Caribbean School US citizen IMG chances

[jllb92]

Hi, im currently an MS4 at a caribbean school, im a US citizen, i scored a 262 on my step1 and had not yet taken CS or CK, I will be doing a clinical externship for 3 months in New york presbyterian columbia medical center in internal medicine(cardio, cath lab and endocrine or gastro), i dont have any publications, i have extensive extracurricular activities about social work, and student organizations and volunteering, i have good grades(A's and some B's), do i have any chance of interviewing/matching in top programs like Mayo or MGH? or its just imposible for an IMG? i want to match in internal medicine, thanks a lot in advance!!

---

Members don't see this ad.

 

[tkim]

Hi, im currently an MS4 at a caribbean school, im a US citizen, i scored a 262 on my step1 and had not yet taken CS or CK, I will be doing a clinical externship for 3 months in New york presbyterian columbia medical center in internal medicine(cardio, cath lab and endocrine or gastro), i dont have any publications, i have extensive extracurricular activities about social work, and student organizations and volunteering, i have good grades(A's and some B's), do i have any chance of interviewing/matching in top programs like Mayo or MGH? or its just imposible for an IMG? i want to match in internal medicine, thanks a lot in advance!!

http://www.massgeneral.org/medicine/education/residency/class-profiles.aspx

3787 applicants / 64 slots = 1.7% match rate

 

[Mad Jack]

Top 10 programs generally won't touch a Caribbean graduate with a ten foot pole. When you can fill your entire program with research geniuses from the top 20 US MD schools, why would you ever want to take a Caribbean graduate?

You've got a chance, however small, at many mid-tier academic hospitals, but you'll basically be throwing your money away applying to top places.

Mayo takes Carib grads, but not at the main clinic.

 

[jllb92]

Top 10 programs generally won't touch a Caribbean graduate with a ten foot pole. When you can fill your entire program with research geniuses from the top 20 US MD schools, why would you ever want to take a Caribbean graduate?

You've got a chance, however small, at many mid-tier academic hospitals, but you'll basically be throwing your money away applying to top places.

Mayo takes Carib grads, but not at the main clinic.

Damn heart breaker, but true, thanks a lot for the reply! but i still got a chance to get an university based program even though its not a top one?

 

[jllb92]

http://www.massgeneral.org/medicine/education/residency/class-profiles.aspx

3787 applicants / 64 slots = 1.7% match rate

Thanks a lot for the reply!

 

[Mad Jack]

Damn heart breaker, but true, thanks a lot for the reply! but i still got a chance to get an university based program even though its not a top one?

Tons of university programs take IMGs. This guy compiled a list a few years back, it should be a good start. Has a percent of IMGs by program. Keep in mind that some of the top tier places will take IMGs, but not Carib grads (such as Yale, who will take Cambridge, Oxford, and other prestigious international grads). It is also four years old. Still, it's a good start.

http://im-for-imgs.com/2011/12/20/img-friendly-internal-medicine-program-list/

 

[physic]

One thing to think about is that getting a "good" residency can lead to a "great" fellowship. Your medical school wont matter when you apply for fellowship, what you do during residency will. With your step 1 scores you will do well long term.

That IMG blog is mine and the % IMGs post is a good place to start.

 

[Shipping News]

One thing to think about is that getting a "good" residency can lead to a "great" fellowship. Your medical school wont matter when you apply for fellowship, what you do during residency will. With your step 1 scores you will do well long term.

That IMG blog is mine and the % IMGs post is a good place to start.

Are you sure that program directors at competitive fellowships don't peek at your school?

 

[jllb92]

Are you sure that program directors at competitive fellowships don't peek at your school?

Well here what he says its true, im sure they peek at your school, but if you have done exceptional in residency they will surely take you, i have LOADS of professors(caribbean all) like that, i even have one from my school that did EM in mayo minnesota and is a professor at Harvard.

 

[physic]

Here is a good example: http://www.brighamandwomens.org/Research/depts/Medicine/Renal/Fellows/Current_Fellows.aspx?sub=3
While Renal is not as competitive as say Cardiology, the Brigham/MGH Renal fellowship is one of the most competitive Renal programs in the country.
One fellow in the first year class is from a Caribbean school, others are international grads, others US grads. All did extremely well in residency.

You can't control where you went to school but you can become the resident that everyone wants to work with by focusing on professionalism to establish your reputation (see this post for details: http://im-for-imgs.com/2012/06/29/w...at-is-expected-from-interns-on-the-first-day/). Your reputation plus your patient care, knowledge and scholarly pursuits will be the basis of the letter your program will write for your fellowship or your post residency position.

 

[rokshana]

Here is a good example: http://www.brighamandwomens.org/Research/depts/Medicine/Renal/Fellows/Current_Fellows.aspx?sub=3
While Renal is not as competitive as say Cardiology, the Brigham/MGH Renal fellowship is one of the most competitive Renal programs in the country.
One fellow in the first year class is from a Caribbean school, others are international grads, others US grads. All did extremely well in residency.

You can't control where you went to school but you can become the resident that everyone wants to work with by focusing on professionalism to establish your reputation (see this post for details: http://im-for-imgs.com/2012/06/29/w...at-is-expected-from-interns-on-the-first-day/). Your reputation plus your patient care, knowledge and scholarly pursuits will be the basis of the letter your program will write for your fellowship or your post residency position.

renal is not a good example...even the best programs don't match and are separate for fellows...

and don't fool yourself, school counts...the good thing is that fellowship interviews are more about who you know (so a great letter from a well respected person in the field carries weight) than necessarily where you went to school or where you did residency (other than the inherent ability to interact with those well respected in the field that comes with doing residency at a big place..

 

[Mad Jack]

Are you sure that program directors at competitive fellowships don't peek at your school?

You are only as good as the last step of training in medical school is generally how it works. That's why you'll see DOs and IMGs in many of the fellowship positions in institutions that wouldn't touch an IMG or DO for a categorical residency position.

 

[Shipping News]

You are only as good as the last step of training in medical school is generally how it works. That's why you'll see DOs and IMGs in many of the fellowship positions in institutions that wouldn't touch an IMG or DO for a categorical residency position.

If you are a US MD, for all intents and purposes, for fellowships you are probably going to be judged by where you did residency but if you went to Harvard or Hopkins you will probably impress somebody on the selection committee. There's no way that kind of bias isn't going to perpetuate itself. Same goes for if you went to Ross, but in the opposite direction.

If you are a DO or IMG, the ladder only goes so high. For competitive fellowships, the top residencies essentially shuffle their players around in the same tier. There are certainly institutions that would not take a certain person for their IM residency that could totally land a rheumatology or infectious disease fellowship there. But that's because those spots, even at big-name places, are not competitive.

But this blanket statement "you are only as good as the last step of training" is extremely naive. In the academic world, you are the sum of your CV, not just the most recent entry in it.

 

[IMreshopeful]

You are only as good as the last step of training in medical school is generally how it works. That's why you'll see DOs and IMGs in many of the fellowship positions in institutions that wouldn't touch an IMG or DO for a categorical residency position.

I highly disagree. For competitive fellowships pedigree makes a big difference in fellowship placement and which places are more likely to interview you. As mentioned the top tier places want to take from other top tier places. It makes them look more prestigious and so they're not going to be abandoning that paradigm anytime soon. Where you went to med school is also most likely taken into account as well although probably has lesser of an effect than your residency placement.

Do I think this is necessarily right? No. It eliminates a lot of people who are probably much better but don't have the word "Harvard" anywhere in their CV. Also there's probably zero correlation to how good of a doctor clinically you are and whether you went to a top tier or whatever. But at this point that's how the world works.

 

[Mad Jack]

I highly disagree. For competitive fellowships pedigree makes a big difference in fellowship placement and which places are more likely to interview you. As mentioned the top tier places want to take from other top tier places. It makes them look more prestigious and so they're not going to be abandoning that paradigm anytime soon. Where you went to med school is also most likely taken into account as well although probably has lesser of an effect than your residency placement.

Do I think this is necessarily right? No. It eliminates a lot of people who are probably much better but don't have the word "Harvard" anywhere in their CV. Also there's probably zero correlation to how good of a doctor clinically you are and whether you went to a top tier or whatever. But at this point that's how the world works.

It certainly helps to have a better pedigree, but the vast majority of fellowships do not completely rule out candidates based on pedigree, unlike residencies, which frequently do. Take a look at the FREIDA profiles of some of the top fellowships in a given field, you'll be surprised by how many IMGs and DOs are there.

 

[IMreshopeful]

It certainly helps to have a better pedigree, but the vast majority of fellowships do not completely rule out candidates based on pedigree, unlike residencies, which frequently do. Take a look at the FREIDA profiles of some of the top fellowships in a given field, you'll be surprised by how many IMGs and DOs are there.

Within which fellowship fields are you referring to? In the top cardiology programs most of the IMGs are from European schools, not Indian or Pakistani, and most of the fellows from more mid tier residencies were usually chief residents. I agree it's more homogeneous in the less competitive fields but those aren't what I was referring to.

 

[Mad Jack]

Within which fellowship fields are you referring to? In the top cardiology programs most of the IMGs are from European schools, not Indian or Pakistani, and most of the fellows from more mid tier residencies were usually chief residents. I agree it's more homogeneous in the less competitive fields but those aren't what I was referring to.

Of course the most competitive places in the most competitive specialties will be a bit more picky. But within the top 10 training programs of any fellowship, there's a few places that take IMGs. Hell, in some fields like Pulm, the majority of top programs do. OP didn't say they want to be a cardiologist at MGH, FFS. We're talking about "in general" here, not the exceptions.

 

[LovelyBRass]

Not sure where you'll match but my best advice on getting you to your personal highest tier (whatever that is, everyone can debate) is

1) take step 2 early and

2) ace fourth year clinicals and Sub-I.

Clinical training is where U.S.-IMG training is notoriously worse than AMG training because of hospital structure and rotation design. An awesome Step 2 and good letters from those fourth year rotations will go a long way to showing you're not just book smart since IM is way more than that

 

[djensenmedi]

I'm a US-IMG (at a program not in the Caribbean). I rocked my boards, aced my clerkships, did a research fellowship between MS3 and MS4, then did three 4th year Sub-Is at various programs stateside. I am now interviewing for residency at some of the best programs in the country for a competitive surgical subspecialty. Don't let these people knock you. You'll have to work a bit harder, but absolutely nothing is off the table. Network. Rotate with influential people stateside and get great letters from them. Have a compelling story and a plan for your career. You'll do just fine.