Help me evaluate my chances in the 2019 match (IMG)

[nirvana88]

Hi. I was initially an IM resident (2016) in a community hospital but was dismissed for problems in professionalism and patient care in my PGY-2 year. Now I am applying for the 2019 match again and would like to know different opinions from experienced people. Here is a brief summary of my CV:
1. Steps: 251/ 245/ 1st pass/ 223 (all first attempts)
2. 2013 grad, have mostly been training since graduation. Initially 2.5 years of IM residency in home country and then 1.5 years in US.
3. 4 published researches (2 archived in PubMed).
4. One poster presentation at an ACP meeting.
5. 4 LORs (From chair of critical medicine at first residency, two faculty members in first residency and may be PD from first residency). Not entirely sure about the PD letter since they've broken promises before.
6. BLS, ACLS certfied.
7. Will be applying as a couple with my wife.

Biggest problem:
Ineligible for J1 visa since I was dismissed. ECFMG says J1 sponsorship in the future is out of the question.

What are my chances and what should I be expecting in terms of interviews? I have gone through every program in ERAS and found 74 programs that sponsor H1, are IMG friendly AND are comfortable with my graduation year.
Another thing I'd like to know is if I apply to a program with my wife and she matches on a J1, can I work on an EAD on a J2?
Thanks.

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[IMreshopeful]

Hi. I was initially an IM resident (2016) in a community hospital but was dismissed for problems in professionalism and patient care in my PGY-2 year. Now I am applying for the 2019 match again and would like to know different opinions from experienced people. Here is a brief summary of my CV:
1. Steps: 251/ 245/ 1st pass/ 223 (all first attempts)
2. 2013 grad, have mostly been training since graduation. Initially 2.5 years of IM residency in home country and then 1.5 years in US.
3. 4 published researches (2 archived in PubMed).
4. One poster presentation at an ACP meeting.
5. 4 LORs (From chair of critical medicine at first residency, two faculty members in first residency and may be PD from first residency). Not entirely sure about the PD letter since they've broken promises before.
6. BLS, ACLS certfied.
7. Will be applying as a couple with my wife.

Biggest problem:
Ineligible for J1 visa since I was dismissed. ECFMG says J1 sponsorship in the future is out of the question.

What are my chances and what should I be expecting in terms of interviews? I have gone through every program in ERAS and found 74 programs that sponsor H1, are IMG friendly AND are comfortable with my graduation year.
Another thing I'd like to know is if I apply to a program with my wife and she matches on a J1, can I work on an EAD on a J2?
Thanks.

I remember your old thread. I hope you actually learned from that experience and have made changes so that you won't make the same mistakes again. Sorry you're going through this process again.
To be frank - I think your chances are pretty poor. You need to apply literally everywhere possible that may take you, but having a prior dismissal from residency is often the kiss of death for future career here as a physician. It's not the same as having to resign or take a leave of absence for other reasons, which can be overlooked. If you are committed to being a physician in the United States then you should also consider applying FM as well, as they tend to be more forgiving. From what it sounds, you also burned a lot of bridges with your PD, and even if programs are considering taking you again, they will almost definitely reach out to your old PD for more information - I would talk to the old PD and come to some sort of frank consensus about what they are going to say.
I'm unsure about the EAD issue - this current administration is pretty anti-immigrant (legal or illegal) and they've already cracked down on the H4 EAD, so I'm not sure this is going to be all that different. I know people who are having issues with this. I would talk to a lawyer or consular officer about it.

 

[IMGASMD]

Hi. I was initially an IM resident (2016) in a community hospital but was dismissed for problems in professionalism and patient care in my PGY-2 year. Now I am applying for the 2019 match again and would like to know different opinions from experienced people. Here is a brief summary of my CV:
1. Steps: 251/ 245/ 1st pass/ 223 (all first attempts)
2. 2013 grad, have mostly been training since graduation. Initially 2.5 years of IM residency in home country and then 1.5 years in US.
3. 4 published researches (2 archived in PubMed).
4. One poster presentation at an ACP meeting.
5. 4 LORs (From chair of critical medicine at first residency, two faculty members in first residency and may be PD from first residency). Not entirely sure about the PD letter since they've broken promises before.
6. BLS, ACLS certfied.
7. Will be applying as a couple with my wife.

Biggest problem:
Ineligible for J1 visa since I was dismissed. ECFMG says J1 sponsorship in the future is out of the question.

What are my chances and what should I be expecting in terms of interviews? I have gone through every program in ERAS and found 74 programs that sponsor H1, are IMG friendly AND are comfortable with my graduation year.
Another thing I'd like to know is if I apply to a program with my wife and she matches on a J1, can I work on an EAD on a J2?
Thanks.

I think your best bet is to get some sort of connection with your PI, and hopefully your search is something meaningful/fruitful at a (hopefully big) academic center. Your road is probably going to be long before a residency will take you.

You have too many variables to juggle with. Visa issue, a spouse who is matching this year, trying to couple match, trying to explain a dismissal from residency in the middle of the year, not able to scramble or obtain another residency right away. It is daunting for most people struggle with just one or two from the above list, you have to deal with all of them. Being a foreign grad without a home institution doesn’t help you with your cause either.

My suggestion:
1. have a very frank discussion with yourself and your spouse. Is being a physician in the US important to you enough to be living separately? If it is, find a research position, hunker down at some big institution and be the best research assistant that you can. Or apply to where you think your spouse will end up as a PhD student? Seen a few physicians cannot get a residency, finished a PhD then get in that way. Very long road, but that was their hook.
2. I am not sure how that Missouri program turned out, maybe you can check that out.
3. Not sure if your program credited you for your PGY-1 year. If they did, you can actually obtain license in some states to practice medicine.
4. As you have heard both here and your original thread, something is not quite right about how you’re dismissed. Most PD I’ve dealt with all know dismissal for anyone (AMG/IMG/FMG) is essentially career ending, unless they have some really compelling reasons, usually they would not do this. So I urge you, as some other have suggested, to also have a very frank discussion with him. It should not be a he said/she said discussion, what’s done is done. You need to ask him/her how you can improve yourself for your next career move. Also if you can use her/him for reference. If what you’ve said is true, not a medical competency/patient safety issue, most likely it is a communication issue. It’s hard for me, I believe some posters here, to fathom to end someone’s career for basically “I don’t like him because I can not communicate with him” issue.

I don’t know anything about visas, so I will not comment on that. You have very strong step scores and you’ve also passed step 3, those will help you; probably not enough to overcome all of your deficits.

Good luck.

 

[nirvana88]

I've had lengthy discussions with people as to why I was dismissed and nobody ever gave me a solid answer. Even the physicians reviewing my dismissal declined to explain and simply said "I agree with everything your PD had to say" but I'm not going to discuss that here again. The whole process took a serious toll on my mental health and thankfully I'm better after seeking professional help.
Having said that, I did make a lot of mistakes that added up and I hope to avoid them in the future.
I guess the best support in my corner is that of faculty members from my last residency who are recommending me. In fact the chair of critical care medicine took special interest and made some calls as well. Some junior faculty members asked me to apply to specific programs where they can personally recommend me as well. Hence, I don't believe my chances are as bleak as one might think.
I do not believe I have the capacity to do FM. I love IM and would not mind trying to continue in my home country either, if it gets to that point.
If @IMGASMD you could please specify which states allow licensing after the first year, please let me know as I did get credit for the first year. Also, which Missouri program are you talking about?

Thank you for your kind wishes.

 

[IMGASMD]

https://www.fsmb.org/step-3/state-specific/

I didn’t know different length for IMGs. So looks like at least two years for IMGs to obtain a license.


Google Missouri and assistant physician.

If you think you have a good chance, by all means good luck with the match!

 

[IMGASMD]

I will also be blunt with you, OP. You reminded me one of my best friends, who is extremely smart, as it shows with your step scores, but just isn’t the best people person. That is also why I am going to spend a little more time with you. I am not sure if it’s cultural or maybe just personality traits. If it’s cultural, you may just need to spend more time in this country. If it’s your personality, you will need to find a program/place that can really understand that. And that may take a long time even if you’re imbedded there.

I think you are extremely polite and well articulated. Our encounter has been brief, but I will tell you that I was a little “ticked” with the fact that I basically spelled out everything that i know about how to get you to the next step. You gave a prefect and well formed reply; at the end you asked me for more information.

Here is what annoyed me: you could have research those answers yourself. Maybe you did, maybe not. Maybe you think your chance of getting into a program along with your spouse is better than I think.

Just an observation, not being malignant. Good luck.

 

[nirvana88]

Thank you for your reply and observation.
I had already searched for licenses after one year but never found any positive result as an IMG with a year of residency. The reason I asked you was may be you knew something not on the FSMB page.
As for the Missouri program, I had absolutely no idea what to search for. Further information with "Assistant physician" makes sense and I'll look it up.
As for your observations, I'm flattered that you think I'm smart. I just consider myself hardworking, the results usually follow. I have been misunderstood and betrayed heavily in the past. That's just something that's part of my personality now. However, I've never been called rude. Arrogant, yes; but never rude.

 

[IMGASMD]

Good. And also because I like you. If you don’t look like WASP, especially at this particular time in this nation’s history. Avoid being arrogant, any hints of being arrogant will not advance your cause, especially in wrong peoples eyes. That can include your own people, other people. :/

 

[W19]

Thank you for your reply and observation.
I had already searched for licenses after one year but never found any positive result as an IMG with a year of residency. The reason I asked you was may be you knew something not on the FSMB page.
As for the Missouri program, I had absolutely no idea what to search for. Further information with "Assistant physician" makes sense and I'll look it up.
As for your observations, I'm flattered that you think I'm smart. I just consider myself hardworking, the results usually follow. I have been misunderstood and betrayed heavily in the past. That's just something that's part of my personality now. However, I've never been called rude. Arrogant, yes; but never rude.

Check out Puerto Rico (PR)... I believe you might be able to get a license in PR and work for any agency of the federal government (e.g., Indian Health Service etc...) in the mainland. Another thing you might do is to try a get an ACN (Area of Critical Need) license in FL after getting a PR license. The ACN license in FL will allow to work in specific facilities designated by the state.

The system has loopholes. You just need to do a little of research so you can exploit these loopholes.

 

[nirvana88]

Thanks for your reply.
However I’m not desperate to work in the US, I just wish to train in IM. If I’m unable to get a residency spot here, I would prefer training back home or some other country.

 

[IMreshopeful]

Thanks for your reply.
However I’m not desperate to work in the US, I just wish to train in IM. If I’m unable to get a residency spot here, I would prefer training back home or some other country.

What would your wife do then?

I’m glad you’ve come to realize that some issues needed to be rectified. I just want you to be realistic that there’s a decent chance this does not work out for you.

 

[nirvana88]

What would your wife do then?

I’m glad you’ve come to realize that some issues needed to be rectified. I just want you to be realistic that there’s a decent chance this does not work out for you.

Well if my wife matches and I don't, of course I'll try to find something local around her but would not go for another specialty or move to Puerto Rico. I'll just keep trying or wait it out and plan accordingly later.

 

[Bobbbyyyy]

OP, I heard a similar story of this happened to someone from a friend of a friend, just curious to know if it was your story or someone else's. I truly felt bad hearing about this news, was your reason for termination anything to do with computer access? Sorry if I am being too nosey, just wanted to know if it was indeed your story that I heard or someone else, anyways good luck, hopefully everything works out.

 

[nirvana88]

OP, I heard a similar story of this happened to someone from a friend of a friend, just curious to know if it was your story or someone else's. I truly felt bad hearing about this news, was your reason for termination anything to do with computer access? Sorry if I am being too nosey, just wanted to know if it was indeed your story that I heard or someone else, anyways good luck, hopefully everything works out.

No, there was no issue with computer access in my case.
Thanks.