you'll get a spot somewhere. surgery is an easy match right now. the thing you have to remember is that most fmgs are older individuals who were practicing physicians in their countries, and although they'll take any residency they can get, they'd much rather do a short residency like im ,fp than a 5 year surgery residency. as far as 186 being too low(although this is a low score) that's not the case. at a respected university program in the m idwest i kid you not there are like 2 or 3 certifiable idiots that are fmgs (i think they're from jamaica) who had scores under 200 that matched(they're pgy 2 now) and were telling the med students on the service how they had multiple interviews. i kid you not these guys sucked, i mean never had thier work done, fund of knowledge was less than the 3rd year med students on the service, but still due to the desperate times matched into a categorical spot at what is a very good training program. this was 2 years ago and things have only gotten worse. you won't match at mass general but you'll get a spot somewhere, probably even a categorical spot. don't listen to all these clueless idiots, half of whom haven't even gone through the match but are speaking out of their asses. believe me i was in the same position last year, and these same clueless idiots were posting all of this bs about how hard it was to get into certain fields and yet after the match you realize how many brain dead idiots who's stats are anything but stellar actually matched into these fields. this was in particular true of er, optho, anasesthsia, and radiology. the only 2 fields that were as hard to get into as their stated reputation, were derm, and orthopedics. here i can confirm that only people with really high board scores and or great connections matched from my class.