Could the IMGs answer a question please?

[Auvelity]

Hello!
As many here my dream is EM. and I took step 1 and CS already (grades pending) and gonna start preparing for CK. but got no SLOE for the upcoming match. I already graduated so rotations are hardddd to get. and I mean I emailed nearly 100 programs with no positive replies regarding observership or anything. so does anyone knows what else can I do? 🙁 I would really love to match in 2017

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[FallingFromSpace]

Hello!
As many here my dream is EM. and I took step 1 and CS already (grades pending) and gonna start preparing for CK. but got no SLOE for the upcoming match. I already graduated so rotations are hardddd to get. and I mean I emailed nearly 100 programs with no positive replies regarding observership or anything. so does anyone knows what else can I do? 🙁 I would really love to match in 2017

Next year may be hard to do as an IMG, as emergency is a tough field to get in to- only one unfilled spot in straight EM this year, two in EM/IM, and you'll need the SLOE for sure. An observership won't do you any good- don't even bother. These places will want to see how you actually perform, so you'll need to do an actual clerkship vs rotation, and actually touch the patient. Regarding finding one, I can only wish you good luck, as I don't have any contacts in that sort of thing.

What I can do is offer an alternative path- not an easy one, unfortunately, but it can work and gives you some options. Consider a prelim year, preferably at a place with a good, (but not very competitive) emergency medicine program that has a history of taking IMGs, and make sure that it's a place where your prelim program director will support you and make sure to schedule an early EM rotation. Establish good relationships with the faculty and residents in the EM program and work your tail off, being clear from the beginning that this is what you want to do, you would appreciate feedback, and that you're looking for a recommendation.

Key thing with this path: it's not easy- you'll work for a year with no guarantee of getting a position and your chances will still not be great, so your best chance will be at that home program that really knows you, (again, don't go for a super competitive place, and make sure they have taken IMGs). You have to nail it, and it's best to have some backups in IM or FM just in case.

Good luck!

 

[Cinematographer]

No SLOE + IMG means you are very, very unlikely to match into EM. As stated above a Prelim year might be your best choice. Good luck.

 

[?atypical CP]

I am a Foreign-IMG who thankfully matched into EM today. Had 2 SLOEs and interviewed at/ranked 9 programs. At most of my interviews I was the only IMG. Met a few MS4 US-IMGs, but they all had SLOEs. I did meet maybe 2-3 Foreign-IMGs in total. Of those, all were PGY-2+, had no SLOEs, and had plenty of experience in the ED as junior physicians in their home countries which were all Anglophone commonwealth nations.

It would help to know more about your situation: visa status/Citizenship, what are you doing post-grad, did you go to a recognized international medical school, can you acquire letters from EM physicians etc

 

[Auvelity]

thank you guys for the input. greatly appreciated.

I graduated in Nov. Im back in my country preparing boards. hopefully will take even step 3 by the match season. and working as a plastic surgery assistant.
I am a Non US IMG from a Not well recognized caribbean medical school. I did a rotation in the US but it was from surgery. so my LORS so far come from US internal med and surgery doctors. In surgery was were I got the little exposure to Emergency Medicine during the trauma calls that made me fall in love for it. but during those I only interacted with the residents shortly because after that we went to CT and took our patients out of the ER lol.
I am going to try again emailing some programs or maybe get an externship at some urgent care. it wont probably be an SLOE but at least will be a letter from an EM doc right?

 

[racerwad]

thank you guys for the input. greatly appreciated.

I graduated in Nov. Im back in my country preparing boards. hopefully will take even step 3 by the match season. and working as a plastic surgery assistant.
I am a Non US IMG from a Not well recognized caribbean medical school. I did a rotation in the US but it was from surgery. so my LORS so far come from US internal med and surgery doctors. In surgery was were I got the little exposure to Emergency Medicine during the trauma calls that made me fall in love for it. but during those I only interacted with the residents shortly because after that we went to CT and took our patients out of the ER lol.
I am going to try again emailing some programs or maybe get an externship at some urgent care. it wont probably be an SLOE but at least will be a letter from an EM doc right?

Unfortunately, a letter from an UC doc will not your application one bit. You really must figure out a way to get some SLOEs. It's an uphill battle. Good luck.

 

[bashwell]

I am a Foreign-IMG who thankfully matched into EM today. Had 2 SLOEs and interviewed at/ranked 9 programs. At most of my interviews I was the only IMG. Met a few MS4 US-IMGs, but they all had SLOEs. I did meet maybe 2-3 Foreign-IMGs in total. Of those, all were PGY-2+, had no SLOEs, and had plenty of experience in the ED as junior physicians in their home countries which were all Anglophone commonwealth nations.

It would help to know more about your situation: visa status/Citizenship, what are you doing post-grad, did you go to a recognized international medical school, can you acquire letters from EM physicians etc

Just curious if you know whether the 2-3 foreign IMGs without SLOEs but plenty of ED experience in Anglophone Commonwealth nations were able to match? That sounds like me, except I'm a dual US-Australian citizen.

 

[gro2001]

Hello!
As many here my dream is EM. and I took step 1 and CS already (grades pending) and gonna start preparing for CK. but got no SLOE for the upcoming match. I already graduated so rotations are hardddd to get. and I mean I emailed nearly 100 programs with no positive replies regarding observership or anything. so does anyone knows what else can I do? 🙁 I would really love to match in 2017

I am a non US IMG. I do not want to discourage you, but you need to be totally clear about this: you have zero chance of matching in EM without an SLOE. Even with one it will be difficult as you have a lot of things going against you (no name recognition from school, lack of EM experience, visa issues, etc), but you will not be able to match at all without one. However, as you are not a US senior, you are able to accept positions outside of the match.

In fact, as I see it, you have 3 options:

1) Find some way to get an SLOE and go through the match. I realize this is difficult to impossible to arrange post graduation. Do not full yourself into thinking 'observerships' or anything short of a real SLOE will somehow do. If getting an SLOE is impossible at this time, forget about this option completely.

2) Find a position outside of the match. This all depends on your network. Who do you know that can call an EM Residency Program Director and have them consider your application outside of the match? If the answer is no one, look one degree of separation away: who do you know who can call someone who is close to an EM PD? If the answer is still no one, you don't have much of a network unfortunately and this option is closed to you as well.

3) Do a prelim year and try again through option 1 or 2. Prelim years suck. But they don't suck quite as much as not matching or doing an entire residency in a specialty you don't like. If options 1 and 2 are not possible, this may be your best option. Do it at a place that will allow you to interact with, and rotate at, a non competitive EM program. Get lots of time with the PD throughout your prelim year. Find an EM faculty member in that program who would be willing to mentor you. Make friends with the EM residents.

4) Do another residency like IM or FM and consider doing a second residency afterwards if you are still in love with EM. If you can stand to do that, do it. At least this way you will be on solid ground of some sort. If somehow at the end of all this you realize you can't live without EM, you can always do a second residency. Not a lot more time than doing a fellowship (if you go to a 3 year EM residency) and you will be able to add breadth to your clinical work by mixing clinic time with ED time (though you probably won't).

5) Aim for your second choice specialty. EM is tough. None of the above options are guaranteed to work. In fact, I will tell you right now, most likely none of them will work. But, there are plenty of good specialties out there. Lots of the things you like about EM you can probably find in FM or IM.

Edit:
So apparently there is a rule I was unaware of. Now programs have to go "all in" or "all out" in terms of offering positions through the match, meaning that if they offer any position outside of the match, they can not participate in the match at all. This is an unfortunate development for FMGs, which makes things even more difficult for them.

 

[gro2001]

Just curious if you know whether the 2-3 foreign IMGs without SLOEs but plenty of ED experience in Anglophone Commonwealth nations were able to match? That sounds like me, except I'm a dual US-Australian citizen.

They almost certainly accepted positions outside of the match.

 

[DeadCactus]

thank you guys for the input. greatly appreciated.

I graduated in Nov. Im back in my country preparing boards. hopefully will take even step 3 by the match season. and working as a plastic surgery assistant.
I am a Non US IMG from a Not well recognized caribbean medical school. I did a rotation in the US but it was from surgery. so my LORS so far come from US internal med and surgery doctors. In surgery was were I got the little exposure to Emergency Medicine during the trauma calls that made me fall in love for it. but during those I only interacted with the residents shortly because after that we went to CT and took our patients out of the ER lol.
I am going to try again emailing some programs or maybe get an externship at some urgent care. it wont probably be an SLOE but at least will be a letter from an EM doc right?

The SLOE and being competitive aside, talking to some EM residents while rotating on trauma is not going to convince any program you really want to do EM or even know what being in EM is about. If you don't have some other experiences to speak from, you're going to need legitimate EM rotations just to be taken as a serious applicant...

 

[Auvelity]

Well guys thank you. I must say I feel very sad of knowing this but appreciate the honesty. Im gonna see how I could get a hands on experience on EM and knock on every door again. because I really want this. if not then try to get a transitional or med prelim where I could get into the ED soon and try to get some connections there. if not then I will have to find a second option on what to do... if any of you guys know anywhere I could get some externship or something at this point please PM me. thank you!

 

[Turfandbuff]

I am a non US IMG. I do not want to discourage you, but you need to be totally clear about this: you have zero chance of matching in EM without an SLOE. Even with one it will be difficult as you have a lot of things going against you (no name recognition from school, lack of EM experience, visa issues, etc), but you will not be able to match at all without one. However, as you are not a US senior, you are able to accept positions outside of the match.

In fact, as I see it, you have 3 options:

1) Find some way to get an SLOE and go through the match. I realize this is difficult to impossible to arrange post graduation. Do not full yourself into thinking 'observerships' or anything short of a real SLOE will somehow do. If getting an SLOE is impossible at this time, forget about this option completely.

2) Find a position outside of the match. This all depends on your network. Who do you know that can call an EM Residency Program Director and have them consider your application outside of the match? If the answer is no one, look one degree of separation away: who do you know who can call someone who is close to an EM PD? If the answer is still no one, you don't have much of a network unfortunately and this option is closed to you as well.

3) Do a prelim year and try again through option 1 or 2. Prelim years suck. But they don't suck quite as much as not matching or doing an entire residency in a specialty you don't like. If options 1 and 2 are not possible, this may be your best option. Do it at a place that will allow you to interact with, and rotate at, a non competitive EM program. Get lots of time with the PD throughout your prelim year. Find an EM faculty member in that program who would be willing to mentor you. Make friends with the EM residents.

4) Do another residency like IM or FM and consider doing a second residency afterwards if you are still in love with EM. If you can stand to do that, do it. At least this way you will be on solid ground of some sort. If somehow at the end of all this you realize you can't live without EM, you can always do a second residency. Not a lot more time than doing a fellowship (if you go to a 3 year EM residency) and you will be able to add breadth to your clinical work by mixing clinic time with ED time (though you probably won't).

5) Aim for your second choice specialty. EM is tough. None of the above options are guaranteed to work. In fact, I will tell you right now, most likely none of them will work. But, there are plenty of good specialties out there. Lots of the things you like about EM you can probably find in FM or IM.

Edit:
So apparently there is a rule I was unaware of. Now programs have to go "all in" or "all out" in terms of offering positions through the match, meaning that if they offer any position outside of the match, they can not participate in the match at all. This is an unfortunate development for FMGs, which makes things even more difficult for them.

I'm FMG & I did all the above. so far I failed 3 times match into EM. But I'm finishing IM now.
you need EM faculty that will fight for you if you are a foreign IMG.

 

[gro2001]

I'm FMG & I did all the above. so far I failed 3 times match into EM. But I'm finishing IM now.
you need EM faculty that will fight for you if you are a foreign IMG.

Sorry to hear you had such a hard time. Good on you for persevering and getting the best out of a tough situation.