Caribbean Schools with Better match lists then DOs?

[MADD!!!]

See my update to my last post. I made some huge mistakes when applying, the largest of which (if you can call it a mistake) was a last minute change of specialty (as in late September, after the application window had already opened.) I had to cobble together a whole new app in less than 1 week, with new letters that I had to politely rush my writers to complete and submit, and an entirely different PS. I also only knew of a handful of programs I was truly familiar with and interested in applying to. I definitely handicapped myself from the start. But like I said, it worked out just fine in the end.

And you're right, my program didn't fill; but it was the first year that had ever happened. We filled again this year with multiple Ivy League grads, and high on our list. Anomaly, which I was happy to be the beneficiary of. My program truly is very high quality!

I had some bad strategy and bad luck, which worked out in the end just fine for me. A huge percentage (even a majority) of the folks who were IMG's were not so fortunate and finished the app season with nothing to show for all the hard work they had put in to get there.

Wow, didn't know you were an IMG. What specialty did you choose? And from your experience, is the DO route better or St. George Carribean?

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[SLC]

Wow, didn't know you were an IMG. What specialty did you choose? And from your experience, is the DO route better or St. George Carribean?

I'm not an IMG, I'm a DO.

My whole point was that I sorta sabotaged myself (unintentionally) but still got a spot, and a good one. Tons of IMG's put their best foot forward and still got nothing.

DO route is always better than Carribean. Anyone who says otherwise is selling something!

 

[AnatomyGrey12]

Wow, didn't know you were an IMG. What specialty did you choose? And from your experience, is the DO route better or St. George Carribean?

He's not. He's a DO from ATSU-SOMA

Edit: his experience isn't the typical because he was going for FM and there are a ton of FM spots in the SOAP.

 

[MADD!!!]

Oo got it. I guess I read something wrong.

 

[Goro]

OK Peach, pay careful attention:

The point here isn't that there are successful Carib grads. The point is how many additional obstacles to success you face by going to a Carib school.

From the wise gyngyn:

"The pool of US applicants from the Caribbean is viewed differently by Program Directors. The DDx for a Caribbean grad is pretty off-putting: bad judgment, bad advice, egotism, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems, weak research skills, high risk behavior. This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to, or can afford to take risks too! So, some do get interviews.


Bad grades and scores are the least of the deficits from a PD's standpoint. A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!

Just about everyone from a Caribbean school has one or more of these problems and PDs know it. That's why their grads are the last choice even with a high Step 1 score.

There was a time when folks whose only flaw was being a late bloomer went Carib, but those days are gone. There are a number of spots at US schools with grade replacement for these candidates."

It's likely you'll be in the bottom half or two thirds of the class that gets dismissed before Step 1. The business plan of a Carib school depends on the majority of the class not needing to be supported in clinical rotations. They literally can't place all 250+ of the starting class at clinical sites (educational malpractice, really. If this happened at a US school, they be shut down by LCME or COCA, and sued.

The Carib (and other offshore) schools have very tenuous, very expensive, very controversial relationships with a very small number of US clinical sites. You may think you can just ask to do your clinical rotations at a site near home. Nope. You may think you don't have to worry about this stuff. Wrong.

And let's say you get through med school in the Carib and get what you need out of the various clinical rotation scenarios. Then you are in the match gamble. I don't need to say a word about this - you can find everything you need to know at nrmp.org.

You really need to talk to people who made it through Carib into residency, and hear the story from them. How many people were in their class at the start, how many are in it now? How long did it take to get a residency, and how did they handle the gap year(s) and their student loans? How many residencies did they apply to, how many interviews did they get, and were any of the programs on their match list anything like what they wanted?

A little light reading:

https://milliondollarmistake.wordpress.com/

http://www.tameersiddiqui.com/medical-school-at-sgu

I always thought that Caribbean students were lucky to match at all, and if they did it was pretty much only to primary care. Everything my advisor told me said that American DOs will pretty much always to better at finding residency, and get better residencies, than Caribbean students. But then I looked at the match lists for Caribbean schools like Ross and St. George and they have great matches! tons of gen surg, urology, ophthalmology, derm, anaesthesia... all the big 3 match lists were better than any DO school list. What's going on here?

 

[WedgeDawg]

So many matches at Icahn!!!! How friendly is Icahn to DO's?

How about all of those IM matches at top hospitals?!!! Most of which would give you a HUGE leg up for fellowships. If a DO matches into Icahn for IM, it's A BIG DEAL. And don't forget, these matches are all ACGME. DO's match into the AOA slots, which after the merger no one knows what's happening.

This is a good example of why pre-meds shouldn't try to interpret match lists in most situations.

Let's look carefully at all the Icahn matches here:

PGY-1
Prelim surgery (real Icahn) x2
Prelim surgery (satellite Icahn)
Categorial psych (satellite Icahn) x5
Categorical anesthesiology (satellite Icahn) x2
Categorical medicine (satellite Icahn) x15

PGY-2
Categorical pathology (real Icahn) x2
Categorical PM&R (real Icahn)
Categorical FM (satellite Icahn)
Categorical peds (satellite Icahn)
Categorical anesthesiology (satellite Icahn) x3
Categorical medicine (satellite Icahn) x10
Categorical psychiatry (satellite Icahn)

Literally zero of these are impressive matches in the sense that you seem to be implying.

For it to be an "impressive" match, we have to first make the assumption that the main Icahn Mt. Sinai hospital is a "top" or "strong" or whatever match for that particular residency program, which is probably not true for a lot of specialties (I have no idea). However, even if the main Icahn hospital is the top match for every single specialty, the vast majority of these matches are to satellite hospitals (St. Lukes, Queens, Elmhurst, etc) and not the main hospital. So none of those are impressive. A preliminary match is not impressive either, no matter where it is, so those are out. That leaves us with two categorical PGY2 pathology matches and one categorical PM&R PGY2 match as the "most impressive". I have no idea at all whether or not Mt. Sinai is considered a top match for either of those specialties, but even so, both of those specialties fall towards the bottom in terms of competitiveness when ranked by step scores and % unmatched (see Charting Outcomes, 2014).

So no, there aren't a lot of IM matches at top hospitals here, sorry.

Also, as a side note they try to play off Stamford Hospital as "Columbia P&S" when it's a teaching affiliate as an away rotation site, not a Columbia P&S owned or operated hospital...

 

[IslandStyle808]

The whole point of getting into DO school is for three reasons 1. lower attrition (caribbean attrition is insanely high), 2. greater amount of programs look at your applications (check the PD surveys on the NRMP site) 3. higher match ceiling (DOs still have the potential to match at high quality programs, I have looked at the specialty sub forums and confirmed this). I will admit there are some really good competitive matches, but out of how many students and how much harder did they have to work at it? <-(rhetorical question)

 

[MADD!!!]

This is a good example of why pre-meds shouldn't try to interpret match lists in most situations.

Let's look carefully at all the Icahn matches here:

PGY-1
Prelim surgery (real Icahn) x2
Prelim surgery (satellite Icahn)
Categorial psych (satellite Icahn) x5
Categorical anesthesiology (satellite Icahn) x2
Categorical medicine (satellite Icahn) x15

PGY-2
Categorical pathology (real Icahn) x2
Categorical PM&R (real Icahn)
Categorical FM (satellite Icahn)
Categorical peds (satellite Icahn)
Categorical anesthesiology (satellite Icahn) x3
Categorical medicine (satellite Icahn) x10
Categorical psychiatry (satellite Icahn)

Literally zero of these are impressive matches in the sense that you seem to be implying.

For it to be an "impressive" match, we have to first make the assumption that the main Icahn Mt. Sinai hospital is a "top" or "strong" or whatever match for that particular residency program, which is probably not true for a lot of specialties (I have no idea). However, even if the main Icahn hospital is the top match for every single specialty, the vast majority of these matches are to satellite hospitals (St. Lukes, Queens, Elmhurst, etc) and not the main hospital. So none of those are impressive. A preliminary match is not impressive either, no matter where it is, so those are out. That leaves us with two categorical PGY2 pathology matches and one categorical PM&R PGY2 match as the "most impressive". I have no idea at all whether or not Mt. Sinai is considered a top match for either of those specialties, but even so, both of those specialties fall towards the bottom in terms of competitiveness when ranked by step scores and % unmatched (see Charting Outcomes, 2014).

So no, there aren't a lot of IM matches at top hospitals here, sorry.

Also, as a side note they try to play off Stamford Hospital as "Columbia P&S" when it's a teaching affiliate as an away rotation site, not a Columbia P&S owned or operated hospital...

Thank you so much for your response! I just have a few questions as I'm learning and still confused. 1) I'm saying the matches are good because they are even affiliated with Icahn, which is a top medical center in general. 2) For Internal Medicine (IM), I'm considering (possibly incorrectly) that going to any of these IM residencies would put you in a good position for a competitive fellowship such as Cards or Gastro, 3) Again, these are matches from the Carribean!!! I'm not trying to say people from the Carribean are getting into Ivy League residencies, but even the fact that they're getting into ones that are even affiliated with a place like Icahn is still better than a local community hospital in a rural city? (I know I have a lot of biases here, and I want to hear your opinion on them. Definitely not saying i'm right, I'm probably wrong on a few or most of these, but this is my train of thought and would like to hear your take on it).

 

[MADD!!!]

I always thought that Caribbean students were lucky to match at all, and if they did it was pretty much only to primary care. Everything my advisor told me said that American DOs will pretty much always to better at finding residency, and get better residencies, than Caribbean students. But then I looked at the match lists for Caribbean schools like Ross and St. George and they have great matches! tons of gen surg, urology, ophthalmology, derm, anaesthesia... all the big 3 match lists were better than any DO school list. What's going on here?

OK Peach, pay careful attention:

The point here isn't that there are successful Carib grads. The point is how many additional obstacles to success you face by going to a Carib school.

From the wise gyngyn:

"The pool of US applicants from the Caribbean is viewed differently by Program Directors. The DDx for a Caribbean grad is pretty off-putting: bad judgment, bad advice, egotism, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems, weak research skills, high risk behavior. This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to, or can afford to take risks too! So, some do get interviews.


Bad grades and scores are the least of the deficits from a PD's standpoint. A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!

Just about everyone from a Caribbean school has one or more of these problems and PDs know it. That's why their grads are the last choice even with a high Step 1 score.

There was a time when folks whose only flaw was being a late bloomer went Carib, but those days are gone. There are a number of spots at US schools with grade replacement for these candidates."

It's likely you'll be in the bottom half or two thirds of the class that gets dismissed before Step 1. The business plan of a Carib school depends on the majority of the class not needing to be supported in clinical rotations. They literally can't place all 250+ of the starting class at clinical sites (educational malpractice, really. If this happened at a US school, they be shut down by LCME or COCA, and sued.

The Carib (and other offshore) schools have very tenuous, very expensive, very controversial relationships with a very small number of US clinical sites. You may think you can just ask to do your clinical rotations at a site near home. Nope. You may think you don't have to worry about this stuff. Wrong.

And let's say you get through med school in the Carib and get what you need out of the various clinical rotation scenarios. Then you are in the match gamble. I don't need to say a word about this - you can find everything you need to know at nrmp.org.

You really need to talk to people who made it through Carib into residency, and hear the story from them. How many people were in their class at the start, how many are in it now? How long did it take to get a residency, and how did they handle the gap year(s) and their student loans? How many residencies did they apply to, how many interviews did they get, and were any of the programs on their match list anything like what they wanted?

A little light reading:

https://milliondollarmistake.wordpress.com/

http://www.tameersiddiqui.com/medical-school-at-sgu

@Peach Newport It's one of those topics that we really need to trust those that are above/ahead of us. It doesn't fully make sense to me either when I compare the match lists, but I have no doubt that if we even remotely considered going the Carib route, we'd understand everything they're saying and be in agreement with them.

 

[GypsyHummus]

Now the big question is, if we had no other choice, do we go to the Caribbean, or do we go to pharmacy school? Both are bad choices that should be avoided, but which one's the worst?

With pharmacy school, you are looking at a relatively steady income of 120K, but you will be miserable for the majority of your adult life and be in 250k debt. Plus there is a big time saturation situation. However, most people graduate.

Caribbean fails 40% of their class, so it's possible to go 150k in debt with no job.

Decisions decisions.

If u wanna spice it up: Optometry vs carribean.

 

[MADD!!!]

Now the big question is, if we had no other choice, do we go to the Caribbean, or do we go to pharmacy school? Both are bad choices that should be avoided, but which one's the worst?

With pharmacy school, you are looking at a relatively steady income of 120K, but you will be miserable for the majority of your adult life and be in 250k debt. Plus there is a big time saturation situation. However, most people graduate.

Caribbean fails 40% of their class, so it's possible to go 150k in debt with no job.

Decisions decisions.

If u wanna spice it up: Optometry vs carribean.

Off topic. We're not talking about money here, just focusing on various ways to become the physicians we aspire to be.

 

[Mikkus]

Thank you so much for your response! I just have a few questions as I'm learning and still confused. 1) I'm saying the matches are good because they are even affiliated with Icahn, which is a top medical center in general. 2) For Internal Medicine (IM), I'm considering (possibly incorrectly) that going to any of these IM residencies would put you in a good position for a competitive fellowship such as Cards or Gastro, 3) Again, these are matches from the Carribean!!! I'm not trying to say people from the Carribean are getting into Ivy League residencies, but even the fact that they're getting into ones that are even affiliated with a place like Icahn is still better than a local community hospital in a rural city? (I know I have a lot of biases here, and I want to hear your opinion on them. Definitely not saying i'm right, I'm probably wrong on a few or most of these, but this is my train of thought and would like to hear your take on it).

I think most of this is just you not understanding since you haven't been through a match. When you interview at one of these satellite hospitals, you will understand. You cannot say the matches are good just because they are affiliated with a name. You cannot assume in general satellites will put you in a good position to get a good fellowship, it just doesn't work that way.
Satellites will not have the same connections, staff, research, or facilities. If you want examples, look at the UPMC satellites. Just attending one of these will not get you a Cleveland clinic cardio match.
Many of the matches on SGU's match list show a main hospital match when in actuality it is a satellite as well, which can be very misleading.
You also can't go by name, you really have to do some research into a program.
Remember, for Carib students to get in these top residencies, they needed much much better scores then their fellow DO and MD candidates. A 250 step might get a carib grad a few decent university interviews in IM, where that same score would put a student much further were they from a US school.
Some program directors also don't want to be judged on how many IMG's a program has, so taking a mediocre USMD looks better on a program than a stellar IMG.

 

[AlteredScale]

Thank you so much for your response! I just have a few questions as I'm learning and still confused. 1) I'm saying the matches are good because they are even affiliated with Icahn, which is a top medical center in general. 2) For Internal Medicine (IM), I'm considering (possibly incorrectly) that going to any of these IM residencies would put you in a good position for a competitive fellowship such as Cards or Gastro, 3) Again, these are matches from the Carribean!!! I'm not trying to say people from the Carribean are getting into Ivy League residencies, but even the fact that they're getting into ones that are even affiliated with a place like Icahn is still better than a local community hospital in a rural city? (I know I have a lot of biases here, and I want to hear your opinion on them. Definitely not saying i'm right, I'm probably wrong on a few or most of these, but this is my train of thought and would like to hear your take on it).

When you are a resident at the main university hospital the amount of resources at your command are enormous. Take for example being at Mount Sinai Hospital as an IM resident. Icahn school of medicine is across the street from the hospital. Let's say you're highly interested in doing bench research with an well known PI in cardiovascular disease during your protected research time (which is also usually inclusive of IM tracks at university programs). That PI may also be a professor within the dept that you wish to do a fellowship in. You show them you can produce scholarly work, you've made a connection that's probably helped your chances of matching in house much stronger.

Mt Sinai St Luke's doesn't offer the same types of resources making it harder to do the work that helps to shape your CV for applying to fellowship. Is it impossible? Of course not. But the types of projects you can work on while a resident at the main campus are probably far stronger and have people with a stronger influence in the field than those that you'd find Asa resident at St Luke's.




Sent from my iPhone using SDN mobile

 

[the argus]

just to clear up some of the factual innaccuracies in this thread...

I don't have the data with me, but I'm fairly certain that even if you did survive to the match (which is already a long'ish shot); your chances in the match are something on the order of 50:50 at best. But if you somehow end up snagging a surgical prelim on your 5th year attempting to match, SGU is going to put your match up on their list without another word. They won't share the data on how many attempts each match may represent. Many schools don't even delineate prelim vs. Categorical matches.

This is a gross misinterpretation and misrepresentation of what the data in the NRMP reports actually represents. US-IMGs are not broken down into seniors vs grads. The big Caribbean schools have first time placement rates of new grads, what most people call "match rate," of 80-90% (granted this doesn't include those lost to attrition prior to graduation). If you look at the ECFMG Charting Outcomes document using 2013 data, you can clearly see that the average time since graduation for unmatched US-IMGs is ~6 years. The majority of these unmatched people aren't fresh grads, they are repeat applicants. This is because there is a subset (5-10%) of caribbean grads that manage to graduate but are poor applicants (step failures, semester failures, etc) and can't match, and end up applying year after year. These people build up over time and skew the percentages in the NRMP reports. If you want to include these people when discussing "chances in the match" then you also have to include all the people from the previous 6 years that did match, otherwise you are way oversampling the yearly unmatched cohort.

I mean, if you want to see the horror up close and personal, just take a look in the SOAP thread down in the resident area of this forum. The overwhelming majority of folks in there are from off-shore schools. And the extremely overwhelming majority who don't succeed with the SOAP are from those schools as well. The few DO's and USMD's who are in there are generally picked up in the first round. By the second and third rounds it's a depressing blend of Carribean grads and FMG's.

Again, lots of this is just horribly untrue. Looking at the SOAP data from 2016,

USMD seniors: 2199 eligible, 635 positions accepted = 29% success rate
USMD previous grads: 995 eligible, 51 positions accepted = 5% success rate
DOs: 817 eligible, 132 positions accepted = 16% success rate
US-IMGs: 4020 eligible, 92 positions accepted = 2% success rate
foreign-IMGs: 5871 eligible, 78 positions accepted = 1% success rate

So firstly, the overwhelming majority of folks in the SOAP are not from offshore schools, 29% are. 29% are AMGs (USMD + DO) and 42% are foreign-IMGs. Secondly, no one does that well in the SOAP. There are more than a "few" AMGs in the SOAP, and the vast majority of them don't get positions. Yes, the success rates are better than for IMGs, but they still aren't very good.

 

[GypsyHummus]

Off topic. We're not talking about money here, just focusing on various ways to become the physicians we aspire to be.

Oh come on, indulge in the hypothetical for a bit.

And pharmacists and optometrists are deff doctors (although arguable for an OD to be called a physician) heck, in a couple states ODs can do minor laser surgery, so that can get a premed junkie's surgery fix (which many premeds idolize the life of a surgeon for some weird reason).

Bonus speculation, carribean vs podiatry school. That might be the most closely related comparison. Podiatry school have absurdly low requirements, but ultimately lead to someone becoming a surgeon. Much better way to be a surgeon than the carribean, and DPMs are still "technically" physicians as the law states (surgery, diagnosis, prescriptions, etc.)

 

[Wjldenver]

Oh come on, indulge in the hypothetical for a bit.

And pharmacists and optometrists are deff doctors (although arguable for an OD to be called a physician) heck, in a couple states ODs can do minor laser surgery, so that can get a premed junkie's surgery fix (which many premeds idolize the life of a surgeon for some weird reason).

Bonus speculation, carribean vs podiatry school. That might be the most closely related comparison. Podiatry school have absurdly low requirements, but ultimately lead to someone becoming a surgeon. Much better way to be a surgeon than the carribean, and DPMs are still "technically" physicians as the law states (surgery, diagnosis, prescriptions, etc.)

Gypsy...start a different thread if you are exploring other allied health careers.

 

[SLC]

just to clear up some of the factual innaccuracies in this thread...

This is a gross misinterpretation and misrepresentation of what the data in the NRMP reports actually represents. US-IMGs are not broken down into seniors vs grads. The big Caribbean schools have first time placement rates of new grads, what most people call "match rate," of 80-90% (granted this doesn't include those lost to attrition prior to graduation). If you look at the ECFMG Charting Outcomes document using 2013 data, you can clearly see that the average time since graduation for unmatched US-IMGs is ~6 years. The majority of these unmatched people aren't fresh grads, they are repeat applicants. This is because there is a subset (5-10%) of caribbean grads that manage to graduate but are poor applicants (step failures, semester failures, etc) and can't match, and end up applying year after year. These people build up over time and skew the percentages in the NRMP reports. If you want to include these people when discussing "chances in the match" then you also have to include all the people from the previous 6 years that did match, otherwise you are way oversampling the yearly unmatched cohort.

Again, lots of this is just horribly untrue. Looking at the SOAP data from 2016,

USMD seniors: 2199 eligible, 635 positions accepted = 29% success rate
USMD previous grads: 995 eligible, 51 positions accepted = 5% success rate
DOs: 817 eligible, 132 positions accepted = 16% success rate
US-IMGs: 4020 eligible, 92 positions accepted = 2% success rate
foreign-IMGs: 5871 eligible, 78 positions accepted = 1% success rate

So firstly, the overwhelming majority of folks in the SOAP are not from offshore schools, 29% are. 29% are AMGs (USMD + DO) and 42% are foreign-IMGs. Secondly, no one does that well in the SOAP. There are more than a "few" AMGs in the SOAP, and the vast majority of them don't get positions. Yes, the success rates are better than for IMGs, but they still aren't very good.

Look at the 2016 main match results and data sheet: http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

Page 1 clearly states that for Osteopathic grads the 2016 match rate was 80.3% the highest in over 30 years. This is for the subset of DO's who participate in the NRMP match. Total GME placement for DO's is consistently in the 98-99% range year over year. There is no huge pack of DO grads making multiple attempts at the match like there is for US-IMG's.

It also states that the match rate for US-IMG's was 53.9% (which is also the highest since 2005). However, when you factor in those Us-IMG's who withdrew or submitted no ROL, the match rate for US-IMG's drops to 38%.

Page 19 has a nice record of the match rates for US-IMG's which has hovered (as a percentage) in the high 40's to mid 50's range for a while now. (Again, this does not factor in the few thousand each year who withdraw or fail to submit a ROL).

So no, my post was not factually inaccurate.

As for SOAP, you attacked my post without reading it clearly. I invited folks to go to the SDN SOAP thread from last year and see who was in it and how it went down. It was there that the overwhelming majority in the thread were IMG's and the overwhelming majority of those who left SOAP empty handed were also IMG's. The USMD's and DO's seemed to pick up spots pretty quickly. Just an observation.

 

[the argus]

Look at the 2016 main match results and data sheet: http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

Page 1 clearly states that for Osteopathic grads the 2016 match rate was 80.3% the highest in over 30 years. This is for the subset of DO's who participate in the NRMP match. Total GME placement for DO's is consistently in the 98-99% range year over year. There is no huge pack of DO grads making multiple attempts at the match like there is for US-IMG's.

It also states that the match rate for US-IMG's was 53.9% (which is also the highest since 2005). However, when you factor in those Us-IMG's who withdrew or submitted no ROL, the match rate for US-IMG's drops to 38%.

Page 19 has a nice record of the match rates for US-IMG's which has hovered (as a percentage) in the high 40's to mid 50's range for a while now. (Again, this does not factor in the few thousand each year who withdraw or fail to submit a ROL).

So no, my post was not factually inaccurate.

As for SOAP, you attacked my post without reading it clearly. I invited folks to go to the SDN SOAP thread from last year and see who was in it and how it went down. It was there that the overwhelming majority in the thread were IMG's and the overwhelming majority of those who left SOAP empty handed were also IMG's. The USMD's and DO's seemed to pick up spots pretty quickly. Just an observation.

I'm not commenting on DO vs USIMG, enough has been said about that. I was just pointing out that your assertion that chances of a US-IMG matching are 50/50 is a misinterpretationof what the NRMP percentages represent. I know what the percentages are in the data reports, but as I explained above, those numbers don't represent what you are saying they do.

And as far as the SOAP, thats fine if that is your response. I just hope everyone realizes that your apparent summary commentary on the SDN SOAP threads doesn't at all accurately reflect actual outcomes in the SOAP.

 

[WedgeDawg]

Thank you so much for your response! I just have a few questions as I'm learning and still confused. 1) I'm saying the matches are good because they are even affiliated with Icahn, which is a top medical center in general.

That's not true. Many highly regarded programs have affiliated sites that are only the same as their main hospitals in name. I point to the Stamford/Columbia example. Stamford is a teaching affiliate of Columbia, but on the whole does not have nearly the same access to Columbia's resources as New York Presbyterian does.

2) For Internal Medicine (IM), I'm considering (possibly incorrectly) that going to any of these IM residencies would put you in a good position for a competitive fellowship such as Cards or Gastro

I don't know enough about internal medicine fellowship matching to give you an accurate answer here, sorry.

3) Again, these are matches from the Carribean!!! I'm not trying to say people from the Carribean are getting into Ivy League residencies, but even the fact that they're getting into ones that are even affiliated with a place like Icahn is still better than a local community hospital in a rural city? (I know I have a lot of biases here, and I want to hear your opinion on them. Definitely not saying i'm right, I'm probably wrong on a few or most of these, but this is my train of thought and would like to hear your take on it).

Any match from the Caribbean should be lauded as a "good" match because the alternative is generally not matching, but just because there is some sort of loose affiliation with a strong academic medical center doesn't mean that the residency is inherently better than another one.

 

[coffee-doc]

Caribbean refugee who dropped out after receiving a few secondaries and waitlist at DOs....It never came to fruition. He was convinced his GPA was the problem-- it wasn't. DOs and MDs don't want to take on carribean dropouts...so he lashed out at Goro--multiple times through multiple accounts. I gotta give it to him--he was persistent.

i know two people personally that have attained a spot at a US medical school , both DO, after dropping out of their first year in the Caribbean. I know it's possible, you just have to not be a dick and be as humble as possible

 

[Ho0v-man]

i know two people personally that have attained a spot at a US medical school , both DO, after dropping out of their first year in the Caribbean. I know it's possible, you just have to not be a dick and be as humble as possible

I know one as well. Said the way the Caribbean is set up that DO is MUCH easier to survive in addition to how it's just obviously safer which this latter point has already been thoroughly discussed.


Sent from my iPhone using SDN mobile

 

[MADD!!!]

I think most of this is just you not understanding since you haven't been through a match. When you interview at one of these satellite hospitals, you will understand. You cannot say the matches are good just because they are affiliated with a name. You cannot assume in general satellites will put you in a good position to get a good fellowship, it just doesn't work that way.
Satellites will not have the same connections, staff, research, or facilities. If you want examples, look at the UPMC satellites. Just attending one of these will not get you a Cleveland clinic cardio match.
Many of the matches on SGU's match list show a main hospital match when in actuality it is a satellite as well, which can be very misleading.
You also can't go by name, you really have to do some research into a program.
Remember, for Carib students to get in these top residencies, they needed much much better scores then their fellow DO and MD candidates. A 250 step might get a carib grad a few decent university interviews in IM, where that same score would put a student much further were they from a US school.
Some program directors also don't want to be judged on how many IMG's a program has, so taking a mediocre USMD looks better on a program than a stellar IMG.

When you are a resident at the main university hospital the amount of resources at your command are enormous. Take for example being at Mount Sinai Hospital as an IM resident. Icahn school of medicine is across the street from the hospital. Let's say you're highly interested in doing bench research with an well known PI in cardiovascular disease during your protected research time (which is also usually inclusive of IM tracks at university programs). That PI may also be a professor within the dept that you wish to do a fellowship in. You show them you can produce scholarly work, you've made a connection that's probably helped your chances of matching in house much stronger.

Mt Sinai St Luke's doesn't offer the same types of resources making it harder to do the work that helps to shape your CV for applying to fellowship. Is it impossible? Of course not. But the types of projects you can work on while a resident at the main campus are probably far stronger and have people with a stronger influence in the field than those that you'd find Asa resident at St Luke's.




Sent from my iPhone using SDN mobile

That's not true. Many highly regarded programs have affiliated sites that are only the same as their main hospitals in name. I point to the Stamford/Columbia example. Stamford is a teaching affiliate of Columbia, but on the whole does not have nearly the same access to Columbia's resources as New York Presbyterian does.



I don't know enough about internal medicine fellowship matching to give you an accurate answer here, sorry.



Any match from the Caribbean should be lauded as a "good" match because the alternative is generally not matching, but just because there is some sort of loose affiliation with a strong academic medical center doesn't mean that the residency is inherently better than another one.

Thank you all very much for the information! I'm glad to say I've learned something new from each of you today.

 

[OrdinaryDO]

 

[OrdinaryDO]

This may be a little late, but those statistics above clearly show that Osteopathic schools match well above the match rate of those Caribbean Schools.

 

[SLC]

And as far as the SOAP, thats fine if that is your response. I just hope everyone realizes that your apparent summary commentary on the SDN SOAP threads doesn't at all accurately reflect actual outcomes in the SOAP.

Your own statement earlier has IMG's as representing the single largest group in the SOAP. US-IMG's alone were as numerous as AMG's, Previous grad AMG's, and DO's (both current and previous grads; though there are basically no previous grad DO's due to the AOA fallback giving DO's a 99% placement rate each ear).

It also shows IMG's (both US and FMG's) as having by far the lowest success rate.

I'm not sure why you think my statement was "factually incorrect". IMG's do much worse in the match, and much worse in the SOAP than either AMG's or DO's. The numbers don't lie.

 

[the argus]

Your own statement earlier has IMG's as representing the single largest group in the SOAP. US-IMG's alone were as numerous as AMG's, Previous grad AMG's, and DO's (both current and previous grads; though there are basically no previous grad DO's due to the AOA fallback giving DO's a 99% placement rate each ear).

It also shows IMG's (both US and FMG's) as having by far the lowest success rate.

I'm not sure why you think my statement was "factually incorrect". IMG's do much worse in the match, and much worse in the SOAP than either AMG's or DO's. The numbers don't lie.

Since you said your earlier post about the SOAP was just a commentary on SDN SOAP threads, and not actual SOAP statistics, I can't argue with that. I don't read the SOAP threads in the ERAS forum so I have no idea about the background of the posters. But as I said before, your comments do not at all accurately reflect the actual statistics of the SOAP.

The overwhelming majority of folks in there are from off-shore schools.

The majority of people in the SOAP are not from offshore schools, 29% are (actually less because US-IMGs also come from India, etc). 29% are AMGs, and 42% are foreign-IMGs. There is no "overwhelming majority." The actual majority are foreign-IMGs, who do not come from "off-shore schools."

And the extremely overwhelming majority who don't succeed with the SOAP are from those schools as well.

Again, most people who are SOAP eligible don't succeed, regardless of educational background. But if there is an "extremely overwhelming majority who don't succeed with the SOAP," it would be foreign-IMGs, not people from "off-shore schools."

The few DO's and USMD's who are in there are generally picked up in the first round. By the second and third rounds it's a depressing blend of Carribean grads and FMG's.

There are more than "a few" DOs and USMDs in the SOAP. As shown above, they make up 29% of SOAP eligible people, the same as US-IMGs. And they most certainly are not "generally picked up in the first round." Overall, 21% of USMDs that are SOAP eligible get a position, and that number is 16% for DOs. That means ~80% of AMGs aren't picked up at all in the SOAP, regardless of round.



And your statement about chances of matching for a US-IMG being 50/50 is factually incorrect. The percentages in the NRMP are skewed by re-applicants as described above, which is way oversampling the poor applicant cohort from the previous years. If you look at US-IMGs <1 year from graduation in the match (the chart is somewhere in the NRMP reports, too lazy to find it right now), their match percentage is actually ~75%, which is very similar to the DO match rate in the NRMP.

 

[Marrowist]

Yawn...

 

[SLC]

Again, lots of this is just horribly untrue. Looking at the SOAP data from 2016,

USMD seniors: 2199 eligible, 635 positions accepted = 29% success rate
USMD previous grads: 995 eligible, 51 positions accepted = 5% success rate
DOs: 817 eligible, 132 positions accepted = 16% success rate
US-IMGs: 4020 eligible, 92 positions accepted = 2% success rate
foreign-IMGs: 5871 eligible, 78 positions accepted = 1% success rate

So firstly, the overwhelming majority of folks in the SOAP are not from offshore schools, 29% are. 29% are AMGs (USMD + DO) and 42% are foreign-IMGs. Secondly, no one does that well in the SOAP. There are more than a "few" AMGs in the SOAP, and the vast majority of them don't get positions. Yes, the success rates are better than for IMGs, but they still aren't very good.

9891/13902 = 71% IMG's in SOAP by your numbers. That's 7 out of every 10. I'd call that an overwhelming majority, wouldn't you?

4011/13902 = ~29% USMD, previous grad AMG, and DO combined.

USIMG's have a 2% success rate in SOAP. The next best group is previous grad AMG's who's success rate is poor but still slightly more than double that of USIMG's.

DO's SOAP success rate is 8x higher. USMD's is nearly 15x higher. Those are pretty big differences IMO.

At the end of SOAP, 3928 USIMG's were left without positions. There were 1564 current year AMG's, 944 prior grad USMD's and 685 DO's. Clearly out of these groups, US-IMG's are by far the single largest group.

My observation from the thread seems inline with the numbers you gave us.

Tell me where I'm saying anything that's not grounded in fact again?

 

[OrdinaryDO]

Just look at the charts. I broke down the major parts of the chart in my excel file I posted above. U.S. Caribbean schools have a very low Match rate.

 

[the argus]

Just look at the charts. I broke down the major parts of the chart in my excel file I posted above. U.S. Caribbean schools have a very low Match rate.

The problem with your chart, and which so many people on this forum also don't seem to get, is that you can't just look at the numbers and make assumptions without understanding where those numbers come from. Much like medicine, the devil is in the details.

As I've stated ad nauseam, those numbers do not represent the chances of matching for a fresh US-IMG grad in the match for the first time. They do represent that for USMDs and DOs because a) they separate USMD seniors vs grads, and 2) DOs have an overabundance of AOA only residency spots so very few DOs go unplaced year after year. But all the US-IMG re-applicants are included in those numbers. So when people say chances of matching are 50/50 for US-IMGs, they very clearly don't understand where those numbers come from.

 

[the argus]

9891/13902 = 71% IMG's in SOAP by your numbers. That's 7 out of every 10. I'd call that an overwhelming majority, wouldn't you?

4011/13902 = ~29% USMD, previous grad AMG, and DO combined.

USIMG's have a 2% success rate in SOAP. The next best group is previous grad AMG's who's success rate is poor but still slightly more than double that of USIMG's.

DO's SOAP success rate is 8x higher. USMD's is nearly 15x higher. Those are pretty big differences IMO.

At the end of SOAP, 3928 USIMG's were left without positions. There were 1564 current year AMG's, 944 prior grad USMD's and 685 DO's. Clearly out of these groups, US-IMG's are by far the single largest group.

My observation from the thread seems inline with the numbers you gave us.

Tell me where I'm saying anything that's not grounded in fact again?

When people say "off-shore schools," they are usually referring to just Caribbean grads, not all IMGs.

And look man, no one is arguing AMG outcomes aren't better in the SOAP than IMGs, I said as much in my first post. But your posts in this thread have, in my opinion (and some other people's), distorted reality. I've said my piece, people can read it and make their own opinions.

 

[SLC]

When people say "off-shore schools," they are usually referring to just Caribbean grads, not all IMGs.

And look man, no one is arguing AMG outcomes aren't better in the SOAP than IMGs, I said as much in my first post. But your posts in this thread have, in my opinion (and some other people's), distorted reality. I've said my piece, people can read it and make their own opinions.

I've used your stated numbers (and accepted them at face value without even verifying that they are even correct) to make my point. I've also directly cited the available numbers from the most recent match report to show that the USIMG match rate is in-fact right around 50%.

You've told us that the rate is higher, but have offered no hard data to back this up.

I agree, people will read this and make their own opinions. It was a pleasure debating this with you however!

 

[DetectiveAlonzo]

ahhhhhh snapppp. The boy Argus is in the cut! It's a party now!

 

[Goro]

This is why I have him on "Ignore". The sputtering about NRMP results while failing to understand any of the numbers got old very quickly.

ahhhhhh snapppp. The boy Argus is in the cut! It's a party now!

 

[the argus]

I've used your stated numbers (and accepted them at face value without even verifying that they are even correct) to make my point. I've also directly cited the available numbers from the most recent match report to show that the USIMG match rate is in-fact right around 50%.

You've told us that the rate is higher, but have offered no hard data to back this up.

I agree, people will read this and make their own opinions. It was a pleasure debating this with you however!

OK I'll try one more time about the US-IMG match rate. It's really not that hard of a concept. I will bold and underline the important parts, and include the citation.
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf

You say the match rate for US-IMGs is 53%, because that's what is listed in the NRMP reports. This number does not refer to first-time match rate (i.e. recent graduates applying to residency for the first time), which is what people are commonly referring to when saying "match rate." This is because the NRMP reports don't separate US-IMG seniors (i.e. in the match for the first time) and US-IMG grads (re-applicants). It does this for USMDs, but not for anyone else.

If you look at the ECFMG report from 2013 (page 5), you will see that the average time since graduation for the unmatched cohort of US-IMGs is 5.7 years. The majority of these people aren't fresh grads, they are re-applicants from previous years.

When quoting that 53% you are not actually describing US-IMGs in the match for the first time, you are describing all US-IMGs in the match regardless of how many times they have applied. There is without a doubt a percentage (~10%) of US-IMGs that manage to graduate from school, but are poor applicants (semester failures, step failures, etc) and are not able to ever match. This small yearly cohort continues to apply every year, builds up over time (hence the 5.7 years above), and drastically skews the US-IMG "match rate".

If you want to include those re-applicants when describing true US-IMG "match rates", then you also have to include all the applicants from those previous years that did successfully match. If you don't do this (like the NRMP data reports), you are way oversampling the poor applicant/unmatched cohort. The NRMP does actually recognize this because they split USMD applicants into those 2 groups, they just don't do it for IMGs for some reason.

People try to say the US MD vs US-IMG match rates are 94% vs 53%, which is in fact comparing 2 completely different data sets.

If you look through the ECFMG document, you will see that US-IMGs <1 year after graduation (listed for each specialty separately) have an overall match rate of ~75%. This is the cohort that is referred to when people commonly talk about "match rate." Granted this doesn't take into account attrition prior to the match, which is no doubt substantial.

Make sense? As Goro says, it's clearly me who doesn't understand these numbers.

 

[SLC]

OK I'll try one more time about the US-IMG match rate. It's really not that hard of a concept. I will bold and underline the important parts, and include the citation.
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf

You say the match rate for US-IMGs is 53%, because that's what is listed in the NRMP reports. This number does not refer to first-time match rate (i.e. recent graduates applying to residency for the first time), which is what people are commonly referring to when saying "match rate." This is because the NRMP reports don't separate US-IMG seniors (i.e. in the match for the first time) and US-IMG grads (re-applicants). It does this for USMDs, but not for anyone else.

If you look at the ECFMG report from 2013 (page 5), you will see that the average time since graduation for the unmatched cohort of US-IMGs is 5.7 years. The majority of these people aren't fresh grads, they are re-applicants from previous years.

When quoting that 53% you are not actually describing US-IMGs in the match for the first time, you are describing all US-IMGs in the match regardless of how many times they have applied. There is without a doubt a percentage (~10%) of US-IMGs that manage to graduate from school, but are poor applicants (semester failures, step failures, etc) and are not able to ever match. This small yearly cohort continues to apply every year, builds up over time (hence the 5.7 years above), and drastically skews the US-IMG "match rate".

If you want to include those re-applicants when describing true US-IMG "match rates", then you also have to include all the applicants from those previous years that did successfully match. If you don't do this (like the NRMP data reports), you are way oversampling the poor applicant/unmatched cohort. The NRMP does actually recognize this because they split USMD applicants into those 2 groups, they just don't do it for IMGs for some reason.

People try to say the US MD vs US-IMG match rates are 94% vs 53%, which is in fact comparing 2 completely different data sets.

If you look through the ECFMG document, you will see that US-IMGs <1 year after graduation (listed for each specialty separately) have an overall match rate of ~75%. This is the cohort that is referred to when people commonly talk about "match rate." Granted this doesn't take into account attrition prior to the match, which is no doubt substantial.

Make sense? As Goro says, it's clearly me who doesn't understand these numbers.

Nowhere in that document (that I've been able to find) does it show that those attempting for their first year have a 75% success rate. Perhaps you can point it out?

However, chart #3 on page 4 of the document lists the overall match rate even lower at 48% for US-IMG's in 2013 (2016 was a decent year apparently).

I understand what you're saying about oversampling. It makes sense. But I'm not just going to take your word for it. The only official info I've been able to find has the match rate for US-IMG's hovering around 50%. Hence my 50:50 chance of matching comment way back at the beginning of the thread.

 

[the argus]

Nowhere in that document (that I've been able to find) does it show that those attempting for their first year have a 75% success rate. Perhaps you can point it out?

However, chart #3 on page 4 of the document lists the overall match rate even lower at 48% for US-IMG's in 2013 (2016 was a decent year apparently).

I understand what you're saying about oversampling. It makes sense. But I'm not just going to take your word for it. The only official info I've been able to find has the match rate for US-IMG's hovering around 50%. Hence my 50:50 chance of matching comment way back at the beginning of the thread.

There's a graph for each specialty listing months since graduation and matched vs unmatched (page 38 for GAS, page 54 for EM, etc), add them up and it comes out to ~75%.


And the reason that 48% is listed is because, as stated on page iii,

"For purposes of this report, match success is defined as a match to the specialty of the applicant’s first-ranked program because that is assumed to be the specialty of choice ... Lack of match success includes matching to another specialty as well as failure to match at all."

So if you had an EM program ranked 1, but matched at an IM program ranked 3, this report would count you as unmatched. There's a significant percentage of people that fall into this group, which is why the match rate is lower in this report than in the general NRMP reports.


The minute Goro starts agreeing with me is when I will be worried. I'm comfortable as long as he disagrees. That dude is terrible.

 

[WedgeDawg]

Regardless of veracity of information or difference of opinion, whatever it may happen to be, please refrain from personal attacks or calling out other users. And that goes for everyone throughout all of SDN.

 

[OrdinaryDO]

What I don't understand is why Argus is even arguing the point about the IMG's being first year matriculating residents or not..There was obviously a reason those IMG's didn't earn a residency match the first go-around, therefore the 53% match rate is still a reliable source of information. In order to reach a 53% residency match rate you would need to have one of these ratios; 90/10, 80/20, 70/30, 60/40, 50/50 and vice versa for those who are senior residency matches and those who are not...None of those ratios are good IMHO.

 

[DetectiveAlonzo]

Everytime one of these threads pops up...





FIGHT!

 

[the argus]

What I don't understand is why Argus is even arguing the point about the IMG's being first year matriculating residents or not..There was obviously a reason those IMG's didn't earn a residency match the first go-around, therefore the 53% match rate is still a reliable source of information. In order to reach a 53% residency match rate you would need to have one of these ratios; 90/10, 80/20, 70/30, 60/40, 50/50 and vice versa for those who are senior residency matches and those who are not...None of those ratios are good IMHO.

Because facts and reality matter. 75/25 is different from 50/50.

The only reason I post on these forums is because when I was looking for this information trying to make this decision, SDN wasn't very helpful. When I started looking at the actual numbers, I realized that there was tons of misinformation on this website, and much of it stemmed from the same handful of people posting the same nonsense over and over.

I don't "advise" people to make certain decisions or not. All I do is try to present the actual information grounded in reality so people can make up their own minds. As it turns out, just correcting other people's untruths is a pretty time intensive job on this forum.

And again, I'm not anti-DO or pro-Caribbean. I don't view the world in this IMG vs DO paradigm that is so prevalent on these forums. I'm pro-reality and anti-nonsense.

 

[cliquesh]

Not that it means anything but my program does not consider Caribbean grads. They will take FMGs, though

 

[OrdinaryDO]

Argus, there are no such thing as "fake" numbers. You can look at the Caribbean match rate from decades ago and see that the trend has been getting more and more worse. Furthermore, Caribbean schools are known for their high attrition rates and major class size - Their rotations are virtually non-existent unless they buy them outright from a hospital, which will probably come to an end sometime soon. Caribbean schools aren't even a consideration for a last resort option for a lot of students mainly because of their reputation with being vastly sub-par..

 

[Goro]

Save your breath. Some people need to have their risky choices confirmed and affirmed.

Argus, there are no such thing as "fake" numbers. You can look at the Caribbean match rate from decades ago and see that the trend has been getting more and more worse. Furthermore, Caribbean schools are known for their high attrition rates and major class size - Their rotations are virtually non-existent unless they buy them outright from a hospital, which will probably come to an end sometime soon. Caribbean schools aren't even a consideration for a last resort option for a lot of students mainly because of their reputation with being vastly sub-par..

 

[BeachBlondie]

OK I'll try one more time about the US-IMG match rate. It's really not that hard of a concept. I will bold and underline the important parts, and include the citation.
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf

You say the match rate for US-IMGs is 53%, because that's what is listed in the NRMP reports. This number does not refer to first-time match rate (i.e. recent graduates applying to residency for the first time), which is what people are commonly referring to when saying "match rate." This is because the NRMP reports don't separate US-IMG seniors (i.e. in the match for the first time) and US-IMG grads (re-applicants). It does this for USMDs, but not for anyone else.

If you look at the ECFMG report from 2013 (page 5), you will see that the average time since graduation for the unmatched cohort of US-IMGs is 5.7 years. The majority of these people aren't fresh grads, they are re-applicants from previous years.

When quoting that 53% you are not actually describing US-IMGs in the match for the first time, you are describing all US-IMGs in the match regardless of how many times they have applied. There is without a doubt a percentage (~10%) of US-IMGs that manage to graduate from school, but are poor applicants (semester failures, step failures, etc) and are not able to ever match. This small yearly cohort continues to apply every year, builds up over time (hence the 5.7 years above), and drastically skews the US-IMG "match rate".

If you want to include those re-applicants when describing true US-IMG "match rates", then you also have to include all the applicants from those previous years that did successfully match. If you don't do this (like the NRMP data reports), you are way oversampling the poor applicant/unmatched cohort. The NRMP does actually recognize this because they split USMD applicants into those 2 groups, they just don't do it for IMGs for some reason.

People try to say the US MD vs US-IMG match rates are 94% vs 53%, which is in fact comparing 2 completely different data sets.

If you look through the ECFMG document, you will see that US-IMGs <1 year after graduation (listed for each specialty separately) have an overall match rate of ~75%. This is the cohort that is referred to when people commonly talk about "match rate." Granted this doesn't take into account attrition prior to the match, which is no doubt substantial.

Make sense? As Goro says, it's clearly me who doesn't understand these numbers.

Not trying to start a flame war -- I'm just presenting the stats:

The basis of your argument seems to be the inconsistency in sampling between the USMGs and the IMGs, right (I'm going to go ahead and lump all non-US grads as "IMG", although it seems in previous posts that you're stratifying that group further)? So, you conclude that the reporting is therefore unstandardized and cannot be taken into account, yes? I think I've covered your point of view.

So, two things stand out to me (and, again, I'm not arguing for or against, I'm just putting this out there for the sake of those that are looking for answers in the future).

1) If you run a z-test on the proportion of SENIOR matches for each group (the categorical classifications being "matched" and "non-matched"; USMG 94%, IMG 75% ), you reject the null hypothesis and conclude that the proportion of seniors that match, from a non-US school, is statistically significantly lower that seniors from a US school (p<0.05).

2) (Taking into account seniors and non-seniors now) The time since graduation is between 1 and 2 years for the match for USMGs; the time since graduation is between 4 and 5 years for the match for IMGs (page 3 of the NRMP and ECFMG Outcomes). This time frame also represents a statistically significant difference (p < 0.o5).

So, as a current pre-med, I am left to look at these numbers and make a judgement call. I can tell you that if I was offered the option of 2 treatment modalities for my acute asthma attacks, and my pulmonologist says, "Ok, option A has a statistically significant less likelihood of working, and--on average--it takes statistically significantly longer to work," I would elect, immediately, for option B.

If I can quote you, "The only reason I post on these forums is because when I was looking for this information trying to make this decision, SDN wasn't very helpful. When I started looking at the actual numbers, I realized that there was tons of misinformation on this website, and much of it stemmed from the same handful of people posting the same nonsense over and over." Great, and I think that's commendable. So, rather than watching people make a bunch of subjective arguments, I've provided a basic, objective statistical analysis.... still paints a pretty drab picture, though.

 

[the argus]

Argus, there are no such thing as "fake" numbers. You can look at the Caribbean match rate from decades ago and see that the trend has been getting more and more worse. Furthermore, Caribbean schools are known for their high attrition rates and major class size - Their rotations are virtually non-existent unless they buy them outright from a hospital, which will probably come to an end sometime soon. Caribbean schools aren't even a consideration for a last resort option for a lot of students mainly because of their reputation with being vastly sub-par..

Not to be harsh, but this exactly the type of afactual nonsense that I was talking about. And BTW, the reason Goro blocks me is because I actually call him out on his nonsense and ask him for proof for the statements he makes. He has never once provided any proof. He then just tries to discredit me (like he's doing now), without ever actually disproving anything I write.

You can look at the Caribbean match rate from decades ago and see that the trend has been getting more and more worse.

Nope, not even remotely true. Taken directly from page 1 of the NRMP 2016 match report,

"The number of active U.S. citizen IMGs increased by 309 from 2015 ... The match rate for those applicants was 53.9 percent, the highest since 2005."

Wanna go back even further? Look at the 1995 NRMP report. The US-IMG match rate from that year was 49.8%, which is actually less than 53.9%!! Going back into the 1980s, the US-IMG match rate has varied from the high 40s to high 50s with gradual increases and decreases.
http://www.nrmp.org/match-data/main-residency-match-data/
http://www.nrmp.org/match-data/nrmp-historical-reports/

Their rotations are virtually non-existent unless they buy them outright from a hospital, which will probably come to an end sometime soon.

Don't want to burst your bubble, but some US schools (especially DO) pay for rotations too. And who says that will come to an end soon? Where are you getting this information? They have been doing this for over 30 years. Ross just built a new multi-million dollar student center on Dominica, so they certainly don't think the end is coming soon for Caribbean schools. I would think they know a little more about this than you or I.

Caribbean schools aren't even a consideration for a last resort option for a lot of students mainly because of their reputation with being vastly sub-par.

That's fine, people are allowed to make their own decisions. And excuse my directness, but I don't put much weight into the opinions of premeds.

 

[the argus]

Not trying to start a flame war -- I'm just presenting the stats:

The basis of your argument seems to be the inconsistency in sampling between the USMGs and the IMGs, right (I'm going to go ahead and lump all non-US grads as "IMG", although it seems in previous posts that you're stratifying that group further)? So, you conclude that the reporting is therefore unstandardized and cannot be taken into account, yes? I think I've covered your point of view.

So, two things stand out to me (and, again, I'm not arguing for or against, I'm just putting this out there for the sake of those that are looking for answers in the future).

1) If you run a z-test on the proportion of SENIOR matches for each group (the categorical classifications being "matched" and "non-matched"; USMG 94%, IMG 75% ), you reject the null hypothesis and conclude that the proportion of seniors that match, from a non-US school, is statistically significantly lower that seniors from a US school (p<0.05).

2) (Taking into account seniors and non-seniors now) The time since graduation is between 1 and 2 years for the match for USMGs; the time since graduation is between 4 and 5 years for the match for IMGs (page 3 of the NRMP and ECFMG Outcomes). This time frame also represents a statistically significant difference (p < 0.o5).

So, as a current pre-med, I am left to look at these numbers and make a judgement call. I can tell you that if I was offered the option of 2 treatment modalities for my acute asthma attacks, and my pulmonologist says, "Ok, option A has a statistically significant less likelihood of working, and--on average--it takes statistically significantly longer to work," I would elect, immediately, for option B.

If I can quote you, "The only reason I post on these forums is because when I was looking for this information trying to make this decision, SDN wasn't very helpful. When I started looking at the actual numbers, I realized that there was tons of misinformation on this website, and much of it stemmed from the same handful of people posting the same nonsense over and over." Great, and I think that's commendable. So, rather than watching people make a bunch of subjective arguments, I've provided a basic, objective statistical analysis.... still paints a pretty drab picture, though.

The question is not USMD vs IMG outcomes in the match. There is no question USMDs have better overall outcomes. As I've said many times on this forum, people should apply 2-3 cycles to US schools before considering going to the Caribbean.

The question is, once you have exhausted US-based options, is the Caribbean a viable alternative? That is the question I am referring to when saying "when I was looking for this information trying to make this decision."

Of course going to school in the US is preferred. But the fact remains that there are more people in the US capable of becoming competent physicians than available positions in US medical schools (at least >2500 yearly, as this is how many US-IMGs place into residency every year). There is also a need for way more resident physicians than the US medical education system provides (>6500 IMGs place every year).

So should someone go to the Caribbean? I don't know, that's a decision they need to make for themself. My goal is to provide the best information to help them make that decision. Just because some random non-physician PhD who teaches basic science at an osteopathic medical school thinks it's a bad idea doesn't mean thats the be all end all. There's a ton of disinformation posted on SDN by people that really have no idea what they are talking about, this thread being a perfect example of that.

 

[BeachBlondie]

The question is not USMD vs IMG outcomes in the match. There is no question USMDs have better overall outcomes. As I've said many times on this forum, people should apply 2-3 cycles to US schools before considering going to the Caribbean.

The question is, once you have exhausted US-based options, is the Caribbean a viable alternative? That is the question I am referring to when saying "when I was looking for this information trying to make this decision."

Of course going to school in the US is preferred. But the fact remains that there are more people in the US capable of becoming competent physicians than available positions in US medical schools (at least >2500, as this is how many US-IMGs place into residency every year). There is also a need for way more resident physicians than the US medical education system provides (>6500 IMGs place every year).

So should someone go to the Caribbean? I don't know, that's a decision they need to make for themself. My goal is to provide the best information to help them make that decision. Just because some random non-physician PhD who teaches basic science at an osteopathic medical school thinks it's a bad idea doesn't mean thats the be all end all. There's also a ton of disinformation posted on SDN by people that really have no idea what they are talking about (see above).

I see. So, by your experience (since you've made it through), you would then suggest that someone attend the Caribbean over, say, PA school? This is in consideration of the fact that match odds are statistically worse and that a person risks making a pretty big financial investment for the former option?

 

[the argus]

I see. So, by your experience (since you've made it through), you would then suggest that someone attend the Caribbean over, say, PA school? This is in consideration of the fact that match odds are statistically worse and that a person risks making a pretty big financial investment for the former option?

There's no one size fits all answer to this question. Lots of factors come into play.

Do you want to be a physcian, or are you comfortable being a physician's assistant? The jobs, depending on your field, will be very different. The pay is also very different.

What's the reason you couldn't get into a US medical school? Were you a non-trad with poor undregrad performance but a good MCAT score and ability to take standardized tests, or are you a traditional premed who just couldn't handle the workload/MCAT? The former would do better than the latter in my opinion.

Do you know what caused your deficiencies and how do you plan on fixing them?

People that make it through the Caribbean without any major red flags (semester failures, step failures, etc) do very well. The overall first time match rate for Ross/SGU has been 85-90% the past couple years. 99% of Ross students who pass the Steps with no failures match within 2 years. 91% of Ross grads match within 2 years regardless of number of step/semester failures. Granted this is after attrition, which for my year was 25% the vast majority occuring in the first year. Most matches are in primary care specialties. The main issues are Caribbean schools will basically take anyone, and have no problem failing people out if they can't keep up. They will also let you continue after failing semesters/steps, which are major red flags when applying for residency.

So people need to be honest with themselves about their deficiencies, and decide the level of uncertainty they are comfortable with.

 

[VolibearMain]

There's no one size fits all answer to this question. Lots of factors come into play.

Do you want to be a physcian, or are you comfortable being a physician's assistant? The jobs, depending on your field, will be very different. The pay is also very different.

What's the reason you couldn't get into a US medical school? Were you a non-trad with poor undregrad performance but a good MCAT score and ability to take standardized tests, or are you a traditional premed who just couldn't handle the workload/MCAT? The former would do better than the latter in my opinion.

Do you know what caused your deficiencies and how do you plan on fixing them?

People that make it through the Caribbean without any major red flags (semester failures, step failures, etc) do very well. The overall first time match rate for Ross/SGU has been 85-90% the past couple years. 99% of Ross students who pass the Steps with no failures match within 2 years. 91% of Ross grads match within 2 years regardless of number of step/semester failures. Granted this is after attrition, which for my year was 25% the vast majority occuring in the first year. Most matches are in primary care specialties. The main issues are Caribbean schools will basically take anyone, and have no problem failing people out if they can't keep up. They will also let you continue after failing semesters/steps, which are major red flags when applying for residency.

So people need to be honest with themselves about their deficiencies, and decide the level of uncertainty they are comfortable with.

A lot of your time can be wasted on SDN by contributing to these types of forums. It is the same cohort of pre-meds marching behind the same group of administrators who have the same copy pasta response.

Utilize the wonderful functions of this website as so, you will save your self a lot of headache.

The answer to this debate is: US MD, US MD, US MD.

Anything else is debatable.