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IMG Wanting to match into surgery

Blitz2006

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    Hey,

    Doing my MD at University of Birmingham (UK). I am a Canadian-British dual citizen. I want to match into Preliminary surgery next year on J1 Visa. However, after 1 year of Preliminary, can I switch into Categorical? And if I do switch into Categorical, can I switch into H1B visa? And switch into PGY2? Or will I have to start from scratch at PGY1? How realistic is it for me to switch into PGY2 categorical? Do spots open up?

    Reason why I want to intially do Preliminary is because J1 is easier to find than H1B hospitals...correct? So can I do 1 year of J1 Preliminary, and then switch over to categorical and get H1B? (I really dont want to be stuck with J1 for 5 years)

    Cheers.
     

    ctdocMD

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      Hey,

      Doing my MD at University of Birmingham (UK). I am a Canadian-British dual citizen. I want to match into Preliminary surgery next year on J1 Visa. However, after 1 year of Preliminary, can I switch into Categorical? And if I do switch into Categorical, can I switch into H1B visa? And switch into PGY2? Or will I have to start from scratch at PGY1? How realistic is it for me to switch into PGY2 categorical? Do spots open up?

      Reason why I want to intially do Preliminary is because J1 is easier to find than H1B hospitals...correct? So can I do 1 year of J1 Preliminary, and then switch over to categorical and get H1B? (I really dont want to be stuck with J1 for 5 years)

      Cheers.

      im not really too sure about visa regulations, however, for an IMG...its easy to match into a prelim...however very difficult to get into a cat. from my experience, i know a lot of US-IMG from carribbean schools that match into cat. but that is only because they have rotated through US hospitals and the carribbean schools follow a US based curriculum which i dont think european schools do. if you want to get into a cat. from prelim, find a program that has a history of admitting prelim into cat. and then see if they are IMG friendly. youll probably need good LORs, board scores and maybe some good research under your belt
       

      VincentAdultman

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        Hey,

        Doing my MD at University of Birmingham (UK). I am a Canadian-British dual citizen. I want to match into Preliminary surgery next year on J1 Visa. However, after 1 year of Preliminary, can I switch into Categorical? And if I do switch into Categorical, can I switch into H1B visa? And switch into PGY2? Or will I have to start from scratch at PGY1? How realistic is it for me to switch into PGY2 categorical? Do spots open up?

        Reason why I want to intially do Preliminary is because J1 is easier to find than H1B hospitals...correct? So can I do 1 year of J1 Preliminary, and then switch over to categorical and get H1B? (I really dont want to be stuck with J1 for 5 years)

        Cheers.

        Not to sound like a d!ck, but whay don't you just go to a British or Canadian program?
         
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        Blitz2006

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          Not to sound like a d!ck, but whay don't you just go to a British or Canadian program?

          Because I like America better :)

          Thanks for the replies. I understand that it is competitive to get into categorical surgery, but I figured that if I do 1 year (PGY1) of Prelim on J1, I can somehow switch into PGY1 or PGY2 categorical, and thus swing into a H1 visa.

          I really don't want to continue on a J1 Visa. So yeah, i guess my main concern is the visa status...
           

          Winged Scapula

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            Because I like America better :)

            Thanks for the replies. I understand that it is competitive to get into categorical surgery, but I figured that if I do 1 year (PGY1) of Prelim on J1, I can somehow switch into PGY1 or PGY2 categorical, and thus swing into a H1 visa.

            I really don't want to continue on a J1 Visa. So yeah, i guess my main concern is the visa status...

            I would look for threads in the ERAS/Match forum, as I know aProgDirector (IM not Surg) is very knowledgable about the differences between visas.

            Switching is difficult; you are essentially on a year long audition and you are competing against almost every other Non-designated Prelim in the country, including AMGs who didn't match, for a position next year. It obviously happens but its a tough road.
             

            Blitz2006

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              Hey,

              Doing my MD at University of Birmingham (UK). I am a Canadian-British dual citizen. I want to match into Preliminary surgery next year on J1 Visa. However, after 1 year of Preliminary, can I switch into Categorical? And if I do switch into Categorical, can I switch into H1B visa? And switch into PGY2? Or will I have to start from scratch at PGY1? How realistic is it for me to switch into PGY2 categorical? Do spots open up?

              Reason why I want to intially do Preliminary is because J1 is easier to find than H1B hospitals...correct? So can I do 1 year of J1 Preliminary, and then switch over to categorical and get H1B? (I really dont want to be stuck with J1 for 5 years)

              Cheers.
               

              ctdocMD

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                you should have no problem getting into a preliminary...the hard part is getting out, ive heard of individuals going on to pgy2 and pgy3 but not in cat which is in my opinion a waste of time and it can take a toll on you
                 

                NotAProgDirector

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                  You're thinking about this all wrong.

                  Once you have a J visa, you cannot get rid of it and switch to an H1b. The two year rule will attach, and nothing (short of a J waiver position) will help -- including marrying a US citizen.

                  As an international student in a US medical school, you will find the visa situation is often not a major barrier. You are likely currently on an F visa, and you will switch your F to an OPT visa for the intern year, and then transition to an H1b (after passing Step 3). Most residency programs will do this, even if they state they are "J only".

                  You should review this thread for more information about visas: http://forums.studentdoctor.net/showthread.php?t=450230

                  Second, as a US grad you should be quite competitive for categorical sugery spots (assuming your performance in medical school is OK). A prelim surgery year should only be your backup plan.
                   

                  mallika123

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                    you can't go from a J1 visa to any other kind of visa without first fulfilling the 2 yr home country return requirement ( or taking up a J1 waiver job). However after I prelim yr u wont be able to take up a J1 waiver job so u're stuck with a) carrying on with the J1
                    b) going back home for 2 yrs & then re-applying
                    the reason that J1 is bad for prelim is cuz God forbid you can't convert to a categorical u have to pack ur bags & leave for 2 yrs..so a prelim on an H1 is always the best bet (if it has to be a prelim at all!!!) however, they're pretty hard to find..most places just allow J1 sponsorship.
                     

                    barcalounger

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                      YAs an international student in a US medical school, you will find the visa situation is often not a major barrier. You are likely currently on an F visa, and you will switch your F to an OPT visa for the intern year, and then transition to an H1b (after passing Step 3).
                      My reading is that this person is a non-US citizen at a non-US medical school, and thus is currently not on any US visa at all.
                       

                      NotAProgDirector

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                        My reading is that this person is a non-US citizen at a non-US medical school, and thus is currently not on any US visa at all.

                        Boy am I dumb. I'm the one thinking about this all wrong. Let's try again:

                        You're an IMG looking to match into surgery in the US.

                        Forget about everything I said above about F and OPT visas.

                        If you get a prelim surgery PGY-1, then you can definitely try to switch into a categorical spot. Most residents in surgery prelim years are trying to do this, so the competition can be stiff. If successful (esp within the same program), you might be able to switch to a PGY-2 or you might have to start over as a PGY-1 again. Each program has a fixed number of slots, and only if one opens up can they possibly take you. There are many stories of residents not getting any further training spot after the prelim year, so you need to know that there is no guarantee.

                        Once you get a J visa, you cannot switch it to an H. The two year rule specifically states that you can't get an H type visa without returning to your home country for 2 years. If you don't want a J visa, you need to get the H for the first year.
                         

                        Leukocyte

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                          Are you ready to take the risk, in case it does not work out in the end? Do you have a "plan B"? To beat a dead horse, getting a Categorical spot after a prelim is very tough, and being an IMG with visa issues makes it even more tough.
                           
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                          Blitz2006

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                            Boy am I dumb. I'm the one thinking about this all wrong. Let's try again:

                            You're an IMG looking to match into surgery in the US.

                            Forget about everything I said above about F and OPT visas.

                            If you get a prelim surgery PGY-1, then you can definitely try to switch into a categorical spot. Most residents in surgery prelim years are trying to do this, so the competition can be stiff. If successful (esp within the same program), you might be able to switch to a PGY-2 or you might have to start over as a PGY-1 again. Each program has a fixed number of slots, and only if one opens up can they possibly take you. There are many stories of residents not getting any further training spot after the prelim year, so you need to know that there is no guarantee.

                            Once you get a J visa, you cannot switch it to an H. The two year rule specifically states that you can't get an H type visa without returning to your home country for 2 years. If you don't want a J visa, you need to get the H for the first year.


                            Cheers for the informative reply, no worries about the mix up. I shoulda been more clear. Like barcalounger said, I am a Non-U.S citizen at a UK school.

                            Thanks for clearing up the Visa situation.

                            So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?
                             

                            Blitz2006

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                              Thx for the informative responses, much appreciated.

                              So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?

                              And whats the scope for matching into prelim surgery for IMG? Its good right. But categorical its bad?
                               

                              XoQo

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                                Thx for the informative responses, much appreciated.

                                So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?

                                And whats the scope for matching into prelim surgery for IMG? Its good right. But categorical its bad?


                                Your answer can be found in the FAQ in this forum

                                http://forums.studentdoctor.net/showpost.php?p=4787063&postcount=6


                                What is the difference between preliminary, designated and non-designated preliminary and categorical residency positions?

                                Preliminary: usually 1-2 years of training done at the beginning of your residency period that does NOT lead to board eligibility in general surgery.

                                Designated preliminary: a position designed or "designated" for an intern who needs 1-2 years of training before going on to a surgical specialty; ie, ortho, ENT, Urology, etc. Many surgical specialties require 1 year of general surgery before embarking on training in the field which leads to board eligibility. Thus, most general surgery programs will designate a certain number of preliminary positions for these candidates; they cannot be filled by non-designated applicants until all the designated positions have been filled.

                                Non-designated preliminary: a position designed for candidates who are not required to do a surgical internship but rather have to do either surgery or medicine (ie, Anesthesiology, Dermatology); a position designed for candidates interested in general surgery board eligibility but who have failed to either match or otherwise secure a Categorical position (see below).

                                Categorical: Residency leading to board certification in general surgery (i.e., a 5-year or longer residency).


                                I am a preliminary surgical intern. Do I have to apply all over again for a position next year?

                                It depends. If you have a designated position, such as a first year in general surgery in preparation for a residency in Urology/Ortho/ENT etc, you should have matched for your PGY-2 position at the same time you matched into your preliminary year. If you didn't match at that time (during your 4th year) then you will need to either go through the match or find a position outside of the match.

                                If you have a non-designated 1 year preliminary position you need to try and obtain training for PGY2 and beyond through the match. Even if the program you are currently training at gives you reason to believe they will offer you a position for next year, unless you have it in writing, you need to go through the match again. Programs are not required to give you a contract until April 1 (90 days before the traditional July 1 start of residency) – a long time after the match. If you don't have a contract from them before mid-fall (when applications go in), you must apply or start looking for a position elsewhere.
                                 

                                Winged Scapula

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                                  Cheers for the informative reply, no worries about the mix up. I shoulda been more clear. Like barcalounger said, I am a Non-U.S citizen at a UK school.

                                  Thanks for clearing up the Visa situation.

                                  So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?

                                  It is not necessary to ask the same question in multiple forums and threads. As a matter of fact, it is a TOS policy violation to cross post. The above question has been thoroughly answered in your thread in the Surgery forum by referencing the Surgery FAQ which deals with this issue.

                                  The only thing I would add is that nothing is guaranteed. While a categorical position leads to BE in a specialty residency contracts are year to year; you are not guaranteed a spot all 5 years (although generally you will be continued on unless there are major problems as a categorical). Similarly,

                                  Prelims are not "cut", but rather they are not offered a contract for the next year. A prelim position is usually for 1 year, after which you are generally not offered another contract (unless you perform in a stellar fashion AND they have a position to give you). Prelims do not continue on through all 5 years; if you haven't been offered a categorical position after 3 years, its time to look elsewhere, IMHO.
                                   

                                  Leukocyte

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                                    So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?

                                    Just to make it simple for you, because you seem to have no idea what you are getting yourself into:

                                    -Preliminary = ONE year deal ONLY (rarly two). Leads to nothing. But it can count towards satisfying the PGY-1 year in SOME specialties that require a PGY-1 year BEFORE entering/starting these specielties. Some of these specialties that may require a surgical PGY-1 year include ENT, Urology, Orthopaedics, Plastics, Anesthesiology, Radiology, PM&R...

                                    This Prelim Surgical year will NOT satify the requirements of other specialties like IM, FM, PEDS, Psychiatry....

                                    It is easier for IMGs to get a prelim surgical year, because no one actually wants to do it unless they HAVE TO.

                                    -Categorical = FIVE years deal (rarely 6). Leads to Board certification in general surgery.

                                    It is much tougher for IMGs to get Categorical surgery, because every AMG and his dog started "liking" surgery after the 80-hour rule came into effect.
                                     
                                    Thx for the informative responses, much appreciated.

                                    So my next question is, what is the difference between prelim and categorical surgery? is categorical just that you are guaranteed a spot all 5 years, where as prelim they cut ppl every year until PGY-5?

                                    And whats the scope for matching into prelim surgery for IMG? Its good right. But categorical its bad?

                                    As stated above, PLEASE read some of the FAQs to get a clearer understanding of the difference between a Preliminary and Categorical resident. This is absolutely critical.
                                     

                                    mallika123

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                                      while it may have been "really easy" to get prelim surgery a while ago, this year i know a couple of people who didn't (scores in the high 90s + observerships + a wee bit of research)...cuz i guess this year the volume of IMGs applying & competing for even those prelim spots was quite a few...most people who got the interviews matched somewhere atleast (for prelim) but some didn't even get >2 interviews.
                                      That being said, if u want surgery in the US, it's the only way to go, unless u do succeed in getting a categorical, which is way harder, but happens sometimes.
                                      A prelim year doesn't guarantee u anything, & if u have visa issues it's an added risk, but it's a chance many of us take. if u have some kinda post grad experience from the UK, it should help..almost every prelim i know that has converted to categorical has been a practicing surgeon from somewhere else! wish i was too.... :(
                                       

                                      mallika123

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                                        think what i said made it sound like prelim surg is also hard to get...it's way easier to get than categorical surg, but more difficult than lets say IM or peds...some people i know who didn't even get interviewed for prelim surg at tiny community hospitals with bad reputations interviewed at UPenn, albert einstein & jefferson for IM..
                                        prelim surg basically helps u get a foot in the door i think..after that it's ur hard work & luck that u're hoping will get u through :)
                                         

                                        mallika123

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                                          i don't think the question of competition arises if u're talking about an american grad/anyone else who's already in a categorical spot..cuz the foreign trained surgeons r in prelim spots..
                                          all i was saying was that in general it is tough to convert from a prelim spot to a categorical...all the IMGs i've met who have managed to accomplish the feat have been foreign trained surgeons already...i guess they manage to wow everyone the way people like me (just out of med school from india) can never hope to do :(
                                           

                                          huron

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                                            Hey,

                                            Doing my MD at University of Birmingham (UK). I am a Canadian-British dual citizen. I want to match into Preliminary surgery next year on J1 Visa. However, after 1 year of Preliminary, can I switch into Categorical? And if I do switch into Categorical, can I switch into H1B visa? And switch into PGY2? Or will I have to start from scratch at PGY1? How realistic is it for me to switch into PGY2 categorical? Do spots open up?

                                            Reason why I want to intially do Preliminary is because J1 is easier to find than H1B hospitals...correct? So can I do 1 year of J1 Preliminary, and then switch over to categorical and get H1B? (I really dont want to be stuck with J1 for 5 years)

                                            Cheers.

                                            If you are a Canadian citizen then you would be wise to investigate the TN visa. (trade NAFTA) That way you avoid all of the problems with the J-1 visa and the difficulty of getting an H-1b. Canadian citizen have much easier access to work in America that citizens of any other nation.
                                             

                                            mallika123

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                                              oh i didn't know that was a possibility..all the canadians i met on the interview trail spoke about J1s only (considering most surg places don't sponsor H1bs)...didn't know there was another kind of visa that they could train on..good to know..
                                               

                                              XoQo

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                                                oh i didn't know that was a possibility..all the canadians i met on the interview trail spoke about J1s only (considering most surg places don't sponsor H1bs)...didn't know there was another kind of visa that they could train on..good to know..

                                                well...for those curious...the State Dept's site about the TN visa is here:

                                                http://www.travel.state.gov/visa/temp/types/types_1274.html


                                                and the list of "approved jobs" for which you are eligible for the TN visa is here:

                                                http://www.nafta-sec-alena.org/DefaultSite/index_e.aspx?DetailID=167#Ap1603.D.1

                                                physicians are listed farther down in the list under "medical or allied professionals" but with the qualifier that you must be in a "teaching or research" position only...dunno if in the world of bureaucratic tape whether or not residency positions count...

                                                -- this may explain why people you met on the trail only held J1s.
                                                 

                                                NotAProgDirector

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                                                  I do not believe you can use a TN visa for clinical medicine. From this site:

                                                  TN physicians are limited to teaching and/or research activities. A TN physician cannot be primarily engaged in clinical patient care. This rule applies even if the TN physician obtained his or her medical education in a U.S. medical school. Patient care incidental to teaching/research is permissible. Canadian physicians seeking entry to participate in residencies, internships or direct patient care must use the J-1 or H-1 classification.
                                                   

                                                  buckley

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                                                    Just to add...
                                                    Agree...cannot change from J1 to H1.
                                                    I met a couple of Canadians in the interview trail and they seem to be having difficulty obtaining the statement of need letter. You may want to look into that.
                                                    Good luck!
                                                     

                                                    Doowai

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                                                      Not to sound like a d!ck, but whay don't you just go to a British or Canadian program?

                                                      I do not know about UK, but its harder for an IMG to get into a Canadian program than into a US program. Very few spots.



                                                      How old are you. Its a long shot to get into categorical - but heck, if you are 26 or something (or heck, in my opinion if you are even 30), you should be able to do an extra year standing on your head.
                                                       
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