Disastrous grades, great step 1 and a desperate IMG

[desperateimg]

Hi everyone,

First time poster, but long time lurker here. I hope that this is the right place for this thread, my apologies to the mods if it isn't. So I'm a medical student in Ireland hoping to land an IM residency in the states. I'm currently in my second last year (fourth year of a five year undergrad program). So basically because of a lot of personal problems med school has not exactly gone my way. My first year grades are great, but after that I had to repeat second med. Then because a lot of issues I missed days on rotation and was barred from sitting the first instance of some of my degree clerkships like psych, opt, ENT. Since I've sorted all of that out I've done really well in ObGyn and should do well in Pads, after that I have family medicine and our final year is dedicated to combined assessment in medicine and surgery and is worth half of the degree score and thus class rank. Anyway I did really well in Step 1, 270 and I feel like I'm finally on top of my ****! However I understand that poor grades and great boards give the impression of a slacker, further enhanced by my having to repeat a year. If I do as strongly on step 2 do I still have a chance at matching? After graduating I have to do an internship here and was then going to do a masters degree in molecular biology in order to continue my research as well as get a chance to do some observerships/externships in the US. I would take any residency in IM, but obviously I want as great a one as I can get. Particularly because I want to do cards which I could come home to do if I have to, but I really want to do a fellowship in the US as well. Could I get into a competitive IM residency or will I just be lucky to get anything?

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[mrheisenberg]

Outstanding USMLE scores are a necessary but not sufficient pre-requisite for IMGs. Doing some electives in the US, getting a true dedicated mentor is probably the most important factor along with high scores. Regarding the struggle you're facing at your med school, this is a major red flag, so use your PS to explain that and how you were able to overcome that.

 

[Animalcules]

Hi everyone,

First time poster, but long time lurker here. I hope that this is the right place for this thread, my apologies to the mods if it isn't. So I'm a medical student in Ireland hoping to land an IM residency in the states. I'm currently in my second last year (fourth year of a five year undergrad program). So basically because of a lot of personal problems med school has not exactly gone my way. My first year grades are great, but after that I had to repeat second med. Then because a lot of issues I missed days on rotation and was barred from sitting the first instance of some of my degree clerkships like psych, opt, ENT. Since I've sorted all of that out I've done really well in ObGyn and should do well in Pads, after that I have family medicine and our final year is dedicated to combined assessment in medicine and surgery and is worth half of the degree score and thus class rank. Anyway I did really well in Step 1, 270 and I feel like I'm finally on top of my ****! However I understand that poor grades and great boards give the impression of a slacker, further enhanced by my having to repeat a year. If I do as strongly on step 2 do I still have a chance at matching? After graduating I have to do an internship here and was then going to do a masters degree in molecular biology in order to continue my research as well as get a chance to do some observerships/externships in the US. I would take any residency in IM, but obviously I want as great a one as I can get. Particularly because I want to do cards which I could come home to do if I have to, but I really want to do a fellowship in the US as well. Could I get into a competitive IM residency or will I just be lucky to get anything?

Try to get a clerkship or sub-I in the US during your final year. Once you graduated and start your masters, you will only be eligible for observerships, which count for nothing. Step scores (no matter how good) without US clinical experience will kill your application to university programs. I have seen it happen to great candidates.

 

[desperateimg]

Try to get a clerkship or sub-I in the US during your final year. Once you graduated and start your masters, you will only be eligible for observerships, which count for nothing. Step scores (no matter how good) without US clinical experience will kill your application to university programs. I have seen it happen to great candidates.

Thanks for your reply as well that of mrheisenberg's. I'm hoping to do an American Sub-I, if I can't I have some Canadian contacts, would a Canadian Sub-I be worthwhile? Are you certain that after graduation I can only engage in observerships? My American and Canadian classmates told me that there are externships for foreign medical graduates to get U.S. experience.

 

[Animalcules]

Thanks for your reply as well that of mrheisenberg's. I'm hoping to do an American Sub-I, if I can't I have some Canadian contacts, would a Canadian Sub-I be worthwhile? Are you certain that after graduation I can only engage in observerships? My American and Canadian classmates told me that there are externships for foreign medical graduates to get U.S. experience.

You will not be able to touch any patient after you graduate (independent of school). PDs know this as well. You want to aim at a sub-I at a prestigious US institutions and rock it. They are not easy to get, but possible. Google what's current and apply in advance (Mayo, Harvard programs ($$$), Cleveland clinic, Yale, MSKCC, etc.). Canadian is better than nothing, but maybe not worth your time applying from Ireland.

 

[desperateimg]

So does that mean all the companies offering externships that specify hands-on experience are just scams? They claim that you can perform practical clinic skills and duties under the supervision of a US licensed physician, so is that just bs?

 

[Mad Jack]

You will not be able to touch any patient after you graduate (independent of school). PDs know this as well. You want to aim at a sub-I at a prestigious US institutions and rock it. They are not easy to get, but possible. Google what's current and apply in advance (Mayo, Harvard programs ($$$), Cleveland clinic, Yale, MSKCC, etc.). Canadian is better than nothing, but maybe not worth your time applying from Ireland.

Yale's internal medicine service does not accept visiting students, just as a fyi.

https://medicine.yale.edu/education...cal_electives/electives/internalmedicine.aspx

 

[Animalcules]

So does that mean all the companies offering externships that specify hands-on experience are just scams? They claim that you can perform practical clinic skills and duties under the supervision of a US licensed physician, so is that just bs?

These are useless and won't help your application

 

[Animalcules]

Yale's internal medicine service does not accept visiting students, just as a fyi.

https://medicine.yale.edu/education...cal_electives/electives/internalmedicine.aspx

But the IM subspecialty services do

 

[rokshana]

So does that mean all the companies offering externships that specify hands-on experience are just scams? They claim that you can perform practical clinic skills and duties under the supervision of a US licensed physician, so is that just bs?

usually these are in doctors' offices...not real clerkships.

 

[mrheisenberg]

So does that mean all the companies offering externships that specify hands-on experience are just scams? They claim that you can perform practical clinic skills and duties under the supervision of a US licensed physician, so is that just bs?

Dude, look at these electives as a golden chance of connecting with a mentor. And what it is, it's someone that will serve you just as like the agent responsible for selling Gareth Bale to Real Madrid earning him millions of dollars.

Nobody from the big leagues will pay attention to your application unless a rockstar professor from Hopkins, Harvard, etc is selling it telling something like you're the best among 1000000 students that worked with him due to such and such reasons.

If I was a PD, this would give some credibility to your app and would add a remarkable incentive for me to give the IV spot to you instead of giving it to some regular Joe from a top 200 med school in the middle of Alaska.

In contrast, if your major reference is an unkown private practice doc who has financial incetives to give you a LOR. Well, do I have to convince you that this would mean **** to me? And that's what an observership/externship is to the eyes of a PD.

Do you still think it's worth the money? Well, if you for some reason didn't have the chance to do an elective. Invest your time in a research fellowship and be productive. Having a proactive US research mentor is also super helpful.

 

[desperateimg]

Thanks guys for the info. You really think that I could get an elective with a good school? I know that I would need a good elective to get into a good residency, but you really think applying to places like Harvard, Hopkins, Yale, etc is worth my time? Not trying to sound sarcastic actually just genuinely curious. I mean applying is great and all, but I don't want to squander the guts of a grand on applying to a load of prestigious med schools for electives. I figure I'll take whatever US university that will give me an Sub-I.

 

[Animalcules]

Thanks guys for the info. You really think that I could get an elective with a good school? I know that I would need a good elective to get into a good residency, but you really think applying to places like Harvard, Hopkins, Yale, etc is worth my time? Not trying to sound sarcastic actually just genuinely curious. I mean applying is great and all, but I don't want to squander the guts of a grand on applying to a load of prestigious med schools for electives. I figure I'll take whatever US university that will give me an Sub-I.

Well, it is worth your time if you want to match into a good university program in the US. A lot of electives will cost significant amounts of money (4000+ USD/ month), so I don't see why you should rotate at a top 50 school if tuition at HMS is the same. There are, however, many cheaper options available, you will need to explore your options. Sub-Is are extremely hard to get, just FYI. Also, you may be able to shine more in a subspecialty rotation in your field of interest. More face time with the attending.