How is the average FMG portrayed?

[DrDre311]

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I do not believe that match data compares individual successes, but some posters are suggesting that automatically, the single cases will reflect the pattern represented by the aggregate data, and I am in disagreement with this.

Whatever you say, man. You can try to justify your viewpoint all you like, but a U.S. allopathic M.D. is a distinct advantage in the U.S. allopathic match. Fair or not, that's the way it is.

Any further input on my part in this thread will be me agreeing with myself.

 

[AlternateSome1]

I agree with you that not all EM programs are the same, but for aguments sake, lets say both students matched at university programs that have a similar ranking.

My general point is that a poster earlier indicated that NRMP match data suggests that all IMGs are at a selective disadvantage against all U.S grads based on the stats., and I am suggesting that the stats do not tell the whole story. Both the program that the U.S grad goes to, as well as the program the IMG goes to matters, as does how well each student approaches the match.

It very much is an uphill stuggle to be an IMG, and I am fairly certain in my case that this has been an extra souce of motivation. I really don't care if I have to work harder. I am more than willing to put forth the effort, partly because I want to make sure I do as well as I can, but mostly, because my future patients will be entrusting me with their health and well-being and I owe it to them to work as hard as I can to prepared to help them.

It sounds like you do not understand the meaning of the word disadvantage. The situation you are describing which forces an IMG to work harder to obtain a residency is considered a disadvantage. This does not mean that all IMGs will be unable to match, nor does it mean IMGs are all less well trained than all AMGs, it simply means the match process is more difficult for a stereotypical IMG than for a stereotypical AMG.

 

[exPCM]

This is the craziest thing I have heard in a long time.

As a PD, I am allowed to choose my residents based upon the school to which they went. If I think that School A is better than School B, then I should be allowed to rank someone from school A above School B.

Is one medical school better than another? Well, take this example: School A gives 80% of all students Honors on Medicine, and 20% pass. School B gives 10% of students Honors, and 90% pass. Given two students with Honors, or two students with Pass, School B gets ranked above School A.

If we're going to do this, then we might as well make the name of everyone's medical school anonymous, else people who go to State U will complain that they are being discriminated against compared with those at Ivory Tower Medical School.

Actually, in that case, we might as well rank people solely by their USMLE scores. Everything else in their application could be seen as biased, discriminatory, or unfair.

The entire country has EEO and antidiscrimination programs. If you want to rank a US grad with lower scores over a Caribbean grad with higher scores (especially if the Caribbean grad is an underrepresented minority) then good luck trying to explain your school A and school B spiel to a jury of laypeople if you ever get sued. The jury will only see you picking someone with lower scores over someone with higher scores.

 

[Tired]

If you want to rank a US grad with lower scores over a Caribbean grad with higher scores (especially if the Caribbean grad is an underrepresented minority) then good luck trying to explain your school A and school B spiel to a jury of laypeople if you ever get sued. The jury will only see you picking someone with lower scores over someone with higher scores.

Typical response from the "please God don't let me get sued" crowd.

You act like aProg is suggesting a change in policy. In fact he's talking about the norm. US Seniors are routinely ranked over Carib grads primarily due to their school, and regardless of their race.

Name me one successful lawsuit regarding this policy, which has been employed for many more years than most of us have been anywhere near medicine. In fact, name me one lawsuit that has been filed.

 

[SLUser11]

Whatever you say, man. You can try to justify your viewpoint all you like, but a U.S. allopathic M.D. is a distinct advantage in the U.S. allopathic match. Fair or not, that's the way it is.

Any further input on my part in this thread will be me agreeing with myself.

311, this bullcrap reasoning is what they do in pretty much every thread in the SDN Caribbean forum. Sometimes I think it shouldn't be allowed because there are impressionable premeds out there that take the easier road after one rejection because they buy into these people's horrible reasoning.

It's best just to not go in there because you'll feel compelled to burst their bubble and then you'll feel like a jerk.....

Honestly, does this belong in the "general residency issues" forum, when it's really just a glorified Premed's WAMC thread?

 

[physiologyman]

ok sorry i didn;t reply in a while I was kind of away but as for the fact that I will probably never be compared to US grads because I went to med straight out of high school it was because of a specific family reason that direly had to be addressed back in pakistan furthermore i was gonna spend a long time there and thought i might enroll in med school there that being said...

lets suppose i did get into a us med school which i believe that if i went through the college system I would have accomplished ( indicating that even while attending school abroad im equal in my abiliy to be competetive as us med student ) IS There any chance of me placing into a competetive residency saying im not different from any other us student (in steps scores, grades research knowledge accent and LOR) except in my med school attended. or would competetive residencies like neurosurgery and plastics derm at prestigious school reject me on the spot without even looking at my stats even if they are better than the us applicants simply becasue if given an opportunity to go to med school in the us i didn't avail it no matter what reason i had to go abroad...

 

[DOCTORSAIB]

ok sorry i didn;t reply in a while I was kind of away but as for the fact that I will probably never be compared to US grads because I went to med straight out of high school it was because of a specific family reason that direly had to be addressed back in pakistan furthermore i was gonna spend a long time there and thought i might enroll in med school there that being said...

lets suppose i did get into a us med school which i believe that if i went through the college system I would have accomplished ( indicating that even while attending school abroad im equal in my abiliy to be competetive as us med student ) IS There any chance of me placing into a competetive residency saying im not different from any other us student (in steps scores, grades research knowledge accent and LOR) except in my med school attended. or would competetive residencies like neurosurgery and plastics derm at prestigious school reject me on the spot without even looking at my stats even if they are better than the us applicants simply becasue if given an opportunity to go to med school in the us i didn't avail it no matter what reason i had to go abroad...

Let me preface this by saying I have several friends who are desi...

For the life of me I cannot understand why some desi family's living in the U.S. send their 17 yr old sons to Pakistan or India for medical school. This has got to be the FOBBIEST (FOB = Fresh Of the Boat) and most ridiculous idea ever.

The unfortunate thing is when you're first shipped off by your family (often father) for med school, you're usually way too young to realize the disadvantage you will be in when it comes time to apply for residency in a few years. Luckily there are a ton of smaller IM and FM programs who will take you if you have good board scores.

In short, train in the U.S. (preferably MD, if not, then DO) at all costs. If you still can't get in, then go to whatever offshore school you want to but do realize that you will be at a DISADVANTAGE when it comes to residency applications, esp in competitive fields.

Dr. Fraud is smoking crack if he thinks otherwise.

 

[yaah]

The entire country has EEO and antidiscrimination programs. If you want to rank a US grad with lower scores over a Caribbean grad with higher scores (especially if the Caribbean grad is an underrepresented minority) then good luck trying to explain your school A and school B spiel to a jury of laypeople if you ever get sued. The jury will only see you picking someone with lower scores over someone with higher scores.

It would be easy to explain to a jury - because board scores are not the only criteria for picking residents. I suspect there is also data out there that reflects that higher board scores do not really correlate that well with residency performance. There are far more factors than where the candidate went to school and what their board scores were. I know people on this site like to make things seem more finite and exact than they are, but residency applications are not all about numbers or specific criteria, and neither is being a successful physician.

 

[exPCM]

It would be easy to explain to a jury - because board scores are not the only criteria for picking residents. I suspect there is also data out there that reflects that higher board scores do not really correlate that well with residency performance. There are far more factors than where the candidate went to school and what their board scores were. I know people on this site like to make things seem more finite and exact than they are, but residency applications are not all about numbers or specific criteria, and neither is being a successful physician.

Actually do you think that lower scores would correlate with better residency performance or do you think there is no correlation at all? If so you are calling in to question whether there is any validity at all to the USMLE as measurement tool. Here is a link to the USMLE bulletin:
http://www.usmle.org/General_Information/bulletin/2008/2008bulletin.pdf
From the bulletin: Goals: To provide to licensing authorities meaningful information from assessments of physician characteristics—including medical knowledge, skills, values, and attitudes—that are important to the provision of safe and effective patient care

 

[Blade28]

Tough to say whether Step 1 is a good indicator/predictor of future residency performance. It's so basic science-heavy and those who study hard for two months can do well on the test - but this doesn't necessarily mean they'll be a great physician.

Step 2 CK is much more clinical but you have to consider the motivations of those taking the test - you have the MS-IVs who take the test early after studying hard for it because they wanted to make up for a lower Step 1 score, and want the higher Step 2 CK score to show up on their ERAS app.

And while Step 3 is even MORE clinical and relevant to future practice, most people hardly study for it and just aim to pass...so the scores here can hardly be used to make any sort of meaningful extrapolation.

 

[BlondeDocteur]

lets suppose i did get into a us med school which i believe that if i went through the college system I would have accomplished ( indicating that even while attending school abroad im equal in my abiliy to be competetive as us med student )

There is absolutely nothing objective to validate that statement except you saying "I'm smart." Because you won't apply to US schools, so you won't be evaluated, and anyway no residency application will see a list of your med school acceptances that you happened to turn down.

If you are a US citizen and attend *any* offshore medical school you will be lumped into the A-IMG category. No distinction, no "family reasons" to go back to Lahore.

I don't know how far along in school you are, but if it's still on the radar I would recommend returning to the US to go to college. Unless, of course, you wish to practice medicine in Pakistan.

 

[Tired]

311, this bullcrap reasoning is what they do in pretty much every thread in the SDN Caribbean forum. Sometimes I think it shouldn't be allowed because there are impressionable premeds out there that take the easier road after one rejection because they buy into these people's horrible reasoning.

You're so FOS. Caribbean schools are incredibly competitive, and produce world-renowned physicians.

Like this guy: http://kidnappingmurderandmayhem.blogspot.com/2008/02/dr-krist.html

"Gary Steven Krist is most infamous for kidnapping Barbara Jane Mackle [pictured] and burying her in a plywood box. With minimal air from a battery-powered fan, she survived four days and three nights before being rescued. The only decent thing Krist ever did was to call the FBI and tell a secretary where Mackle could be found . . .

In 1976, the Georgia Pardons and Parole Board denied his parole bid and issued a statement: “[Krist] has been a menace to society all his adult life.” . . .

A self-proclaimed genius, he went to Alaska to work on a fishing boat. Later, he attended a medical school in the Carribean and began practicing medicine in a small town in Indiana . . ."

 

[xaelia]

As I remember it xaelia did score 99s/250+ on step 1 and 2.

Who else is in the, now totally irrelevant, 750 Club? 😉

 

[yaah]

Actually do you think that lower scores would correlate with better residency performance or do you think there is no correlation at all? If so you are calling in to question whether there is any validity at all to the USMLE as measurement tool. Here is a link to the USMLE bulletin:
http://www.usmle.org/General_Information/bulletin/2008/2008bulletin.pdf
From the bulletin: Goals: To provide to licensing authorities meaningful information from assessments of physician characteristics—including medical knowledge, skills, values, and attitudes—that are important to the provision of safe and effective patient care

I'm sure there is some correlation, it's just that it is unlikely to be a pure correlation. It's like how SATs and MCATs have some correlation, but are far from fully effective tools at predicting future performance. I suspect USMLEs function as an effective (but blunt and relatively non-specific) tool to measure potential and intelligence. However, one of their most effective functions is to measure test-taking abilities, and residency programs want to train residents who will pass their requisite board exam and move on into practice. To have trainees fail these future board exams is an embarassment, and if you are a good test taker, you will have a better chance.

I suspect that the correlation works most effectively at the extremes, particularly the lower extremes. Those who cannot successfully pass the USMLEs probably do perform at a lower level, however you wish to measure it. Of course, like everything, there will always be exceptions. I'm sure most residency programs will minimize the importance of lower USMLE scores if the other qualifications or characteristics of the applicant are stellar.

 

[DrFraud]

You're so FOS. Caribbean schools are incredibly competitive, and produce world-renowned physicians.

Like this guy: http://kidnappingmurderandmayhem.blogspot.com/2008/02/dr-krist.html

"Gary Steven Krist is most infamous for kidnapping Barbara Jane Mackle [pictured] and burying her in a plywood box. With minimal air from a battery-powered fan, she survived four days and three nights before being rescued. The only decent thing Krist ever did was to call the FBI and tell a secretary where Mackle could be found . . .

In 1976, the Georgia Pardons and Parole Board denied his parole bid and issued a statement: "[Krist] has been a menace to society all his adult life." . . .

A self-proclaimed genius, he went to Alaska to work on a fishing boat. Later, he attended a medical school in the Carribean and began practicing medicine in a small town in Indiana . . ."

Even more strange is that the same Caribbean school attended by this guy placed 3 of its grads into orthopedic surgery in 2008.

http://www.rossu.edu/medical-school/files/2008ResidencyList.pdf

You would think that PDs at these programs would be more on top of things 🙄

 

[buckley]

Hmm... I went into the Match with a good idea that it was a disadvantage being an IMG. Yes, I cannot prove it, but I have no doubt that a US senior counterpart would be chosen ahead of me. Sure it was a major kick to the ego, but heck, I just remind myself that I am the newbie trying to gain entry into a system and getting access to the training. I remember one particular bitchy US senior who seemed to hate me for no reason whatsoever-- I asked her if something was wrong and she told me point blank (I'm still adjusting to how brutally frank, bordering rude, many americans can be--perhaps overgeneralization on my part, so please forgive me) that she could not take how I can have the same job as her when I don't even have a visa and I don't have the debt that she has. I respect that. I dont see how we can ever be "friends" though.
Oh and it is a good idea to get US seniors just because they do know the system already. I am not being a traitor to my IMG-mates with zero US experience. It's just the truth. But I think (I hope), a few more weeks on the floors and it should even out that advantage...Still as my friend warned me, the IMG discrimintaion continues on to fellowship apps...I say, accept it as fact and work it through.

I think no matter what policy would be instituted, it would just be hypocrisy. Discrimination is not something you work on in paper.

 

[ERzone]

How many patients who see doctors, either in ER or Primary or anywhere, ASK their doctor, oh, by the way, before you touch me or ask me questions, could you please tell me where you went to medical school?? Again, lets get real about this....who cares, take good care of me and do the right thing...I don't give a "crap" where you went to medical school!! GET IT???

 

[Winged Scapula]

How many patients who see doctors, either in ER or Primary or anywhere, ASK their doctor, oh, by the way, before you touch me or ask me questions, could you please tell me where you went to medical school?? Again, lets get real about this....who cares, take good care of me and do the right thing...I don't give a "crap" where you went to medical school!! GET IT???

Patients do ask. Less so in emergency situations where they have no choice, but don't fool yourself that there aren't certain segments of the population who do care and will refuse to let you touch them.

I've also seen patients refuse to see my ex (a trauma surgeon, so generally an emergency) not because of where he went to medical school (in the US and clearly with an American accent) but because of his race. I've had friends face the same thing and have racial epithets hurled at them.

Then again, I've been in practice for several months now and only one patient has commented on where I trained (which they found on our website) and then only to say they were "disappointed" that I didn't have much of an accent.

By and large, you will meet patients who will find something to complain about, whether its where you went to medical school, what your race is, your accent, etc. I can't tell you how many patients say this stuff in front of me about foreign doctors, how they can't understand them, how they only want to see American doctors, etc. It would be foolish to think this doesn't happen.

 

[Tired]

Even more strange is that the same Caribbean school attended by this guy placed 3 of its grads into orthopedic surgery in 2008.

Even more strange is that you would look at the successes of 3 students from a class of 400 and take that as a sign that everyone respects the Carribean schools and they are competitive in the match.

 

[BlondeDocteur]

Ditto Tired.

3 matched in ortho-- good work; these were three peeps who clearly just needed a "second shot" to prove themselves, and did so.

Why not discuss the numerous kids who didn't match? Or the massive attrition before even making it to 4th year? Or the 48 people who matched into prelim positions only, but are still counted as successful matches by the school's academic affairs office?

 

[DrFraud]

Even more strange is that you would look at the successes of 3 students from a class of 400 and take that as a sign that everyone respects the Carribean schools and they are competitive in the match.

Even more bizarre is your math skills if you only think that only 3 of the grads are successes...

 

[Faebinder]

I'm sure there is some correlation, it's just that it is unlikely to be a pure correlation. It's like how SATs and MCATs have some correlation, but are far from fully effective tools at predicting future performance. I suspect USMLEs function as an effective (but blunt and relatively non-specific) tool to measure potential and intelligence. However, one of their most effective functions is to measure test-taking abilities, and residency programs want to train residents who will pass their requisite board exam and move on into practice. To have trainees fail these future board exams is an embarassment, and if you are a good test taker, you will have a better chance.

I suspect that the correlation works most effectively at the extremes, particularly the lower extremes. Those who cannot successfully pass the USMLEs probably do perform at a lower level, however you wish to measure it. Of course, like everything, there will always be exceptions. I'm sure most residency programs will minimize the importance of lower USMLE scores if the other qualifications or characteristics of the applicant are stellar.

What you stated is the very reason why the USMLE has a disclaimer statement on its site that you shouldn't use the USMLE as the sole academic determining factor for admission to residency. Your ability to do fast multiple choice questions pretty much determines how well you do with your base knowledge and whether or not you result in your residency program being on probation for not having most of its grads pass the boards (coincidently fast multiple choice as well.)

If the boards changed to be like the USMLE Step 3 CCS... I bet you we would say a huge difference between step1/step2 scores and the boards (which might force step1/step2 to change to that style). Either way, you need to master the ability to do multiple questions at the rate of 1 question per 1.2 minutes.

 

[Faebinder]

Still as my friend warned me, the IMG discrimintaion continues on to fellowship apps...I say, accept it as fact and work it through.

Not exactly... it continues well beyond the fellowship, it just becomes less impacting overall because private practice doesn't care about where you graduated from. An IMG trying to become part of the faculty in a university program is likely to face more scrutiny.

 

[Faebinder]

You're so FOS. Caribbean schools are incredibly competitive, and produce world-renowned physicians.

Like this guy: http://kidnappingmurderandmayhem.blogspot.com/2008/02/dr-krist.html

"Gary Steven Krist is most infamous for kidnapping Barbara Jane Mackle [pictured] and burying her in a plywood box. With minimal air from a battery-powered fan, she survived four days and three nights before being rescued. The only decent thing Krist ever did was to call the FBI and tell a secretary where Mackle could be found . . .

In 1976, the Georgia Pardons and Parole Board denied his parole bid and issued a statement: “[Krist] has been a menace to society all his adult life.” . . .

A self-proclaimed genius, he went to Alaska to work on a fishing boat. Later, he attended a medical school in the Carribean and began practicing medicine in a small town in Indiana . . ."

You know, I agreed with most of what you said.. till you sited the example. Really? US allopathics dont have any kinda weirdo/criminals/mance-to-society? 😴

 

[Tired]

You know, I agreed with most of what you said.. till you sited the example. Really? US allopathics dont have any kinda weirdo/criminals/mance-to-society? 😴

I don't know, how does that make you feel?

Tell me about your relationship with your mother.

 

[Ypo.]

You know, I agreed with most of what you said.. till you sited the example. Really? US allopathics dont have any kinda weirdo/criminals/mance-to-society? 😴

I've met a few. 😉

 

[ZonaRidicularis]

.

 

[Faebinder]

I've met a few. 😉

It's not nice to talk about other posters on here like that.

 

[Runsnakedinrain]

I went to school in the Caribbean and am now starting rotations in the U.S. I was fully aware of the career-long difficulties I would have to deal with before I made the decision to apply. All of the issues with residency and colleagues and patients stated in this thread are very real. So why am I still excited about my career if it will be impossible (yes, impossible) to realize my full potential in terms of residency placement and respect from some colleagues and patients? I will just work hard and get the best residency spot I can. If you can distinguish yourself from other students around you then you increase your chances of matching at a place you can deal with. What if the field that really draws my interest is out of my reach because of my Caribbean status? That would be unfortunate but never in my life has only one thing drawn my interest, I am sure there will be other fields of medicine I would enjoy. What about prejudice from others because of where I went to school even after I finish my training? It only hurts me to get all upset about it, I know it will happen and when it does life will go on.

What am I getting at here? Do not delude yourself. Prepare for all the hurdles those around you will put up because that is the only way to move forward. Be the best doctor you can because at some point someone is going to need your help with their health. This post was no revelation for me, I know what is coming.

This was wordy and will be mostly mush to most readers. But writing has always made me smile and this post was more about me than it was contributing to a thread that seems about dead. And now, back to Halo3.

 

[Taurus]

Even more bizarre is your math skills if you only think that only 3 of the grads are successes...

I'm not quite sure why it's so hard for you to accept what people have been saying. It's well known that IMG's are at a disadvantage when matching compared to US grads.

Not only do they have much harder time matching into the competitive specialties but they also generally match into less desirable residencies. Not all residencies in the same specialty are equal.

3/400 matched into ortho from Ross. You should also consider where they matched into as well.

My school matched 5/150 into ortho in excellent residencies.

 

[sirus_virus]

The entire country has EEO and antidiscrimination programs. If you want to rank a US grad with lower scores over a Caribbean grad with higher scores (especially if the Caribbean grad is an underrepresented minority) then good luck trying to explain your school A and school B spiel to a jury of laypeople if you ever get sued. The jury will only see you picking someone with lower scores over someone with higher scores.

Sued? Anyone can correct me if I am wrong, but there is no such thing as "uderrepresented minority" considerations when it comes to residency employment. Residency programs can pick whom so ever they choose based on whatever criteria they want to go with.