IMG chances at residency

[goodluck4all]

Hi all,
Looking for honest opinions and advice here

I am an old graduate seeking career in the US

Graduation year: 2012
Step 2 CK - 250's
Step 1 - 230's
Step 2 CS postponed. So still waiting for that
No USCE

Finished Pediatrics Residency abroad and now practicing as pediatrician

I am a green card holder

1. What are my chances for getting into residency in pediatrics in the US ?

2. Which is better ? Applying for residency PGY1/2 or doing fellowship in a relatively noncompetitive fellowship then repeating residency?
3. Another question: is it good if I get a research position in pediatrics for the next year while waiting for my CS then apply for residency? Would that help my CV ?

Sorry for the lengthy post
Any advice is appreciated

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[jurassicpark]

Howdy. Those are strong scores. I am assuming you went straight to residency and working as a pediatrician in the country you are at right now with no red flags?

The biggest issue is the Step 2 CS, as a FMG (assuming you are not a USIMG as you are practicing in a foreign country) most programs will almost absolutely want to see a passed CS score. With all this craziness, i understand it's extremely difficult to arrange.

You have do a residency here before you can do a fellowship.

A good research position is always helpful, especially if it gets your foot in the door for some US clinical experience and strong letters of rec from US physicians. Not to mention if it's at an academic center, may help a program get to know you so you can stand out even more from the crowd.

Best of luck!

 

[goodluck4all]

Howdy. Those are strong scores. I am assuming you went straight to residency and working as a pediatrician in the country you are at right now with no red flags?

The biggest issue is the Step 2 CS, as a FMG (assuming you are not a USIMG as you are practicing in a foreign country) most programs will almost absolutely want to see a passed CS score. With all this craziness, i understand it's extremely difficult to arrange.

You have do a residency here before you can do a fellowship.

A good research position is always helpful, especially if it gets your foot in the door for some US clinical experience and strong letters of rec from US physicians. Not to mention if it's at an academic center, may help a program get to know you so you can stand out even more from the crowd.

Best of luck!

Thank you for your reply
Yes I went straight into residency

Regarding the CS, that's what makes me nervous. It was cancelled 2 days out and now I'm just waiting for them to reschedule. But there is nothing I can do about it right now

Thanks for the advice. I guess I will entertain the idea of research for this year till the CS situation resolves

 

[Splenda88]

Peds is not competitive. You will match into a solid program if your English speaking ability is ok...

 

[goodluck4all]

Peds is not competitive. You will match into a solid program if your English speaking ability is ok...

Thanks. That's encouraging to hear

 

[Ganon]

How did you take step 2 before step 1?

 

[goodluck4all]

Step 1 is not a prerequisite for step 2 CK

 

[NotAProgDirector]

The honest answer is that it's impossible to predict. Your scores are good, but your YOG is > 5 years out. Some peds programs may see your prior experience as a plus, others may see it as a negative (potentially needing to change your current habits). Some states have a 7 year limit on USMLE scores to get a license -- since you took S2 in 2014, you'd need to take and pass S3 by the same date in 2021 -- still possible, but COVID delays may create problems.

If you're happy in your home country, you could certainly apply and see what happens.

If you're already here in the US and planning on staying no matter what, then you might as well apply and see what happens.

You will need US LOR's, most likely. You could try to get a spot with only foreign LOR's. So you should do something in the US that would allow you to get a US LOR. Clinical work would be best but is very difficult to come by. Research is better than nothing, for sure.

 

[goodluck4all]

The honest answer is that it's impossible to predict. Your scores are good, but your YOG is > 5 years out. Some peds programs may see your prior experience as a plus, others may see it as a negative (potentially needing to change your current habits). Some states have a 7 year limit on USMLE scores to get a license -- since you took S2 in 2014, you'd need to take and pass S3 by the same date in 2021 -- still possible, but COVID delays may create problems.

If you're happy in your home country, you could certainly apply and see what happens.

If you're already here in the US and planning on staying no matter what, then you might as well apply and see what happens.

You will need US LOR's, most likely. You could try to get a spot with only foreign LOR's. So you should do something in the US that would allow you to get a US LOR. Clinical work would be best but is very difficult to come by. Research is better than nothing, for sure.

Thanks for the feedback
I am aware of the of the step 3 situation and originally was planning to do it this year before even applying as I am limited in time. But with the COVID-19 situation I don't know what will happen
I do thing I can utilise my experience as a positive factor and I am not focused on habits and actually flexible for every hospital I worked with. but the idea is that the PD see it that way
I will do an elective definitely. I am in my home country and waiting for the immigrant visa. When I travel to the US for the green card, I will do an elective for at least a month

The COVID-19 hit my plans hard. But I suppose everyone took a hit. I hope for the best

 

[CalmAndCollected]

Hi all,
Looking for honest opinions and advice here

I am an old graduate seeking career in the US

Graduation year: 2012
Step 2 CK - 250 - 2014
Step 1 - 236 - 2019
Step 2 CS postponed. So still waiting for that
No USCE

Finished Pediatrics Residency abroad and now practicing as pediatrician

I am a green card holder

1. What are my chances for getting into residency in pediatrics in the US ?

2. Which is better ? Applying for residency PGY1/2 or doing fellowship in a relatively noncompetitive fellowship then repeating residency?
3. Another question: is it good if I get a research position in pediatrics for the next year while waiting for my CS then apply for residency? Would that help my CV ?

Sorry for the lengthy post
Any advice is appreciated

Scores and greencard will help massively. Lack of USCE and YOG can hurt you. Some programs dislike previous residency experience, other programs view it as a huge boon, it just depends on the program.

Your best bet is to get as much USCE as you can, make connections in programs that take FMGs (particularly programs that have taken people from your same school or people who take FMGs from a similar cultural background as you). Taking your Step 2 CS is basically a requirement before applying, and taking your Step 3 will open up many more doors.

I would also recommend get in touch with other people who have gone through the same process as you so they can help you build up a good application.

 

[goodluck4all]

Scores and greencard will help massively. Lack of USCE and YOG can hurt you. Some programs dislike previous residency experience, other programs view it as a huge boon, it just depends on the program.

Your best bet is to get as much USCE as you can, make connections in programs that take FMGs (particularly programs that have taken people from your same school or people who take FMGs from a similar cultural background as you). Taking your Step 2 CS is basically a requirement before applying, and taking your Step 3 will open up many more doors.

I would also recommend get in touch with other people who have gone through the same process as you so they can help you build up a good application.

Thank you for your reply

Then I will do an elective for sure, and register for step 3 as soon as I pass CS
I am still considering doing a 1 year research position if I find one. With COVID-19, I think I will have a year wasted and was thinking maybe spending it in research will improved my CV

 

[FlowLimited]

To clarify, in pediatrics it's unusual but not impossible to do a fellowship before residency. I have seen practicing pediatricians from abroad come for an extended observership (1-3 months) in the subspecialty of their choice, become ECFMG certified if not already, and then get accepted as a fellow the next application cycle. I haven't had any involvement with these cases, so I can't speak to all the details, but it can happen.

I'm not sure if this is better or easier than going the normal residency --> fellowship route.

Do you actually want to be a pediatric subspecialist? Or are you only considering that as a potential gateway to practice in the US?

 

[goodluck4all]

To clarify, in pediatrics it's unusual but not impossible to do a fellowship before residency. I have seen practicing pediatricians from abroad come for an extended observership (1-3 months) in the subspecialty of their choice, become ECFMG certified if not already, and then get accepted as a fellow the next application cycle. I haven't had any involvement with these cases, so I can't speak to all the details, but it can happen.

I'm not sure if this is better or easier than going the normal residency --> fellowship route.

Do you actually want to be a pediatric subspecialist? Or are you only considering that as a potential gateway to practice in the US?

I intend to do a sub-specialty training in the US either way., I am interested in intensive care actually, which is competitive. So, it's difficult to get a position I think.
The thing that several of my friends there told me is that if I am interested in a less competitive fellowship I could get into one because many positions are left unfilled (e.g. pediatric pulmonology, nephrology, pediatric rheumatology). Something like a 50-60% filling rate !!

 

[CalmAndCollected]

Thank you for your reply

Then I will do an elective for sure, and register for step 3 as soon as I pass CS
I am still considering doing a 1 year research position if I find one. With COVID-19, I think I will have a year wasted and was thinking maybe spending it in research will improved my CV

The most ideal situation would be to find a research position where you can also have some clinical exposure. For example, research with an attending who will let you help/shadow him clinically. That way the experience doubles as both clinical and research, and the recommendation letter you ultimately get from this mentor will be much more valuable.

 

[goodluck4all]

The most ideal situation would be to find a research position where you can also have some clinical exposure. For example, research with an attending who will let you help/shadow him clinically. That way the experience doubles as both clinical and research, and the recommendation letter you ultimately get from this mentor will be much more valuable.

Do you have any idea as to how can I find such position ? I've been extensively researching the web for such a position.
Do you think it's possible to contact an attending directly for a position?

 

[CalmAndCollected]

Do you have any idea as to how can I find such position ? I've been extensively researching the web for such a position.
Do you think it's possible to contact an attending directly for a position?

It is much easier said than done, unfortunately... It's a mix of being resourceful enough and being lucky enough to find something like that. Your best place to start is to either focus on a specific region where you want to go due to family connections, or focus on places that have FMGs as residents or staff (particularly if they are from your school or ethnic background).

Do you know anyone else who is currently in the process or recently completed the process of becoming a peds resident? Many of these opportunities spread through word of mouth, and it might be hard to give you specific advice unless they are also in the peds world.

 

[goodluck4all]

It is much easier said than done, unfortunately... It's a mix of being resourceful enough and being lucky enough to find something like that. Your best place to start is to either focus on a specific region where you want to go due to family connections, or focus on places that have FMGs as residents or staff (particularly if they are from your school or ethnic background).

Do you know anyone else who is currently in the process or recently completed the process of becoming a peds resident? Many of these opportunities spread through word of mouth, and it might be hard to give you specific advice unless they are also in the peds world.

I have colleagues from med school in the US but they are in medicine. don't know anyone in pediatrics. But none of them went through the same situation... They went immediately for the match after graduation.

I guess I will do what I can, keep looking, and have faith I will find something

 

[CalmAndCollected]

I have colleagues from med school in the US but they are in medicine. don't know anyone in pediatrics. But none of them went through the same situation... They went immediately for the match after graduation.

I guess I will do what I can, keep looking, and have faith I will find something

It might still be worth reaching out for their help/advice regarding your application or they may have a connection to peds for all you know (maybe they did a rotation with someone).

 

[goodluck4all]

It might still be worth reaching out for their help/advice regarding your application or they may have a connection to peds for all you know (maybe they did a rotation with someone).

Sorry, I didn't mention that I am in contact with them and they are helping through the whole process but they don't know of such a position

 

[CalmAndCollected]

Sorry, I didn't mention that I am in contact with them and they are helping through the whole process but they don't know of such a position

Ah, got it. How did they reach out to people to get their foot in the door?

Have you considered other people from your school who have already graduated a while ago and are attendings? Or do you know of any more recent graduates from your school who are in the same shoes?

 

[goodluck4all]

Ah, got it. How did they reach out to people to get their foot in the door?

Have you considered other people from your school who have already graduated a while ago and are attendings? Or do you know of any more recent graduates from your school who are in the same shoes?

Yes some of them are attendings in internal medicine but they are still new attendings and are new in their hospitals. They know the process in general but they aren't connected. I haven't passed the CS yet anyways, so we haven't talked deep in this regard. But one thing I didn't consider is if they can actively ask around in their hospitals for a research position in peds. i guess will do that after I get the green card