IMG aiming for IM and Cards later

[kk0319]

Greetings.

I'm a south american medical student to be graduated from a medical school in 2 years. I'm thinking on going to the US to do IM, then cards, and then staying there to live. I have yet to do the steps, or to have USCE so I haven't a clue of what my real chances are, but I would like to make myself an idea, as it would be very expensive to get into the process and not even matching in IM (our country's currency is too devaluated and a dollar is almost like an ingot of gold).

What I want to know is the most recommended path through the forest of residencies and fellowships to cards. From what I've read, it's suggested to do the observership (for me, it's complicated to do a clerkship) in the top spot where you'll be aiming for IM, which has to be a respected place in order to match in cards in the fellowship. I've read a lot and I have no objective and conclusive information as to what observership (if it even counts) is the best. I've found that the Cleveland Clinic in Florida offers observership and residency in IM, some sources say that the program is awful for getting fellowships while other say the opposite. I don't know. I would like to know a IMG friendly place for IM where I have possibilities of matching (i.e. they have accepted IMG in the past) for going after cards later and what kind of credentials, researchs and USCE I would need. Some sources say that I need about 2-6 months of USCE, while others say that's an exaggeration. I don't even know where to do the observership to begin with, I just want some advice. I would be grateful if you help me, even with a 'that's never gonna happen' cold shower. I'll only try the whole process if I score 250 or more in step I (optimistically), so I just want to know what would be the correct path to take.

Thank you very much for reading this.

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[abrutus]

I think you are being to hard on yourself. You do not have to score 250 or above as an IMG to land a residency in Internal medicine. I dont know where are you getting your information. The statistics are readily available on the internet that speak as the current average step 1 score of IMGs that match into internal and its no where near 250. (is lower).
Having said that, yes, the higher you score, the better your chances will be, but what if you end up scoring 245 or 240 or 238, will the world be over for you? not at all my friend.
I have friends that have FMG friends that landed residency spots with 0 USCE at time of application, so this is my advice.
First, commit yourself to taking the boards, yes, it will be expensive and it will take you some time, but do your best and score as High as you can. That is usually the decisive factor for an IMG. After that.. Doing an observership or externship is a secondary thing. You are looking for them to make contacts and those LoRs.. but you are worrying to far in advance. First, worry about scoring high in your exams, and once you`ve done that, work on observerships. You do not have to do your observership in the hospital you want to match. Yes, It can improve your chances, but again, people match into Internal Medicine every year W/O USCE.
Yes, you will not match into hopkins, or harvard or standford but you can match into a good program that can help you land fellowship afterwards.
What residencies are IMG friendly? My friend, you will have to do that research yourself. I am applying this year to IM, and after I selected the states I wanted to apply to, I had to go through each of their websites to see who was IMG friendly and had fellowship placements, and there are a lot of them.. (thank God). So.. dont worry ab out clinicals or Observerships... If you were not able to do a rotation while you were a student, different programs will have different points of view on observerships. So dont stress over that.
Kill the boards and you will be able to get somewhere good! good luck!

 

[bashwell]

Good advice from @abrutus to focus on your USMLEs. I also agree if you absolutely can't do away rotations for whatever reason, then it's not necessarily the end of the world.

However, I did want to quickly add there are some places which do require IMGs to have USCE in order to apply. For example, see Indiana University:

International Graduates are welcomed to apply but must have clinical experience in a U.S. hospital. Outpatient experiences and observerships without real hands-on experience will not be sufficient.

http://medicine.iupui.edu/RESIDENCY/application/selection

 

[abrutus]

Yes, bashwell is right. as I was applying I came across several hospitals that required USCE to apply, but the number of hospitals that did not required it far exceeded the ones that did.
Just to make you feel at ease. I scored 240s in both exams and have gotten interviews from decent places so far with cero USCE , having said that, when it comes to enhancing your application, getting USCE is ^frosting on the cake^.

 

[kk0319]

Thank you very much for your help! I'm currently studying for the step 1, planning to do Kaplan, Goljan, CMMRE, First Aid, Kaplan Qbank, USMLERx and USMLEWorld during the year to take the test in october. I've already made a list about IM programs excluding california, it added up to around 390 programs, from which around 70 require hands on USCE, 30 USCE of any sort, and the rest stating that you don't need USCE, but it strenghtens your application. I've programmed my calendar to do some 3 months electives in my last year and using those LORS to match the same year. I hope you all match into your desired programs! Thanks for the advice.