Dual subject application during ERAS process

[TyrionLannister03]

---

Members don't see this ad.

Hey i'm an IMG and am fairly uninformed about the process of application via ERAS. I hail from India and am looking for a US residency. I had a couple of doubts that i couldn't find while sieving the internet for the same.

So how it works in my home country is you have a single examination. Following this, they reveal your marks and your ranks are put up and then based on those ranks you get to apply to the college of your choice, for the desired subject.

For eg. : Say in a college X there's 2 residency post for rads, 2 for gen surg and 2 for IM. A person with rank 1, in a college x, will have the first say in the subject that he wants, all the 6 seats being on offer. Similarly the person who secures the rank 6 will have only one seat on offer depending on the ones taken prior by the above 5 rank.

The reason i'm being so meticulous is to find out is say after securing my USMLE sores for step 1 and 2, could i apply for a certain college in the state of Tennessee for an IM spot, while could i apply for a Gen Surg spot in the state of Texas?
If the process is unified and i have to fill my preferences in a single form, where they ask me what my subject of preference is in that particular order say 1. IM 2. Gen Surg 3. Psych and i apply far and wide, will i be getting calls from IM as well as GS programs or would they perceive it in negative light, for me to be a candidate whos not sure of what he wants?

Also what are the demerits to listing more than 1 contrasting subject (Say choice 1 as IM and choice 2 as GS) on your ERAS application?

 

[theonlytycrane]

 

[TyrionLannister03]

View attachment 228894

What seems to be the issue? 🙁
im sorry if its a stupid question to ask, but could you please help me out

 

[togaedere]

The US system just works differently from what you are used to and may be challenging to explain.

Basically how it works is that people go to an undergraduate institution for ~4 years and then after that go to medical school for another ~4 years, which more often than not is a different institution. It’s in med school where you take the USMLE exams, get your scores, and apply to residency. This is just terminology, but you don’t go to college for residency, you get linked up to a hospital system through the match.

To apply through ERAS, you load your USMLE scores, your letters of recommendation, your curriculum vitae, your personal statement(s) etc all through the system. You can apply to as many programs as you want — IM, Gen Surg, whatever. You just have to make sure that your personal statements are matched up to the programs you are applying to. That is don’t form an IM letter and send it to a Gen Surg program.

Then you either will get interviews or you won’t, and you’ll rank those programs you interviewed at. Some programs may screen you out cus you are an IMG.

Those are the basics. Let me know if there are more questions!

What seems to be the issue? 🙁
im sorry if its a stupid question to ask, but could you please help me out

 

[togaedere]

Oh and yes you can apply to many programs in any state. They won’t know where else you are applying so apply to as many programs in as many different fields as you want.

Hey i'm an IMG and am fairly uninformed about the process of application via ERAS. I hail from India and am looking for a US residency. I had a couple of doubts that i couldn't find while sieving the internet for the same.

So how it works in my home country is you have a single examination. Following this, they reveal your marks and your ranks are put up and then based on those ranks you get to apply to the college of your choice, for the desired subject.

For eg. : Say in a college X there's 2 residency post for rads, 2 for gen surg and 2 for IM. A person with rank 1, in a college x, will have the first say in the subject that he wants, all the 6 seats being on offer. Similarly the person who secures the rank 6 will have only one seat on offer depending on the ones taken prior by the above 5 rank.

The reason i'm being so meticulous is to find out is say after securing my USMLE sores for step 1 and 2, could i apply for a certain college in the state of Tennessee for an IM spot, while could i apply for a Gen Surg spot in the state of Texas?
If the process is unified and i have to fill my preferences in a single form, where they ask me what my subject of preference is in that particular order say 1. IM 2. Gen Surg 3. Psych and i apply far and wide, will i be getting calls from IM as well as GS programs or would they perceive it in negative light, for me to be a candidate whos not sure of what he wants?

Also what are the demerits to listing more than 1 contrasting subject (Say choice 1 as IM and choice 2 as GS) on your ERAS application?

 

[TyrionLannister03]

I am aware of the residency part, pardon the way i put it in words. Much thanks for the explanation.

I however have more doubts regarding the next part. While applying through the system/ERAS with the required parameters i.e.

Imagine i upload my CV through ERAS, I'd like one tailor made for the IM programs and one for the Gen Surg programs, highlighting my experiences in the same. I'm not sure as to whether the system would then enable me to upload Lor, cv and sop different for one subject and another for another subject.
Cause if i upload just a uniform list of CV, Lor and sop the different programs would be receiving the same documents.

or

Does it work based on program as in say for program x and program y, the eras application applies my basic filters of demography and scores and other transcripts. But i get to send them cv, lor and sop separately? And i could do that for all the programs i apply to i.e send the key components tailor made to those programs?

My basic dilemma is, I happen to be one of those weird types that like and are proficient (atleast feel so) in both IM and GS. As an IMG, if i do get high scores id be tempted to test my luck and apply for GS program if applicable. Also knowing how difficult it is for the IMG's to get into GS i want to maintain a solid realistic outlook towards IM, cause that seems to be the more available option to take.
So when i do apply id like to add both as the stream of preference for residency. I however would not want the IM programs and PDs to know that i applied for GS and vice versa (cause a colleague once told, that there's unnecessary scrutiny - where they perceive it as you not being sure and they want candidates who wouldn't drop out/quit or worse be disinterested.)

I would really like to thank you for offering your time and help, maybe i could do the same for someone else. 🙂

 

[TyrionLannister03]

The US system just works differently from what you are used to and may be challenging to explain.

Basically how it works is that people go to an undergraduate institution for ~4 years and then after that go to medical school for another ~4 years, which more often than not is a different institution. It’s in med school where you take the USMLE exams, get your scores, and apply to residency. This is just terminology, but you don’t go to college for residency, you get linked up to a hospital system through the match.

Also for the clarification, we have Universities and multiple hospitals under the universities. There are teaching colleges attached to some of these hospitals and hence in a broad sense we use the term college to apply for the residency.

 

[NotAProgDirector]

The way ERAS works, you only get a single CV. On it, you list everything you've done. It will be the same for all of your applications.

But, you can send 4 LOR's to each program, and you can pick and choose. So you can have 4 LOR's for GS, and a different 4 for IM. Or, you can send any combination of LOR's to any program.

You also get a Personal Statement, and that can be different for every program.

Realistically, you're going to want / need US experience to apply in the US. It's going to be difficult, but not impossible, to obtain adequate experience in both GS and IM.

 

[TyrionLannister03]

@aProgDirector Thank you sir.

Realistically, you're going to want / need US experience to apply in the US. It's going to be difficult, but not impossible, to obtain adequate experience in both GS and IM.

This is going to be an issue for me. 🙁
I would appreciate some help.
The issue is im already 3Years post graduation. The institution/Medical college-hospital that i was a part of has 2 years mandatory rural service/ working in an under-served or economically backward area in the country which i completed. I have a document attested and confirmed by my college and my dean with records maintained with them for verification. Issue is that took two years off my time, i decided to pursue residency in US just this jan and have been preparing with a view to writing my step 1 step 2 and the cs by the time and apply for sept 2019 applications, cause i wont be ready by sept 2018 with all the scores.

I have heard that you require a minimum of step 1 score to apply for most observerships (being graduated, clerkships are out of the equation). I have also heard that you're supposed to mail most of these programs 6 months in advance and then too its difficult to land a spot with them. I do not know how long does one have to shadow to get a LOR or whether 2 doctors from the same shadowing program can give me 2 LORs. I'm starting afresh and know some basics but am lost on the most of the technicalities regarding the application process, USCE and research papers.

I might come out as ignorant and i am and hence im calling out or looking for help. Thanks in advance

 

[togaedere]

Yeah we also have universities connected to hospitals, it’s just the terminology that was throwing me off. No one in the US would say they were going to college for residency, even though they might say a specific university system — Stanford, Harvard, Ohio State University, etc — as where they attend residency. Semantics but it made it initially confusing to know if we were talking about the same thing.

Other people know more than I do about this, but I do agree that finding an observership seems difficult. I went to med school at a place that offered observerships and there was always a long wait list. I have no idea if 2 people would give out letters of recommendation during an observership but it doesn’t seem out of the realm of possibility. There are some residencies that offer them and some that don’t, so it’s just a matter of getting linked up to a system and getting as much experience as you can.

Being 3 years post graduation is going to hurt you. It’s not clear in your post but have you been doing anything clinical in the meantime?

@aProgDirector Thank you sir.



This is going to be an issue for me. 🙁
I would appreciate some help.
The issue is im already 3Years post graduation. The institution/Medical college-hospital that i was a part of has 2 years mandatory rural service/ working in an under-served or economically backward area in the country which i completed. I have a document attested and confirmed by my college and my dean with records maintained with them for verification. Issue is that took two years off my time, i decided to pursue residency in US just this jan and have been preparing with a view to writing my step 1 step 2 and the cs by the time and apply for sept 2019 applications, cause i wont be ready by sept 2018 with all the scores.

I have heard that you require a minimum of step 1 score to apply for most observerships (being graduated, clerkships are out of the equation). I have also heard that you're supposed to mail most of these programs 6 months in advance and then too its difficult to land a spot with them. I do not know how long does one have to shadow to get a LOR or whether 2 doctors from the same shadowing program can give me 2 LORs. I'm starting afresh and know some basics but am lost on the most of the technicalities regarding the application process, USCE and research papers.

I might come out as ignorant and i am and hence im calling out or looking for help. Thanks in advance

 

[TyrionLannister03]

Yeah we also have universities connected to hospitals, it’s just the terminology that was throwing me off. No one in the US would say they were going to college for residency, even though they might say a specific university system — Stanford, Harvard, Ohio State University, etc — as where they attend residency. Semantics but it made it initially confusing to know if we were talking about the same thing.

Other people know more than I do about this, but I do agree that finding an observership seems difficult. I went to med school at a place that offered observerships and there was always a long wait list. I have no idea if 2 people would give out letters of recommendation during an observership but it doesn’t seem out of the realm of possibility. There are some residencies that offer them and some that don’t, so it’s just a matter of getting linked up to a system and getting as much experience as you can.

Being 3 years post graduation is going to hurt you. It’s not clear in your post but have you been doing anything clinical in the meantime?

Sorry for the confusion! Its just i'm not yet habituated on the semantics concerning this whole thing.

I was fairly surprised by the quick response rate and i'm getting to learn a lot, abating my anxiety, lol.

So to explain my situation better, we have 2 year clinical service to be done in an economically backward area of the country. The choice of area is not for us to make, but there are designated centres (appx 150) across the country and you could choose and go and work in one, post completing formalities. You basically become the attending physician/resident doctor for those two years include OP care, IP care, duty days, health camps etc. and operate as junior resident. (and i'm again not sure of the semantics here)(basically we apply for license post our grad and we can practice with the same)
Its a part of how our college/hospital works, to give back to the society. Even though i graduated in 2015, and the university send my transcripts to my college and they held it with them. I could only collect them when i had completed my two years of clinical service. i received my transcripts in 2017 sept to be precise.
We sign a legal bond with the college while initial admissions, expressing our commitments for the same. The other option is to pay a fee to break the bond, which in our case was btw 600,000 INR / roughly 10K usd. Seems cheap when converted but i wanted to clinically apply what i had learnt and at the same time do something good.

i have a different perspective to this, but people who are applying to residency might say it was not the wisest of choices, well its in the past. I know that i need ECFMG certification and step 1 and 2 scores and to pass cs. This i intend to do by next year, cause realistically i have 8 months now for sept 2017; and im not in a flow to clear everything by then, except CS, which i think i could deal with as presenting a case or examination of systems, relevant clinical knowledge or for that matter barrier w.r.t to accents and command on language has never really been an issue for me.

Sept 2019 (4 years post grad as per the system, but 2 years of that is accounted from my med college/hospital itself), for 2020 match is the best i could do. I know my chances would be slim but that's not something im willing to not try over.

If anybody could help me in anyways even in the perspective of providing any knowledge, i'd be humble enough to accept it.

"A Lannister always pays his debts" 🙂

 

[TyrionLannister03]

I'm sorry i didn't proof read before dispatching, some edits:

Even though i graduated in 2015, the university send my transcripts to my college and they held it with them till i either pay the legal amount to break the bond or work as a doc for 2 years*

This i intend to do by next year, cause realistically i have 8 months now for sept 2018**

 

[NotAProgDirector]

What you would do is take S1 and S2. You're correct that many observerships will want S1 scores at least, if not both steps. Observerships are usually not "hands on", you just follow around and don't actually get to do anything. Some programs will consider them US experience, some will not. Being more than 3 years out from graduation may limit your options, but some programs might use 5 years as a cut off, or might not have any cut off at all.

Realistically, if you do well on the USMLE and get some US experience, you will have some chance of getting an FM spot here in the US. Getting GS with no surgical experience and multiple years out of medical school is probably impossible.

Only you can determine if it's worth the investment in time and money to try to get a spot in the US.

 

[TyrionLannister03]

FM and IM are realisitic possibility?

Also LOR's are the only reflection of USCE? or Do they have a specific duration in mind to ascertain or deem whats suitable?
For eg. A IM/GS LOR would be considered enough or the fact that you have dones 2 months in IM/5months in GS etc. counts?

I have heard some of my ex professors mentioned about the 3 and 5 year cut off period. Any realistic chances of knowing which colleges have what?

Also Prelim spots for GS then switch to PGY2, realistic or could it be more damning?

I know you have left it at my discretion when you have said its upto me worth knowing if its worth the time and money, but id like you to share some insights based on your experiences.

 

[NotAProgDirector]

FM more realistic than IM. But you don't have step scores yet, so hard to say anything.

The more USCE you have, the better. And most docs won't write you an LOR unless you spend enough time with them. The more time you spend in one field, the more problems you might have getting interviews in a different field.

Some programs advertise their cutoffs on their websites. Some do not.

Switching to a PGY2 from prelim GS is difficult. Getting a PGY-2 GS spot is very difficult -- as you can imagine, many of the prelim GS interns are trying to do so. Few succeed. A prelim GS spot will count for a PGY-2 in Radiology, Ophthalmology, and Dermatology. The last two are not happening for you. Radiology might be a possibility. If you go into FM or IM, you'd need to start as a PGY-1 again.

 

[W19]

See how how you do in step1/2... Your best shot are path, FM and IM in that order.