FMG getting in to residency with an NP degree

[Afrin]

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Hello! All,

My husband is an FMG who is working on his NP and will graduate in a year and half. He is currently working in hospital as an RN and the hospital has three residency programs- surgery, IM, and FP. He is an ECFMG certified with expired CSA that he took it in 2000. Though in 2000 he passed CSA in first attempt, but he failed it twice while he was trying to re-take it. His current status is usmle step i 1999, step ii 1998, ECFMG certified, but need to retake CSA. He is wondering about his chance of getting in to a residency position after finishing his NP degree. He can also retake his boards since he didn’t take step iii yet. Can his NP degree help him secure a residency anyway? Does he need to retake all his boards to make them current? His previous usmle scores were not competitive either.

 

[Raryn]

Hello! All,

My husband is an FMG who is working on his NP and will graduate in a year and half. He is currently working in hospital as an RN and the hospital has three residency programs- surgery, IM, and FP. He is an ECFMG certified with expired CSA that he took it in 2000. Though in 2000 he passed CSA in first attempt, but he failed it twice while he was trying to re-take it. His current status is usmle step i 1999, step ii 1998, ECFMG certified, but need to retake CSA. He is wondering about his chance of getting in to a residency position after finishing his NP degree. He can also retake his boards since he didn’t take step iii yet. Can his NP degree help him secure a residency anyway? Does he need to retake all his boards to make them current? His previous usmle scores were not competitive either.

I have no idea what a CSA is, but the answer is with a year of graduation getting on 2 decades old, he has practically no chance of matching into residency, no matter what he gets on his USMLE retakes. Maybe if he made some major, major connections with a program director.

To be honest, if he's already a pretty much fully trained NP, he'd be way better off just using his NP degree and working as a midlevel for the rest of his life, especially given the fact he's probably in his mid-40s by now and the time investment to complete MD training compared to the return on top of a mid-level degree is probably not worth it.

 

[gutonc]

I have no idea what a CSA is, but the answer is with a year of graduation getting on 2 decades old, he has practically no chance of matching into residency, no matter what he gets on his USMLE retakes. Maybe if he made some major, major connections with a program director.

CSA is the old version of Step 2CS that only IMGs had to take.

To be honest, if he's already a pretty much fully trained NP, he'd be way better off just using his NP degree and working as a midlevel for the rest of his life, especially given the fact he's probably in his mid-40s by now and the time investment to complete MD training compared to the return on top of a mid-level degree is probably not worth it.

Absolutely agree with this. He's not getting a residency...full stop. Finish NP training and move on from there.

 

[IMPD]

Agree with all of the above.

 

[Afrin]

Thanks for your responses. So there will be no chances at all even if he does well in retaking USMLE and work a couple of years as an NP. He also has an MHA (master of health care administration) and research experience. He doesn't want to stay as midlevel for the rest of his life.

 

[gutonc]

Thanks for your responses. So there will be no chances at all even if he does well in retaking USMLE and work a couple of years as an NP. He also has an MHA (master of health care administration) and research experience. He doesn't want to stay as midlevel for the rest of his life.

No. There is seriously no hope at all for getting a residency when he's 15 years out from med school, is a foreign grad and has Step failures/retakes.

If he doesn't want to remain a mid-level, he should either go into administration (hospitals love nurses in administration) or go back wherever home is and be a physician there.

 

[IMPD]

Thanks for your responses. So there will be no chances at all even if he does well in retaking USMLE and work a couple of years as an NP. He also has an MHA (master of health care administration) and research experience. He doesn't want to stay as midlevel for the rest of his life.

NPs can practice independently, which I'm sure he will if he is so inclined. I think offering advice in these situations is akin to what oncologists do sometimes. "Is there NO CHANCE"? Well, I suppose that Stage V lung ca might just regress on it's own, but yes, there is NO CHANCE. We're trying to help here, not diminish his ambition. Look into the many areas that NPs are independent.

 

[Afrin]

Thanks for your responses again. The place he works as an RN there is one current FM resident who is an FMG and graduated in 80s. The same program also had quite a few FM residents in last five years who were FMG and graduate of 80s and 90s. He also talked to one of the IM residency faculties at his hospital who advised him to retake the USMLEs then apply. A very good friend of him (AMG) and surgery resident at his hospital also advised him to retake his USMLEs and then apply for residency. Considering all these he does want to put his efforts again in USMLEs after finishing his NP. Now what is your opinion?

 

[ThoracicGuy]

Thanks for your responses again. The place he works as an RN there is one current FM resident who is an FMG and graduated in 80s. The same program also had quite a few FM residents in last five years who were FMG and graduate of 80s and 90s. He also talked to one of the IM residency faculties at his hospital who advised him to retake the USMLEs then apply. A very good friend of him (AMG) and surgery resident at his hospital also advised him to retake his USMLEs and then apply for residency. Considering all these he does want to put his efforts again in USMLEs after finishing his NP. Now what is your opinion?

He's welcome to try. If he can make a personal connection with the FM department, he could have a chance of getting in. First he needs to pass those exams. Do I think he'll get into a program where he doesn't have a personal connection? Unlikely. Overall the chances are poor, but if he wants to try, all it takes is time and money for the exams. The NP degree is not going to do alot to make his application more worthwhile vs someone in a similar position as your husband.

 

[Raryn]

Once again, I want to ask, what is he hoping to get from a residency that he cannot get from just working with the NP degree he has already obtained?

If he wants to do primary care, then by golly, he can already do primary care with (in pretty much every state) minimal supervision at best. If he wants to be a specialist (of any sort), it's going to be nigh-on impossible to match and he will use years of his life at a $50,000 salary when he could be chugging along as an NP.

What on earth is the point? I wouldn't advise this path to someone who has already completed a terminal degree in a related field if they were 30, much less (almost?) 50. I could see something else about giving it a try again if he was working as a cab driver right now, or even doing research, but if he's an NP? Really?

 

[Afrin]

Thank you all for your responses. Thoracicguy, my husband will compete against other IMGs, not against AMGs. When most IMGs do not have any US clinical experience , which is always desirable by the majority of the programs, don't you think his full time RN experience in a level II trauma hospital and experience of working as an NP for a couple of years should make him competitive. Raryn, to practice as an NP one needs masters only. But people do go for DNP and work hard for two more years since it gives them satisfaction and also they can addressed as doctor. MY husband thinks with NP degree he can never introduce himself to his patient as doctor or physician. He does not want to go for terminal degree DNP, since it is lot more time and money and also not required to practice as an NP. He can definitely take the boards again and apply for residency that he can do while working as an NP. He is confident he can score very high this time in USMLEs. With pay cut for some years while doing residency, he should be able to recover it afterwards since the pay for the physicians are higher than NPs, though not a whole lot.

 

[rokshana]

Thank you all for your responses. Thoracicguy, my husband will compete against other IMGs, not against AMGs. When most IMGs do not have any US clinical experience , which is always desirable by the majority of the programs, don't you think his full time RN experience in a level II trauma hospital and experience of working as an NP for a couple of years should make him competitive. Raryn, to practice as an NP one needs masters only. But people do go for DNP and work hard for two more years since it gives them satisfaction and also they can addressed as doctor. MY husband thinks with NP degree he can never introduce himself to his patient as doctor or physician. He does not want to go for terminal degree DNP, since it is lot more time and money and also not required to practice as an NP. He can definitely take the boards again and apply for residency that he can do while working as an NP. He is confident he can score very high this time in USMLEs. With pay cut for some years while doing residency, he should be able to recover it afterwards since the pay for the physicians are higher than NPs, though not a whole lot.

frankly even with a DNP you shouldn't be introducing yourself as "doctor".
point being…what does going for residency do that he can't already do with the NP? that is the question you haven't been able to answer…cuz his ego takes a hit? that's what it sounds like to me.
maybe the experience will help, but its not going to overcome the fact that he is an old grad, an FMG, with failed attempts with his steps (esp the CSA)…he's just not that competitive as an applicant (even if he is competing with other FMGs). So while not TG, IMHO, no the experience as an NP isn't going buy him all that much. And as it has been stated here, if he is looking to do something more competitive than PC, then there is even less of a chance that he would be get a spot. If he really feels the need to pursue the residency, then he needs to make some connections with the programs wherever he is and see if they will match him.

 

[mvenus929]

Thank you all for your responses. Thoracicguy, my husband will compete against other IMGs, not against AMGs. When most IMGs do not have any US clinical experience , which is always desirable by the majority of the programs, don't you think his full time RN experience in a level II trauma hospital and experience of working as an NP for a couple of years should make him competitive.

1. With the crunch in us grads and limited residency spots, he would be competing against AMGs. Maybe not the best AMGs, but still ones who want to get a job as a doctor someday.

2. No his working as a nurse will not help him get a residency position, because the two jobs are wholly different. It's like working as a cashier at a fast food joint and then trying to get a job as a head chef at a restaurant. They're both in the food industry, but they are very, very different jobs.

 

[BoardingDoc]

frankly even with a DNP you shouldn't be introducing yourself as "doctor".

Somewhat unrelated to the general topic, but THIS. This idea drove me nuts as a med student and it still does. Introducing yourself as Dr. Soandso as a DNP is disingenuous. It willfully creates a perception within the mind of the patient that you know to be false. Would it be ok for a social worker in the hospital with a PhD in sociology to introduce themselves as "doctor?" Yes, it's technically true but it needlessly complicates things and confuses/irritates patients for no reason other than the stroking of one's own ego. /rant

 

[Raryn]

Somewhat unrelated to the general topic, but THIS. This idea drove me nuts as a med student and it still does. Introducing yourself as Dr. Soandso as a DNP is disingenuous. It willfully creates a perception within the mind of the patient that you know to be false. Would it be ok for a social worker in the hospital with a PhD in sociology to introduce themselves as "doctor?" Yes, it's technically true but it needlessly complicates things and confuses/irritates patients for no reason other than the stroking of one's own ego. /rant

It's also illegal in a good number of states to introduce yourself as a doctor in a clinical setting without an MD/DO/DMD/DDS/whatever the podiatry degree is.

 

[Winged Scapula]

It's also illegal in a good number of states to introduce yourself as a doctor in a clinical setting without an MD/DO/DMD/DDS/whatever the podiatry degree is.

DPM

 

[maxxor]

It's also illegal in a good number of states to introduce yourself as a doctor in a clinical setting without an MD/DO/DMD/DDS/whatever the podiatry degree is.

Don't forget optometrist 😉