students get excellent step scores. So is it that their medical school that makes a difference? Shouldn't that not make a difference.
[I think for 2008, Ross got students into a Yale affiliation, and at the Mayo Clinic, Mt. Sinai.]

Thanks

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[digitalising]

Guys, I have always wondered:
If Carib students enter the match along with US student, why don't a few Carib students get great residencies as a result every year?
(great residencies= residencies at top/famous hospitals).

I am sure many Carib students get excellent step scores. So is it that their medical school that makes a difference? Shouldn't that not make a difference.
[I think for 2008, Ross got students into a Yale affiliation, and at the Mayo Clinic, Mt. Sinai.]

Thanks

For the same reason that a Harvard med school grad is unlikely to get a horrible residency. Prestige, perception, and access.

 

[ChairmanMao]

Guys, I have always wondered:
If Carib students enter the match along with US student, why don't a few Carib students get great residencies as a result every year?
(great residencies= residencies at top/famous hospitals).

I am sure many Carib students get excellent step scores. So is it that their medical school that makes a difference? Shouldn't that not make a difference.
[I think for 2008, Ross got students into a Yale affiliation, and at the Mayo Clinic, Mt. Sinai.]

Thanks

Well there simply aren't that many great residencies out there (I'm thinking of dermatology/neurosurgery/cardiology, etc.) There will always be fewer of those residency spots than applicants because those fields are competitive (they pay a lot), training takes a longer time (6-10 years), and there aren't enough attending physicians who specialized in those fields. For this reason, the top of the creme at most US medical schools get those spots first, followed by Foreign medical school graduates.

This doesn't mean that Carribbean or foreign medical students are any less capable, it's just how the system is set up. In the US, most residency spots favor US medical school graduates with high board scores. Granted, even then, it comes down to the most arbitrary of reasons. At the medical center where I work, the radiation oncology department interviews 200 medical students for 2 spots. A lot of these students scored in the 85th percentile on their boards and come from the most prestigious US medical schools (Harvard, Johns Hopkins, Duke). The department there simply won't consider foreign medical school graduates no matter how high they scored because they already have huge numbers of US medical school graduates applying.

To be honest, if you graduated from an accredited US medical school, the type of school matters a lot less than your board scores (US medical schools are already so competitive that if you can get into one, you're pretty much on equal footing with someone who graduated from Harvard or Johns Hopkins). However, if you graduated from a foreign medical school, the reputation of your school will come into question since it isn't LCME accredited. As a result, some residency programs will exclude you from their programs or may not give equal consideration compared to if you had graduated from a US allopathic school.

 

[MonAmiMD]

Well there simply aren't that many great residencies out there (I'm thinking of dermatology/neurosurgery/cardiology, etc.) There will always be fewer of those residency spots than applicants because those fields are competitive (they pay a lot), training takes a longer time (6-10 years), and there aren't enough attending physicians who specialized in those fields. For this reason, the top of the creme at most US medical schools get those spots first, followed by Foreign medical school graduates.

This doesn't mean that Carribbean or foreign medical students are any less capable, it's just how the system is set up. In the US, most residency spots favor US medical school graduates with high board scores. Granted, even then, it comes down to the most arbitrary of reasons. At the medical center where I work, the radiation oncology department interviews 200 medical students for 2 spots. A lot of these students scored in the 85th percentile on their boards and come from the most prestigious US medical schools (Harvard, Johns Hopkins, Duke). The department there simply won't consider foreign medical school graduates no matter how high they scored because they already have huge numbers of US medical school graduates applying.

To be honest, if you graduated from an accredited US medical school, the type of school matters a lot less than your board scores (US medical schools are already so competitive that if you can get into one, you're pretty much on equal footing with someone who graduated from Harvard or Johns Hopkins). However, if you graduated from a foreign medical school, the reputation of your school will come into question since it isn't LCME accredited. As a result, some residency programs will exclude you from their programs or may not give equal consideration compared to if you had graduated from a US allopathic school.

Thank you ChairmanMao for the most concise and well explained answer. I just always wondered about it and am able to understand it better. I think at some point, FMGs will come through and get these spots...It's definitely worth hoping for.

Thanks again everyone!

 

[Tigerz_Fan]

I can only speak for IM, but I do know Carib grad at large University centers in anesthesia, surgery, radiology, GI, cards, FP, rheum, endocrine and so on.

Generally, AMGs are preferred over IMG/FMG. Unfortunate. In IM, sometimes FMGs are favored over IMG (Carib) because most FMGs have years of experience in research, have already completed a residency +/- fellowship.

Even so, if you are a Carib grad and you have research, publications, great USMLE scores you are going to do fine in the Match.

Guys, I have always wondered:
If Carib students enter the match along with US student, why don't a few Carib students get great residencies as a result every year?
(great residencies= residencies at top/famous hospitals).

I am sure many Carib students get excellent step scores. So is it that their medical school that makes a difference? Shouldn't that not make a difference.
[I think for 2008, Ross got students into a Yale affiliation, and at the Mayo Clinic, Mt. Sinai.]

Thanks

 

[rom73085]

Well there simply aren't that many great residencies out there (I'm thinking of dermatology/neurosurgery/cardiology, etc.) There will always be fewer of those residency spots than applicants because those fields are competitive (they pay a lot), training takes a longer time (6-10 years), and there aren't enough attending physicians who specialized in those fields. For this reason, the top of the creme at most US medical schools get those spots first, followed by Foreign medical school graduates.

This doesn't mean that Carribbean or foreign medical students are any less capable, it's just how the system is set up. In the US, most residency spots favor US medical school graduates with high board scores. Granted, even then, it comes down to the most arbitrary of reasons. At the medical center where I work, the radiation oncology department interviews 200 medical students for 2 spots. A lot of these students scored in the 85th percentile on their boards and come from the most prestigious US medical schools (Harvard, Johns Hopkins, Duke). The department there simply won't consider foreign medical school graduates no matter how high they scored because they already have huge numbers of US medical school graduates applying.

To be honest, if you graduated from an accredited US medical school, the type of school matters a lot less than your board scores (US medical schools are already so competitive that if you can get into one, you're pretty much on equal footing with someone who graduated from Harvard or Johns Hopkins). However, if you graduated from a foreign medical school, the reputation of your school will come into question since it isn't LCME accredited. As a result, some residency programs will exclude you from their programs or may not give equal consideration compared to if you had graduated from a US allopathic school.

You also mention Cardiology which is not a specific residency. The highest rates of residency matches from FMG are straight into Internal Medicine (As well as Family Medicine) which is the pathway into Cardiology, as after your four year residency in IM, you do a 1-2 Yr. fellowship in Cardiology.

 

[Tigerz_Fan]

You also mention Cardiology which is not a specific residency. The highest rates of residency matches from FMG are straight into Internal Medicine (As well as Family Medicine) which is the pathway into Cardiology, as after your four year residency in IM, you do a 1-2 Yr. fellowship in Cardiology.

I am very sure that the author knows this. He is directly mentioning cards because many people apply to IM with the intention of applying to cards. And if you want to get specific, cardiology fellowship is 3 years after IM, not 1-2 years.

 

[dragonfly99]

Cardiology is a 3-5 year total fellowship after 3 years of IM.
3 years is the minimum. If you do interventional cardiology, electrophysiology, or research years, it will be 4-5.

The problem with matching into IM from the Carib and wanting cardiology is that you are less likely to match at a major academic medical center than a similar US graduate. This in itself will make it harder to get cards fellowship, plus many Carib grads have not done research during med school, and it's hard to find time during residency. That, plus the fact that some Carib grads aren't good standardized test takers (so lower USMLE scores) and that there is still some stigma attached to Carib grads, will make it generally harder to get a cardiology fellowship coming from the Caribbean. However, there are Carib grads who go on to do things like cardiology.

 

[BrainBuff]

This year's match seem to be a reflection of what's coming ahead for the future. The Match was extremely tough and the Scramble was horrible for AMGs. With more US MD and DO schools opening up every year and with the fixed cap on residency positions, one can only expect that IMGs will have a very hard time finding desirable residencies in the next few years.

Time to really buckle up guys!

 

[ChairmanMao]

You also mention Cardiology which is not a specific residency. The highest rates of residency matches from FMG are straight into Internal Medicine (As well as Family Medicine) which is the pathway into Cardiology, as after your four year residency in IM, you do a 1-2 Yr. fellowship in Cardiology.

Yeah, as the other posters have pointed out. I'm thinking about cardio fellowships after the IM residency. Just because many Carribbean medical students managed to match into an IM residency does not mean that they will have the same amount of luck getting a card fellowship. Those are very competitive and as dragonfly pointed out, Carribbean students are at a distinct disadvantage when applying for those fellowships.

 

[McGillGrad]

Indeed, it is finally getting to a point where only the best can make it.

That's always a good thing.

This year's match seem to be a reflection of what's coming ahead for the future. The Match was extremely tough and the Scramble was horrible for AMGs. With more US MD and DO schools opening up every year and with the fixed cap on residency positions, one can only expect that IMGs will have a very hard time finding desirable residencies in the next few years.

Time to really buckle up guys!

 

[Boilermaker]

I have been looking to apply to Caribbean schools and seeing a mix of reactions on the difficulty in obtaining residency after graduation from one. Before I make the decision to attend a Caribbean school I want to know what kind of "hoops I will have to jump through," as one poster put it, in order to practice medicine in lets say New York, California, or Missouri. I am also wondering if there is a possibility of landing residencies to train in general surgery or orthopedic surgery upon graduation, or if these are very low chances for most Caribbean graduates? When I Google search various hospitals I see a lot of Caribbean students in IM, and many posters talking about IM, do a lot of people like IM or is that just what people usually match into from the Caribbean?

I feel positive about the whole thing, and feel that if I graduated from a Caribbean school like SGU, I would have a chance at being a surgeon. I have read countless resumes of people that have made it through the Caribbean in all sorts of medical specialties. However it would be nice to hear some current information from residents, recent graduates, or other knowledgeable posters about their experiences.

 

[Jersey]

http://www.nrmp.org/data/advancedatatables2009.pdf

I've attached this so you can get an idea how many F/IMGs matched into positions vs. AMGs. As you can see, almost half of the positions in the Match are in FM, IM, Peds and Psych. The majority of the rest are in primary care type positions. Then take a look at Cat Surgery. 1065 slots out of a total of 22,400. Out of 1065 slots, only about 235 went to non-AMGs. Not bad, but not good either. At least there's a chance.

The fact that you're going the Carib route suggests that your stats aren't good enough for the U.S. possibly meaning that your test taking skills aren't as good as the AMGs. And don't let anybody kid you, USMLE scores mean a lot. It will be an uphill battle.

I just went through the Match from SGU. I never wanted to be a surgeon, just a good old family Doc and I did pretty good for myself.

Go for it. But remember, primary care is not so bad. You're still a Doc...

One more thing. I don't feel that I had to jump through any real hoops to get here. Maybe a few extra filings with the ECFMG, but nothing too stressful. And go to SGU, AUC, Ross or Saba if Cali is in your future. Also, I believe only SGU and Ross rotate in NJ.

 

[BrainBuff]

Thank you ChairmanMao for the most concise and well explained answer. I just always wondered about it and am able to understand it better. I think at some point, FMGs will come through and get these spots...It's definitely worth hoping for.

I hate to burst your bubble but it is very unlikely that international medical graduates "come through" in the future and get these spots.

Match results compared to last year:

USMD 93.1% (-)1.1% from last year
USDO 69.9% (-)1.7% from last year
USIMG 47.8% (-)4.1% from last year

Of the three groups, foreign medical graduates took it the worst with a 4.1% drop from previous year. This should be taken as a sign of things to come for everyone.

 

[McGillGrad]

It is in direct correlation to the standards required to gain acceptance to each respective category. It's logical.

As with everything else in life, worry about yourself because I will be counting on a 100% match rate. What other people do is their undoing.

I hate to burst your bubble but it is very unlikely that international medical graduates "come through" in the future and get these spots.

Match results compared to last year:

USMD 93.1% (-)1.1% from last year
USDO 69.9% (-)1.7% from last year
USIMG 47.8% (-)4.1% from last year

Of the three groups, foreign medical graduates took it the worst with a 4.1% drop from previous year. This should be taken as a sign of things to come for everyone.

 

[RussianJoo]

I hate to burst your bubble but it is very unlikely that international medical graduates "come through" in the future and get these spots.

Match results compared to last year:

USMD 93.1% (-)1.1% from last year
USDO 69.9% (-)1.7% from last year
USIMG 47.8% (-)4.1% from last year

Of the three groups, foreign medical graduates took it the worst with a 4.1% drop from previous year. This should be taken as a sign of things to come for everyone.

I totally agree. if you're considering SGU, AUC, Ross, Saba, then you should be able to get into a DO school somewhere. that's a much safer bet especially since you're starting out now. it will continue to get harder and harder for USIMGs to match into any specialty let alone something as semi-competitive as gen-surgery and super competitive like ortho.

the only hoops i can think of are more higher fees for USMLE exams, and possibly more paper work to fill out. also you'll have to be careful of where you do your rotations because you might have licensing issues later on. not major hoops but still can be a pain in the butt.

 

[Boilermaker]

My stats are a little above a 3.0 in both the science and the cumulative GPAs with a major in chemical engineering, and a minor in mathematics from Purdue, with a first MCAT score of 30, and a second of 37. After reading MDApplicants.com, I see that some people after completeing post-bac work gain acceptance to US-MD schools with similar or below my stats, sometimes well below, with around 2.5 ish science GPAs. I would be very happy with acceptance to an Osteopathic school though if it were a possibility. I thought of obtaining an MS as another option of increasing my profile, but would prefer to begin the medical curriculum immediately. I am planning to apply to Caribbean Allopathic, Osteopathic, and US Allopathic medical schools. I really don't mind where the degree is from as long as I get into a surgical residency in the future if it is a possibility. The comments I am hearing about statistics of residency match from the Caribbean are unfortunate, but I am not completely down about it. I guess I will have to try my luck and see what happens. I have been told I'm a good interviewer, so maybe that will help.

 

[BrainBuff]

Boilermaker, with a 3.0 GPA and a 33 MCAT ( 30 and 37 WILL BE averaged) your chances for a US MD acceptance are dismal, unless you are an URM and have significant medical exposure and volunteerism. Your application will have to scream something very loud for you to get secondary applications and even interviews. A lot of people think that getting further postgraduate work makes them look better, but the jury is still out on that one. What seems to be more effective is taking a year off to work in a medical field, doing charity work and/or research .

By applying the coming cycle, you can get an idea of how you do and then plan a year off to buff up your credentials. That seems pretty reasonable. Just make sure you apply to less competitive schools - Drexel, Rosalind Franklin come to mind and your state schools of course.

 

[howelljolly]

It is in direct correlation to the standards required to gain acceptance to each respective category. It's logical.

As with everything else in life, worry about yourself because I will be counting on a 100% match rate. What other people do is their undoing.

a similar correlation holds for the USMLE pass rate... AMG - FMG - USIMG. A prof at a US school told me that this is rigged... there are different curves to maintain a roughly 97% - 75% - 50% pass rate respectively.

Mebbie the match is rigged too...

 

[Boilermaker]

Well I did research in orthopedics for 2 semesters under the guidance of faculty members at Purdue. I also have done research at Washington University School of Medicine. Several years of off and on home construction in habitat for humanity or home rehabbing for people with next to nothing. I was part of a pre medical internship at St. Louis University's hospital in the ER and other volunteer work. I have shadowing experience from different docs both DO and MD surgeons. I have family members in the medical field, and I have a past professor emeritus from a school, not from the school of medicine though, he is listed as early famous alumni at various schools though where there are medical schools. And wouldn't my MCAT be 33.5 and not a 33 because of the averaging, that would be taking away points from me. I also worked at Monsanto and another biochemical engineering company.

One thing that I am really not sure about. Some close family friends and neighboors of ours, are oral surgeons, they have MDs and DDSs, would those be good people to have as LORs, or would they not because they originally got DDS degrees. I think a letter from them would be a plus because they can attest to my character, I am not sure though.

How do I look for osteopathic and caribbean with the 3.0 cumalative GPA, and 3.1 science GPA, and the MCAT (30 & 37) averaged to a 33? I also have an in-state osteopathic school that says 2.5 gpa as the minimum requirement, I know though that acceptances are much higher. I could do some work in Denver in a hospital for a while and do some skiing, my sister is a senior financial analyst at the hospital and maybe could hook me up with something. If you think I look okay for osteopathic and caribbean, I may just apply away and go for it though. My dad said he would pay for an MS if I wanted it, but I don't know if I need it.

 

[howelljolly]

How do I look for osteopathic and caribbean with the 3.0 cumalative GPA, and 3.1 science GPA, and the MCAT (30 & 37) averaged to a 33? .

I havent really followed the thread... but i just wanted to mention a negative, that you really should keep in mind.

Plenty of people go to the Caribbean for med school having done a lot of good work in a particular field... and it isnt enough to get them into a residency. People go to the Caribbean with MS and PhDs, and loads of publications in fields like optho... but the Carib degree is too much of a hurdle.

So, just something to keep in mind. It really stanks to see people that tried to further their existing work by going for a Carib MD, and end up with nothing.

 

[RussianJoo]

You have a lot of connections at various US med schools. I really think you should use them. Have letters of Rec from the faculty memebers that you worked with and ask them if it's possible for them to call someone on the admission council on your behalf. This will help a lot, and others who have these connections use them all the time so don't feel bad. Med school admission just like getting a residency is equally about who you kow as it is about your grades.

Also I think you have a very good chance at being accepted at a DO school, Chem-E is one of the hardest majors at any school if not THE hardest major and some places will look at that positively.

I don't think you should waste your time applying to any carib schools. Worst case if you see you're not getting enough interviews or aren't getting positive feedback you can always apply later in the year. Carib schools have 2 or 3 admission cycles and so you can apply after you find out if you were accepted into a US school or not and still start on time, more or less. Also Carib school admission process is usually much faster than US school admission process. So apply to MD and DO schools first and if you don't gain admission then apply to carib schools and you'll be able to start either in the summer or in Jan.

 

[rkaz]

So apply to MD and DO schools first and if you don't gain admission then apply to carib schools and you'll be able to start either in the summer or in Jan.

I just found out today that I was accepted to SGU. The idea of being in an 'MD' program is tempting, but as I am currently holding an acceptance at an established DO program (AZCOM), I think I should just run with it and matriculate into the osteopathic program. I'll have to think about this for the next few days, but am strongly leaning DO. It's nice to find some reassurances here though.

 

[RussianJoo]

you can't go wrong with going to a US school no matter if it's MD or DO. The match rates are higher for DO's than carib MDs. and with the continued increase of both US MD and DO students and almost no increase in residency programs your safest bet is to go to a US DO or MD school. You see lots of post poping up now after the match of how Carib schools are done simply because it's getting harder and harder for IMGs to match in the US. I was predicting this almost a year ago on valuemd but of course no one cares to listen until it's too late.

If you're in your 2nd or 3rd year of a carib med school you'll have a tougher time matching but will still be ok. however if you're just applying to med school now i strongly encourage you to not go to a carib school because in 4 or years when you're going to be getting ready to match into a residency you'll find that most of the spots will go to US grads and there simply won't be enough spots for imgs. already the img match rate is around 47%, this will continue to drop, this is a reality and a fact, and it makes sence because US MD schools are increasing class sizes and there are a number of new MD schools opening up. Also DO schools are growing at an almost exponential rate.

 

[rkaz]

Thanks so much for taking the time to reply, RJ. Much appreciated.

 

[BrainBuff]

Fully agree with RJ

 

[Boilermaker]

Well if all of these schools are increasing enrollment, and if new DO schools and medical schools are popping up, doesn't that mean that eventually more hospitals and residency problems are going to appear as well?

Is this problem with residency size temporary? I find it hard to believe that any physician would not ever get a residency even after a couple of years. If someone has story of this happening I would be interested in hearing this, because I did not know it was possible to never match.

Also, are there residencies that don't take part in the match, and just accept applications from doctors?

 

[RussianJoo]

med school enrollment is indipendent of residency spot. residency spots are paid for by medicare so if medicare goes under new residencies will not open up. currently there's a surplus of residencies when compaired to US grads (MD and DO), thus there's no need to increase residencies in the eyes of the US government and in the eyes of the US med schools. the US government doesn't care if carib grads fail to match into a residency, these residencies weren't ment for them in the first place.

The programs that don't participate in the match are those programs that are on probation due to any of the following reasons: either too many residents fail the boards, the residency can't provide enough patients or eough variety of patients so that the residents get propperly trained, the teaching at these institutions is terrible and the residents are just used as cheap labor. There might be others but those are the main ones. So you wouldn't want to go to a residency program that doesn't participate in the match. those program can shut down at any time and you'll have to find another program willing to take you, or you might have a very hard time passing the boards and being board certified (a requirement by many hospitals and groups), or hospitals and groups might simply not hire you or offer you much lower wages than someone who finished a residency program that's not on probation. and if you want to get a fellowship you can kiss that good bye.

 

[amakhosidlo]

Wait, so when you hear of someone "pre-matching", that's the type of program they're signing on with?

 

[McGillGrad]

Wait, so when you hear of someone "pre-matching", that's the type of program they're signing on with?

no, you can offer prematches while having spots in the match

 

[BrainBuff]

Well if all of these schools are increasing enrollment, and if new DO schools and medical schools are popping up, doesn't that mean that eventually more hospitals and residency problems are going to appear as well?

Is this problem with residency size temporary? I find it hard to believe that any physician would not ever get a residency even after a couple of years. If someone has story of this happening I would be interested in hearing this, because I did not know it was possible to never match.

Also, are there residencies that don't take part in the match, and just accept applications from doctors?

Boilermaker, it is really unheard of NOT to EVER find a residency spot. What happens is that you may end up in a less desirable place, community hospital or a specialty that you do not want to do (like Psychiatry, whose ranks are swollen with IMGs).

I have a friend (graduated from a puerto rican school) who wanted Surgery really bad. He could not get in. After a couple of years he finally got into a really bad program in New York, that unfortunately for him was also pyramidal. He could not go into the third year. Eventually, after 6 years from graduating from med school,he had to get into an internal medicine residency and he finished it.

The road may be convoluted and frustrating, but eventually I think everyone finds a spot somewhere.

 

[dtminhthu]

I've talked to many pre health advisors regarding the caribbean route, as well as having talked to actual physicians. If you can get into any US med school, whether it is MD or DO, GET IN THERE! It'll be much easier for you to get into residencies of your choice later on.

However, that does not mean carib grads don't have a chance. There are residency sites that take ONLY foreign medical graduates or at least take in majority of them. Usually these sites are in TX, NY, or other states along east coast. I have a website for the surgery association, which lists all the surgery residencies you can get into. Go through hundreds of pages in residency profiles and you will find out what your chances are if you go into a foreign med school like caribbeans.

http://www.facs.org/residencysearch/search/search.html

 

[howelljolly]

Boilermaker, it is really unheard of NOT to EVER find a residency spot. What happens is that you may end up in a less desirable place, community hospital or a specialty that you do not want to do (like Psychiatry, whose ranks are swollen with IMGs).

I have a friend (graduated from a puerto rican school) who wanted Surgery really bad. He could not get in. After a couple of years he finally got into a really bad program in New York, that unfortunately for him was also pyramidal. He could not go into the third year. Eventually, after 6 years from graduating from med school,he had to get into an internal medicine residency and he finished it.

The road may be convoluted and frustrating, but eventually I think everyone finds a spot somewhere.

Incidentally, a graduate from a school in Puerto Rico is an American grad... the Puerto Rican schools are LCME certified.

 

[BrainBuff]

I know howelljolly, I was just illustrating this example that I know even from an American grad perspective. Nevertheless, it should be noted that the Puerto Rican schools are the lowest ranked of all the ones LCME certified.

 

[howelljolly]

I know howelljolly, I was just illustrating this example that I know even from an American grad perspective. Nevertheless, it should be noted that the Puerto Rican schools are the lowest ranked of all the ones LCME certified.

Oh, yeah, well.... its bad.