For programs where >50% of residents are IMG....

[qqw]

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Is that a red flag? I assume this is because fewer US medical graduates did not apply?
I went to a program's website and viewed the "meet the residents" section and about 95% were foreign medical graduates...not just talking about carribean, im talking Iraq, Syria, etc graduates.

Also, this particular program has USMLE only listed in Frieda? There are a few DO residents though. Should I even apply as an American DO with only COMLEX?

 

[Please_Stand_By]

I've wondered this too. Thus far I've generally seen these scenarios:

Program A: 0-1% USMD, 90-95% FMG, 5-10% DO

Program B: 5% USMD, 75% FMG/IMGs, 20% DO

Program C: 100% IMG (and a few scattered FMGs).

I feel better seeing programs with 50% USMD, 30% IMG, 20% DO, but what is the point of applying to a program that's straight up all Caribbean students if you're USMD/DO? Is there some unwritten rule that they take IMGs only? It's gotta be more than chance alone...

 

[swlabr1980]

Well, there usually is a good reason why many US grads aren't ranking those programs highly.

 

[qqw]

I noticed that at these 2 programs im talking about, the progam director's name sounds foregin. I wonder if its not that US graduates rank them lower, but that the PD's are just biased towards FMG to "Even out" the bias against FMG elsewhere.

 

[gutonc]

I noticed that at these 2 programs im talking about, the progam director's name sounds foregin. I wonder if its not that US graduates rank them lower, but that the PD's are just biased towards FMG to "Even out" the bias against FMG elsewhere.

Well that went racist pretty quickly

 

[Psai]

Well that went racist pretty quickly

I don't know why people are so quick to call racism these days. It's really ****ing annoying and doesn't contribute to any conversation ever. You're acting like someone said something intentionally harmful to you personally. It wasn't even racist, it's a fact.

When you are trying to narrow down hundreds of programs to a handful that you are realistically interested in, seeing how many fmgs are there is a very easy way to weed out the undesirable programs. I don't understand how people have a problem with this basic concept.

 

[Mad Jack]

I don't know why people are so quick to call racism these days. It's really ****ing annoying and doesn't contribute to any conversation ever. You're acting like someone said something intentionally harmful to you personally. It wasn't even racist, it's a fact.

When you are trying to narrow down hundreds of programs to a handful that you are realistically interested in, seeing how many fmgs are there is a very easy way to weed out the undesirable programs. I don't understand how people have a problem with this basic concept.

He was saying that these programs might be more competitive if not for some sort of inherent bias toward FMGs, which is

1) BS

and

2) Racist because there's a hell of a lot of American-born PDs with "foreign-sounding" names. Medicine is diverse. When a third of medical students are non-white at many US schools, jumping to the non-white name=FMG conclusion is pretty damn racist.

 

[DrSnips]

I think the word you're looking for is xenophobic.

 

[gutonc]

I think the word you're looking for is xenophobic.

Agree that is a better word.

 

[Psai]

He was saying that these programs might be more competitive if not for some sort of inherent bias toward FMGs, which is

1) BS

and

2) Racist because there's a hell of a lot of American-born PDs with "foreign-sounding" names. Medicine is diverse. When a third of medical students are non-white at many US schools, jumping to the non-white name=FMG conclusion is pretty damn racist.

No he's not, he's saying that the programs are suspect because they have a ton of people from other countries and even the PD sounds like they are from a foreign country. So he's wondering if the program is mostly fmg because program directors are choosing foreign grads over amgs vs the programs suck so amgs avoid them.

Mostly FMG program, foreign sounding pd name, also likely foreign. It's a very easy conclusion to draw. Guess what homeboy? Medicine is all about making connections from limited information and assumptions play into that.

 

[visari]

It's reasonable to say that you will be careful with programs with no US grads at all because there might be a reason people are not going there (poor training, malignant, no exposure ...etc) but to say:

I noticed that at these 2 programs im talking about, the progam director's name sounds foregin. I wonder if its not that US graduates rank them lower, but that the PD's are just biased towards FMG to "Even out" the bias against FMG elsewhere.

http://www.troll.me/images/full-******/you-just-went-full-potato-man-never-go-full-potato.jpg

 

[the argus]

The main problem is not that the comment was racist or xenophobic. The main problem is that it was stupid and ridiculous. It shows a fundamental lack of knowledge and understanding about GME in the United States. There are brand new Charting Outcomes documents that will help illustrate this.
http://www.nrmp.org/match-data/main-residency-match-data/

in 2016, USMDs had a 98% (3422/3506) match rate in IM.
in 2016, DOs had a 87% (503/577) match rate in IM.

There were 7,352 total spots in IM offered this year. Even if every AMG that applied (4,083) matched, there would have still been >3,200 categorical IM spots unfilled this year.

The reason you see IM programs filled completely with IMGs/FMGs is because there aren't enough US grads applying to fill the available spots. These programs are considered less desirable, and the lack of AMGs is a reflection of 2 possible things. Either 1) AMGs do not want to train there, or 2) the PD would rather take a FMG with high board scores than a bottom of the barrel AMG applicant.

It has nothing to do with FMG PD's wanting to "even out" bias. If desirable AMGs were applying to and ranking these programs, the programs would take them.

 

[235009]

I noticed that at these 2 programs im talking about, the progam director's name sounds foregin. I wonder if its not that US graduates rank them lower, but that the PD's are just biased towards FMG to "Even out" the bias against FMG elsewhere.

Basically the same thing


Sent from my iPhone using SDN mobile app

 

[qqw]

lol... well first, im not a "he". please check out the symbol to the left.

second, i'm not white. I'm American born though.

if you think that was racist, you likely have "guilty white boy syndrome", (or perhaps just a disgruntled, reverse-racist, non-white individual quick to complain about anything) 😉

im not the same "brown" as the PD though. so i suppose you can still argue racism to 1) satisfy some of that guilt you suffer from and 2) prove to everyone what a good person you are

its totally reasonable to question why a UNIVERSITY program with fellowships have 98% medical graduates from outside the country, including outside Caribbean. and mostly from certain countries (do they also not get any applicants from china, india, europe, africa...???)

Very odd that these 2 programs are consistently avoided by American applicants, Caribbean applicants, and most foreign applicants from outside a general geographical region. Could be coincidence, could be just the way the chips fell (for all 3 years), but not all of us are terrified to explore other reasons.


Anywho...back to my original question, are these worth applying for?
I kinda hope the guilt-ridden posters here are right, cause then I'm sure I'll get in right away and likely get that fellowship I want because I'm an American graduate, and the reason they have so many FMGs is cause no other american graduates apply! I got this! 😀

 

[the argus]

lol... well first, im not a "he". please check out the symbol to the left.

second, i'm not white. I'm American born though.

if you think that was racist, you likely have "guilty white boy syndrome", (or perhaps just a disgruntled, reverse-racist, non-white individual quick to complain about anything) 😉

im not the same "brown" as the PD though. so i suppose you can still argue racism to 1) satisfy some of that guilt you suffer from and 2) prove to everyone what a good person you are

its totally reasonable to question why a UNIVERSITY program with fellowships have 98% medical graduates from outside the country, including outside Caribbean. and mostly from certain countries (do they also not get any applicants from china, india, europe, africa...???)

Very odd that these 2 programs are consistently avoided by American applicants, Caribbean applicants, and most foreign applicants from outside a general geographical region. Could be coincidence, could be just the way the chips fell (for all 3 years), but not all of us are terrified to explore other reasons.


Anywho...back to my original question, are these worth applying for?
I kinda hope the guilt-ridden posters here are right, cause then I'm sure I'll get in right away and likely get that fellowship I want because I'm an American graduate, and the reason they have so many FMGs is cause no other american graduates apply! I got this! 😀

what university program is this? I don't recall any programs that fit this description from when I went through the process a few years ago.

 

[notinkansas]

He was saying that these programs might be more competitive if not for some sort of inherent bias toward FMGs, which is

1) BS

and

2) Racist because there's a hell of a lot of American-born PDs with "foreign-sounding" names. Medicine is diverse. When a third of medical students are non-white at many US schools, jumping to the non-white name=FMG conclusion is pretty damn racist.

Since many web sites list the school that residents, faculty and program directors attended, you can't assume the determination was made by "foreign sounding" names.

 

[thehundredthone]

No he's not, he's saying that the programs are suspect because they have a ton of people from other countries and even the PD sounds like they are from a foreign country. So he's wondering if the program is mostly fmg because program directors are choosing foreign grads over amgs vs the programs suck so amgs avoid them.

No, they were wondering if the program is mostly FMG because the program director has a 'foreign sounding' name and is thus choosing foreign graduates over equally qualified AMGs in an attempt to somehow "even out the bias against FMGs elsewhere".

Mostly FMG program, foreign sounding pd name, also likely foreign. It's a very easy conclusion to draw. Guess what homeboy? Medicine is all about making connections from limited information and assumptions play into that.

Why do you assume the information is limited? You can look up the medical education of most program directors to see if they're AMGs, can you not?

Anywho...back to my original question, are these worth applying for?
I kinda hope the guilt-ridden posters here are right, cause then I'm sure I'll get in right away and likely get that fellowship I want because I'm an American graduate, and the reason they have so many FMGs is cause no other american graduates apply! I got this! 😀

What is your question, really? Are you asking whether the reason that the program is largely FMG is because American graduates apply and don't match? Do you feel like you will get a representative sample for that based on the answers on this forum? Because the post quoted below is quite factual with the numbers. If you're wondering about applying with just COMLEX scores, contact the program administration and ask them. I say this because you're asking specifically about 2 programs. Also, fellowship is an entirely different ball game.

There were 7,352 total spots in IM offered this year. Even if every AMG that applied (4,083) matched, there would have still been >3,200 categorical IM spots unfilled this year.

The reason you see IM programs filled completely with IMGs/FMGs is because there aren't enough US grads applying to fill the available spots. These programs are considered less desirable, and the lack of AMGs is a reflection of 2 possible things. Either 1) AMGs do not want to train there, or 2) the PD would rather take a FMG with high board scores than a bottom of the barrel AMG applicant.

You're wrong, they're taking our jerbs. Everyone wants a meritocracy until they realize they were deemed not good enough. There may be a fraction of MDs that would rather have 3200 more unfilled spots and 3200 fewer IM graduates each year than see someone with a 'foreign name' fill them. "Someone's gotta fill the primary care deficiency, but it won't be me, and it can't be the IMG/FMG, and definitely not the midlevel."

 

[Mad Jack]

Since many web sites list the school that residents, faculty and program directors attended, you can't assume the determination was made by "foreign sounding" names.

I noticed that at these 2 programs im talking about, the progam director's name sounds foregin.

His methodology was clearly stated. Regardless, even if a PD is foreign, they are unlikely to favor IMGs over US grads, but are rather more likely to put them on a more even footing if they are from an institution they are personally more familiar with from overseas. I doubt there are a bunch of bitter IMG PDs that are merrily burning US MD apps while muttering about how they'll teach the US grads a lesson or some such nonsense. It implies this "us versus them" mentality that I've never really seen exhibited in the hospital.

 

[the argus]

I doubt there are a bunch of bitter IMG PDs that are merrily burning US MD apps while muttering about how they'll teach the US grads a lesson or some such nonsense. It implies this "us versus them" mentality that I've never really seen exhibited in the hospital.

Off topic, but replace IMG with DO and this is the exact thought process that a bunch of "knowledgable" people on this forum cite for why MDs won't take previous AOA residency positions in competitive specialties post merger.

 

[Mad Jack]

Off topic, but replace IMG with DO and this is the exact thought process that a bunch of "knowledgable" people on this forum cite for why MDs won't take previous AOA residency positions in competitive specialties post merger.

Oh, I fully agree. DOs are going to lose out hard post-merger in the competitive specialties. If even half of those spots go to MDs, that's a huge blow (plus many programs will close anyway). I predict more than half of the slots will go MD, because they're going to take the best candidates they can.

 

[qqw]

His methodology was clearly stated. Regardless, even if a PD is foreign, they are unlikely to favor IMGs over US grads, but are rather more likely to put them on a more even footing if they are from an institution they are personally more familiar with from overseas. I doubt there are a bunch of bitter IMG PDs that are merrily burning US MD apps while muttering about how they'll teach the US grads a lesson or some such nonsense. It implies this "us versus them" mentality that I've never really seen exhibited in the hospital.

Guilt Jack has a point. Its impossible for a PD to have bias and can't be included as a possible scenario. They are robot-like beings who have no emotion or life experiences.
A US MD program with fellowships that repels nearly all American graduates, MD and DO alike, Caribbean graduates, and foreign graduates from the majority of the world has a very good explanation, one that preferably does not provoke much guilt.

One possible scenario is that this specific program's link on ERAS has unfortunately been broken for all except a select geographic location where it can be presumed that ERAS's servers happen to be the strongest.

Furthermore, concepts such as "its who you know", networking, favoritism, and bias - while prevalent in all other workplaces - do not exist in medicine because jack has never personally seen it exhibited with her own eyes.

We don't know for sure. We may never know. All we know is that the reason is the most comfortable, least offensive one.

 

[the argus]

Guilt Jack has a point. Its impossible for a PD to have bias and can't be included as a possible scenario. They are robot-like beings who have no emotion or life experiences.
A US MD program with fellowships that repels nearly all American graduates, MD and DO alike, Caribbean graduates, and foreign graduates from the majority of the world has a very good explanation, one that preferably does not provoke much guilt.

One possible scenario is that this specific program's link on ERAS has unfortunately been broken for all except a select geographic location where it can be presumed that ERAS's servers happen to be the strongest.

Furthermore, concepts such as "its who you know", networking, favoritism, and bias - while prevalent in all other workplaces - do not exist in medicine because jack has never personally seen it exhibited with her own eyes.

We don't know for sure. We may never know. All we know is that the reason is the most comfortable, least offensive one.

You still haven't told us which programs you are talking about. Please be specific. Just because a program has fellowships doesn't make it a university program.

 

[Mad Jack]

Guilt Jack has a point. Its impossible for a PD to have bias and can't be included as a possible scenario. They are robot-like beings who have no emotion or life experiences.
A US MD program with fellowships that repels nearly all American graduates, MD and DO alike, Caribbean graduates, and foreign graduates from the majority of the world has a very good explanation, one that preferably does not provoke much guilt.

One possible scenario is that this specific program's link on ERAS has unfortunately been broken for all except a select geographic location where it can be presumed that ERAS's servers happen to be the strongest.

Furthermore, concepts such as "its who you know", networking, favoritism, and bias - while prevalent in all other workplaces - do not exist in medicine because jack has never personally seen it exhibited with her own eyes.

We don't know for sure. We may never know. All we know is that the reason is the most comfortable, least offensive one.

I never said there isn't inherent bias, just that it isn't specifically IMG vs US MD bias. Reading comprehension dude.

 

[rokshana]

Mostly FMG program, foreign sounding pd name, also likely foreign. It's a very easy conclusion to draw. Guess what homeboy? Medicine is all about making connections from limited information and assumptions play into that.

Sanjay Gupta.... Must be an FMG....

 

[rokshana]

lol... well first, im not a "he". please check out the symbol to the left.

second, i'm not white. I'm American born though.

if you think that was racist, you likely have "guilty white boy syndrome", (or perhaps just a disgruntled, reverse-racist, non-white individual quick to complain about anything) 😉

im not the same "brown" as the PD though. so i suppose you can still argue racism to 1) satisfy some of that guilt you suffer from and 2) prove to everyone what a good person you are

its totally reasonable to question why a UNIVERSITY program with fellowships have 98% medical graduates from outside the country, including outside Caribbean. and mostly from certain countries (do they also not get any applicants from china, india, europe, africa...???)

Very odd that these 2 programs are consistently avoided by American applicants, Caribbean applicants, and most foreign applicants from outside a general geographical region. Could be coincidence, could be just the way the chips fell (for all 3 years), but not all of us are terrified to explore other reasons.


Anywho...back to my original question, are these worth applying for?
I kinda hope the guilt-ridden posters here are right, cause then I'm sure I'll get in right away and likely get that fellowship I want because I'm an American graduate, and the reason they have so many FMGs is cause no other american graduates apply! I got this! 😀

In this instance DO does not equal AMG...
There are programs that prefer DOs over F/IMGs and programs that prefer F/IMGs over DOs... For the most part no one prefers either over a solid AMG...

And the program may have taken people from a certain school or program because simply they are familiar with the product of that school... They had a good resident and are willing to take them over someone from a different school... But for you, as a DO... It probably doesn't make much sense to apply to places that don't have a DO presence.

 

[Psai]

Sanjay Gupta.... Must be an FMG....

It's called context clues, learn about it

 

[DOorDONT]

I don't understand what's so difficult about this. YES, program directors that are FMG, have taken FMG grads over MD/DO grads. This is RAMPANT in the NYC area. The NYC area is all about board scores. At one of my clinical rotation sites, there was interview day. There was an American MD student who wanted the IM position in a Brooklyn hospital. There was also an FMG at that same interview. The US MD student only had 6-8 weeks to study for Step 1 and got a respectable 230. The FMG, came from India, had 2 YEARS!!! To study for STEP 1, and got a 262. The FMG ended up getting the job (I realized this weeks later, when I met him again) over the American MD student. In a business stand point it makes sense. The FMGs are "indentured servants" in a way. The program directors hold their VISAS so they can't speak up and they have to work over 100hours a week because, they're "free labor". So I can see why Program Directors would want FMGs over an American MD/DO. If you're running a business, wouldn't you want a worker that you don't have to train and works for free?

 

[DOorDONT]

I think as we have more and more medical students graduating in the United States, STEP 1 scores and STEP 2 scores will be EXTREMELY CRUCIAL. Medical schools better start gearing up in the "STEP Scores ARMs RACE". US MD schools should probably just start creating curriculums around STEP 1 and how to do very well, so their students get higher scores and have all their doors open.

 

[868853]

I went to SLR/Mount Sinai St Luke's-Roosevelt. It's known as being one of the better university-affiliated programs in NYC/the country, decent research opportunities, decent fellowship match, minimal scut (by NYC standards) etc and I can shed a bit of light on the topic.

Usually AMGs are preferred over DOs and IMGs with the rest of the applications being equal. Programs, like SLR, with a high percentage of IMGs tend to have more due to IMGs having much higher USMLE scores, than the AMGs who are interviewing there, and therefore are more likely to pass their IM boards. As soon as a board pass rate starts to falter one of the first intervention these programs make is to recruit more IMGs with strong scores. AMGs with 200-220 on their USMLEs are likely to find themselves in a university program, somewhere, and those same AMGs are the ones who are more likely to fail their IM boards and hurt the program's pass rate.

Most (IMG) SLR residents score 240s-260s on their Step 1 & Step 2.

Basically, IMGs with great USMLEs and DOs with mediocre-great USMLEs, are favored over AMGs with very poor USMLEs at most programs. And this is the make-up of most of the interviewed candidates at the programs that have more IMGs/DOs than AMGs.

Tbh, there was always a stigma surrounding SLR because it had a high percentage of IMGs that made AMGs stay away, I'm happy because I benefited from it created an opportunity for me and it was a great place to be a resident, however, I could never really figure out why so many AMGs stayed away just because it's a "community" program, our fellowship match was and is better than a fair amount of mid/low-tier university programs, and having friends at university programs in other cities we had it better in a lot of ways as residents.

The only thing I would consider a proper red flag from an applicant standpoint is a program that is 100% Caribbean graduates, think of the smaller programs in Brooklyn. Because some people graduate from Carib programs with 210s on their USMLEs and match, but with a profile like that you can bet they're going to end up at the most malignant of programs.

 

[NITRAS]

I went to a program that was almost exclusively IMG. I had terrible step 1 score who made interesting match ranking....oops. The location was pretty undesirable, (unless you like heat, and 5 hours from anywhere you want to go). A pretty even mix between India/Pakistan, Middle East, and Central American countries. Mostly pretty sharp people, but I felt I had a strong leg up in medical education, plus English as a first language helped with 70% of the patients. I feel I learned medicine pretty well, but certainly not a tertiary academic center.

The PD was white......if that matters.

 

[GastriqueGraffin]

If you as a program can avoid having to sponsor visas while having better fellowship matches and job placements (thus making the program look more attractive) why not? Additionally many are affiliated with medical schools and will give preference to their own students.

In answer to OP, I’d say it’s a relative red flag but don’t use their fellowship match as a meter for how good their program is because it would be comparing apples and oranges.

 

[Anicetus]

If you as a program can avoid having to sponsor visas while having better fellowship matches and job placements (thus making the program look more attractive) why not? Additionally many are affiliated with medical schools and will give preference to their own students.

In answer to OP, I’d say it’s a relative red flag but don’t use their fellowship match as a meter for how good their program is because it would be comparing apples and oranges.

That makes sense but why do some of the top IM programs have FMGs (not Caribbean) and no DOs with that mentality of dealing with visas If the straight up reject most of the American MDs that apply?

 

[rokshana]

That makes sense but why do some of the top IM programs have FMGs (not Caribbean) and no DOs with that mentality of dealing with visas If the straight up reject most of the American MDs that apply?

Realize that many of the FMGs are coming from domiciled schools where it’s as difficult or even more difficult to get into med school...they are the best of their countries students...Many, if not most, DO students went DO because they couldn’t get into a USMD school...programs know that.

 

[GastriqueGraffin]

That makes sense but why do some of the top IM programs have FMGs (not Caribbean) and no DOs with that mentality of dealing with visas If the straight up reject most of the American MDs that apply?

Many of those IMGs have stellar applications and can contribute greatly to the program with not just knowledge with 100% board passage rate but also with excellent research background and fellowship prospects. Many of those IMGs only red flag is that they happen to be from a different country from birth.

DOs and Caribbean MDs have a lot of stigma associated with them relating to their knowledge and test taking abilities. Often their only positive aspect is that they don’t have visa issues.

These are all generalities and of course we all know of many exceptions in both cases.