turquoiseblue

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if someone would post up all the residency requirements (criteria) for all specialties for FREE!!

why do we have to email each and every program to find that information out. it is painstaking work and criteria sometimes change yearly

maybe they should state it on ERAS so we know what we qualify for....since ERAS rules the land anyways...and we pay for it....

why do people have to spend so much money to so many sites that have varying information, just to access information that could be provided on a list that could be compiled for free??!!

why can't all the programs join forces and create a floating movable criteria list, since they've decided to have criteria at all when initially in the old days they didn't have hardly any criteria and just passing was considered good as gold?

change is good!

by the way, last time I checked, (which was many years ago)...I heard that the AMA prohibited score criteria so that applicants can be viewed as their entire picture rather than by just a score. Why do they yet still make criteria and stand strong by it when it really isnt allowed?
 
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brotherman

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if someone would post up all the residency requirements (criteria) for all specialties for FREE!!

why do we have to email each and every program to find that information out. it is painstaking work and criteria sometimes change yearly

maybe they should state it on ERAS so we know what we qualify for....since ERAS rules the land anyways...and we pay for it....

why do people have to spend so much money to so many sites that have varying information, just to access information that could be provided on a list that could be compiled for free??!!

why can't all the programs join forces and create a floating movable criteria list, since they've decided to have criteria at all when initially in the old days they didn't have hardly any criteria and just passing was considered good as gold?

change is good!

by the way, last time I checked, (which was many years ago)...I heard that the AMA prohibited score criteria so that applicants can be viewed as their entire picture rather than by just a score. Why do they yet still make criteria and stand strong by it when it really isnt allowed?
I would venture a conjecture the reason why the criteria are based heavily on scores is the large number of applicants per available spot. Its simple supply and demand. As the number of spots relative per applicant decreases, the ability of the programs to be discriminatory using whatever criteria they deem useful increases. Hence, scores are used, because they are a proxy, albeit imperfect, for predicting a resident's performance.
As to why things should be free? Why should someone spend hours and hours of time, to go through various websites of programs, compile different requirements and then post them on a website for free? Unless, of course, this website is comprised of user generated content.
 

aProgDirector

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Part of the problem is that many programs, including mine, don't have strict criteria. In general I'd like a USMLE score to be above a certain cutoff, but that's just one factor. I look at the whole application. So if I publish a "cutoff", some people who are below that cutoff might have actually gotten interviewed had they applied (or I'd simply answer "flexible" to what my cutoff was).

As for the AMA saying that USMLE scores can't be used for residency selection, I'm not sure what you are referring to. But, I can say that 1) I'm not a member of the AMA, 2) I don't care what the AMA says, and 3) They can't dictate how I run my program.
 

turquoiseblue

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Part of the problem is that many programs, including mine, don't have strict criteria. In general I'd like a USMLE score to be above a certain cutoff, but that's just one factor. I look at the whole application. So if I publish a "cutoff", some people who are below that cutoff might have actually gotten interviewed had they applied (or I'd simply answer "flexible" to what my cutoff was).

As for the AMA saying that USMLE scores can't be used for residency selection, I'm not sure what you are referring to. But, I can say that 1) I'm not a member of the AMA, 2) I don't care what the AMA says, and 3) They can't dictate how I run my program.
That's cool. It is good for many programs to not have strict criteria or too many people will get cut off and go to medical school for nothing.

It's just that these cut offs create a possibility of an MD taking the USMLE and never becoming a resident in the US, which is difficult for the US citizens, especially if they get stuck with a USMLE score that they can't change. If they are to have score criteria, then I would hope that they make it so that someone can retake the USMLE to improve their score, but of course that hasn't happened yet.

The score criteria creation may account for the rift of US citizens that don't get selected in a residency program, which outweigh the number of those on visas who do get in who happened to score higher. I'm not saying I dont want them here, I'm just saying that where do these left out US citizens go if they can't practice in their home country (the US). Of course someone on a visa wants to be here too and i dont mind that, but why would they get preferred over a US citizen. some of them even think that it is unfair and wonder how they got in so easy and a US citizen did not.

Not to mention, a person who was from antoher country did residency there and can already be a doctor and come here and get residency easier than a measly us citizen who went to the carribean and has no prior experience.

Of course we (the US) run on laissez faire, but its not fair (pun intended) to its own citizens.

Even my immigrant parents agree on the unfairness that the US residency programs can't even take US citizens as opposed to someone who does not reside here in the states.

But really I wish everyone could get into residency. The world would be a happier place.

I just saw someone who had multiple attempts on their steps (more than me) match into FP, whereas I applied to the same programs and got nothing.
They can fail many times but happen to get a high score in the end....some get a low score in the end but not as many attempts...

There's just a little bit of discombobulation in the selection process.

All in all i hope i get in somewhere some day and wish the same for others too. I'm just talking about how bout some fairness and justice for all.
 
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Touchdown

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Why not instead of cutoffs posting average USMLE scores (broken down between US Seniors and IMGs) and the middle 50 spread like every undergrad and medical school does. That way you dont have to commit to a cut off but we know our realitive chances.
 
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if someone would post up all the residency requirements (criteria) for all specialties for FREE!!

why do we have to email each and every program to find that information out. it is painstaking work and criteria sometimes change yearly

maybe they should state it on ERAS so we know what we qualify for....since ERAS rules the land anyways...and we pay for it....

why do people have to spend so much money to so many sites that have varying information, just to access information that could be provided on a list that could be compiled for free??!!

why can't all the programs join forces and create a floating movable criteria list, since they've decided to have criteria at all when initially in the old days they didn't have hardly any criteria and just passing was considered good as gold?

change is good!

by the way, last time I checked, (which was many years ago)...I heard that the AMA prohibited score criteria so that applicants can be viewed as their entire picture rather than by just a score. Why do they yet still make criteria and stand strong by it when it really isnt allowed?
I think like aprogdirector said, it's the whole package. Interestingly, on one of my interviews, a program director showed me his ERAS view, and how he can custom set a lot of filters. If you set a filter at Step 1 240, you may have only 10 people interviewing at your Family Medicine program, but if you set it at 200, you might have a lot more, for example. I'm sure it changes every year based on the applicant base. Then again, I've heard a lot of program directors say they spend a moment to at least glance through each and every application. I certainly imagine once you've gone through several thousand applications and several residency classes, you internalize a ton of decision-making criteria and develop a "gestalt" about selecting people.

USMLE averages are already posted for every specialty - ex. the average plastics applicant has a 241. Most American applicants have access to a Dean's office or Department Chairman / PD at their home institution, who can easily tell them where they would be competitive. Isn't there also a document that shows how program directors prioritize selection criteria?
 

odieoh

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I don't really think there is a need for some sort of centralized system for this. Most people generally know based on their board scores what specialties they would be competitive for. Within each specialty there are some programs that are more competitive and some not so much. People can apply broadly and include some of the ultracompetitive programs along with more realistic ones if board scores are a concern. I really doubt that too many programs within the less competitive fields have a hard cutoff line for board scores. More competitive specialties often do have a cutoff just as a way of narrowing the field because there are so many applicants.

You are in a unique and regrettable situation Turquoise. Honestly I don't know of anyone else in your predicament. Your posts sometimes imply that there are lots of others who have finished med school yet are unable to find residency spots. I just don't think that's the case. In the rare case it does happen, I have a hard time imagining it being something other than the resident/med student sabotaging themself. You started and subsequently quit 2 different residency spots, correct? If that is true, and there are also board score concerns, well that is a recipe for disaster.
 

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Also, a filter for passing scores may not do someone much good if they have a bunch of fails on their record. I don't know how the scores are listed/filtered, but if it is a minimum score then the failed exams may come up as kicking someone out (due to not reaching the minimum score) even if they had a passing score later on.
 
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Also, a filter for passing scores may not do someone much good if they have a bunch of fails on their record. I don't know how the scores are listed/filtered, but if it is a minimum score then the failed exams may come up as kicking someone out (due to not reaching the minimum score) even if they had a passing score later on.
I believe that only the most recent score is reported by the filter. I don't believe # of attempts is a possible filter.

Here is the ERAS user manual for residency programs:
http://www.aamc.org/programs/eras/programs/techsupport/downloads/2010pdwsresidency.pdf

It has a section on filters. One I found interesting was filtering by medical schools "with a special association to your program" -- which may be designed for home programs to interview home school applicants... but the phrasing in that manual implies (to me) that it could facilitate the classic UCSF/Harvard conduit, or Cornell/Columbia for example. Obviously AOA status is another classic filter, but I am surprised grades are not included as a possible filter.

Here is another link about filtering criteria:
http://forums.studentdoctor.net/showthread.php?t=465227
 

turquoiseblue

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if the system is to remain the way it is, and if that many IMG US citizens can't get into US residency due to score criteria and heavy competition, shouldn't something be done about it so that they can have a job somehow in the United States? Maybe there can be some way for these residents to improve so they can definitely get in. it is very difficult to get a job as a US IMG and even as a nonUS IMG.


There are 25,520 spots in the Match with 33,534 total applicants. 5508 are US IMGS (1946 didn't match--1749 did), 10,671 are nonUS IMGs (4365 didn't match--2881 did). Thus, 1946 US IMG's + 1078 US grads didn't match. 17,127 are US grads (1078 +747 didn't match). This scramble only had 414 PGY1 positions and 46 PGY2 positions for thousands of left out IMG's to compete for.

I'm sure if I went to another country Im not going to be preferred over their citizens. Shouldn't there be a system put in place so that some of these repeats will eventually get in..like a program for residents to improve their application (because i know that research doesn't help that much and puts you further from your medical education)..it's not right that people that went to med school have to be out of a job.

"im just sayin'!'
 
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odieoh

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if the system is to remain the way it is, and if that many IMG US citizens can't get into US residency due to score criteria and heavy competition, shouldn't something be done about it so that they can have a job somehow in the United States? Maybe there can be some way for these residents to improve so they can definitely get in. it is very difficult to get a job as a US IMG and even as a nonUS IMG.

Shouldn't there be a system put in place so that some of these repeats will eventually get in..like a program for residents to improve their application (because i know that research doesn't help that much and puts you further from your medical education)..it's not right that people that went to med school have to be out of a job.

"im just sayin'!'
Once again Turquoise, I'm really sorry about your situation. But you just have such a messed up view of things. Who is it that you think is going "do something" about any of this and why should they? What exactly would a "program for residents to improve their application" consist of? Who would pay for such a program and what really could they do to improve an applicant's application? Take your own case. What do think it is going to take to improve your application? How could some government sponsored program help you? And why should taxpayer money go toward such a program to assist medical graduates who have dug their own graves and subsequently want help getting back out?
 

turquoiseblue

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Once again Turquoise, I'm really sorry about your situation. But you just have such a messed up view of things. Who is it that you think is going "do something" about any of this and why should they? What exactly would a "program for residents to improve their application" consist of? Who would pay for such a program and what really could they do to improve an applicant's application? Take your own case. What do think it is going to take to improve your application? How could some government sponsored program help you? And why should taxpayer money go toward such a program to assist medical graduates who have dug their own graves and subsequently want help getting back out?
How is this a messed up view. it is reality and it is true. something should be done.

there are a lot of people out there with this exact same view. it is not just me. its just that many of them don't bother to come on this particular site, but I know exactly where they are. you are on the other side of the green grass where it's greener so you don't realize that what you say against change in this system. it does'nt really pertain to you im sure you don't care to change a thing because you personally don't need it, but there are others that do.

this site shows there are 300+ people that share this view and many others who haven't yet signed this. i didn't create this by the way someone else did: http://www.thepetitionsite.com/1/j1-visa-abuse and http://www.thepetitionsite.com/m/sign/593616478

If they continue to use score as criteria, they might as well either allow the passing score to be 80 so that no one can pass until they get that score or just allow people to retake the exam until they can reach that level. A 75 is good enough to be ecfmg certified, yet that certification is no good without a score of 80 or above or so it seems.
 
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odieoh

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Well, you were on the green side of the fence as well. Twice. And twice you jumped back over to where you are.

Please answer the questions about what you think a government sponsored program would do to help applicants in your situation.
 

turquoiseblue

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Once again Turquoise, I'm really sorry about your situation. But you just have such a messed up view of things. Who is it that you think is going "do something" about any of this and why should they? What exactly would a "program for residents to improve their application" consist of? Who would pay for such a program and what really could they do to improve an applicant's application? Take your own case. What do think it is going to take to improve your application? How could some government sponsored program help you? And why should taxpayer money go toward such a program to assist medical graduates who have dug their own graves and subsequently want help getting back out?
Here are your answers: the government, ECFMG, ACGME, or the current program directors should do something about it. or anyone for that matter who can do something. It is a democracy so the people rule, and even minorities should get chances too. A program for residents may consist of maybe a year of clinical resident work that doesn't count toward a degree, but is at least paid and is a place to learn and improve any possible deficiences. There are very few places that offer this...(PAs or medical assistants do this these days but I think they should allow for MD's to do that too, there are not that many of them anyways, at least 2000 or less. You can't be a PA or MA unless you are certified specifically for that, and that makes an MD have to go back to school and spend more $$ for a job they may not even get yet again). They used to allow MD's to do PA work but since the PA was created now they want certification and i know it is about money making schemes. It doesn't have to be government sponsored, it could be sponsored by the people of the country--basically anyone. Tax payers dont have to pay if it weren't government. I dont see why taxpayers are paying for US IMGs' to be left out of their own country by sponsoring more of those on visas, not that i have anything against them it's just about fairness. I haven't dug any graves at all. I got credit for all my rotations. a resident education should be an education, not a regular job where someone can threaten and ruin you. it is called GME (Graduate Medical Education)....so its not really supposed to be a job at all they're supposed to teach. and the second residency i was in i left because I was ill and they wouldn't let me work anymore. im trying to get that so i can finish the year but i dont know if it will happne they're supposed to let you finish and mine didn't . that is not me in a grave it is them trying to ruin my life for no reason. My PD told me I was in good standing.

I don't see why we have to to complete years, why can't it be so we can go back and finish if we had some type of family problem to take care of, or illness etc. kind of like college where you take classes as you need. but of course they'd never think of doing that.
 

odieoh

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Here are your answers: the government, ECFMG, ACGME, or the current program directors should do something about it. or anyone for that matter who can do something. It is a democracy so the people rule, and even minorities should get chances too. A program for residents may consist of maybe a year of clinical resident work that doesn't count toward a degree, but is at least paid and is a place to learn and improve any possible deficiences. There are very few places that offer this...(PAs or medical assistants do this these days but I think they should allow for MD's to do that too, there are not that many of them anyways, at least 2000 or less. You can't be a PA or MA unless you are certified specifically for that, and that makes an MD have to go back to school and spend more $$ for a job they may not even get yet again). They used to allow MD's to do PA work but since the PA was created now they want certification and i know it is about money making schemes. It doesn't have to be government sponsored, it could be sponsored by the people of the country--basically anyone. Tax payers dont have to pay if it weren't government. I dont see why taxpayers are paying for US IMGs' to be left out of their own country by sponsoring more of those on visas, not that i have anything against them it's just about fairness. I haven't dug any graves at all. I got credit for all my rotations. a resident education should be an education, not a regular job where someone can threaten and ruin you. it is called GME (Graduate Medical Education)....so its not really supposed to be a job at all they're supposed to teach. and the second residency i was in i left because I was ill and they wouldn't let me work anymore. im trying to get that so i can finish the year but i dont know if it will happne they're supposed to let you finish and mine didn't . that is not me in a grave it is them trying to ruin my life for no reason. My PD told me I was in good standing.

I don't see why we have to to complete years, why can't it be so we can go back and finish if we had some type of family problem to take care of, or illness etc. kind of like college where you take classes as you need. but of course they'd never think of doing that.
I know I'm kind of banging my head against the wall by even trying to reason with you, but let me try one last time and I'm done. And let me emphasize again that I do truly feel for your situation and I wish you all the best. I argue with you because with your current attitude and the way you perceive things, you are headed for many years of frustration and I hope to try and steer you away from that. It's unlikely that anything anyone says will help, but I'll try.

Let me also say that I'm not necessarily saying that our system is perfect regarding US citizens and foreign grads/citizens. If there are US citizens with reasonable board scores/med school performance being left out of residency spots in favor of FMG non US citizens, it is wrong and something should be done. I haven't dug deep on the research, but I strongly suspect that the vast majority of those going unmatched have performance problems on boards, schoolwork, or both. No, board scores are not a perfect measure. Someone with stellar scores can be a complete asshat to work with, and you can't tell someone's true personality from a 15 minute interview. BUT, someone with horrible board scores can be just as much an asshat, plus they do poorly academically. And there is SOME correlation between clinical performance and academic record. So its understandable that scores and grades are meaningful to programs.

For your particular situation, I'm sorry to say it but no one has a vested interest in helping you. You really don't fall into the category of the victim US citizen who lost out on residency positions to foreign citizens. You were given a spot, twice! You already had the deck stacked against you with prior poor academic performance and Caribbean education, yet twice programs were still willing to give you your shot. There had to be more than just illness with the second program. If a resident is performing well and has a debilitating medical circumstance, programs find a way to arrange it so they can continue once they are well.

Your attitude that residency should be like community college and you can just take a class or two here or there at your own pace is comical. Running a residency is an extremely complex task, and having a resident quit messes things up in all sorts of ways that affect call schedules, vacation schedules, patient care, clinic schedules, etc etc etc. PD's want good board scores, but they also want someone they know will show up to work. Your past leaves that in question.

I am sorry that you are stuck in the predicament you are. But you really need to realize that you are largely to blame, and it is extremely unlikely that you are going to find a residency spot. Some sort of program for troubled residents is not going to materialize, nor should it. (Would you want your family member to be treated at a clinic run by residents who couldn't find residencies? Me either.)

Peace.
 

turquoiseblue

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I know odieoh, thanks for your input, but I've heard it all before. I think I'll make it though. :D and btw im not an a**hat at all.....i dont even know what that is supposed to mean either! please dont even tell me! sounds gross!

But anyways,

For example, for starters, what would be nice is more attendings or doctors in private practice to offer medical assisting/externship type jobs to MD's who are looking for residency and pay you for it so you can at least have a job and also have some good LOR's, instead of hiring MAs or PAs to do their work. Then it could be educational, purposeful for both student and attending. I've seen some do it recently, but not many. I've seen research offer volunteer research, but is that fair, how can a person survive doing free research? Great you get published. but I was paid $500 per month without enough to pay rent or food. MD is nothing important to anyone unless it is a residency program. I dunno it's just hard to find decent worthwhile jobs out there for those that don't have residency yet. I dont think it is just me either. I've seen many in this predicament. I mean why doesnt anyone want to help a future resident in need at all? people seem selfish to not offer more of that and yet ask a poor resident to pay them $2000+ per month to rotate with them and get an LOR that may or may not be good. IT's awful!
 

odieoh

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I know odieoh, thanks for your input, but I've heard it all before. I think I'll make it though. :D and btw im not an a**hat at all.....i dont even know what that is supposed to mean either! please dont even tell me! sounds gross!

But anyways,

For example, for starters, what would be nice is more attendings or doctors in private practice to offer medical assisting/externship type jobs to MD's who are looking for residency and pay you for it so you can at least have a job and also have some good LOR's, instead of hiring MAs or PAs to do their work. Then it could be educational, purposeful for both student and attending. I've seen some do it recently, but not many. I've seen research offer volunteer research, but is that fair, how can a person survive doing free research? Great you get published. but I was paid $500 per month without enough to pay rent or food. MD is nothing important to anyone unless it is a residency program. I dunno it's just hard to find decent worthwhile jobs out there for those that don't have residency yet. I dont think it is just me either. I've seen many in this predicament. I mean why doesnt anyone want to help a future resident in need at all? people seem selfish to not offer more of that and yet ask a poor resident to pay them $2000+ per month to rotate with them and get an LOR that may or may not be good. IT's awful!
Doing an externship like that actually sounds like a reasonable thing, if there is one out there. Having to PAY someone to follow them sounds fishy. I agree with you that at this point research is pointless. If you are to have a shot at all, some sort of solid clinical performance is your best bet. I don't know if its possible to maybe find an attending associated with a FM/IM program and arrange an externship or even offer to do medical assisting. If you can establish some ties with a program and demonstrate some clinical skills, that would be the one way you could get your foot in the door somewhere. I think you would be hard pressed to get them to pay you however. Good luck, keep us updated!
 
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Umm it was your choice to leave the country to get your education? You knew going in that going foreign was an unsure prospect and foreign grads have all kinds of hurdles. Everyone who goes abroad knows that. No one made you do it, and it wasn't a US school, so you should deserve a position as much any other person who went to school in a foreign country: zero. Still, a lot of foreign grads get to show their mettle and shine. It sounds like you got a bunch of chances to redeem yourself that no one had to give you. If you flunked so many exams, why should people keep giving you chances?
 

turquoiseblue

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Umm it was your choice to leave the country to get your education? You knew going in that going foreign was an unsure prospect and foreign grads have all kinds of hurdles. Everyone who goes abroad knows that. No one made you do it, and it wasn't a US school, so you should deserve a position as much any other person who went to school in a foreign country: zero. Still, a lot of foreign grads get to show their mettle and shine. It sounds like you got a bunch of chances to redeem yourself that no one had to give you. If you flunked so many exams, why should people keep giving you chances?
pretty much everyone got in residency from my school. the education there was equivalent to a US school. Very few didn't get a spot. almost all my classmates are attendings now. I had no idea it would be like this to go to a foreign country for med school. no one told me the future. Everyone told me all i have to do to get in is pass. well that's not exactly true. I saw people flunk more exams than i ever could imagine and still got a spot this year, so i should get a chance. I should be allowed back in residency regardless of what anyone of you say and i will :luck:

anyways this thread is not about me it is about the generalized unfairness of the system.
 
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pretty much everyone got in residency from my school. the education there was equivalent to a US school. Very few didn't get a spot. almost all my classmates are attendings now. I had no idea it would be like this to go to a foreign country for med school. no one told me the future. Everyone told me all i have to do to get in is pass. well that's not exactly true. I saw people flunk more exams than i ever could imagine and still got a spot this year, so i should get a chance. I should be allowed back in residency regardless of what anyone of you say and i will :luck:

anyways this thread is not about me it is about the generalized unfairness of the system.
Uhh your post just proved that the system was pretty fair - very few of your classmates didn't get a spot, and almost all your classmates are attendings. That's a glowing statement to to America giving US citizens at foreign schools a chance to practice. If the vast majority of those people succeeded, it means the system is generally fair, not unfair. I think it's pretty accurate that all you have to do is pass, and some random person will give you a shot one day. Even if you heard nothing else about med school but "all you have to do is pass", you can't say that applied to you anymore the moment you failed. You aren't on the same playing field anymore as people who passed and all bets are off.

Where are the examples of people who flunked many more exams than you and got a spot? Probably not more than a handful, and probably made up for it in other ways, or else their future employers have poor judgment. Even still, if they got positions, that shows fairness and people willing to give many chances, not unfairness. What reason did your old program give for not letting you finish your year? What reason did they give for not hiring you back for future years? How come you can't work there again even as a volunteer and get back into their good books? Maybe you should consider a lawsuit if your old residency violated your contract and you feel wronged by them. You could hire the same attorneys as the Serrano case against JHU. If you have a real legitimate case, they would take you in a minute on contingency and you wouldn't pay a cent.
 

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Uhh your post just proved that the system was pretty fair - very few of your classmates didn't get a spot, and almost all your classmates are attendings. That's a glowing statement to to America giving US citizens at foreign schools a chance to practice. If the vast majority of those people succeeded, it means the system is generally fair, not unfair. I think it's pretty accurate that all you have to do is pass, and some random person will give you a shot one day. Even if you heard nothing else about med school but "all you have to do is pass", you can't say that applied to you anymore the moment you failed. You aren't on the same playing field anymore as people who passed and all bets are off.

Where are the examples of people who flunked many more exams than you and got a spot? Probably not more than a handful, and probably made up for it in other ways, or else their future employers have poor judgment. Even still, if they got positions, that shows fairness and people willing to give many chances, not unfairness. What reason did your old program give for not letting you finish your year? What reason did they give for not hiring you back for future years? How come you can't work there again even as a volunteer and get back into their good books? Maybe you should consider a lawsuit if your old residency violated your contract and you feel wronged by them. You could hire the same attorneys as the Serrano case against JHU. If you have a real legitimate case, they would take you in a minute on contingency and you wouldn't pay a cent.

the unfairness lies in that i noticed US citizens don't get in the system before non US citizens...mainly due to score criteria...its not just me its numerous others that have to deal w/ this. not only that there are residency unfairnesses as in not being able to get back in, etc. i wish they had some way we could get in i mean its like a whole career lost which I pretty much worked my entire life to go into.

the 1st program wasnt good to stay at. at the time they said i could return later like others have, but later on don't even respond to my emails or calls, and tell me to apply via eras, which i did but they dont rehire i dont think.

with the 2nd one i did did not give me a reason why they wouldn't let me continue. i only had 2 months to go. i think that wasn't good of them at all to do that. im trying to get them to let me finish because i was already in good standing. im right now waiting for a response.
i dont think they allow you to volunteer and i dont have enough money to live there without getting a salary. that sounds good to maybe get a case out of it.....i'll see about that after i get a response from them.

yeah i'll still apply but i dont know if it will ever be fruitful.
 

aProgDirector

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It's just that these cut offs create a possibility of an MD taking the USMLE and never becoming a resident in the US, which is difficult for the US citizens, especially if they get stuck with a USMLE score that they can't change. If they are to have score criteria, then I would hope that they make it so that someone can retake the USMLE to improve their score, but of course that hasn't happened yet.
Yes, this is true. I'm not sure this is completely unfair. You go to a medical school outside the US, where no one is regulating it and I have no idea how good your education is, and then pass an exam. I don't see that as guaranteeing you anything.

There have been several threads on whether US Citizen IMG's should get preference to non-US citizen IMG's. Usually three arguments are made:

1) US Citizens pay taxes, and since residencies are paid with tax dollars it's only fair that UC citizens who paid into the tax system get the spots.

I don't buy this. Taxes are not a "I paid $X in, so I should get $X out". And, as a student, you personally have probably (although it would depend on how much work you did) pay much taxes in. And if someone came from an indigent family background, they might not have paid any taxes in.

2) US Citizens get gov't backed loans, so taxpayers are on the hook if they default, so we should make sure they don't default.

Honestly, I think this argues that US gov't backed loans should not be allowed for international schools, rather than guaranteeing residency spots.

3) Other countries don't let non citizens train or given them only leftovers, so we should do the same.

Just because other people/countries do something isn't a good reason for us to do it.

Even my immigrant parents agree on the unfairness that the US residency programs can't even take US citizens as opposed to someone who does not reside here in the states.
Your parents aren't exactly unbiased in this situation.

But really I wish everyone could get into residency. The world would be a happier place.
And I wish that I got a free vacation to Mexico every year.

Why not instead of cutoffs posting average USMLE scores (broken down between US Seniors and IMGs) and the middle 50 spread like every undergrad and medical school does. That way you dont have to commit to a cut off but we know our realitive chances.
This is an interesting request. It's not likely to happen. Medical school MCAT and GPA ranges are probably all very similar, I expect there is some spread but not much, so schools don't have much to lose by reporting this.

USMLE score ranges probably vary widely between programs, and programs don't want to be "ranked" based on their USMLE averages, which is CERTAINLY what would happen.

Also, a downstream effect of this would be to make USMLE scores MORE important in the selection process. If the ranking of my program depended on the average USMLE score, I'm more likely to take people with higher USMLE scores.

I believe that only the most recent score is reported by the filter. I don't believe # of attempts is a possible filter.
Correct. Note that the most recent always equals your highest score.

if the system is to remain the way it is, and if that many IMG US citizens can't get into US residency due to score criteria and heavy competition, shouldn't something be done about it so that they can have a job somehow in the United States? Maybe there can be some way for these residents to improve so they can definitely get in. it is very difficult to get a job as a US IMG and even as a nonUS IMG.
You decided to go to a foreign country for medical school.

In doing so, you took US dollars and spent them in a foreign country, hence worsening our trade deficit.

Your school is not accredited by any US body, and we have no idea how good it is.

You then come back to the US, and somehow we must "definitely get you in" to a residency program? I don't exactly see that we owe you anything.

There are 25,520 spots in the Match with 33,534 total applicants. 3942 are US IMGS (1204 didn't match), 9,987 are nonUS IMGs (3291 didn't match--meaning 6696 did! and meaning they are often preferred over a US citizen as 1204 US IMG's + 949 US grads didn't match) . 17,127 are US grads (949 didn't match). This scramble only had 414 PGY1 positions and 46 PGY2 positions for thousands of left out IMG's to compete for.

It is not too much to ask for a US citizen to get preference, only 1204 nonUS IMG's will be displaced out of the match, but the rest still can get the positions, which is a lot (9987 - 1204 - 949 = 7834 of them!).
Ignoring the numbers (which don't line up with my read of the NRMP 2010 tables, but that's not really relevant), the question remains why inferior US IMG's should be given precedence over superior FMG's, the arguments I have discussed above.

Shouldn't there be a system put in place so that some of these repeats will eventually get in..like a program for residents to improve their application (because i know that research doesn't help that much and puts you further from your medical education)..it's not right that people that went to med school have to be out of a job.
Here are your answers: the government, ECFMG, ACGME, or the current program directors should do something about it. or anyone for that matter who can do something. It is a democracy so the people rule, and even minorities should get chances too. A program for residents may consist of maybe a year of clinical resident work that doesn't count toward a degree, but is at least paid and is a place to learn and improve any possible deficiences. There are very few places that offer this...(PAs or medical assistants do this these days but I think they should allow for MD's to do that too, there are not that many of them anyways, at least 2000 or less. You can't be a PA or MA unless you are certified specifically for that, and that makes an MD have to go back to school and spend more $$ for a job they may not even get yet again). They used to allow MD's to do PA work but since the PA was created now they want certification and i know it is about money making schemes.
You do raise some interesting questions / ideas. First, I see a big difference between "further education to make me a better doctor" and "a job which pays money". If I were to hire you as a medical assistant, I would expect you to work as a medical assistant. I would not be willing to pay you to shadow me, present cases to me, discuss patient management with me, etc. So, you probably can get a job as an MA but I would expect that to simply be taking BP's, putting patients into rooms, etc. I don't think that would be very helpful towards your goal of getting a residency.

If you're going to shadow me around, learn, etc, that's a volunteer position. There are plenty of physicians around who might let you do that, but I don't see anyone giving you a salary and benefits for this.

It doesn't have to be government sponsored, it could be sponsored by the people of the country--basically anyone. Tax payers dont have to pay if it weren't government.
I really don't know what you're trying to say here. The "people of the country" is the government. If you mean that some person somewhere should pay for you to get more experience, that's not realistic unless you can find a job where you can be productive, yet gain clinical experience.

The one possibility often raised is being a PA. As you mention, there is the obvious politics where those who have PA degrees do not want to be displaced by foreign MD's. You could imagine that if foreign MD's could simply be hired as PA's, we might see all US PA's out of a job, and you still have the same quality control issues -- just because someone has a foreign MD or equivalent, how do we know that they really know clinical medicine? And the USMLE or similar exam is not acceptable proof.

I dont see why taxpayers are paying for US IMGs' to be left out of their own country by sponsoring more of those on visas, not that i have anything against them it's just about fairness.
The cost to US taxpayers is exactly the same wether a USIMG or an FMG gets a spot. If the FMG is a "better" applicant, then the US taxpayer is getting the better deal with them.

A resident education should be an education, not a regular job where someone can threaten and ruin you. it is called GME (Graduate Medical Education)....so its not really supposed to be a job at all they're supposed to teach.
In that case, you'd pay me tuition to attend. And people get kicked out of school all the time.

I mean why doesnt anyone want to help a future resident in need at all? people seem selfish to not offer more of that and yet ask a poor resident to pay them $2000+ per month to rotate with them and get an LOR that may or may not be good. IT's awful!
Because untrained residents only slow me down. Why should I pay you if you don't improve my bottom line?

i wish they had some way we could get in i mean its like a whole career lost which I pretty much worked my entire life to go into.
Sadly, as others here have been trying to tell you, the only one to blame here is yourself. You went to an offshore school. You didn't do very well on the USMLE, the only standardized assessment we have of your skills. Despite this, you got into two different residencies yet couldn't finish either. You seem to think that none of this is your fault.

with the 2nd one i did did not give me a reason why they wouldn't let me continue. i only had 2 months to go. i think that wasn't good of them at all to do that. im trying to get them to let me finish because i was already in good standing. im right now waiting for a response.
As others have mentioned, if your performance had been really satisfactory, they would have let you continue. Most likely they told you that your performance was not satisfactory, and you missed it / didn't clue in to it. Much like the way you are not listening to the advice you are getting here.
 

turquoiseblue

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[/QUOTE] As others have mentioned, if your performance had been really satisfactory, they would have let you continue. Most likely they told you that your performance was not satisfactory, and you missed it / didn't clue in to it. Much like the way you are not listening to the advice you are getting here.[/QUOTE]

no the second one told me i was in good standing but didn't want me to finish because they said it was a new year to start. they never told me i was unsatifactory. i dont know where they went thinking it is okay.

i dont have to 'humble myself' to listen to people that tell me i'll never make it in life. that's someone that is out of their mind to listen to some of the awful rude and unpleasant things said to me on here. im glad im not rude like that to condescend on someone like has been done to me. some of you have no clue. because you've never had it as hard as I have.

By the way, using visas to get 'better qualified applicants' is abuse of the system to thwart US IMGs out of a job. they should limit them...i wonder how many there are..they should remove that number of visas to force PDs to have to accept US IMGs.
 
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turquoiseblue

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http://forums.studentdoctor.net/showthread.php?t=684398

this has a post showing the number of visas offered......in 09..not far away from the present...

around 9074 visas......hmmmmmmmm.
displacing a lot of US citizens arent ya? if you took away just around 2000 of these visas then there would be room for US IMGs and also some AMGs that were thrown away.
i know you AMGs hate offshore schools with a passion don't you....they suck away money according to many...but they're quality of education is usually equivalent to the US. especially if they already took the USMLEs and get ecfmg certified meaning they're qualified as any US grad. as it is the same test.

quality of care is not the issue in a residency program just yet.... residency is a learning place not a place to hire migrant workers. it is a place to start out and learn, especially for US citizens who weren't in a prior country that allows them to work there.

i know i have a point here. don't even correct me if im wrong because im right :smuggrin:
 
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no the second one told me i was in good standing but didn't want me to finish because they said it was a new year to start. they never told me i was unsatifactory. i dont know where they went thinking it is okay.

i dont have to 'humble myself' to listen to people that tell me i'll never make it in life. that's someone that is out of their mind to listen to some of the awful rude and unpleasant things said to me on here. im glad im not rude like that to condescend on someone like has been done to me. some of you have no clue. because you've never had it as hard as I have.

By the way, using visas to get 'better qualified applicants' is abuse of the system to thwart US IMGs out of a job. they should limit them...i wonder how many there are..they should remove that number of visas to force PDs to have to accept US IMGs.
Suggestion 1: Stop spending time on an internet forum pining about things when no one is going to help you (especially when you dont listen to them). A better use of this time is to stand outside the ACGME office with a group of people and placards voicing your opinion.

Suggestion 2: Stop feeling bad for yourself. You left your second program because you wanted to have the cake and eat it too. You dug your own grave. You know what IMGs who want radiation oncology/derm do? Many of them do a 3 year IM residency first. Yeah...thats right. They put in 3 years. If your scores arent good, you need to fight for it. And that would involve doing what it takes...because guess what? You didnt before.

Who TF are you to make these rules? AMGs on this board say they would rather have a well-accomplished non-US citizen IMG treat patients rather than a mediocre US-citizen IMG. Again, stop pining on an internet forum. Stand in front of the White House. Obama passed the health care bill...maybe he will look at you now.

Force PDs.....yeah, thats about it...isnt it?

I am annoyed with people on this forum thinking that residency is God's given right to them. It is a job, and you need to work hard and qualify for it. The United States is possibly the most open country and gives you as many opportunities, that no other country offers. You did your residency outside, now you need to do the time. It is also evident that if you work at it hard enough in this system, you will get to where you want. But this silver-spoon, silver-platter business is ridiculous.

I have yet not found a person who cannot get into 'a' residency (the biggest argument for people who are upset with this year's match result is that "how can we be left without a job" :scared:?). Guess what? Yale Anesthesia and OBGYN went to scramble this year. UMD and Emory went to scramble in IM. There arent issues with you getting a residency. There are issues with people like you, who feel a sense of entitlement (mostly when they dont deserve it) and will not take what comes their way - regardless of what is the competitiveness (or lack thereof) of their application.

So just suck it up and work your way upwards man. Or else you will perenially be unhappy.

And move away from the keyboard and monitor.

Peace.
 
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Girl, seriously, look at yourself in the mirror now, now you're ranting and raving with foam at your mouth and lashing back at the top of your lungs. It isn't pretty. Calm down. AProg's reply to you wasn't rude, it was plain realistic. Deep breath. I'm not against you.

How did you do in med school? Did you pass all your classes? Get honors? If you didn't, and it sounds like you're at the end of your rope here, maybe you could try to repeat medical school and maybe become a DO. As painful as repeating sounds, it could be your only way to become a doctor in this country. Look at the posts below about wanting to create 3 year DO schools. NYCOM already has a 3 year DO program for people with foreign medical degrees. Go through it, fill in you knowledge gaps, do your rotations, take your COMLEX steps I, II, and III and use those to apply for Osteopathic residencies (which rarely fill completely, and are supposed to be just as good). No more USMLE in your past and you can be licensed in every single state. Plus, I'm sure you'll be a great student during clinical rotations because you know exactly what to do. :thumbup:

At some point you've got to figure out when to stop chasing residencies with your existing qualifications and go down a totally different route, like this one. How many rejections is it going to take? You're just burning yourself out every time you rant about unfair immigration laws because none of that can help you now. :luck:
 

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The first question the attending on my psychiatry service would always ask after we interviewed a patient was "How did that patient make you feel?" If it was frustrated or exasperated, chances are the patient had an Axis II disorder.

I'm not sayin', I'm just sayin'...this thread should have ended with aPD's post.
 

turquoiseblue

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good idea speculatrix about the DO program...

about my personal life.... well im thinking of going PHD or PA school or med school, or even practice overseas in NZ or UK. another option i was thinking was to do medical assisting/research...i got an interview for that to go to. at least it will hold me over while im applying to various schools or programs. i dont know what the future holds, but for now im preparing and ready to take step 3 in a few days....
 
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I've spent a little time reviewing your history as you've outlined in previous posts. You are truly in a difficult situation. And clearly you can't continue like this much longer.

You have MBA, correct? Perhaps it's time to look for a job using that degree. One of your mistakes, I think, was to try to finish that degree while starting internship. Residency pretty much requires a full time effort. It's also not clear why you got the MBA. Are you able to clearly articulate what career path you hoped it would help you move down?

You're probably not going to like my next suggestion: Sounds like a lot of your problems are due to your interpersonal skills. Obviously you don't perceive that there is a problem. But when you keep talking about how other people keep doing you wrong, over and over, there is a problem. I know because I had a similar problem (though to a lesser degree). At two separate hospitals, nurses filed complaints about me saying they were "afraid to call me" because they were afraid that I "would bite their heads off" To this day, I don't understand what i did. I don't perceive my interactions on the phone to be any different than that I witnessed in my (male) counterparts. That said, I had to do something different or risk disciplinary action. Sometimes I feel like I'm being fake and overly nice, and that I'm begging them to do their jobs. But things have gotten better.

I've had to do some self-assessment. I came to realize that there is something about my personality that causes many people to not like me on first impression. That is a dangerous place to be. If people like you, then they will give you the benefit of the doubt. If they don't, they won't.

You seem to have some time on your hands. I'd suggest some personal development on how to improve your rapport with people. In all likelihood you are an OK person. But it sounds like you aren't making that impression. Changing the way people perceive you isn't fun, but it is worthwhile.
 

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I've spent a little time reviewing your history as you've outlined in previous posts. You are truly in a difficult situation. And clearly you can't continue like this much longer.

You have MBA, correct? Perhaps it's time to look for a job using that degree. One of your mistakes, I think, was to try to finish that degree while starting internship. Residency pretty much requires a full time effort. It's also not clear why you got the MBA. Are you able to clearly articulate what career path you hoped it would help you move down?

You're probably not going to like my next suggestion: Sounds like a lot of your problems are due to your interpersonal skills. Obviously you don't perceive that there is a problem. But when you keep talking about how other people keep doing you wrong, over and over, there is a problem. I know because I had a similar problem (though to a lesser degree). At two separate hospitals, nurses filed complaints about me saying they were "afraid to call me" because they were afraid that I "would bite their heads off" To this day, I don't understand what i did. I don't perceive my interactions on the phone to be any different than that I witnessed in my (male) counterparts. That said, I had to do something different or risk disciplinary action. Sometimes I feel like I'm being fake and overly nice, and that I'm begging them to do their jobs. But things have gotten better.

I've had to do some self-assessment. I came to realize that there is something about my personality that causes many people to not like me on first impression. That is a dangerous place to be. If people like you, then they will give you the benefit of the doubt. If they don't, they won't.

You seem to have some time on your hands. I'd suggest some personal development on how to improve your rapport with people. In all likelihood you are an OK person. But it sounds like you aren't making that impression. Changing the way people perceive you isn't fun, but it is worthwhile.
I dont know why i got that MBA. I've realized I dont really like business that much, just wanted to learn more about it, because my dad owned some businesses (he's a doctor though).

I can't find jobs using that MBA at all, because I don't have past experience.

I did find a website to get entry level MBA jobs, but i haven't bothered to apply yet, because I've been studying for step 3 and hoping i can do something more clinical, but if worse comes to worse I will do those...but they're sales..something im not interested in at all.

I have applied to some pharm rep jobs but haven't heard back, and usually never do. I hate sales though.

Maybe not on forums...i have no idea..i meet a lot of people that totally misunderstand me on forums though...and in attempts to get them to understand they misunderstand it even more and miss the point completely so i've given up....but I interact in real life okay, but im not very outspoken. i usually stay quiet anymore. i did fine in my last program....everything went pretty smoothly in terms of interacting with people, but the first program i was at had some really mean unfriendly collegues and nurses... i definitely learned from that experience and on how to stay quiet and not say too much especially to nurses or colleagues (because even they can backstab you, as i have seen happen to me before...) or even attendings or PD's and how to avoid conflict, so the next one went much more smoothly. i try to stay neutral..not saying im perfect at it at all...there is always someone that wants to ruin my day though of course...or want to tick me off just because they don't like me..although im nice to them or didn't even say anything to them...it's not a perfect world at all and i dont think many of you have perfect interpersonal skills either.
 

turquoiseblue

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Reading turquoiseblue's threads is like standing at the edge of a black hole. Just doesn't make sense.
I've reiterated this over and over it seems but the point of this thread was deviated and people started talking about me personally; HOWEVER, the real point of this thread is visas..and the USMLE score criteria being sky high..and how PD's need to get rid of 2000 visa spots so that US IMG's can get back in their own country instead of hiring foreign non US citizen IMG's instead. There are about 9000 visas spots, and 2000 Us citizen IMG's and some AMGs (949 of them) don't match. Meaning that their spots went to a non US citizen.

PD's let most AMG's and DO's in no matter what their scores are, they get preferred, so they need to do the same for US citizen IMG's. It is only 2000 visas to cut out. what is the big deal about that? If the carribean education is equivalent to the US and these people live here already, then why not at least show favor to their own citizens?

Yes they want "better applicants", but is it fair to throw out their own US citizens just to hire people with better USMLE scores from other countries? About 2000 US citizens don't have residency right now.

ANYWAYS im sure absolutely no one knows what im talking about yet still!! because they don't want to change any of it!

Check the NRMP statistics and see it for yourself:
http://www.nrmp.org/data/advancedatatables2010.pdf
 
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odieoh

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Turquoise-

I still have a couple of issues with what you are saying. First of all, you say the point of this thread is to deal with the visas/FMG's taking your spot. Once again let me point out that you are not a victim of this. You got 2 spots. If you are now taking up the crusade for other IMG's who never got a spot, well fine. But don't try to play it like you are a victim.

Second, you keep making the claim that Caribbean grads are of the same caliber as US grads and that the education is equivalent. How are you coming to this conclusion? I can't say that I have hard data to the contrary, but I don't think you have any hard data to support your claim either. Furthermore, I think its safe to say that the vast vast majority of US students that end up going to a Caribbean school do so because they didn't get in to a US school. And WHY didn't they get in in the US? Most likely they had inferior academic performance compared to the students who were accepted. Why did you go to the Caribbean?

So that being the case, the schools are starting with a less stellar group of students. As far as the quality of education, there's really not a good way to measure other than USMLE scores. Unfortunately even this can be skewed, because as I understand it a lot of the Caribbean schools don't let their students even sit for the USMLE until they pass some sort of in house equivalent, or Kaplan equivalent. That basically artificially inflates the pass rate, someone can sit through 2 years of school and if they don't learn the material well enough, basically the school does not let them take the USMLE and thus the pass rate is inflated.

So really, the fact that US IMG's are having trouble getting in to residencies is in a way evidence that those grads are not performing well academically and possibly clinically. USMLE scores and clinical evaluations are really the only way residencies have to screen applicants, and if the Caribbean grads were equal in those areas, they would not be having difficulties finding spots.
 

turquoiseblue

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Turquoise-

I still have a couple of issues with what you are saying. First of all, you say the point of this thread is to deal with the visas/FMG's taking your spot. Once again let me point out that you are not a victim of this. You got 2 spots. If you are now taking up the crusade for other IMG's who never got a spot, well fine. But don't try to play it like you are a victim.

Second, you keep making the claim that Caribbean grads are of the same caliber as US grads and that the education is equivalent. How are you coming to this conclusion? I can't say that I have hard data to the contrary, but I don't think you have any hard data to support your claim either. Furthermore, I think its safe to say that the vast vast majority of US students that end up going to a Caribbean school do so because they didn't get in to a US school. And WHY didn't they get in in the US? Most likely they had inferior academic performance compared to the students who were accepted. Why did you go to the Caribbean?

So that being the case, the schools are starting with a less stellar group of students. As far as the quality of education, there's really not a good way to measure other than USMLE scores. Unfortunately even this can be skewed, because as I understand it a lot of the Caribbean schools don't let their students even sit for the USMLE until they pass some sort of in house equivalent, or Kaplan equivalent. That basically artificially inflates the pass rate, someone can sit through 2 years of school and if they don't learn the material well enough, basically the school does not let them take the USMLE and thus the pass rate is inflated.

So really, the fact that US IMG's are having trouble getting in to residencies is in a way evidence that those grads are not performing well academically and possibly clinically. USMLE scores and clinical evaluations are really the only way residencies have to screen applicants, and if the Caribbean grads were equal in those areas, they would not be having difficulties finding spots.

then why are pretty much most of my classmates now attendings?
If you passed ur USMLE scores and are good enough to be ECFMG certified that means you are equivalent to a US doctor. Higher criteria was just made up just because of competition purposes, but an ECFMG certified doctor is qualified enough to do residency in the US. I passed my clinical skills assessment, which is a requirement for ECFMG certifiication, not to mention had plenty of experience in residency. LOR's and Deans Letters and transcripts are also a measure of how well they do as well in addition to USMLE's. A person shouldn't be seen as a score that is stuck w/ them forever, they are a dynamic whole person that should be evaluated for who they are.

But also residency is a place to start, not for people that were already residents in their own country that already know everything an attending knows. That's why i think you don't need that level of qualifications to be a resident. You just need to be ECFMG certified, but PD's are allowing people that are already attendings into residency from foreign countries that are not even citizens just to have it easier, that means the purpose of residency is no longer teaching but just a job to fill. Yes i want the best for everyone but i think that if 2000 visas are cut off of the existing 9000, then that will make PD's have to even look at a US IMG 's application at all. Yes a US IMG doesn't have experience because they don't get to do residency in the country they graduate from they actually want one in the US because they live there and speak American English and have difficulty getting spots elswhere in the world unlike other foreign grads who can easily get a job in their own country and make a decent living. so basically these US IMG's that qualify for ECFMG certification and work so hard for their MD are ruined. Is that okay???

They used to prefer US citizens but i noticed the trend is to not do that anymore. something is going wrong there. too much freedom to use visas to the point it is abused and pushes out its own US citizens.
 

Rabbit Hole

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I've reiterated this over and over it seems but the point of this thread was deviated and people started talking about me personally; HOWEVER, the real point of this thread is visas..and the USMLE score criteria being sky high..and how PD's need to get rid of 2000 visa spots so that US IMG's can get back in their own country instead of hiring foreign non US citizen IMG's instead. There are about 9000 visas spots, and 2000 Us citizen IMG's and some AMGs (949 of them) don't match. Meaning that their spots went to a non US citizen.

PD's let most AMG's and DO's in no matter what their scores are, they get preferred, so they need to do the same for US citizen IMG's. It is only 2000 visas to cut out. what is the big deal about that? If the carribean education is equivalent to the US and these people live here already, then why not at least show favor to their own citizens?

Yes they want "better applicants", but is it fair to throw out their own US citizens just to hire people with better USMLE scores from other countries? About 2000 US citizens don't have residency right now.

ANYWAYS im sure absolutely no one knows what im talking about yet still!! because they don't want to change any of it!

Check the NRMP statistics and see it for yourself:
http://www.nrmp.org/data/advancedatatables2010.pdf
Fight The Suits in the boardroom all you want.. more power to you! Just please don't waste another year of your life chasing ghosts. I'm sure you are looking for a new job right now and I hope you find something you are happy with. If match doesn't work out again next year at least you will have something to fall back on.

I think you should also take a visit to see a professional (psychiatrist, psychologist) to get an objective perspective on where you are at in your life and what you can do for the future. They'll be able to give you a better assessment in a non-judgmental way and you will only benefit from that.
 

odieoh

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then why are pretty much most of my classmates now attendings?
If you passed ur USMLE scores and are good enough to be ECFMG certified that means you are equivalent to a US doctor. Higher criteria was just made up just because of competition purposes, but an ECFMG certified doctor is qualified enough to do residency in the US. I passed my clinical skills assessment, which is a requirement for ECFMG certifiication, not to mention had plenty of experience in residency. LOR's and Deans Letters and transcripts are also a measure of how well they do as well in addition to USMLE's. A person shouldn't be seen as a score that is stuck w/ them forever, they are a dynamic whole person that should be evaluated for who they are.

But also residency is a place to start, not for people that were already residents in their own country that already know everything an attending knows. That's why i think you don't need that level of qualifications to be a resident. You just need to be ECFMG certified, but PD's are allowing people that are already attendings into residency from foreign countries that are not even citizens just to have it easier, that means the purpose of residency is no longer teaching but just a job to fill. Yes i want the best for everyone but i think that if 2000 visas are cut off of the existing 9000, then that will make PD's have to even look at a US IMG 's application at all. Yes a US IMG doesn't have experience because they don't get to do residency in the country they graduate from they actually want one in the US because they live there and speak American English and have difficulty getting spots elswhere in the world unlike other foreign grads who can easily get a job in their own country and make a decent living. so basically these US IMG's that qualify for ECFMG certification and work so hard for their MD are ruined. Is that okay???

They used to prefer US citizens but i noticed the trend is to not do that anymore. something is going wrong there. too much freedom to use visas to the point it is abused and pushes out its own US citizens.
You just seem to be contradicting your own arguments:

Argument A: "Most" of my classmates made it through the system just fine, found residency spots and are now attendings. I myself had two shots at doing so as well.

Argument B: This system is totally broken!!!! The FMG non citizens are taking all our spots!!

Which is it?

Also, you seem to think that being ECMG certified = all anyone needs to do to get a residency. If you manage to scrape by, finally pass med school after failing and repeating many courses, finally barely passing USMLE after failing several times, then yes, you are ECMG certified, and all that means is that you are ELIGIBLE for a residency. It does not OBLIGATE anyone to take you and it does not mean you DESERVE a spot. It means if you are legal to move forward with your medical education. The burden of finding a residency then lies squarely on your own shoulders. If your application is weak, there is no guarantee of a spot for you, nor should there be. And being ECMG certified does NOT mean your education was as good as anywhere else. It means you were able to jump over the lowest hurdle necessary to continue your education.
 
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aProgDirector

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no the second one told me i was in good standing but didn't want me to finish because they said it was a new year to start. they never told me i was unsatifactory. i dont know where they went thinking it is okay.
Several things about this:

1. If you were out on medical leave (FMLA) then they must legally re-instate you to your position when you return from leave. There is some chance that you were not FMLA eligible, since the law only requires employers to offer FMLA to employees who have worked for 12 months. But many hospitals / residency programs offer FMLA from day 1.

2. They did not offer you a spot back because they did not want to. The fact that you don't seem to realize this is very telling. If your performance had been fine, they would have found a way to restart your training.

offshore schools ... they're quality of education is usually equivalent to the US.
No, it's not.

If you passed ur USMLE scores and are good enough to be ECFMG certified that means you are equivalent to a US doctor.....but an ECFMG certified doctor is qualified enough to do residency in the US
This is certainly not true. The USMLE measures one aspect of being a physician. It measures medical knowledge (at least as can be measured by a multiple choice test). If you pass it, then all you have proven is that you have a minimum level of knowledge considered acceptable for a medical license. Note that just passing with a low score means that you're knowledge is "just barely acceptable". There are many other aspects to being a physician that the USMLE does not measure, and there is no simple way that I can measure them from your diploma from an international school, LOR's from community physicians I have no knowledge off, transcript of courses I have no idea what they really are, etc.

ECFMG certification is a minimum -- an absolute floor below which you are considered to be incompetent. If someone passed their USMLE Step 1 with a 185 (currently the minimum pass rate) and someone else fails with a 184, is the person with a 184 really any different than the person with a 185? Probably not, but the line needs to be drawn somewhere.

If you just pass the USMLE's you are clearly better off than someone who fails, but only slightly better off / more knowledgable.

Reading turquoiseblue's threads is like standing at the edge of a black hole. Just doesn't make sense.
... and, you get sucked in and can't get out

I can't find jobs using that MBA at all, because I don't have past experience.
Although somewhat off track, this is just as telling as your medical story. MBA's don't automatically get you some great business job. You need to take that training and do something with it. Blaming your inability to get a business job on your MBA is silly. It's your responsibility to make something of it.

I did find a website to get entry level MBA jobs
If this is how you think you can get a good job with an MBA, it's honestly sad. And a good example of why you're medical career has come to a halt.

then why are pretty much most of my classmates now attendings?
That's a really good question.

If US IMG's are so marginalized by the system, by PD's taking FMG's needing visas, then you'd expect many of your classmates to be in the same situation. But, it appears that most of your classmates have done just fine -- despite their carib eduation limitations, USMLE's etc.

So this really doesn't support your argument at all. In fact, it suggests the problem is you, not the system.

I passed my clinical skills assessment, which is a requirement for ECFMG certifiication, not to mention had plenty of experience in residency.
I'm not sure I would use your prior experiences in residency as a strength. You failed out of one, and (at best) dropped out of another.

LOR's and Deans Letters and transcripts are also a measure of how well they do as well in addition to USMLE's. A person shouldn't be seen as a score that is stuck w/ them forever, they are a dynamic whole person that should be evaluated for who they are.
Dean's letters from carib schools are mostly useless (although to be fair, SGU and Ross's dean's letters have improved greatly over the last 2 years). LOR's from most carib schools (and in fact from most US schools) are also worthless. They all say "best medical student I have ever worked with". So, PD's tend to use 1) the quality of your med school especially of the clinical years, 2) your USMLE's, 3) your grades in your clinical years (if useful, and again for many carb schools these are not useful, as 80+% get an "A" or "Honors"), 4) Letters from someone in the field that you know/trust.

But also residency is a place to start, not for people that were already residents in their own country that already know everything an attending knows.
Here's something we agree upon. I agree that it seems unreasonable that PD's choose foreign trained / practicing docs because it's "easy" to teach them, because they know everything already. I don't know how you would stop this, though. And, is it fair to someone who trained in another country and then moves here for some other reason to simply say that they cannot be trained to work here?

Yes i want the best for everyone but i think that if 2000 visas are cut off of the existing 9000, then that will make PD's have to even look at a US IMG 's application at all.
Although it's getting lost in the details, this is a real issue to discuss. Arguments can be made that US Citizens should have priority for spots. I discussed some of these arguments above. The only one that makes any sense to me is simply "protecting our own". Whether we'd be willing to try to get every US Citizen a spot to the exclusion of some foreign students, and risk ending up with a "lower quality" physician workforce, is a complicated question that people are unlikely to come to any agreement about. You either believe in one side, or the other.

i know i have a point here. don't even correct me if im wrong because im right :smuggrin:
Although you probably meant this in jest / as sarcasm, it's actually your problem for real.

And saying that you have trouble communicating with people on this forum but you do fine in real life demonstrates your lack of insight into your problem. Trust me, the communication problems demonstrated on this thread translate directly into your clinical work and are likely the reason for being terminated from two residencies.
 

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so how does it help me to have people telling me what a complete loser and absolute waste of life i am for being an FMG with low scores and messed up residency experiences that will never amount to anything at all in any job whatsoever or even life itself? or does it help you more by boosting your ego? better docs r more positive.
 
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captaincrunch

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Hello,

Maybe I'm wasting my time here, but I've been reading these threads and thought I would weigh in. I've noticed a theme in turquoiseblue's threads. Most are seeking for some way to get into a residency despite lackluster credentials (e.g., connections, research, re-taking boards, and now some sort of government-mandated remediation process). You can insist that this isn't about you, but I think we all know that this isn't just an abstract discussion. You're talking about yourself and you're hoping for a way back in.

I strongly disagree with the notion that foreign citizens are given preference over American IMGs. In fact, the hassles of visas are often so annoying that many programs won't bother. What's more, at most residency programs, the presence of even a single foreign grad is seen as a sign of academic weakness, so that most university programs won't rank them at all. Just look at the rosters of university programs and see for yourself.

I can tell you from personal experience that self-reflection and introspection are essential for self-improvement. I have certainly faced my own setbacks (I won't get into the exact details), but I have been able to overcome them and move my career forward by reflecting on my own performance. Almost invariably a poor test score, low clinical eval etc leads to anger. I think in most cases, this anger is misplaced and often focused in no particular direction. Usually after a cold beer and a day off, we are able to reflect with a little more perspective, collect ourselves and learn from our mistakes. Unfortunately, I think this process is lacking in you.

I'm going to be brutally honest with you. Let's do a hypothetical exercise where you are the program director and you have to review your own application. You're looking for the strongest candidates who will do well and represent your program well after residency:

1) You graduated from a foreign medical school despite being a US citizen. This suggests an undergraduate performance that was below that of your peers (e.g., GPA, MCATs, etc).

2) At medical school you performed below expected and had to retake USMLE exams multiple time, again suggesting poor academic performance. You seem to insist there is some unfairness in the test rather than admit any shortcomings.

3) At your first residency you left under some degree of duress. While you may disagree with your evaluations, it seems that any letter from this program would reveal a perceived deficiency in clinical skills and in-service exams. Despite this problem, you insist you left on "good terms," which suggests a lack of insight into these deficiencyies. On this forum, we don't know exactly what they are. Remember, even if you disagree, nobody on this forum believes in a nurses/resident/attending conspiracy against you. Programs are going to react the same way.

4) At your second program, you left after 10 months, but failed to get credit for the year. As aPG states, this seems very suspicious and the logical conclusion is that the program didn't want you back. All you offer in explanation is that the program was starting a new year and couldn't/wouldn't continue you due to scheduling issues. Again, nobody on this forum believes this. You may disagree with our assessment, but realize that residency programs will react the same way. It looks like your contract was not renewed, most likely for performance-related issues.

5) Despite these deficiencies, you offer no insight or evidence that you can change.

Now be the residency program director and make an executive decision. Accept the candidate or not?

The truth is, nothing is for certain. At any college, huge numbers of people start as "premed," but the numbers get winnowed down by grades in the basic science classes. The process repeats itself with MCATs and again with the application process. More leave due to a lack of interest or a change in heart. Once in medical school, there is further attrition, often due to poor academic performance, personal issues, etc. A significant number (as you pointed out), will also fail to get the field they want (e.g., derm), and must settle for something else.

Some also fail out of residency. It is not something programs relish doing; believe me, nothing is worse for the morale of a program than firing a resident. Sadly, some will also drop out later in their careers (e.g., burnout, lawsuits, drug/alcohol abuse). It's sad, but at some point the integrity of our field must be protected, and patients need to be protected from doctors with competency issues. It seems to me that you have been given every chance to remediate and have failed at every step.

While I may be harsh in my assessment, I think you are taking people's comments too personally. Your personal worth is not tied to a career in medicine. Allow me to repeat: your personal worth is not tied to a career in medicine. Perhaps some cognitive behavioral therapy can help you separate your feelings of self-worth from these issues. Perhaps if this helps, you may even be able to salvage your career. I don't know; I honestly think at this point you would be a long-shot.

I can tell you this: printed USMLE cutoffs, personal contacts, research papers, externships, a different nationality, taking nursing classes, etc will not improve your chances. The only way you can salvage your career is to do a lot of self-reflection and personal improvement. Once you do this, you can try to tackle some of the problems on your application.

I say this with all honestly: I wish you the best of luck.
 

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Several things about this:

1. If you were out on medical leave (FMLA) then they must legally re-instate you to your position when you return from leave. There is some chance that you were not FMLA eligible, since the law only requires employers to offer FMLA to employees who have worked for 12 months. But many hospitals / residency programs offer FMLA from day 1.

2. They did not offer you a spot back because they did not want to. The fact that you don't seem to realize this is very telling. If your performance had been fine, they would have found a way to restart your training.
Thanks for this info. It was a prelim position, so it was only a year long. I had completed 10 months. last 2 months i was out for illness that i now recovered from. I would like to finish it up for completeness sake, so I will find out about this FMLA. I emailed ACGME about it and they did not respond yet.

If US IMG's are so marginalized by the system, by PD's taking FMG's needing visas, then you'd expect many of your classmates to be in the same situation. But, it appears that most of your classmates have done just fine -- despite their carib eduation limitations, USMLE's etc.

So this really doesn't support your argument at all. In fact, it suggests the problem is you, not the system.
Many of my classmates scored well. i spared you details until now but if it is any consolation, i was in a situation where my parents were going through a horrible divorce and my mom was ill, so i was worried about my family and probably depressed at the time during my medical school time. I studied and understood the material as I was supposed to and was diligent about it and had good work ethic and loved and was interested in what i was reading, but i wasn't a good test taker. my parents would pick fights w/ me my dad was horribly mean to me on the phone a lot especially before my USMLE tests (just because i didn't like his woman for cheating on my mom), and i'd be crying the night before over it not able to sleep at all. it is what happened and made things many times more difficult to concentrate on school. just recently my dad told me not to expect anything from him in the future because i couldn't fit some things of his in my suitcase. i was so polite about it and still i get that reaction. but i didn't care this time. i am able to not care at all anymore cuz i've seen it all before and how my life gets ruined from his rudness. i mean he's a doctor. can you imagine what it is like to know a doctor treats ppl like that over such petty issues?

yes im over it now, it was years ago and i could care less about it now, but those were huge stressors in my life that affected my school and test performance. i can never tell a program about it of course they'll tell me its just an excuse, but truly it was difficult time in my life. at least it was a learning experience and made me a better person to deal with such situations more easily.

Here's something we agree upon. I agree that it seems unreasonable that PD's choose foreign trained / practicing docs because it's "easy" to teach them, because they know everything already. I don't know how you would stop this, though. And, is it fair to someone who trained in another country and then moves here for some other reason to simply say that they cannot be trained to work here?
i would think it could be sent to congress to limit the total number of visas by 9000 minus 2000 (or whatever the number of US citizens left out is).

Although it's getting lost in the details, this is a real issue to discuss. Arguments can be made that US Citizens should have priority for spots. I discussed some of these arguments above. The only one that makes any sense to me is simply "protecting our own". Whether we'd be willing to try to get every US Citizen a spot to the exclusion of some foreign students, and risk ending up with a "lower quality" physician workforce, is a complicated question that people are unlikely to come to any agreement about. You either believe in one side, or the other.
it won't be 'lower quality' because by the end that resident will be a doctor like anyone else and be as good as the program taught them to be, and nothing less than that. They will have to take boards like anyone else too. The finished product is what matters, not how good they were when they started residency. No one is supposed to know anything when they start residency. some may but not everyone does as most just started. It is a learning process.

i know i can't change the world....but im just sayin' (i hate that phrase but sounds good to use it right this instant).
 
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Rabbit Hole

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1. If you were out on medical leave (FMLA) then they must legally re-instate you to your position when you return from leave. There is some chance that you were not FMLA eligible, since the law only requires employers to offer FMLA to employees who have worked for 12 months. But many hospitals / residency programs offer FMLA from day 1.

2. They did not offer you a spot back because they did not want to. The fact that you don't seem to realize this is very telling. If your performance had been fine, they would have found a way to restart your training.
I looked back at some of her posts to figure out the timeline of her journey thus far and to get a better picture of what's going on.

(correct me if I'm wrong)

Step 1 - 76 (1st attempt)
Step 2 CK - passed (2nd attempt)
Step 2 CS - passed (2nd attempt)
Step 3 - (currently preparing for 2nd attempt)
ECFMG certified
US IMG - Caribbean

2003 - graduated
2004 - scrambled into PGY-1 categorical IM --> "resigned" after 6 months
- LOR from PD --> "suboptimal performance"
Somewhere in between - research experience, good LOR
2008-2009 - non-ACGME paid externship surgery 8 months --> did not finish because took medical leave for 2 months
- LORs from externship --> good

She has been reapplying for the match every year since 2004. The year is now 2010.


And saying that you have trouble communicating with people on this forum but you do fine in real life demonstrates your lack of insight into your problem. Trust me, the communication problems demonstrated on this thread translate directly into your clinical work and are likely the reason for being terminated from two residencies.
Spot on.
I was hoping your sage PD advice could get through to her but I don't think that's even strong enough. I'm not sure she even read it thoroughly.. and you took all that time to write it.

I hope she realizes what she looks like ON PAPER. I think you mentioned in some other thread that you skim through applicants under the "cut-off" line to see if there are any gems that stand out. What in FSM's name could she possibly do at this point to make her stand out from the bottom of the pile?

In any case, turquoiseblue if you're reading this, I hope you get a JOB. I think you needed a bolus of reality check. All this makes me wonder.. where are your parents in all this? .. and why have they not intervened? I really hope you are not lying to them about what you're up to in life.

Also, can you please lower the notch on your pity party "Woe is me" "I'm the victim". I wish you could stand outside yourself and see what you come across like. You complain A LOT.

Your character has been shining in this crusade of yours.

This truly is turning into a super massive black hole. Goodluck trying to make sense of it.
 
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Rabbit Hole

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turquoiseblue said:
i dont have to 'humble myself' to listen to people that tell me i'll never make it in life. that's someone that is out of their mind to listen to some of the awful rude and unpleasant things said to me on here. im glad im not rude like that to condescend on someone like has been done to me. some of you have no clue. because you've never had it as hard as I have.

By the way, using visas to get 'better qualified applicants' is abuse of the system to thwart US IMGs out of a job. they should limit them...i wonder how many there are..they should remove that number of visas to force PDs to have to accept US IMGs.
lol.
 

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TB:

ACGME has nothing to do with FMLA. Contacting them about this issue will get you nowhere.

If you took FMLA during those two months of residency, you would have filled out paperwork from your GME office and they would be in the best position to advise you on this issue. Here is the info from my residency program:

Family and Medical Leave Act (FMLA)

As required by the FMLA, our programs allow eligible residents to take up to twelve weeks paid or unpaid leave in a rolling twelve month period for certain family or medical reasons. These reasons include childbirth and care for the resident's child after birth or placement for adoption or foster care; care for the resident's spouse, son or daughter, or parent who has a serious health condition; or a serious health condition that makes the resident unable to perform his/her job. Residents are eligible for FMLA leave (if they meet the defined family or medical reasons) if they have:

been employed for at least 12 months and
been employed for at least 1250 hours of service during the 12-month period immediately preceding the commencement of the leave.
Paid leave time (sick and vacation time), if available, is required to be substituted prior to going into unpaid status. If a resident is on FMLA leave, his/her health insurance continues.

More information on FMLA leave can be obtained through the Office of Graduate Medical Education.


I don't see the point in checking in to this if you were in a Prelim position. You could only be reinstated for the 2 months remaining in the year and I fail to see how that would help you in your goal to get back into residency as there are few fields in which a Prelim Surgery year satisfies the criteria for internship.

Finally, a bit of personal input. I'm sorry that you feel the users are being mean to you. They are simply trying to get you to realize what appears to be a lack of insight into your problems. I also took time off during residency for a medical reason; the difference was that my program wanted me back, took me back and found a way to have me graduate on time. They even made phone calls to other PDs for me as my fellowship applications were delayed because of the leave. Your program did not appear to want to do this; believe me, in surgery programs most of the time almost any warm body taking call is better than none. So I find it hard to believe they wouldn't have taken you back unless there were major issues with your work ethic, clinical skills, fund of knowledge, or interpersonal interaction (or combination of all).

Best of luck to you.
 

turquoiseblue

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thanks for the info WS. i will find out because PGY2 will only take 12 months, not 10 months. i previously did get accepted into a PGY2 position in a pretty competitive specialty, so it is possible but someone took it away while i was unable to access my mail during the 2 months i was ill. i also wanted to try military options and that requires 12 months....i tried to squeeze by with 10 months in a lot of cases but most PD's just don't want to do that.

By the way i like the thread link below: it shows some hope, but im sure im not THAT lucky. I believe in destiny so whatever happens will happen...i may be successful and i may be not.....only God knows my future fate....

http://forums.studentdoctor.net/showthread.php?t=710987
 
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michaelrack

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I don't see the point in checking in to this if you were in a Prelim position. You could only be reinstated for the 2 months remaining in the year and I


Best of luck to you.
TB: My guess is, that if FMLA applies, the most that you could hope for is 2 months salary. I don't think that you will be successful in using it to get your position back.

good luck
 
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TB: My guess is, that if FMLA applies, the most that you could hope for is 2 months salary. I don't think that you will be successful in using it to get your position back.

good luck

Best of luck to turquoiseblue with your search. :luck: It must be a tough situation to be in, regardless of how much responsibility each party has in this. I didn't read through everything, seems like a lot has happened.

FMLA may not apply because it takes 12 months of employment before a person is eligible. This is not to say that the individual program would not choose to offer this as a benefit to interns before they've worked 12 months. I would check with the program.

Also, is there a limit to the amount of time it takes to pass all of the steps? I think I heard that there was. Best of luck with Step 3.