HI, I am IMG from India, that means I need visa for matching and my profile is 207/230/cs pass. I have Sloe’s but due to my low scores and visa status I have been subject ti condescending veiws on matching into EM. I love EM, i had the best 2 months of rotations when I was in EM. How do I improve my resume to get IV’s from programs. Any suggestions are welcome.
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Do you know anything about how your rotations/SLOEs went? In general, EM is not all that friendly to IMGs. With those scores and needing a visa I'd say your chances are very very low.
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You will not get any IVs let alone match in EM without some sort of connection to a program or a PD as a foreign IMG especially with low board scores. Not trying to be mean but that’s reality.
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Not gonna happen. Would re-calibrate goals.
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You could try for FM and do an EM fellowship after. You’ll be able to work in some rural EDs through that route, although not every place will take you
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You are talking apples to oranges. Not all IMGs are the same. NRMP breaks down match data between US-born IMGs (ie. citizens who go to caribbean schools) and non-US IMGs (citizens of another country applying to residency in the US). Non-US IMGs have a really low match rate in EM. In 2018, only 1% of EM residency spots were filled by a non-US IMG.
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A good place to start is the CORD application guide for IMGs, see the attachment below. Lots of good data and recommendations in there. This is a huge uphill battle, even if your board scores were excellent. The fact that they aren't is going to make this EXTREMELY unlikely. That's not being condescending, that's being honest so you don't pin all your hopes on this. You need to formulate a backup plan that you are working on while also working to try and get into EM. Probably the best situation imaginable would be getting a prelim surgery or transitional IM year at a place with an EM residency that isn't real competitive. Will that guarantee you a spot the following year? No, but that's probably going to be the best chance you'll have as a backup if you aren't willing to give up the EM dream and just accept a backup in FP or IM.
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Not that options were requested but here goes another one:
OP, you could also apply to pediatrics (very IMG friendly) and then do a Peds EM fellowship (or just work in urgent cares/EDs w/o a fellowship).
OP, you could also apply to pediatrics (very IMG friendly) and then do a Peds EM fellowship (or just work in urgent cares/EDs w/o a fellowship).
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Great advice from gamerEMdoc. I absolutely agree with everything they said.
I am a non US IMG myself and have been advising US and non US IMGs for a few years now. I just celebrated one of my non US IMG mentees matching in EM. So please don't take what I say as condescension or discouragement. Your chances of matching in EM are very very low. Not zero, but to describe them as anything except very low would be misleading.
Assuming your SLOEs are from the US, you've done the most important thing, which is get US clinical experience. Your board scores aren't great, but that's not modifiable at this point. In terms of what you can do from this point on:
-Apply broadly. Apply to every program in the country (excluding California if you have not graduated yet). This is going to be super expensive, but you really can't afford not to. In my experience, a candidate in your situation would expect to get 0-6 interviews.
-Apply to backups. I would recommend throwing in some prelim IM, prelim surgery, as well as categorical IM residency spots. It's great that you love EM. But having a job in any field is so much better than not having a job, that I would strongly recommend to apply to backups. Also, doing an intern year in the US will help immensely if you choose to reapply next year.
-Get your application ready by September 15. Have everything ready the day ERAS opens. Even though most programs will not look at your application that early, some do.
-Make sure your school follows an appropriate format for the MSPE (Dean's letter). This is a surprisingly common problem for foreign medical schools. Work with your dean's office to get them to do this properly.
-Polish your personal statement. Another surprising problem for FMGs. One of the fears of taking in an FMG who the PD is unfamiliar with is that they are not going to be able to communicate well. Other than making sure your personal statement doesn't have any grammatical or spelling errors, make sure it's read by a few US EM people so it doesn't sound weird.
-Network. Submit an abstract to ACEP. Go to the residency fair. Talk to people. Afterwards when you email them, you can mention you've met before and it makes you more real to them.
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As someone from a surprisingly similar background, who has been through the process this year, I am afraid I do not have very encouraging news. Last year around the same time, I sought advice on this forum. @gro2001 and @gamerEMdoc had some very good advice then. I applied widely with what I thought was enough backup options. One year later, I didn't match, not even to my backup options. When I come across non-US IMGs considering a career in EM, I always ask them if they think there is a chance they would be happy doing internal medicine and critical care. For most people, that is a FAR simpler path. Every year 2000+ non-US IMGs match into Internal medicine, as opposed to 20+ in Emergency Medicine. And even in those 20 spots, a few are Saudi Arabia (SACM) government-sponsored spots. You are going against very bad odds. It might be worthwhile to take a step back and think about all the reasons why you might want to put yourself through all this. If you are still convinced, then, by all means, follow the advise above and go for it. We are all in it together. Good luck!
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I have 2 SLOE's, rotation went well but both the programs are not IMG friendly where I did my rotations.
yes they do, but their applicants all have dual degrees which make them competitive. But yes that is an option
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thank you for your reply
That is true and out of 1% also mostly are SAUDIS who are taken in because their own government pay for their salaries while they are working in USA. But then I always heard during the rotations that "EM is made for someone who is made for EM" and according to NRMP data the PD's do place having SLOE's as a major plus point. I had to struggle to get rotations in EM, but since I wanted it so bad I did it. Having low scores is a big hindrance but my desire for EM is much much more than to do anything else in life. I don't know how to convey this to US PD's.
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As an intern who participated in the interview and ranking process at my program this year, you have very little chance of matching in EM. Our program does take US-IMGs, but we aren't able to take residents that require Visas. There are so many great US grads with great scores, great personalities, who love EM. With so many great people applying to EM who don't require a VISA and DO have great board scores, your chance of finding a program that is willing to provide a VISA for EM is highly unlikely.
Why not train in EM in India and live there? I've checked, and India does have EM programs.
If you really want to leave India, I recommend, as others suggested, to apply to FM and IM programs that rotate through the ED and have ED residencies at their hospitals. Then, if the ED loves you, you could try to get them to take you into their EM program.
Unfortunately, your love of EM doesn't mean you'll be a good fit for a program. This happens to US grads too, especially those with low board scores.
Why not train in EM in India and live there? I've checked, and India does have EM programs.
If you really want to leave India, I recommend, as others suggested, to apply to FM and IM programs that rotate through the ED and have ED residencies at their hospitals. Then, if the ED loves you, you could try to get them to take you into their EM program.
Unfortunately, your love of EM doesn't mean you'll be a good fit for a program. This happens to US grads too, especially those with low board scores.
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I am a resident at one of those really prestigious programs and all IMG applications are screened-out (as are Caribbean and DO applicants). Do I agree with this? Absolutely not. But it's the reality.
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There really aren't. There are two programs (referred to as masters in emergency medicine) that are somewhat similar to what a US emergency medicine residency program would be like. Admittedly, they are pretty large and graduate more people every year than a typical US emergency residency program in the US does. The quality of the training and graduates is also below that of what is in the US (though the curriculum looks similar on paper). This is not a knock on either the trainees or the faculty at all. It's just really difficult to reproduce high quality graduate medical education in an emerging field in a setting where graduate medical education is not standardized. Then there are numerous other courses/certificates/diplomas that are variable and have almost no standardization with extremely limited recognition (even within India). Those aren't really worth speaking about as it's comparing apples to oranges. Either way I don't think it is possible to get high quality emergency medicine training in India at this time.
I don't know if you have experience working internationally, but as someone who does, emergency medicine is just not the same in most countries. In some it's very similar. In others it's not similar at all, but still fun. Practicing EM in a country where it is not an established field is not fun at all (outside of a relief/development context). There is something to be said for going somewhere and starting up a program (though that's such an uphill battle in most places I really don't envy people who choose to make it their life's work) but that's something that is done after you've attained high quality training yourself and seen how it should be done.
Also, perhaps you didn't mean it that way, but people generally don't be like to be told where you think they should live and work. That's not the kind of advice we should give out unless it's been asked for. OP asked on how to maximize their chances on matching in EM in the US, not which country they should build their career in.
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deleted109597
There's more than 2 programs in India. I've taught at 4 separate programs. Aster has multiple sites, and there's others with master's programs in joint with GWU and Baylor.
I agree it's not great, and there's less opportunity to work in the US, but it's not zero.
I agree it's not great, and there's less opportunity to work in the US, but it's not zero.
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I didn't really want to spiral this into a discussion of emergency medicine training in India, because it's such a mess. Also, I acknowledge that others (including yourself and the OP) may know more about this topic than me, or have more information. I am happy to be corrected. My knowledge comes from working in the region. In the department I work in, we have quite a few docs from India and the specific training pathways and how they've shaped their careers is a common topic of discussion, so I am somewhat (but not absolutely) confident of what I'm saying.
But to resolve our disagreement: we might be talking about different things. There aren't any true 'emergency medicine residency programs' in India exactly.
There are several different pathways:
-MD in EM (doesn't mean what we'd think it means, as the main medical doctor degree in the country is MBBS, newer thing, still unclear what's going to happen with recognition of it (at this time it's recognized but for some reason general consensus is that this is questionable); there are also only 84 spots through 30 institutions)
-DNB in EM (2-3 years, there seem to be about 20 accredit programs in this pathway offering around 90 spots (though I can't confirm this as I can't find a comprehensive list of DNB programs from an official source; in the past this was a way for essentially 'fellowship' training in EM after specialization in another field, though I believe this is no longer the case)
-MEM (most similar to a US style residency program in my opinion, which is what I was referring to, with one bing run by GWU and another by SEMI; however there are a lot of variable MEMs in other centers that are kinda dodgy. Also, technically even the GWU program is not recognized by the MCI, each MEM seems to graduate around 50-60 people per year).
-Fellowship in EM: don't know much about this.
Also, if you are referring to the GWU program for example, it's one program that I believe trains people at 5-6 different primary sites (at least according to their website). I could imagine that someone could say these are 5-6 different training programs. By training programs I was referring to MEMs like the GWU program (and considering all of their sites as one program). By that count, there are only two residency-like training programs in EM in India: the GWU program and the SEMI program. I couldn't find the Aster programs you are referring to on the MCI list or non official lists of training programs. Could be they are not up to date, or could be these are non accredited training programs of some sort.
In summary, there are very few training programs in India that even approximate what EM training in the US is like. They suffer from issues of quality, recognition, or both. As to work opportunities: I think you meant less opportunity to work than in the US? Because there really isn't any opportunity to work in the US without doing some post graduate training in the US. Licensure alone requires FMGs to complete usually 3 years of post graduate education in the US.
Some resources to back up what I'm saying:
College and Course Search | MCI India
Illegal 'PG degrees' plague emergency medicine - Times of India
https://nbe.edu.in/mainpdf/curriculum/EMERGENCY-MEDICINE.pdf
Program Graduates | The Ronald Reagan Institute
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This is so true. In fact the Medical Council of India is trying hard to crack down on these MEM (Masters in Emergency Medicine) courses springing up in hospitals around the country, with no meritorious system of selection of candidates, and available to any med school grad who can dish out equivalent of 20k+ $.
MCI, NBE crack down on ‘illegal’ PG medical courses - Times of India
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Hi. First of all, I really hope you got into an EM program of your choice.
I'm a fellow indian IMG currently in the penultimate year of my graduation at AFMC and am keen on EM.
You mention that you were able to get SLOEs which is apparently key to getting into EM programs. I have no idea as to how to get an SLOE, nevermind 3 of them as is advised.
Currently I'm very sceptical about matching with an EM program and I'm even considering dropping the idea and pursuing something else.
It would be great if you could describe as to how you were able to get USCE and the SLOE.
michealscott981
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If you don't mind me asking, where'd you do your rotations? I'm literally dying looking for EM rotations as an IMG.
michealscott981
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Wow. Thanks a lot. That's really helpful.
Are you aware of any good EM Electives that accept IMGs?
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India has 22 official languages, English being of them!
And that defeats the purpose of having an official language.
In other news, still on the lookout for quality electives in EM that accept IMGs....
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Literally, you are dying from the moment of conception. However, looking for EM rotations is NOT killing you. Literally.
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Lol...
michealscott981
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No problem.
Don't have a definitive list, but you should go to the list of accredited programs on the aamc website (ERAS 2020 Participating Specialties & Programs) and look up electives for each program individually. I'm still looking stuff up as well!
