Foreign physician (almost) confused about the American system

[Zergliederung]

Hello. I am an Argentine that will soon graduate from medical school here in Buenos Aires. I am engaged to an American and as soon as I finish school we' ll move to her country. I know that I have to take the USMLEs but there's a lot of other things that work different in the US. I' m interested in a surgical residency, mostly general surgery but it could also be otorhinolaryngology or urology (or orthopedic surgery but apparently it's crazy competitive in the US for some reason, not so much here). I don't really care how much I get paid and I would preferably like to work in the Northwest. Thus, my questions are:

1) Looks like it's important to get recommendation letters. I assume that one from an Argentine doctor will be useless so how would I be able to get one from an American doctor? While taking the USMLEs can I just go to a hospital and say "Hey, I wanna help" and they will let me do it or are there programs for that? (In case it sounds crazy, here in Argentina it's normal to do it). I don't know any American doctors in the US by the way.

2) I don't quite understand the match. Here if you wanna work in a certain province (state) you have to take the residency test for that particular province, and you can take many test if you have different options. Is there only one match? Do I get to choose in what state I would like to work and I would either get that state or nothing at all or could I end up being sent to a state I didn't select?

3) How much will they care about what I did here in Argentina? Will my grades be taken into consideration considering there is a different grading system here?

Any advice? not moving is not an option =).
Thank you very much!

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[mvenus929]

1. It is common for international graduates to do some sort of observership, but I'm not sure the logistics of arranging one. You cannot just walk into a hospital and expect to do anything due to various privacy and malpractice laws.

2. So, the USMLE is nation-wide, there is no specific state tests. The match is also nation-wide, but does not necessarily include all programs. You apply to programs via ERAS, go on interviews, and then rank via NRMP the programs you interview at. The programs do the same. A computer matches you up. You can end up not matching at all, but you cannot be matched somewhere you do not rank.

3. It will vary from program to program and whether said program has any experience with your school.

 

[clausewitz2]

The relative competitiveness of ortho here versus most of the rest of the world is one of the few things in medicine susceptible to a monocausal explanation. That explanation is money.

 

[DubVille]

Hello. I am an Argentine that will soon graduate from medical school here in Buenos Aires. I am engaged to an American and as soon as I finish school we' ll move to her country. I know that I have to take the USMLEs but there's a lot of other things that work different in the US. I' m interested in a surgical residency, mostly general surgery but it could also be otorhinolaryngology or urology (or orthopedic surgery but apparently it's crazy competitive in the US for some reason, not so much here). I don't really care how much I get paid and I would preferably like to work in the Northwest. Thus, my questions are:

Not to sound overly negative but otorhinolaryngology and urology are just as competitive, if not harder, to match into than orthopedics. The Northeast is also generally "harder" to match into then the south, Midwest, and central states but that is a broad statement. Foreign graduates have much lower chances of matching, especially in most of your desired specialties. I don't know much about how a program director views Argentinian education. I'd assume it's held in higher esteem than most other South American/Carribean/Eastern European and Asian schools. Also not sure how your visa will work since many programs prefer to take residents without visa issues.

1) Looks like it's important to get recommendation letters. I assume that one from an Argentine doctor will be useless so how would I be able to get one from an American doctor? While taking the USMLEs can I just go to a hospital and say "Hey, I wanna help" and they will let me do it or are there programs for that? (In case it sounds crazy, here in Argentina it's normal to do it). I don't know any American doctors in the US by the way.

You will need to do an observship as mentioned above. Many big hospital systems have an international education department that you go through to get approval to watch. You won't really be allowed "do" anything (procedures, etc) because of malpractice/legal issues. I think to get approval through international education department you will need a CV and maybe copies of USMLE scores if you have them.

2) I don't quite understand the match. Here if you wanna work in a certain province (state) you have to take the residency test for that particular province, and you can take many test if you have different options. Is there only one match? Do I get to choose in what state I would like to work and I would either get that state or nothing at all or could I end up being sent to a state I didn't select?

As mentioned above: you will need transcripts, verification of completion of med school. USMLE scores, letters of recommendation, and a personal statement. You then apply to all desired specialties and locations (do this ASAP) when it opens (I think it opens in September approximately 10 months before you would start). Your information will be available to the programs and hopefully you start to receive interview offer over the next 2-3 months. Interviews typically happen from late October to late January. At then end of it all you ranks all the programs you interviewed at, and are interested in attending. The match is binding, so you basically have to go where you match (if you don't you will likely never have a chance of getting a residency spot). You sub,it your list in February and the programs rank their interviewed candidates and a computer tries to get you into your highest ranked position.


3) How much will they care about what I did here in Argentina? Will my grades be taken into consideration considering there is a different grading system here?

I'm not totally sure as above. My inexperienced guess is that it will be viewed better than many foreign schools since the country is more "first world/developed" and therefore should have better education/infrastructure. Most Western Europen, Australian, Canadian grads will probably be viewed in a "higher regard" but that's my guess. The great majority foreign applications here are from Asian countries and the Carribean.

Do as good as possible on the USMLE! You will need high scores to match in any surgical field. Doing research at a hospital or university would be very helpful. You will likely need to build your application by doing research, completing USMLE, and doing observship said for a year before applying. Unfortunately, large gaps after graduation are not viewed favorably either. So you really need to get your stuff together.

Good luck.

Any advice? not moving is not an option =).
Thank you very much!

 

[ThoracicGuy]

Hello. I am an Argentine that will soon graduate from medical school here in Buenos Aires. I am engaged to an American and as soon as I finish school we' ll move to her country. I know that I have to take the USMLEs but there's a lot of other things that work different in the US. I' m interested in a surgical residency, mostly general surgery but it could also be otorhinolaryngology or urology (or orthopedic surgery but apparently it's crazy competitive in the US for some reason, not so much here). I don't really care how much I get paid and I would preferably like to work in the Northwest. Thus, my questions are:

1) Looks like it's important to get recommendation letters. I assume that one from an Argentine doctor will be useless so how would I be able to get one from an American doctor? While taking the USMLEs can I just go to a hospital and say "Hey, I wanna help" and they will let me do it or are there programs for that? (In case it sounds crazy, here in Argentina it's normal to do it). I don't know any American doctors in the US by the way.

2) I don't quite understand the match. Here if you wanna work in a certain province (state) you have to take the residency test for that particular province, and you can take many test if you have different options. Is there only one match? Do I get to choose in what state I would like to work and I would either get that state or nothing at all or could I end up being sent to a state I didn't select?

3) How much will they care about what I did here in Argentina? Will my grades be taken into consideration considering there is a different grading system here?

Any advice? not moving is not an option =).
Thank you very much!

If you are able to delay your graduation to allow you to do rotations in the US, that would be ideal. General surgery could be a possibility, but ENT, Urology, and Ortho are not likely to take many FMGs.

 

[Winged Scapula]

Start here: http://www.ecfmg.org

You will need an ECFMG certificate to start residency.

 

[rkaz]

If your fiancée is willing to apply for your visa for you, that would eliminate the visa issues as you'd be soon a green card holder. You'd still face the other hurdles of being a foreign medical graduate.

 

[Crayola227]

Long hard road.

There's threads already you can look at on this board.

As far as USMLE, you will need to work incredibly hard, harder than any other test you have ever taken, because you need scores higher than any other US applicant. Unfair but true.

This is an incredibly uphill battle and lots to learn what you as a foreign (to US) medical graduate have to do to get a position.

This will be even more difficult if you and your partner try to match as a couple.

You may have to set your sights much lower in terms of what is considered "competitive" specialty here.

I suggest you start reading other threads on this board ASAP.

 

[RustBeltOnc]

Hello. I am an Argentine that will soon graduate from medical school here in Buenos Aires.

3) How much will they care about what I did here in Argentina? !

UBA is known as a decent school. I agree with the above that the surgical subspecialties might be impossible. But you can get into general surgery and some other fields.

 

[Zergliederung]

Thanks everyone for your replies. I' ve done research for the last 4 years here and I also am a pharmacology teacher assistant, hopefully that' ll help. We won't try to match as a couple (does she need to be a doctor for that? she is not), anyways, looks like I' ll get assigned to go wherever and she' ll just come along. Thanks for the green card tip. We might have to hire someone for the whole paperwork issue.

 

[dozitgetchahi]

There's an international student forum here on SDN...I'd recommend starting there as people hanging out in that forum are going to be much more useful in answering issues that apply to your situation.

 

[Winged Scapula]

Thanks everyone for your replies. I' ve done research for the last 4 years here and I also am a pharmacology teacher assistant, hopefully that' ll help. We won't try to match as a couple (does she need to be a doctor for that? she is not), anyways, looks like I' ll get assigned to go wherever and she' ll just come along. Thanks for the green card tip. We might have to hire someone for the whole paperwork issue.

Yes, the "Couples Match" assumes you are both physicians applying for a US residency position. If she is not a physician, you are not eligible for the couples match with her*.

*couples match can be with any other physician, need not be a romantic partner