IMG with weird resume needs guidance

[doktor_Merkwürdigliebe]

Hello guys,
During the past years I have always been a lurker, but after a couple of weeks torturing myself with questions, I had an idea: let's ask SDN! I really hope someone will come up with valuable tips because right now I am lost.

#background
IMG (europe)
graduated in 2014
currently enrolled in a residency program in my country
spent last 1.5 y doing research in one of the top US institutions​

#USMLE situation
Step 1 216 (second attempt)
Step 2 CK 219
Step 2 CS coming in few weeks​

#remaining part of my cv (highlights)
1 LOR from research supervisor at current US institution, huge name (although he doesn't practice anymore) [he knows about my scores, but I don't think he fully understands the drama]
1 LOR from physician of the same institution who allowed me to be an observer for 2.5 months (IM and cards) [he may have a role in selecting residents]
1 LOR from my mentor from med school back in my country
several publications (one in a top journal, first name, IF = 13), one award from a conference
3rd quartile of my med school [yeah I know, I suck]​

I know that my chances to match in IM here are... 0. From what I was able to understand, people here start looking at you around 240. Definitely not my case.

Now the questions for you:

1. Should I talk with the physician explaining my situation and see what he has to say? (pretty scared of disappointing him) Would you still apply here?
   
2. Would match into a IM preliminary position help me in a future attempt to match at this very prestigious institution? (Which unfortunately does not have a preliminary track)
   
3. I clearly have an interest for research that I don't want to give up, what are my best options in the NYC area? [I don't like NYC, is just because my gf works there] Any option 1h far from Manhattan is great.
   
4. Does it make sense if I say that since I have a more or less a decent CV but terrible scores I can aim for programs where usually people with higher scores than mine would match?
   e.g. NYU website says their residents have an avarage Step 1 Score of 227, can I have a chance there? No, because of the failure or because it doesn't work this way?
5. Does the fact that I passed my steps while being a resident a plus?
6. Does the fact I am already a specialist in my weird branch a plus?

I believe that's enough questions so far.
I hope someone will find the time to answer, I would really appreciate some feedback.

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[IMreshopeful]

Hello guys,
During the past years I have always been a lurker, but after a couple of weeks torturing myself with questions, I had an idea: let's ask SDN! I really hope someone will come up with valuable tips because right now I am lost.

#background
IMG (europe)
graduated in 2014
currently enrolled in a residency program in my country (weird stuff you guys don't have here in the US)
spent last 1.5 y doing research in one of the top US institutions​

#USMLE situation
Step 1 216 (second attempt)
Step 2 CK 219
Step 2 CS coming in few weeks​

#remaining part of my cv (highlights)
1 LOR from research supervisor at current US institution, huge name (although he doesn't practice anymore) [he know about my scores, but I don't think he fully understands the drama]
1 LOR from physician of the same institution who allowed me to be an observer for 2.5 months (IM and cards) [he may have a role in selecting residents]
1 LOR from my mentor from med school back in my country
several publications (one in a top journal, first name, IF = 13), one award from a conference
3rd quartile of my med school [yeah I know, I suck]​

I know that my chances to match in IM here are... 0. From what I was able to understand, people here start looking at you around 240. Definitely not my case.

Now the questions for you:

1. Should I talk with the physician explaining my situation and see what he has to say? (pretty scared of disappointing him) Would you still apply here?
   
2. Would match into a IM preliminary position help me in a future attempt to match at this very prestigious institution? (Which unfortunately does not have a preliminary track)
   
3. I clearly have an interest for research that I don't want to give up, what are my best options in the NYC area? [I don't like NYC, is just because my gf works there] Any option 1h far from Manhattan is great.
   
4. Does it make sense if I say that since I have a more or less a decent CV but terrible scores I can aim for programs where usually people with higher scores than mine would match?
   e.g. NYU website says their residents have an avarage Step 1 Score of 227, can I have a chance there? No, because of the failure or because it doesn't work this way?
5. Does the fact that I passed my steps while being a resident a plus?
6. Does the fact I am already a specialist in my weird branch a plus?

I believe that's enough questions so far.
I hope someone will find the time to answer, I would really appreciate some feedback.

Oh man. I wouldn’t even talk about a decent NYC program as a possibility primarily due to step 1 failure. That alone will screen you out of so many programs. The research and pubs are good but it’s going to be very tough to pursue a high powered academic residency even with all of that because of failing a step exam. And no, it doesn’t really matter nor does anyone care if you did this all during residency.

Your gf being in NYC definitely cannot limit you there. I would apply everywhere possible and not have any delusions that you’ll be guaranteed any sort of top residency.

 

[doktor_Merkwürdigliebe]

Oh man. I wouldn’t even talk about a decent NYC program as a possibility primarily due to step 1 failure. That alone will screen you out of so many programs. The research and pubs are good but it’s going to be very tough to pursue a high powered academic residency even with all of that because of failing a step exam. And no, it doesn’t really matter nor does anyone care if you did this all during residency.

Your gf being in NYC definitely cannot limit you there. I would apply everywhere possible and not have any delusions that you’ll be guaranteed any sort of top residency.

Now, I don't want to play "fantasy MATCH" here, but let's say I can ask my research supervisor to personally call a program in order to receive an interview - because as you correctly said I will be screened out for my steps score.
In that case, which academic program would you bet on NYC? i.e. which is the least competitive academic IM program in NYC?

Outside of NYC, but on the Est coast, any suggestion?

 

[Xurros]

Now, I don't want to play "fantasy MATCH" here, but let's say I can ask my research supervisor to personally call a program in order to receive an interview - because as you correctly said I will be screened out for my steps score.
In that case, which academic program would you bet on NYC? i.e. which is the least competitive academic IM program in NYC?

Outside of NYC, but on the Est coast, any suggestion?

With your IMG status and step failure, your chances of matching at any program, let alone one in NYC, are slim to none. Even if someone makes a phone call for you to get an interview, you will probably be ranked very low on their list, if you're even ranked at all.

 

[Redpancreas]

I know you have some hx. in publications but the #1 factor that can disqualify you for IM is Step 1. Also, everyone who applies to these research fellowships gets them so doing research at Harvard, for example, doesn’t mean much. You not only don’t have a shot at any of those top Manhattan programs or Montefiore (least best, but decent program in Bronx) but will get screened out at any decent lower tier research university on the east coast like UConn, Rutgers, UMaine, etc. In fact, even most community programs have a 220 threshold. I would say that you would have a shot at IM if you apply broadly and have a take-what-you-get attitude but you have seemed to convinced yourself that your research will somehow make up for your boards (Step 1 failure/near Step 2 failure) as well as no distinguishing factors, plus being an IMG.

 

[doktor_Merkwürdigliebe]

I know you have some hx. in publications but the #1 factor that can disqualify you for IM is Step 1. You not only don’t have a shot at any of these Manhattan programs and are not going to get a look at Montefiore either (least best of the known NYC established programs academic programs) but will get screened out at any decent lower tier research university such as places like UConn, Rutgers, UMaine, etc. In fact, even most community programs put a 220 threshold. I would say that you would have a shot at IM if you apply broadly and have a take-what-you-get attitude but you have seemed to convinced yourself that your research will somehow make up for your boards (Step 1 failure/near Step 2 failure) as well as no distinguishing factors, plus being an IMG.

Got you. However, I didn’t convince myself of anything, I was just trying to put everything on the table. I am perfectly aware of my situation. As I am aware that other options exist out there.
My aims as well are not set in stone. I will get the best option I have, and that’s why I posted my question here.

 

[Redpancreas]

Got you. However, I didn’t convince myself of anything, I was just trying to put everything on the table. I am perfectly aware of my situation. As I am aware that other options exist out there.
My aims as well are not set in stone. I will get the best option I have, and that’s why I posted my question here.

I just said it SEEMED like you’ve convinced yourself...otherwise you would already known the difficulty and not have bothered asking. Instead you mention your “research at a top institution” as if it would be a factor. You must have read about the 226 average for NYU on an SDN thread from 1999. NYU is a highly competitive IM program for both its strength and Manhattan location averages with Step 1 averages likely in the mid 240s today. My friend who matched there had a 247 and multiple years of research prior to medical school.

You call your situation as “weird”, but that doesn’t quite describe the situation. It’s better characterized as “tough/difficult/unrealistic”. Weird would be something like you failed Step 1 due to extenuating circumstances but got 283 on Step 2 or something like that.

 

[rokshana]

Hello guys,
During the past years I have always been a lurker, but after a couple of weeks torturing myself with questions, I had an idea: let's ask SDN! I really hope someone will come up with valuable tips because right now I am lost.

#background
IMG (europe)
graduated in 2014
currently enrolled in a residency program in my country
spent last 1.5 y doing research in one of the top US institutions​

#USMLE situation
Step 1 216 (second attempt)
Step 2 CK 219
Step 2 CS coming in few weeks​

#remaining part of my cv (highlights)
1 LOR from research supervisor at current US institution, huge name (although he doesn't practice anymore) [he knows about my scores, but I don't think he fully understands the drama]
1 LOR from physician of the same institution who allowed me to be an observer for 2.5 months (IM and cards) [he may have a role in selecting residents]
1 LOR from my mentor from med school back in my country
several publications (one in a top journal, first name, IF = 13), one award from a conference
3rd quartile of my med school [yeah I know, I suck]​

I know that my chances to match in IM here are... 0. From what I was able to understand, people here start looking at you around 240. Definitely not my case.

Now the questions for you:

1. Should I talk with the physician explaining my situation and see what he has to say? (pretty scared of disappointing him) Would you still apply here?
   
2. Would match into a IM preliminary position help me in a future attempt to match at this very prestigious institution? (Which unfortunately does not have a preliminary track)
   
3. I clearly have an interest for research that I don't want to give up, what are my best options in the NYC area? [I don't like NYC, is just because my gf works there] Any option 1h far from Manhattan is great.
   
4. Does it make sense if I say that since I have a more or less a decent CV but terrible scores I can aim for programs where usually people with higher scores than mine would match?
   e.g. NYU website says their residents have an avarage Step 1 Score of 227, can I have a chance there? No, because of the failure or because it doesn't work this way?
5. Does the fact that I passed my steps while being a resident a plus?
6. Does the fact I am already a specialist in my weird branch a plus?

I believe that's enough questions so far.
I hope someone will find the time to answer, I would really appreciate some feedback.

not sure why you think your resume is "weird"...you are an IMG with a failure on step I and overall low scores, no CS and an old YOG. Can the rest of your stuff help, yeah, but not overcome the failed step I score and your IMG status (esp if you are visa requiring).

there are IMG friendly programs in the NYC area, but they are certainly not academic...with your scores, most academic programs are going to be out of reach for you, despite doing research at some prestigious place, inside NYC as well as outside NYC...

you need to sit down and decide what is it that you want...is being near the gf the most important thing? then you may have to look to low tier IM or FM programs in the NYC area. Is it getting the most competitive IM program you can? then you need to look at any and all programs throughout the country. Is it doing research? then you may not need to do anything differently that you are doing now...

 

[Simba699]

Academic IM would be extremely hard for you if that 216 was 1st attempt. It is out of the question if you have a failed attempt. Frankly, you’ll be lucky to match IM at all. IMG Applicants better than you have gone unmatched in years past.

 

[Trisphorin]

there are many community programs in NYC and NJ with lots of IMGs like Wyckoff, Atlantic health, St. Michaels, JSMC..etc. If your sole goal is to stay near NYC, i think you do have a chance at those places. Like mentioned above, academic programs in manhattan is certainly out of reach. Having interviewed at some those places, the average step is probably in the mid 240s. And if you want to do fellowship, your research will definitely help and might mitigate Step scores to some extent.

 

[doktor_Merkwürdigliebe]

there are many community programs in NYC and NJ with lots of IMGs like Wyckoff, Atlantic health, St. Michaels, JSMC..etc. If your sole goal is to stay near NYC, i think you do have a chance at those places. Like mentioned above, academic programs in manhattan is certainly out of reach. Having interviewed at some those places, the average step is probably in the mid 240s. And if you want to do fellowship, your research will definitely help and might mitigate Step scores to some extent.

Thanks, I will look into those programs

 

[IMreshopeful]

Got you. However, I didn’t convince myself of anything, I was just trying to put everything on the table. I am perfectly aware of my situation. As I am aware that other options exist out there.
My aims as well are not set in stone. I will get the best option I have, and that’s why I posted my question here.

I think the best way to maximize your chances at a good match are to
- double apply IM and FM. Possibly psych Or neuro
- apply literally everywhere

Unfortunately having a step 1 failure is a nearly insurmountable problem

 

[Xurros]

I think the best way to maximize your chances at a good match are to
- double apply IM and FM. Possibly psych Or neuro
- apply literally everywhere

Unfortunately having a step 1 failure is a nearly insurmountable problem

I would not recommend psych as a backup-- the psych match has gotten a lot more competitive in recent years (with the most recent charting the outcomes quoting a 10% unmatched rate even for AMGs). From my friends who applied into psych this year, the match was also brutal to some people (particularly those with lower stats).

 

[rokshana]

I would not recommend psych as a backup-- the psych match has gotten a lot more competitive in recent years (with the most recent charting the outcomes quoting a 10% unmatched rate even for AMGs). From my friends who applied into psych this year, the match was also brutal to some people (particularly those with lower stats).

psych may be getting more competitive in that everything is getting more competitive, but its not a ROADS specialty...there are plenty of F/IMGs in psych...its still back up worthy.

 

[doktor_Merkwürdigliebe]

psych may be getting more competitive in that everything is getting more competitive, but its not a ROADS specialty...there are plenty of F/IMGs in psych...its still back up worthy.

even if psych would be a smart option, I will stick with IM. Still conflicted about FM, although I have seen that here in the US is slightly different than Europe, way more challenging than a mere "gatekeeper".

 

[IMGASMD]

I was intrigued when I saw the word “weird” in the title. After following this thread for a while, I am not sure you’ve grasp the whole situation. Sounds like you feel you still have a lot of choices, I think in reality you have very few. Many already posted that you should apply to as many spots as you possibly can. Others have suggested to apply more than one field. You seem very resistant to do either. I have seen plenty of practicing foreign doctors with spectacular scores unable to secure a residency spot. They then retreat to academics and obtain a full PhD before they get a residency spot. I’ve met foreign doctors who know even with their score and experience they will not get a spot, they become techs and MAs. I’ve seen a US born IMG do more than two prelim surgery year at his father’s institution, still unable to secure a residency spot.

Please be realistic and think long and hard about if you really want to be a resident in this country and how flexible you can be regarding the location.

 

[IMreshopeful]

even if psych would be a smart option, I will stick with IM. Still conflicted about FM, although I have seen that here in the US is slightly different than Europe, way more challenging than a mere "gatekeeper".

I just want to make sure you’re clear on your options.

Having a step 1 failure will shut you out of most IM residencies. Even the community programs will likely not take applicants who have weaker stats, no matter how much research you do, because they want people who can pass their boards and graduate from their program.

If your goal is to become a doctor in the US, I think you need to
- consider applying to FM as well (which won’t be a joke either with a step 1 failure)
- consider another specialty as well as backup

If you can live with doing some other career that is not a physician, then think about that as well.

 

[doktor_Merkwürdigliebe]

I was intrigued when I saw the word “weird” in the title. After following this thread for a while, I am not sure you’ve grasp the whole situation. Sounds like you feel you still have a lot of choices, I think in reality you have very few. Many already posted that you should apply to as many spots as you possibly can. Others have suggested to apply more than one field. You seem very resistant to do either. I have seen plenty of practicing foreign doctors with spectacular scores unable to secure a residency spot. They then retreat to academics and obtain a full PhD before they get a residency spot. I’ve met foreign doctors who know even with their score and experience they will not get a spot, they become techs and MAs. I’ve seen a US born IMG do more than two prelim surgery year at his father’s institution, still unable to secure a residency spot.

Please be realistic and think long and hard about if you really want to be a resident in this country and how flexible you can be regarding the location.

All good points. Thanks.

 

[Animalcules]

Hello guys,
During the past years I have always been a lurker, but after a couple of weeks torturing myself with questions, I had an idea: let's ask SDN! I really hope someone will come up with valuable tips because right now I am lost.

#background
IMG (europe)
graduated in 2014
currently enrolled in a residency program in my country
spent last 1.5 y doing research in one of the top US institutions​

#USMLE situation
Step 1 216 (second attempt)
Step 2 CK 219
Step 2 CS coming in few weeks​

#remaining part of my cv (highlights)
1 LOR from research supervisor at current US institution, huge name (although he doesn't practice anymore) [he knows about my scores, but I don't think he fully understands the drama]
1 LOR from physician of the same institution who allowed me to be an observer for 2.5 months (IM and cards) [he may have a role in selecting residents]
1 LOR from my mentor from med school back in my country
several publications (one in a top journal, first name, IF = 13), one award from a conference
3rd quartile of my med school [yeah I know, I suck]​

I know that my chances to match in IM here are... 0. From what I was able to understand, people here start looking at you around 240. Definitely not my case.

Now the questions for you:

1. Should I talk with the physician explaining my situation and see what he has to say? (pretty scared of disappointing him) Would you still apply here?
   
2. Would match into a IM preliminary position help me in a future attempt to match at this very prestigious institution? (Which unfortunately does not have a preliminary track)
   
3. I clearly have an interest for research that I don't want to give up, what are my best options in the NYC area? [I don't like NYC, is just because my gf works there] Any option 1h far from Manhattan is great.
   
4. Does it make sense if I say that since I have a more or less a decent CV but terrible scores I can aim for programs where usually people with higher scores than mine would match?
   e.g. NYU website says their residents have an avarage Step 1 Score of 227, can I have a chance there? No, because of the failure or because it doesn't work this way?
5. Does the fact that I passed my steps while being a resident a plus?
6. Does the fact I am already a specialist in my weird branch a plus?

I believe that's enough questions so far.
I hope someone will find the time to answer, I would really appreciate some feedback.

Sorry to read this. You are really in a tough spot. I assume you want to stay in the US because of your girlfriend but you will have a long and likely highly frustrating battle in front of you if you want to end up practicing at an academic medical center as an internist. Securing a residency position in IM is going to be the hardest part even with your mentors’ help. It looks like you did observerships but not hands-on training in the US, this will hurt you just as much as the low scores. The failure is making sure you will get screened out almost everywhere academic. Why do you want to stay in the US? If you want to do academic medicine and research, I would highly consider staying in Europe, especially if you are practicing in Germany or Austria, which I assume based on your profile name. Would your girlfriend consider moving? I am just not sure you would be happy at a low community program if you have been dreaming of Harvard, Columbia, and NYU.