Did I make a mistake?

[VowelMovement]

Ok so I'm a U.S. born citizen who went to pakistan after high school for med school. I had many reasons for going (saves time, admission is a little easier, cheaper). I didn't take the Caribbean route because i'm pakistani and i had some family there that could take care of me if i needed anything. Right now I'm done with my first year and passed all my exams, I'm overall really happy with my life there...not how i expected studying there would be (since i'm on campus almost 24/7 i didn't get a chance to see the 3rd world-ness lol). Only thing that bothers me is the scorching hot weather. Anyways I'm at home in NY for my break and starting to get worried, the more research i do, the more i found out that by the time i'll be trying to match..it'll be extremely hard to get into a residency. I'm not even saying something competitive..people are telling me that in 4 or 5 years there will be so many medical graduates and not enough seats for them. So even IM will be difficult to match into for an IMG. I'm really starting to second guess going to Pak and don't know what to do. My father is a physician but i don't think that will help me at all as this isn't pakistan where you can do whatever you want as long as you have the right connections. Should i just take a chance and follow through and see what happens? or withdraw and enroll in undergrad here? I just turned 19 so i wouldn't really be behind. Sorry for the long rant but i'm just really confused and anxious because i have to deposit fees for my second year in a week and i feel like after i complete second year..there'll be no turning back. This will be the longest week of my life :/

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[the argus]

There isn't even anything to debate here. If you goal is to practice medicine in the US, quit school in Pakistan and go to undergrad in the US.

 

[IlDestriero]

School in Pakistan is great as long as you are comfortable with being a physician in Pakistan. You probably will never be one here.
I had a regular cab driver that I used in LA that was a cardiologist in Russia. I used him for years. I'm sure he still drives his cab.

 

[Leonidis I]

When it comes time for residency apps, you will be considered 2nd-to-the-bottom on the totem pole behind US MD's, US DO's, and Caribbean MD's. The only people you will be considered above are non-US citizen FMG's (eg Pakistani citizens studying at your school).

Caribbean MD's will be considered above you because at least their curriculum mirrors that of the US and they do clinical rotations in the US whereas your curriculum is teaching you how to be a doctor in Pakistan and I assume you have clinical rotations in Pakistan. So residency programs would feel more comfortable having a Carib grad than you.

With more US schools opening/expanding and residency spots not keeping up at a 1:1 pace, it will make it harder for those at the bottom of the totem pole to match. And those that do match will be relegated to "less desirable" specialties like FM, peds, psych, community IM programs, etc. This is already happening now.

So in that regard it makes sense to come back. But just because you come back to the US to do premed isn't a guarantee either. Are you a strong student? What were your grades/SAT scores in high school? Do you feel confident you can pull off a decent GPA (~3.7) and score around the 80th percentile on the MCAT? About 60% of people who apply to MD schools don't even get into one in any given cycle. Are you open to going to DO schools if your scores aren't up to mark?

Your best bet, assuming you are 100% confident you want to be a physician, is to try and get into a BS/MD program with lax requirements but I'm not sure if they accept students with your situation.

 

[JP2740]

Yes you made a mistake. Not sure why you thought it was a good idea in the first place.

 

[IlDestriero]

It is important to remember, as noted above, that many premed students don't make it to medical school, ever.
I would bet 1/2 of the science and engineering college freshmen think they may want to be a physician. I think at least 75% of the biology majors I went to school with were "premed". By the time they have to take the MCAT, most either select out by choice or academically. A few hundred thousand hopefuls drop down to ~90k people actually taking the MCAT each year, and when it comes time to apply only about 45k apply, including people that took the MCAT in other years, non traditionals that took some time off, and reapplicants. And of that number only about 20k are successful in getting into any medical school.
It is a hard road that requires skill, intelligence, dedication, and commitment.
Good luck.

 

[Wordead]

I'll offer a somewhat different opinion - I've seen some IMGs, notably Aga Khan grads, get accepted in surgical subspecialties whereas DOs and Caribs won't even get a second look. I think the reason is pretty obvious.

 

[JP2740]

I'll offer a somewhat different opinion - I've seen some IMGs, notably Aga Khan grads, get accepted in surgical subspecialties whereas DOs and Caribs won't even get a second look. I think the reason is pretty obvious.

DOs can get into their own surgical subspecialty programs though. I mean I know you're just being devil's advocate, but this guy went straight from high school. He didn't even try getting into an american school.

 

[qw098]

I'll offer a somewhat different opinion - I've seen some IMGs, notably Aga Khan grads, get accepted in surgical subspecialties whereas DOs and Caribs won't even get a second look. I think the reason is pretty obvious.

whats aga khan?

 

[thepretender67]

http://www.mc.vanderbilt.edu/root/vumc.php?site=neurosurgery&doc=16652


I don't know much about aga khan but apparently vandy neurosurgery is turned on by the school.

 

[the argus]

The OP is a US citizen. He didn't grow up in Pakistan and become one of the top Pakistani medical grads. He will be treated like all other US-IMGs if he applies to residency as a Pakistani medical graduate. The success stories from Aga Khan really have no relevance in his situation

 

[VowelMovement]

..

So in that regard it makes sense to come back. But just because you come back to the US to do premed isn't a guarantee either. Are you a strong student? What were your grades/SAT scores in high school? Do you feel confident you can pull off a decent GPA (~3.7) and score around the 80th percentile on the MCAT? About 60% of people who apply to MD schools don't even get into one in any given cycle. Are you open to going to DO schools if your scores aren't up to mark?

Your best bet, assuming you are 100% confident you want to be a physician, is to try and get into a BS/MD program with lax requirements but I'm not sure if they accept students with your situation.

Well on paper I was an above average high school student, graduated with a 3.62 and 2090/2400 on my SAT. But if you look at my transcript you'll see i slacked off on our school's mandatory art and computer skills classes. I used to just skip a lot. But my science classes saved me, especially bio and chem. I was accepted into 6 out of the 9 colleges i applied to before graduating and one of them was my first choice, so coming back for undergrad isn't out of the question.

 

[VowelMovement]

I don't know what to do because in Pakistan I'm already a medical student and have 4 years left before graduating whereas in america I'd have to do 4 years of undergrad and only hope to be accepted into a school. All the americans in my situation at my medschool are advising me to stay but that's probably just to make themselves feel better, idk.

 

[hallowmann]

http://www.mc.vanderbilt.edu/root/vumc.php?site=neurosurgery&doc=16652


I don't know much about aga khan but apparently vandy neurosurgery is turned on by the school.

Looks to me like the most recent (out of 2, the other graduated from med school 10 yrs before he started there) resident from Aga Khan spent 3 years after graduating working in the Vandy spinal outcomes lab. After 3 years as a post-doc, I'd say she paid her dues and made the right connections to get the spot.

Personally, OP, I think you'd be much safer coming back. If you don't want to do that, you could always finish the remaining 4 years, and only be 1-2 yrs behind if you failed to match, did your med school pre-reqs in a hurry, and applied to US med schools. That's still an extra couple years without attending salary, but I don't imagine it's impossible (more work mind you).

Still though, wouldn't you want the opportunity to be any kind of doc you want to be? You'd really be limiting yourself by not even trying for that US medical degree.

 

[einsteinm]

If you stay, just plan on doing well on your STEPs (230's+). That should be your focus, not your school's curriculum which prepares you to practice in Pakistan. Take STEP 1, CS before you graduate and CK before you apply. Programs don't like people taking years off after graduation to study for STEPs.

If you feel you are motivated and don't need much guidance, then you may make it into IM or FP. But the safer route is to do UG. Because even with a DO, you will be able to match into almost anything.

 

[Morzh]

Do I understand correctly that you are a US citizen who graduated from high school just last year, and are now 1 year into a 5 year program in Pakistan... but with the intention of returning the the US to train? So you're, like, 19 years old? Why would anyone do that unless they already failed to get into a US medical school and US-IMG was their last resort??

Dude just come back to the states, enroll in a university, and do things like a normal person. While your 1 year won't transfer any credit at least you should be well-prepared to rock undergrad academically (if you've really been studying like you claim). If you are committed and confident in your ability to do well you're only sabotaging yourself by staying there. It's not that you have no chance of getting a residency spot... but you're making an unforced error and voluntarily painting a big red flag on your CV for no reason!

 

[chizledfrmstone]

Yes you made a mistake. Not sure why you thought it was a good idea in the first place.

Because Pakistani parents convince their kids it's a great shortcut and they will be saving time and money. I know a few people who took that route and had a very difficult time finding residencies.

All the Pakistani physicians kept trying to get their kids to go there until they saw how hard it is to get a residency these day.

Aga Khan University is Pakistan's top medical school. I've met some competent physicians who have graduated from there.

Notable alumni

• Dr. Adil H Haider, MD, MPH, a graduate of Aga Khan University (AKU), is a well known Trauma Surgeon and Outcomes researchScientist in the United States.[22] He is currently serving as the Kessler Director of the Center for Surgery and Public Health atBrigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health.[23] He has also served as Associate Professor of Surgery, Health Policy and Management and Anesthesiology and Critical Care Medicine and the Director of the Johns Hopkins Center for Surgical Trials and Outcomes Research at the Johns Hopkins School of Medicine andBloomberg School of Public Health.[24][25][26] Dr Haider developed Doctella, a smartphone app that provides patients with checklists before undergoing any surgery or medical procedure.[27] Dr Haider is the current Recorder of Association for Academic Surgery.

 

[cbrons]

It is important to remember, as noted above, that many premed students don't make it to medical school, ever.
I would bet 1/2 of the science and engineering college freshmen think they may want to be a physician. I think at least 75% of the biology majors I went to school with were "premed". By the time they have to take the MCAT, most either select out by choice or academically. A few hundred thousand hopefuls drop down to ~90k people actually taking the MCAT each year, and when it comes time to apply only about 45k apply, including people that took the MCAT in other years, non traditionals that took some time off, and reapplicants. And of that number only about 20k are successful in getting into any medical school.
It is a hard road that requires skill, intelligence, dedication, and commitment.
Good luck.

Thx for making me feel good about myself.

 

[Stagg737]

I'll also add that if you're really motivated and doing well in your science courses, then you could bust your butt and potentially graduate undergrad in 2-3 years here. There are multiple people at my school that are M1s who graduated a year early and came straight to med school. Either way, if you want to be sure that you can practice here it would be a mistake to not go to med school here. Especially if you want a decent amount of choice in what you do and where you go for residency.

 

[camedstudent23]

If you stay, just plan on doing well on your STEPs (230's+).

230's? Caribbean MD's who match into a specialty have higher step scores than the corresponding US MD's. A FMG from Pakistan is going to have to absolutely kill Step (>250's)

 

[einsteinm]

He will be preferred over true IMGs because he grew up in the states and can probably interview better. I know a few US IMGs this cycle who got in with close to 230s step 1/2. However, it's really a crapshoot. I'd agree with you though, you do want to aim for 250s to have a shot at a community program.

Also some IMGs are actually viewed better than Caribbean grads who couldn't get into a U.S. school after 4 years of undergrad by some PDs, but that's a topic for another day.

 

[Wordead]

DOs can get into their own surgical subspecialty programs though. I mean I know you're just being devil's advocate, but this guy went straight from high school. He didn't even try getting into an american school.

Yeah, but the DO subspecialty programs (at least for ENT/plastics) are largely rural programs with inferior case loads and variety. They are largely....less than great for training.

The OP is a US citizen. He didn't grow up in Pakistan and become one of the top Pakistani medical grads. He will be treated like all other US-IMGs if he applies to residency as a Pakistani medical graduate. The success stories from Aga Khan really have no relevance in his situation

That's a good point, though we have no idea how OP is doing in medical school. I agree that he's more than likely a middling student rather than one of the top grads that I was referring to. I'm just not so certain that quitting med school and taking on 8 years of educational debt for a miniscule bump in chances of matching is really worth it, especially since who knows if he would even make it through the coursework and application process.

 

[RingOfFire]

It is important to remember, as noted above, that many premed students don't make it to medical school, ever.
I would bet 1/2 of the science and engineering college freshmen think they may want to be a physician. I think at least 75% of the biology majors I went to school with were "premed". By the time they have to take the MCAT, most either select out by choice or academically. A few hundred thousand hopefuls drop down to ~90k people actually taking the MCAT each year, and when it comes time to apply only about 45k apply, including people that took the MCAT in other years, non traditionals that took some time off, and reapplicants. And of that number only about 20k are successful in getting into any medical school.
It is a hard road that requires skill, intelligence, dedication, and commitment.
Good luck.

I can tell you that some people have pursued fields that are conceptually much harder than medicine. Physics, Mathematics. I had a pre-med student with great grades that instead decided to get her doctorate in mathematics because she loved math/physics and did not want her skills to go to waste.

 

[zeppelinpage4]

Thx for making me feel good about myself.

I had the same reaction haha. I've felt like a dumb*** the last two years here. It's easy to forget the value of simply being in medical school sometimes.

As for OP. I don't know man, this is a tough call. Definitely, if you want to practice in the U.S., a degree from a U.S. med school gives you the ideal and best chance, You've picked a tougher, but not impossible road going abroad.

I guess question is, does facing the difficulties matching outweigh your desire to finish med school sooner. Not having applied to residencies, I can't answer that myself, but it's something to think about. Whatever happens though, I wish you all the best and hope things work out.

I know several physicians who trained in south Asian med schools but they're all from a much older generation, when it might have been easier.

 

[criticalelement]

Just to warn the op. Most of the people responding dont have the experience of applying for the match as a foreign medical graduate. Neither do I. But what I CAN tell you that I see physicians from foreign medical schools all over the place that somehow matched into the US. IT may be getting harder but we still admit FMGs. Look at the match statistics every year. THis information is readily available and transparent. Don;t blindly listen to any horses you know what say anything about mcats or premeds making it to medical school and the stats of people actually succeeding. This does not apply to you because you are in medical school already.

 

[cbrons]

If you can get a 250 on Step 1 then stay. Try and make some connections, rotate here. I dont think I would drop out just to do undergrad rubbish for 3 years and jump through that MCAT hoop. That would be pretty sweet if you could somehow match here at 22. Youll definitely need connections, cant really guide you on that. Basically you will have to do the exact opposite of what you did in terms of researching med school options when researching residency options

 

[the argus]

230's? Caribbean MD's who match into a specialty have higher step scores than the corresponding US MD's. A FMG from Pakistan is going to have to absolutely kill Step (>250's)

This is just patently false. Matching US-IMGs and FMGs have lower (and in a few instances equal) step scores than US MDs in every specialty.

This idea that IMGs/FMGs must have astronomical step scores to match, while very prevalent on this forum, is completely untrue. You don't have to take my word on it.
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

Despite this, as a US-IMG who just went through the match I can tell you that the OP should without a doubt drop out of Pakistani med school and come back to the US. Being a US-IMG inhibits your ability to match in a non-primary care specialty (though certainly possible), makes it very difficult to have geographic preferences, and basically disqualifies you from top tier programs regardless of specialty. Can you do well as a US-IMG? Absolutely, I matched into a mid-tier university program. But to say that this is a good option when you are 19 and have basically a clean slate is silly.

 

[PL198]

I can tell you that some people have pursued fields that are conceptually much harder than medicine. Physics, Mathematics. I had a pre-med student with great grades that instead decided to get her doctorate in mathematics because she loved math/physics and did not want her skills to go to waste.

that's extremely rare.

 

[Psai]

This is just patently false. Matching US-IMGs and FMGs have lower (and in a few instances equal) step scores than US MDs in every specialty.

This idea that IMGs/FMGs must have astronomical step scores to match, while very prevalent on this forum, is completely untrue. You don't have to take my word on it.
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

Despite this, as a US-IMG who just went through the match I can tell you that the OP should without a doubt drop out of Pakistani med school and come back to the US. Being a US-IMG inhibits your ability to match in a non-primary care specialty (though certainly possible), makes it very difficult to have geographic preferences, and basically disqualifies you from top tier programs regardless of specialty. Can you do well as a US-IMG? Absolutely, I matched into a mid-tier university program. But to say that this is a good option when you are 19 and have basically a clean slate is silly.

That compares US seniors with independent applicants

 

[username456789]

That compares US seniors with independent applicants

This is true, but if you look towards the beginning of the document, you'll see that US-IMGs and FMGs make up the majority of "independent applicants", while the DOs (and a few other small factions) make up the minority. That's not to say that those damn dirty DOs couldn't be drastically pulling down the average, but it's probably not the case.

 

[the argus]

That compares US seniors with independent applicants

US-IMGs/FMGs make up ~70% of independent matched applicants, DOs make up ~25%.

Furthermore, if you read the fine print in the document on page 6 you will see, "USMLE Step scores are not available for most osteopathic medical school students and graduates included in the independent applicant group."

So therefore, the step scores listed for independent applicants by and large correspond to step scores for US-IMGs/FMGs.

 

[Psai]

my bad, lol i totally misread that

 

[the argus]

Generally, when people put things in quotation marks, that signifies that they are quoting something someone said. What you did was a clear misinterpretation. What the document actually says is "Overall, there were Step 1 scores for 88.1 percent of applicants. All of the applicants who did not have Step 1 scores were those who took the USMLE exams but whose data were not shared with the NRMP, or osteopathic medical school seniors and graduates who either take an alternative examination (the Comprehensive Osteopathic Medical Licensing Examination, or COMLEX-USA)."

DOs made up 16% and previously unmatched US applicants made up 10%. US IMGs made up 30% and non-US foreign grads, made up 43%.

Why make things up when you posted a link that has facts right there? I'm not saying that the data is not suggestive and I also am under the impression that US seniors score higher than the other groups but you're making assumptions that may or may not be true.

Dude, read the fine print above the paragraph you referenced. What I put in quotes is in fact a direct quote. I'm not making anything up or misinterpreting anything.

And the percentages I quoted were for MATCHED applicants. Your percentages are for total applicants. I was talking about step scores of MATCHED independents vs MATCHED US MDs

 

[PhillyMed777]

You will definitely have trouble coming back here for residency. I've seen friends trying shortcuts like this, and not having the "CVs" for US MD or hoping to trim years of education requried, thinking its an easier path to an equal outcome. But it's simply not true.

 

[Leslie_Knope]

I would think long and hard about dropping out of medical school right now. AMCAS asks if you have EVER previously matriculated to medical school, which includes overseas medical schools. As a previous matriculant, you will not be able to apply to certain schools, because they automatically screen out such applicants. Furthermore, those schools that will consider your application, will consider the previous matriculation a red flag.

An example of a school that explicitly states you cannot be considered for admission as a previous matriculant: http://medicine.utah.edu/admissions/policies/index.php#previously

 

[Jabbed]

I would think long and hard about dropping out of medical school right now. AMCAS asks if you have EVER previously matriculated to medical school, which includes overseas medical schools. As a previous matriculant, you will not be able to apply to certain schools, because they automatically screen out such applicants. Furthermore, those schools that will consider your application, will consider the previous matriculation a red flag.

An example of a school that explicitly states you cannot be considered for admission as a previous matriculant: http://medicine.utah.edu/admissions/policies/index.php#previously

I feel like matriculation to a non-Caribbean international medical school would be extremely easy to cover up and unlikely to be discovered during a routine application screening.

 

[Jabbed]

OP if you want to practice outside of the US, stay in Pakistan.
If you want to practice stateside, dropout and go to college in the US. If you graduate in 3 years you'll even earn back your 1 year deficit.

 

[Leslie_Knope]

I feel like matriculation to a non-Caribbean international medical school would be extremely easy to cover up and unlikely to be discovered during a routine application screening.

Lying is not a good idea in this situation.

 

[2Nice]

If you want a shorter route, look for BS/MD programs. There are quite a few around. Sounds like it's within reach with your stats so far. I do know some FMGs here who are in residency, but they have done a lot of grueling work to get where they are. From what I'm seeing, the most feasible thing is to move back here after you graduate and start doing research like crazy while pursuing another degree (MPH, MS, PhD or the like). But I'd go the BS/MD route if I were in your shoes.

 

[deleted500612]

When it comes time for residency apps, you will be considered 2nd-to-the-bottom on the totem pole behind US MD's, US DO's, and Caribbean MD's. The only people you will be considered above are non-US citizen FMG's (eg Pakistani citizens studying at your school).

The most recent match statistics show a 53% match rate for US IMGs vs 49.4% for FMGs... barely a difference. The difference could easily be attributed to language fluency and cultural compatibility issues alone, certainly not enough of a difference to say that IMGs are given priority over FMGs. One could argue that in theory they probably should be, but that certainly does not appear to be the case statistically.

Caribbean MD's will be considered above you because at least their curriculum mirrors that of the US and they do clinical rotations in the US whereas your curriculum is teaching you how to be a doctor in Pakistan and I assume you have clinical rotations in Pakistan. So residency programs would feel more comfortable having a Carib grad than you.

Do you have any citations for this? From what I've heard the IMGs with the highest US match rates are actually matriculating from commonwealth medical schools such as in Australia and Ireland/UK, which do not mirror US curriculum.

With more US schools opening/expanding and residency spots not keeping up at a 1:1 pace, it will make it harder for those at the bottom of the totem pole to match. And those that do match will be relegated to "less desirable" specialties like FM, peds, psych, community IM programs, etc. This is already happening now.

So in that regard it makes sense to come back. But just because you come back to the US to do premed isn't a guarantee either. Are you a strong student? What were your grades/SAT scores in high school? Do you feel confident you can pull off a decent GPA (~3.7) and score around the 80th percentile on the MCAT? About 60% of people who apply to MD schools don't even get into one in any given cycle. Are you open to going to DO schools if your scores aren't up to mark?

Your best bet, assuming you are 100% confident you want to be a physician, is to try and get into a BS/MD program with lax requirements but I'm not sure if they accept students with your situation.

Yeah I think either option poses a risk. Coming back to the US to do undergrad and then apply to med there, you risk not getting into medical school at all. Staying in Pakistan you risk not getting a residency at the end of medical school anyway. I guess it depends on whether the risk of having a US undergrad degree with no career prospect, or having a Pakistani medical degree with no career prospects outside of Pakistan sounds worse to you.

As it stands, the match rates for IMGs is 53%, which is basically a coin flip... not overly reassuring. The coin can be somewhat weighted in your favor though, depending on a multitude of factors such as board scores, doing rotations in the US with good LoRs (not sure if this is possible from a Pakistan school), etc. If you are dedicated enough to get strong board scores and LoRs you increase your chances of landing a US residency significantly above that 53%, but then again you'd probably be good enough to get into an allo school in that case anyways which would be an even safer bet. I can definitely see how the thought of wasting 4 years doing an undergrad degree would be unappealing if there is a much faster route to get to the same finish line though. A lot of things to consider in regard to risk vs reward balancing I suppose.

For what it's worth, one of my classmates has a cousin who is a US citizen and did the Pakistani medical school route. He just graduated this year and matched to a US IM program.

 

[Doctor Bob]

As with anything in medicine...

Decide what you want to do. Determine what pathway gives you the best odds to achieve that goal. Don't try to find shortcuts. Missing out on what you want to do with the next 40 years of your life in order to save a year or two is a bad plan.

 

[the argus]

The most recent match statistics show a 53% match rate for US IMGs vs 49.4% for FMGs... barely a difference. The difference could easily be attributed to language fluency and cultural compatibility issues alone, certainly not enough of a difference to say that IMGs are given priority over FMGs. One could argue that in theory they probably should be, but that certainly does not appear to be the case statistically.



Do you have any citations for this? From what I've heard the IMGs with the highest US match rates are actually matriculating from commonwealth medical schools such as in Australia and Ireland/UK, which do not mirror US curriculum.



Yeah I think either option poses a risk. Coming back to the US to do undergrad and then apply to med there, you risk not getting into medical school at all. Staying in Pakistan you risk not getting a residency at the end of medical school anyway. I guess it depends on whether the risk of having a US undergrad degree with no career prospect, or having a Pakistani medical degree with no career prospects outside of Pakistan sounds worse to you.

As it stands, the match rates for IMGs is 53%, which is basically a coin flip... not overly reassuring. The coin can be somewhat weighted in your favor though, depending on a multitude of factors such as board scores, doing rotations in the US with good LoRs (not sure if this is possible from a Pakistan school), etc. If you are dedicated enough to get strong board scores and LoRs you increase your chances of landing a US residency significantly above that 53%, but then again you'd probably be good enough to get into an allo school in that case anyways which would be an even safer bet. I can definitely see how the thought of wasting 4 years doing an undergrad degree would be unappealing if there is a much faster route to get to the same finish line though. A lot of things to consider in regard to risk vs reward balancing I suppose.

For what it's worth, one of my classmates has a cousin who is a US citizen and did the Pakistani medical school route. He just graduated this year and matched to a US IM program.

As I said before, I'm a US-IMG that thinks the OP should come back to the US and do undergrad. That said, to say that his chance of matching as a US-IMG is 53% is a misinterpretation of the data. I've gone through in detail why this is the case in another thread, here it is if you want to read.

I'll give you a perfect example of misinterpreted data used to make half-cocked arguments. This is from earlier in this thread.



This quote was liked by Goro/Lord_Vader/etc, and they're right, that 53% would be ****ing horrifying if it actually represented the chances of matching as a US-IMG, but it doesn't. And it doesn't take much detective work to understand why that number doesn't represent that. But people just throw it out there because it fits their argument, rather than actually understanding where it comes from. I'll put it all here so you don't even have to leave this thread.

If you look at the ECFMG report from 2013,
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf,
you will see that the average time since graduation for the unmatched cohort of US-IMGs is 5.7 years.

When people say "match rate", they usually mean the chances of a recent graduate who is in the match for the first time. This is exemplified by the fact that the NRMP data reports actually breaks up US allopathic applicants into US seniors vs. US grad.

But 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. The NRMP data reports don't differentiate US-IMG senior vs US-IMG grad. 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 reapplicants 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 US allopathic 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. The yearly match rates for NRMP defined US grads (i.e. non-matched applicants from previous years) are actually 40-50%, showing that poor applicants, regardless of where they come from, do not do very well in the match.

The first-time match rate for the big 3 caribbean medical schools is between 80-90%. Granted this does not take into account students lost to attrition before graduation, which is no doubt substantial.

But when people say caribbean grads have a ~50% chance of matching, they are grossly misinterpreting the data.

 

[Mad Jack]

Yeah, but the DO subspecialty programs (at least for ENT/plastics) are largely rural programs with inferior case loads and variety. They are largely....less than great for training.



That's a good point, though we have no idea how OP is doing in medical school. I agree that he's more than likely a middling student rather than one of the top grads that I was referring to. I'm just not so certain that quitting med school and taking on 8 years of educational debt for a miniscule bump in chances of matching is really worth it, especially since who knows if he would even make it through the coursework and application process.

It would be a huge bump in his chances. Only one in the Pakistani USIMGs matches, last I checked. Pakistan's top school may be well received, but the others, well, not so much. And in the future, things will undoubtedly get worse.

 

[Mad Jack]

The most recent match statistics show a 53% match rate for US IMGs vs 49.4% for FMGs... barely a difference. The difference could easily be attributed to language fluency and cultural compatibility issues alone, certainly not enough of a difference to say that IMGs are given priority over FMGs. One could argue that in theory they probably should be, but that certainly does not appear to be the case statistically.



Do you have any citations for this? From what I've heard the IMGs with the highest US match rates are actually matriculating from commonwealth medical schools such as in Australia and Ireland/UK, which do not mirror US curriculum.



Yeah I think either option poses a risk. Coming back to the US to do undergrad and then apply to med there, you risk not getting into medical school at all. Staying in Pakistan you risk not getting a residency at the end of medical school anyway. I guess it depends on whether the risk of having a US undergrad degree with no career prospect, or having a Pakistani medical degree with no career prospects outside of Pakistan sounds worse to you.

As it stands, the match rates for IMGs is 53%, which is basically a coin flip... not overly reassuring. The coin can be somewhat weighted in your favor though, depending on a multitude of factors such as board scores, doing rotations in the US with good LoRs (not sure if this is possible from a Pakistan school), etc. If you are dedicated enough to get strong board scores and LoRs you increase your chances of landing a US residency significantly above that 53%, but then again you'd probably be good enough to get into an allo school in that case anyways which would be an even safer bet. I can definitely see how the thought of wasting 4 years doing an undergrad degree would be unappealing if there is a much faster route to get to the same finish line though. A lot of things to consider in regard to risk vs reward balancing I suppose.

For what it's worth, one of my classmates has a cousin who is a US citizen and did the Pakistani medical school route. He just graduated this year and matched to a US IM program.

http://www.ecfmg.org/resources/NRMP...atch-International-Medical-Graduates-2014.pdf

Commonwealth schools actually have lower placement rates than SGU, AUA, and Sackler.

Now, as to everything else- he's better off coming to the states and using that for years to get an employable undergrad degree, so that, in 4 years time he can actually get a damn job if he doesn't get into medical school. A foreign MBBS is a completely useless degree if he fails to match. You should also keep in mind that there has been a massive increase in US class sizes over the last few years. If 100% of US grads were to match, there would only be enough slots for 25-30% of foreign graduates to obtain training come 2020, depending on the rate of GME growth. Things are getting far more competitive. If op ignores that, he may well waste 6 years of his life and never become a physician, as no US MD program will take a person that has already passed the Steps.

 

[hallowmann]

Just to warn the op. Most of the people responding dont have the experience of applying for the match as a foreign medical graduate. Neither do I. But what I CAN tell you that I see physicians from foreign medical schools all over the place that somehow matched into the US. IT may be getting harder but we still admit FMGs. Look at the match statistics every year. THis information is readily available and transparent. Don;t blindly listen to any horses you know what say anything about mcats or premeds making it to medical school and the stats of people actually succeeding. This does not apply to you because you are in medical school already.

Are you implying that since you "see" FMGs in practice/residency, its not as bad as people on here suggest? I won't even get into the unnecessary insult slinging you did to people who went out of their way to give OP advice (not really sure you needed to put down people just to make your point, but hey, if that's your thing).

To address the first point, I actually personally know FMGs (many in my extended family alone, let alone many acquaintances that I know). Matching as an FMG, even one with permanent residence or citizenship (know plenty of those as well), is very difficult. We're talking applying to 150-200 FM & IM programs even when you have 250s in the Steps, only to get single digit (really <5) interviews and not match for 2-3 years (I have relatives in this exact situation).

The only consistent way any recent FMGs I personally know (very smart people, but not the "best" in the field) have been able to secure residency has been through connections built over 2-3 years of essentially post-doc research. Sometimes they have connections already established, so that's not a huge issue, but I'm not seeing this as being the case with the OP (maybe it will be in 4 years, I don't know).

Now I'm not saying its impossible and so far all I've given is anecdotes, but you really should look at all the data (as you suggested). Match rates for US-IMGs is 53%, so for every 1 IMG you "see", there's another that didn't match. An even better example would be to look at the IMG charting outcomes report. On page 21, we can see that out of the US-IMGs that applied from Pakistan, 76 matched and 209 did not (26.7%). Out of the non-US IMGs from Pakistan, 254 matched and 429 did not (37.1%). So yes, some people do match, but I wouldn't really trust those odds when it comes to having to go through the hell of med school, the match, and still possibly not having a future in the field.

 

[deleted500612]

http://www.ecfmg.org/resources/NRMP...atch-International-Medical-Graduates-2014.pdf

Commonwealth schools actually have lower placement rates than SGU, AUA, and Sackler.

Now, as to everything else- he's better off coming to the states and using that for years to get an employable undergrad degree, so that, in 4 years time he can actually get a damn job if he doesn't get into medical school. A foreign MBBS is a completely useless degree if he fails to match. You should also keep in mind that there has been a massive increase in US class sizes over the last few years. If 100% of US grads were to match, there would only be enough slots for 25-30% of foreign graduates to obtain training come 2020, depending on the rate of GME growth. Things are getting far more competitive. If op ignores that, he may well waste 6 years of his life and never become a physician, as no US MD program will take a person that has already passed the Steps.

Hmm, looking at your link it seems to not provide any statistics for UK/Australia schools, and Ireland shows a higher match right than any Caribbean school. Sackler is indeed the highest though.

Numbers from your link...

Antigua (AUA): 47% match rate
Saint Maarten (AUC): 61% match rate
Grenada (SGU): 67% match rate
Ireland: 69% match rate
Israel (Sackler): 76% match rate

 

[IlDestriero]

No no no.
Don't show the data, someone posted earlier that the Caribbean has an 80-90% match rate. Don't burst their bubble man, it's Easter.

 

[Mad Jack]

Hmm, looking at your link it seems to not provide any statistics for UK/Australia schools, and Ireland shows a higher match right than any Caribbean school. Sackler is indeed the highest though.

Numbers from your link...

Antigua (AUA): 47% match rate
Saint Maarten (AUC): 61% match rate
Grenada (SGU): 67% match rate
Ireland: 69% match rate
Israel (Sackler): 76% match rate

Ah, I meant AUC, not AUA. Easy to mix up my diploma mills.

Looks like not enough US citizens even applied from Commonwealth countries for there to be reliable statistics. And the Irish students were all non-US citizens, so they were likely a cut above any US Irish school graduate, since they had to compete, rather than pay, their way in. You can see the trend that foreign grads outperform US citizens in matching from most countries on the list- China, India, Pakistan, Egypt, etc-, as they tend to be top performers from their respective countries, rather than US students that were either incapable or too lazy to get into a US medical school. I'd imagine Irish matches from USIMGs are a bit lower than the 69% of native Commonwealth citizens matching out of the schools, so that 69% for FMGs can't really be generalized to USIMGs.

 

[Mad Jack]

Oh, and op, if you look at the data, only 36 of 176 USIMGs coming out of Pakistan matched their preferred specialty last year. Don't do it bro. Come back to the states and do things the right way if you want to be a doctor. Or you can spend the next four years of your life and tuition money getting a degree that will most likely get you no residency, or might get you a residency in the middle of nowhere in FM or IM.

 

[Studic]

Urm...so on one hand you've got the normal US route ( undergrads and then med school) and on the other you've got this 5 year course. Both allows you a chance for residency?
But the usual 5 year undergraduate medicine courses are MBBS degrees, right? Would they be treated like an MD program? I don't think so. I guess they would be given very low preference.

So what's the difference between an MBBS degree and an MD one, apart from MD requiring an undergraduate degree? Does the MD degree give you more speciality in a particular field? [sorry for the tangent but this thread gave me some questions]