FMG - Some help please

[ll1002]

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Hi to all, I'm a FMG graduating this year from a university in the UK. For many reasons, I want to emigrate to the US, but am finding the process of getting licensed to work there very complicated.

The basic process, as I understand, is:
1) Pass the USMLE
2) Get ECFMG certified
3) Apply for the residency matching

The problem is, for family reasons, I may need to stay on in the UK for the next 5 years or so. During this time, I will be working and continuing with my training in UK hospitals. So, here are some questions I have:

1) Will any of my specialty training in the UK count at all? Or will I have to start everything from scratch (redo all of residency)? Could I potentially have a shorter residency, seeing that I've had some years of training in the UK?
It's pretty depressing to know that I'll have to start all over again, at an age where I may have a family of my own which would make residency somewhat harder to go through. I know this would be the likely scenario, but am hoping against the odds that someone here has heard of FMGs whose prior specialty training in another country was recognised and had his/her residency length reduced.


2) In a thread below, someone mentioned that the longer you're out of med school, the harder it'll be to get into a residency program. Is this still the case even if I've been actively working as a doctor during those years after med school?


3) Is the matching process the only way to apply for residency positions?

4) Will recruiters help at all in this situation ?

Would greatly appreciate any info at all. The whole process is is complicated and feels rather overwhelming. If there are any FMG who managed to go through this and are now working in the US, could you please share your experience or give some guidance? Many thanks for reading this.

 

[NotAProgDirector]

Hi to all, I'm a FMG graduating this year from a university in the UK. For many reasons, I want to emigrate to the US, but am finding the process of getting licensed to work there very complicated.

The basic process, as I understand, is:
1) Pass the USMLE
2) Get ECFMG certified
3) Apply for the residency matching

I would suggest you change #1 to "Do as well on the USMLE as possible". A barely passing score will make getting a spot much more difficult, although not impossible.

Also, you've left off the process of getting a green card/visa, which is part of the matching process but is a whole experience in it's own right.

The problem is, for family reasons, I may need to stay on in the UK for the next 5 years or so. During this time, I will be working and continuing with my training in UK hospitals. So, here are some questions I have:

1) Will any of my specialty training in the UK count at all? Or will I have to start everything from scratch (redo all of residency)? Could I potentially have a shorter residency, seeing that I've had some years of training in the UK?
It's pretty depressing to know that I'll have to start all over again, at an age where I may have a family of my own which would make residency somewhat harder to go through. I know this would be the likely scenario, but am hoping against the odds that someone here has heard of FMGs whose prior specialty training in another country was recognised and had his/her residency length reduced.

You will not get any credit for your UK training. I have heard rumors of people getting 1 year of credit for some amount of foreign training, but have never actually met anyone who has done this. It will be board specific -- i.e. it might happen in IM or FP but certainly will not happen in Surgery.

In addition, the board (i.e. the ABIM for medicine) would need to be petitioned to grant this credit, and only program directors can petition the board. So, you would need to first find a program willing to take you, then they would need to petition the board for advanced credit, and then the board might (or might not) grant the credit. You can't petition the board yourself, get the credit, and then look for a PGY-2 position.

2) In a thread below, someone mentioned that the longer you're out of med school, the harder it'll be to get into a residency program. Is this still the case even if I've been actively working as a doctor during those years after med school?

Yes, although it depends on what you're doing. If you're working as a GP in an office, your inpatient skillset will be deteriorating and PD's will worry. If you are working in an inpatient setting, or especially if you are working in an academic setting, then it won't be as big a deal.

3) Is the matching process the only way to apply for residency positions?

No. IMG's can sign "prematch" contracts outside the match. Basically, the easiest way to do this is to apply during the usual application season (Sept-Nov) and interview. Programs may offer you a spot outside the match, and then you have to decide to either take it or stay with the match and try to get something "better", but risk getting nothing. You can also try to get a spot off cycle -- there is no central list of such programs (although SDN is trying!) and it's basically trial and error.

4) Will recruiters help at all in this situation ?

No. residency programs are listed on the AMA's website via FREIDA, you can review them and apply vis ERAS. A recruiter will not help much, unless they help you focus on which programs make the most sense for you / take IMG's / etc.

 

[Winged Scapula]

You will not get any credit for your UK training. I have heard rumors of people getting 1 year of credit for some amount of foreign training, but have never actually met anyone who has done this. It will be board specific -- i.e. it might happen in IM or FP but certainly will not happen in Surgery.

Actually, last fall the ABS changed their policy on foreign training and is is *possible* to be granted some credit for foreign surgical training: http://home.absurgery.org/default.jsp?policycredforeign&ref=index_pd

In addition, the board (i.e. the ABIM for medicine) would need to be petitioned to grant this credit, and only program directors can petition the board. So, you would need to first find a program willing to take you, then they would need to petition the board for advanced credit, and then the board might (or might not) grant the credit. You can't petition the board yourself, get the credit, and then look for a PGY-2 position.

As noted in the link above, this is also how it works in surgery. You may be approved for a year's credit if you have done 3-4 years of surgery abroad (or you may get 2 years credit if you have completed surgical training abroad and have the equivalent of Board Certification), but you have to be in a US program who has to petition the board for you.

 

[buckley]

I agree...passing the USMLE is not enough, strive to do well. it's a competition, really. You must also think about visa issues. If you are going for the H1 visa, you need to take Step 3 and get a program willing to sponsor you for it.

To reiterate and add points:

In general, you can't take credit for training outside the US.

You can take posts outside the match, but your options would be limited. If you join the match, come eras season, some PDs might offer you a "pre-match", you can legally take this, but you will have to withdraw from the match. Rightly so, considering you are already signing a contract with someone.

Year of grad does come into play, but of course if you spent the last 5 years being an uber glorious physician with lots of published works, that would be a plus. It's tricky about doing previous residencies. Some PDs like them (imagine an intern who can do the work of an attending) and some don't (harder to unlearn than to teach a new slate). More often though, the earlier you apply, the better. We live in a world where youth is a virtue.

There are many "plus" and "minus" and lots of gray areas. Fom what I've learned, really, just do the best with what you have. So you're an old grad, what can you do? Other than beating yourself up or berating those young ones, go improve that CV. If your Mle scores are pretty low (this is quite hard to remediate, so do really well), go for geat LORs. My main fault was that I did not have any US experience. So I just addressed that during the interviews.

I honestly don't think you need recruiters. Save your money. It's a lot of work and can be very nerve racking at times, but it can be done.


Good luck!

 

[ll1002]

Lots of thanks to everyone who replied. I've been doing a lot of reading on this, and am getting a clearer picture of the process, and starting to plan a timeline for myself. At least I now know there may be some chance of receiving credit for my training in the UK, and could at the very least enquire about it when I apply. My apologies for crossposting this in the international board - I was worried FMGs who've gone through the pracess may not read this board if they're done with residency. I'll probably have more questions as I go along, and it's good to know I can get some help here. Thank you.