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IMG and US Grad competitiveness equivalency

Discussion in 'Clinical Rotations' started by Cuts, Feb 15, 2002.

  1. Cuts

    Cuts Member
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    Sorry about the confusing thread title. What I mean to ask is this: Let's say an IMG and a US Grad are both vying for Residency spot X. Let's further say that Residency spot X is somewhere in the middle of the spectrum on the range of competitiveness (i.e. both applicants have a decent shot at it). Now, theoretically, let's say that the IMG and US Grad both have IDENTICAL credentials... same board scores, same LORs, same clinical evals, same performance on their interviews. Now, if this is the case, I'm sure the PD would choose the US Grad... understandable enough. What I'm curious about is to what degree would the IMG have to improve his aforementioned credentials to gain that edge over the "mediocre" US grad for the PD to pick him over the US grad. I know this is tough to theorize and even tougher to quantify, but being an above average to stellar IMG, your advice/opinions would be invaluble to me in deciding on where and what to apply to. Thanks very much.
     
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  3. Goofy

    Goofy Senior Member
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    Cuts,

    IMG are severely disadvantaged when it comes to US residencies. I would even take your analogy further to say that a blatantly inferior AMG in terms of raw numbers gets the spot over the IMG. The hard and fast rule in residency is that AMG comes before an IMG no matter what. There are exceptions, but they are few and far between. Perhaps the only thing looked at before board scores is school of origin.

    This is financially motivated. Programs are reimbursed an additional 100k a year for accepting a home grown med student. Taking an FMG would mean losing a minimum of 300k. As a result, AMG's, any AMG's get first licks.

    Obviously there are many qualified IMG's who will be a bit miffed about this, but there are reasons, legimitate ones in my opinion, to favor AMG's, but thats an entirely different discussion.

    In any case, there are tons of slots in this country, ample room for qualified IMG's to receive quality training. Best of luck.
     
  4. navs

    navs Member
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    I would agree 100%.

    First though I don't think their will be many "average" AMGs matching in rads, just above avg. to stellar!! So now an IMG, no matter how good, is competing against an AMG that is good. I would say 10 out of 10 the AMG wins. I also agree with the idea that they probably should.

    BUT there are many programs in the country, namely primary care fields, that have room for IMGs, but if it comes down to a program or a field choosing a AMG or IMG, undoubtly the AMG wins.

    Not fair, but this is life.
     
  5. Knight

    Knight Junior Member
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    Does this preference for AMG over IMG carry over to fellowships (e.g. cardiology or gastroenterology)?

    Also, besides financial incentives, are there other objective reasons for this preference or is it more of an issue of political pressure and bragging rights?
     
  6. Goofy

    Goofy Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Knight:
    <strong>Does this preference for AMG over IMG carry over to fellowships (e.g. cardiology or gastroenterology)?

    Also, besides financial incentives, are there other objective reasons for this preference or is it more of an issue of political pressure and bragging rights?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It does carry over to fellowship, but the issue is a bit more obscured here. If an IMG does outstanding work in a medicine program, it is considered in poor taste to take an inferior AMG to the same fellowship. That doesn't mean the AMG doesn't have an advantage, he/she does, but once you train at an institution your an insider.

    There are other reasons why programs discriminate against IMG's. For whatever reason, there is a stigma attached to foreign trained phsyicians. As a result, program reputations are often judged solely on how many IMG's they admit. Outsiders don't know what paper scores applicants achieved. What is visible is whether or not the residents are foreign trained.

    I would add that lumping all foreigners like this can be counterproductive, as there are many highly qualified/trained individuals in other countries. At the same time, as a whole, the medical training opportunities in the states are world class. And residents from US schools, even with lower numbers, may arguably recieve superior training. This is not a generalization, as there are any number of excellent foreign programs. But there are also a rather large number of awful programs. The worst program in the states, is still one of the best around.
     
  7. Moony

    Moony Member
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    Ok I may be going a little off the topic here since the discussion is about AMG Vs IMG in securing a residency spot.As Klebsiella said:
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">There are other reasons why programs discriminate against IMG's. For whatever reason, there is a stigma attached to foreign trained phsyicians. </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Now I understand to a certain extent why AMGs are preferred over IMGs by residency program directors.But when an IMG does start working in a residency program that has lets say majority or equal numbers or AMGs, do his/her coworkers still carry in their minds this "stigma attached to foreign trained physicians".I mean do IMGS feel uncomfortable working alongside AMGS?Are they treated with the same respect as a fellow AMG resident would be.Do any friendships develop at all?My main concern in asking all of these is I may be starting residency in the USA and am somewhat anxious about what my relationships with my colleagues will be like?I dont want to feel secluded, lonely and disrespected.Sometimes this worries me so much that I think about giving up on medicine here in the USA and starting another career altogether.
    Anyone with any personal experiences or comments please respond.
    Thanks.
     
  8. Goofy

    Goofy Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Moony:
    <strong>Ok I may be going a little off the topic here since the discussion is about AMG Vs IMG in securing a residency spot.As Klebsiella said:
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">There are other reasons why programs discriminate against IMG's. For whatever reason, there is a stigma attached to foreign trained phsyicians. </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Now I understand to a certain extent why AMGs are preferred over IMGs by residency program directors.But when an IMG does start working in a residency program that has lets say majority or equal numbers or AMGs, do his/her coworkers still carry in their minds this "stigma attached to foreign trained physicians".I mean do IMGS feel uncomfortable working alongside AMGS?Are they treated with the same respect as a fellow AMG resident would be.Do any friendships develop at all?My main concern in asking all of these is I may be starting residency in the USA and am somewhat anxious about what my relationships with my colleagues will be like?I dont want to feel secluded, lonely and disrespected.Sometimes this worries me so much that I think about giving up on medicine here in the USA and starting another career altogether.
    Anyone with any personal experiences or comments please respond.
    Thanks.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Moony,

    Once in a program you should not feel inferior to AMG counterparts. If you pull your weight and demonstrate that you are a quality resident, there is no need to feel inferior, nor should your colleagues make you feel this way.

    I can tell you that residents who don't do their work, dumping on everyone else are the ones viewed in a very negative way. There are some dopes who will brand you regardless of how good you are, but the vast majority of your peers will respect quality work, and deservedly so.
     
  9. navs

    navs Member
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    As it goes for forming relationships with fellow house staff, I am sure this involves aspects that have nothing to do with where u are trained.

    At first, I am sure there are many AMGs with their preconceived notions of FMGs just as there are AMGs who are open minded.

    Once u start battling in the "trenches" together, developing a relationship or rapport with each other has more to do with: How good u are, are u easy to get along, do u help out others, are u professional, etc. In other words, personality and professionality mean more.

    BUT I am confident there are those AMGs who will never change their minds about FMGs, but don't think they are in the majority. Unfortunately they are probably are the same people who end up being the PDs and Chiefs who hate FMGs.

    Good luck.
     
  10. UHS2002

    UHS2002 Senior Member
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    Once you matched into a program, as a IMG, you don't have to worry about discrimination by your fellow residents for one simple reason:
    in the vast majority of programs, the current residents have a big, if not the biggest, input on how the program is going to rank the applicants. If they ranked you high enough for you to match, then it is because they don't have a problem with you being an IMG.
     
  11. Goofy

    Goofy Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by UHS2002:
    <strong>Once you matched into a program, as a IMG, you don't have to worry about discrimination by your fellow residents for one simple reason:
    in the vast majority of programs, the current residents have a big, if not the biggest, input on how the program is going to rank the applicants. If they ranked you high enough for you to match, then it is because they don't have a problem with you being an IMG.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I'm not sure what this advice means.
     
  12. pags

    pags Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by UHS2002:
    <strong>Once you matched into a program, as a IMG, you don't have to worry about discrimination by your fellow residents for one simple reason:
    in the vast majority of programs, the current residents have a big, if not the biggest, input on how the program is going to rank the applicants. If they ranked you high enough for you to match, then it is because they don't have a problem with you being an IMG.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I really don't think that residents have much input on who is on their PD's rank list.
     
  13. Goofy

    Goofy Senior Member
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    Pags,

    You were able to decipher the meaning better than I. I agree with ya. Residents have next to no role in rank lists. If they are stellar applicants and offering a personal reference to the PD, it might move you up on the list a bit. It should be realized though that residents do not participate in the ranking process at all. This posters comments are entirely wrong. It seems we have gone off on a tangent, oops!
     
  14. GreatPumpkin

    GreatPumpkin Mystical Treatbringer
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by pags:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by UHS2002:
    <strong>Once you matched into a program, as a IMG, you don't have to worry about discrimination by your fellow residents for one simple reason:
    in the vast majority of programs, the current residents have a big, if not the biggest, input on how the program is going to rank the applicants. If they ranked you high enough for you to match, then it is because they don't have a problem with you being an IMG.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I really don't think that residents have much input on who is on their PD's rank list.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Depends on the program. In my program we have a lot of input. We fill out comment sheets on every candidate we meet and the chiefs sit on the committee. :)
     
  15. UHS2002

    UHS2002 Senior Member
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    Does that mean that all the residents and the faculty at the 10 programs I just applied to were lying to me <img border="0" title="" alt="[Eek!]" src="eek.gif" /> ????

    I was specifically told by ALL the programs I applied to that faculty AND residents both have a vote in the compilation of the program's ranking list. At some programs each resident's vote had the same weight as a faculty member's vote, at some not quite as much, but was still factored in.

    Who knows, perhaps that varies from specialty to specialty. I applied FP (both community and university based) and that was the case at EVERY single program I applied to. Apparently, this is somewhat true for Path, as Pumpkin pointed out. I know Pags is applying Rad and he seems to disagree, so perhaps that is not the case for Rad. Klebsiella, what kind of programs did you apply to?

    BTW, I was addressing Moony's question:
    "But when an IMG does start working in a residency program that has lets say majority or equal numbers or AMGs, do his/her coworkers still carry in their minds this "stigma attached to foreign trained physicians".

    I know Match Day is approaching and everyone is getting a little antsy, but aren't you guys a little too quick to jump at my throat?! After all I WAS ADDRESSING one of the dude's questions. Jeeez...
     
  16. Jim Picotte

    Jim Picotte Senior Member
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    I think it's different for every program as to who has the input on the new residents. Generally as pags said in radiology, typically only the PD has say. At nearly every interview I went to, all the residents told me they had "zero" input for the rank list but I'm sure the PD asked them who they liked at the end of the interview day.

    I also know of a local surgery program where the residents have an equal vote and actively decide the rank list with everyone else so it really just depends. There is no hard and fast rule.
     
  17. Sevo

    Sevo Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Depends on the program. In my program we have a lot of input. We fill out comment sheets on every candidate we meet and the chiefs sit on the committee. :) [/QB]</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It really is program dependent. In fact, I've been to a few programs (all of those being prelim int. med) in which almost every resident I met had a copy of my entire application.

    However, for the majority of my interviews (in anesthesia), it appeared that my interview "score" was strictly determined by a handful of attendings, with my interviews with the program director and chairman weighing more than all the others combined.
     
  18. Sevo

    Sevo Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Knight:
    [qb]Does this preference for AMG over IMG carry over to fellowships (e.g. cardiology or gastroenterology)? [qb]</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Although it's dependent on the field, from what I've seen (and heard) preference, in general, tends to be given to graduates of the home program and then according to residency pedigree.

    Other factors that certainly also come into play are research and "who you know" (and is willing to come to bat for you) and "who the program director & chairman knows."
     
  19. imyy4u

    imyy4u Junior Member

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  20. kamya

    kamya Member
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