Int med Residency match at Hopkins or mayo ?

[Lovethemarrow]

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Hey!
Just short info about my self:
- norwegian, aged 26
- graduated with cum laude from a very though hungarian medical school
- Extremely dedicated to work and learning medicine. I completed medical school in eastern europe with ADHD, although on medication but still a clue about my stamina and work ethics.
As a kid i wanted to become a world class fotball player but injured my ankle just before i was going to be nominated to the youth national team. So its not the first time i iam aiming high...
- Have 2 excellent recomendations letters from the national hospital of norway, Rikshospitalet university hospital.
- 1 letter from the former chariman of the english program of my university in hungary. The professor did earlier teach at a boston university.
The letters are written by the chairmen of the internal medicine division(also the chairman of the scandinavian gastroenterology journal) and surgical division
- Currrently completing the norwegian rotations, that lasts 18 months after med school. Need to complete Psych + int med + surgery + fam med rotations to get fully certified as a doctor.
This is recommended by the few norwegians that went to the US. I think this is a wise decision since iam used to work as a doctor before/if i go over seas.
- My goals is to become a hematologist and i wanted to do this since i joined my grandfather at the coagulation laboratory in oslo as small kid.
I want to learn from the best and become one of the best. You never win a silver medal. I cant have fun with the things i do if iam not doing it with the best minds. Psyhiatric disordeR hu ?

How to get accepted at places like this ?
1) what kinds of score ranges on the usmle ?
2) do the they accept foreign international medical graduates ?
3) how much does the recommendation letters mean? How many ? who should write them ?
4) Do i need a language course ? I studied in english and spoke english practically everyday but iam not sure if my english skills are good enough, althoug i hope so.
5) How can i become more competetive ? without going the us and shadow doctors etc. Can i do something from norway while iam completing my rotations ?
6) Is it possible to complete a PHD while doing a residency ? iam aware of the insane schedule you guys are operating with but just need to ask. because in norway it takes 5 years to do int med spec but then you have time to complete you phd so it might be a "waste" of time to go to the US if i just consider just the numbers. It would take me 7-8 y to become hematologist in norway but then i also finished my PHD on the path to get there.
7) Other things?

Do you think that getting accepted into programs like this is to difficult for an IMG or is it possible for me to do something like this ?
Any advice or opinion about this project is very welcome and i would appreciate alot any response that i get.

Have a nice weekend!

 

[gutonc]

No matter what you do, you will not get into Hopkins. Without US experience, you will not get into Mayo, or any other "top" programs and will have a hard time getting into any mid-level programs.

In my opinion, your best option is to get into a community or low-tier academic IM program then work your tail off and shoot for the best hem/onc fellowship program you can get after that.

 

[Lovethemarrow]

Strange. 2 Norwegians Are currently doing ortopedic/int ped at Yale. 1 completed int-ped last year. Is it a clearly defined criteria to have us experience ? They dont write any specific things about that. Maybe i Missed it ? Do u know that this is impossible for a fact or do you just say it because it seems to be impossible? I know it will be difficult but if i Get a good score om the usmle my application will be as strong as possible considering that iam a foreign medical graduate. I find it strange that they dont want the best applicants to apply if they Are foreign....

 

[jdh71]

Strange. 2 Norwegians Are currently doing ortopedic/int ped at Yale. 1 completed int-ped last year. Is it a clearly defined criteria to have us experience ? They dont write any specific things about that. Maybe i Missed it ? Do u know that this is impossible for a fact or do you just say it because it seems to be impossible? I know it will be difficult but if i Get a good score om the usmle my application will be as strong as possible considering that iam a foreign medical graduate. I find it strange that they dont want the best applicants to apply if they Are foreign....

You don't understand, it's not about you being foreign as much as it is about your CV. It's NOT impressive enough. You are not one of the best applicants, even if you get a 270 on your USMLE.

Also, Yale =/= to Hopkins, not even close for Internal Medicine

 

[ResidentMD]

Not to mention, cocky people dont get too far.

You never win a silver medal. Really? 🙄

 

[KRichards62]

4) Do i need a language course ? I studied in english and spoke english practically everyday but iam not sure if my english skills are good enough, althoug i hope so.

Yes. You need a language course.

 

[dragonfly99]

Yes, an English course would probably help.
Without US clinical experience, I think it will be very hard to get into one of the more academic US internal medicine programs. How do you think a US applicant would fare if he/she tried to get into a top Norwegian hospital for residency but had never worked with any Norwegian patients or worked in a Norweigian hospital or clinic? I think it is fair.

I think your idea to do an internship in Norway (or the 18 months) is a good idea.

If you do hem/onc in the US, it would be at least 6 years, and that is basically without much research time (might be 1 year or less of it during fellowship). PhD over here usually takes 5-9 years - 4 would be a super fast PhD. You can do research during a medical fellowship usually by taking an extra 1-2 years to do your fellowship. If you want a PhD that will probably take 4-6 years extra, I would guess.

Johns Hopkins would be probably impossible to get into. They probably have, for example, a ton of people with multiple publications already, and some have very high USMLE scores as well, and are from some medical school well known to the people at Johns Hopkins and may have rotated there as medical students also.

Your letters of recommendation sound good, but you have to realize that they don't mean a whole lot except to people who know the guys who wrote the letters. If these guys know people on the faculty at US research universities, then they can probably easily help you get a spot doing a master's degree, PhD or postdoc. Getting into residency is a bit different, although again it will help if you apply to places where your letter writers know people.

Mayo Clinic I think is quite hard to get IM residency if you are an IMG/FMG. I do think they've taken some occasionally. Again, I do think you would need clinical experience rotating in the US as a medical student. You also don't know what score you'll get on the USMLE yet. You also don't mention if you have research publications.

If you really want to do residency in the US, then you have to just go for it in general and not just fixate on one or two popular/famous institutions. If you get some clinical experience in the US and do well on the USMLE, you can probably get a spot somewhere. There are places like Detroit, Michigan, and Iowa, other places that are cold and in the Midwest, etc. where they don't get as many applicants. You should be looking at places like Yale, Dartmouth, etc. if you want to shoot high. Even for US students, getting into Johns Hopkins or Mayo is extraordinarily difficult.

 

[211498]

I would say that the missing US clinical experience is the main issue. If I were in your shoes, I'd apply broadly for research positions for the time after your internship in Norway, take the USMLE steps during the research time. After two years you'll have some LORs from US faculty, know some people and you'll be fluent in English. I'm pretty sure that afterwards applications to IM programs with a longterm shot at Heme/Onc will be successful.

P.S.: A FMG should never limit himself to 2 or 3 top-notch programs

 

[Instatewaiter]

Hopkins does occasionally take FMGs- it's pretty rare though. In the intern class there is one now, from Brazil. He did almost an entire year of clinical work in the US though- and at some impressive places like the BI, the Brigham, and Case if I remember correctly and must have rocked the boards. He also applied to like 50 programs and was astounded that he match JHH.

 

[newsubstancep]

If you really want Hopkins or Mayo its *possible. But yes, it will take US clinical/research experience for almost any university spot in the US.

The most tried and true way for IMGs to match here is to come here for a 6 month to one year research project with a preceptor, and make a strong impression day in and day out from 7AM to 7PM. When it comes time for the match, these attendings vouch for the IMGs. Just because you see a Norwegian on a matchlist doesnt tell the whole story, everyone works insanely hard for their spots. Theres no shortcut to it, everyone who applies to Hopkins is overqualified, some have researched there and not matched. You can find their emails and ask them how they did it and they might give you some clues or hook-ups.

You may be a star back home, but everyone who comes here is a star back home. But dont be discouraged, if you are hardworking, its possible and nobody on this forum can stop you or help you for that matter.

 

[Lovethemarrow]

http://content.healthaffairs.org/cgi/content/abstract/29/8/1461
😛
Just a note on how USA and its citizens view themselves in generall.
If you were that decents doctors you should be able to beat IMG on different metrics.
I know this is only one metric and maybe a bunch of others that that says otherwise but still its funny to see how 95 % of you american medical students/residents that i have been in contact with have a attitude that IMGs are *****s etc.

The only reason why i would like to do a residency is because i save probably 2 years on doing this. Unfortunately its not compatible with a normal life if i want to do a phd while iam working. It takes 6 years in norway to be full certified as an internist an 1.5 more years in a subspecialty for acceptance.
we work 40h a week and once a week we have a on call duty to serve thoe hospital and new admissions etc.
I think i will stay home and do a phd while i do my int med spec and then consider again later the possibility of doing a fellowship.

I wonder how you guys can believe that you become such great doctors bye working 80h a week, have time to family, relax and then after a year still have a healthy lifestyle and so on...
I know it doesnt matter but if you considered to vote more for the democratic party/opinions you might get a more healthy lifestyle bye time.

Ill just do the USMLEs and do my int med spec in norway and then consider to do the fellowship if its possible without an us based residency.

 

[jdh71]

http://content.healthaffairs.org/cgi/content/abstract/29/8/1461
😛
Just a note on how USA and its citizens view themselves in generall.
If you were that decents doctors you should be able to beat IMG on different metrics.
I know this is only one metric and maybe a bunch of others that that says otherwise but still its funny to see how 95 % of you american medical students/residents that i have been in contact with have a attitude that IMGs are *****s etc.

The only reason why i would like to do a residency is because i save probably 2 years on doing this. Unfortunately its not compatible with a normal life if i want to do a phd while iam working. It takes 6 years in norway to be full certified as an internist an 1.5 more years in a subspecialty for acceptance.
we work 40h a week and once a week we have a on call duty to serve thoe hospital and new admissions etc.
I think i will stay home and do a phd while i do my int med spec and then consider again later the possibility of doing a fellowship.

I wonder how you guys can believe that you become such great doctors bye working 80h a week, have time to family, relax and then after a year still have a healthy lifestyle and so on...
I know it doesnt matter but if you considered to vote more for the democratic party/opinions you might get a more healthy lifestyle bye time.

Ill just do the USMLEs and do my int med spec in norway and then consider to do the fellowship if its possible without an us based residency.

Classy.

It's not our fault you're not pretty enough to get into Hopkins. I find it totally intellectually vacuous and dishonest to then go on and paint american stereotypes in your, ironically enough, stereotypical eurotrash temper tantrum that we didn't tell you that you were the unique and beautiful flower you seem to think you are.

Know what? Do it. Apply. And when you don't get any interviews continue to blame "America" for your deficiencies. Sounds like a win-win for your clearly pathological ego-defence mechanisms.

Peace. Out.

 

[Instatewaiter]

http://content.healthaffairs.org/cgi/content/abstract/29/8/1461
😛

I don't know why but I'm not sure the "Foundation for Advancement of International Medical Education and Research" would give you an objective publication.

Just a note on how USA and its citizens view themselves in generall.
If you were that decents doctors you should be able to beat IMG on different metrics.
I know this is only one metric and maybe a bunch of others that that says otherwise but still its funny to see how 95 % of you american medical students/residents that i have been in contact with have a attitude that IMGs are *****s etc.

no reason to be bitter that hopkins won't want you. Hopkins doesn't want a lot of US grads either. Jeez, I though europeans were supposed to be relaxed.

Ill just do the USMLEs and do my int med spec in norway and then consider to do the fellowship if its possible without an us based residency.

I think you have to do your IM training in the US before you can subspecialize. I may be wrong but I think you'd have to do IM residency here before you could be considered for things like Cards, GI and the like.

 

[himanshu82]

Lots of IMGs are very qualified and intelligent, but program directors of residencies aren't as familiar and don't know the faculty members at international institutions.

American medical graduates are very intelligent, and American medicine, like other medical systems, will always be incredible because they only take the best of the best from across the world.

Being someone who wants to do a PhD, it seems very weird to me that you came to this broad conclusion about America and American medicine without even doing any research.

 

[FutureDoc4]

I've read that study before (when someone else was throwing it around) as proof that we Americans aren't "as smart as we think we are".

Please read through my BRIEF analysis before drawing conclusions from one study you were able to search for on pubmed.

People gave you honest advice and insight. SOme of it you probably don't like, but its better to have the truth told to you than have some BS.

And if you think so little of our "American system" (working 80 hrs a week, etc) than why bother to come here at all?

What is true, is that there are MANY places in the US and world to get a top notch graduate medical education. It does not have to be Hopkins or Mayo. In either case, good luck to you.







I briefly read through the paper. Some important things to keep in mind:

1) Who sponsored the study? FAIMER--Foundation for the Advancement of International Medical Education and Research..... just like a drug study sponsored by a pharm company, you got to consider bias here.

2) They picked some very specific measures and completely ignored others. Looking at in hospital stay and mortality for CHF and MI. They address things like in hospital mortality but fail to address post-hospitalization outcomes (--important measures of quality)

3) The sample sizes for the groups are most definitely not equally distributed (Figure 2). Number of patients cared for by USMG n=172,000....non-US IMG n=54,360......USIMG n=17,000. With this large number of cases and large difference in number of patients seen, the variability between cases cannot be completely captured by the numbers here (using a clinical severity score). USMG cared for more than 3x the number than non-US IMG, which I think could most def affect the analysis (should of been equally sized cohorts looked at).

4) This for some of you that don't have a strong statisical background. Their biggest argument is that non-US IMG have a statisically significant lower mortality rate than USMG 0.91 95% CI (0.86-.97). If some of you don't realize....if a CI crosses 1.0 it would be statistically insignificant.... with the numbers being so close.... you have to wonder if analytical bias came into the analysis. But, most other major factors such as overalll mortality had no significant differences between the groups.

5) Finally, my biggest problem with the study:

A) We tend to select for the BEST foreign IMG (aka think of the top 10% of a medical school class abroad) for US residencies. This could def speak volumes to the fact that IMG are not overall stronger or there is a better quality of education aboard. But, that the best students from other countries measures do tend to do well in our medical education system.

B) This study looks at mortality after these attendsing have passed USMLE Step 1-3, survived residency, fellowship, and specialty exams in a US training system. Aka survived a US training !!! *I could not believe this was inadequately addressed in the paper

Any IMG that came here that were not up to "snuff" would of been weeded out in internship, residency etc. (This happens way more often than most people think). So, these IMG have already proved themselves and been EDUCATED in medicine in the United States through our residency program Hence, I would not expect much of a difference in outcomes.


WHat does that say more about? The quality of graduate (residency) medical education here or the quality of IMG? I think it speaks volumes to the intensity and quality of residency training in the United States and our ability to weed out graduates that do not have what it takes.


Finally, to avoid misinformation. IN MOST other countries (e.g. India, where your parents can more easily buy you in), medical school admissions are NOT as strict. However, schools more actively fail people out.

Example of a difference:
US medical school admissions rate for School X: 15%
Those that fail to graduate in 5 years: 1-2%

International medical schoool admissions rate: 30-50%
Those that fail to graduate in 5 years: 10-20%

http://content.healthaffairs.org/cgi/content/abstract/29/8/1461
😛
Just a note on how USA and its citizens view themselves in generall.
If you were that decents doctors you should be able to beat IMG on different metrics.
I know this is only one metric and maybe a bunch of others that that says otherwise but still its funny to see how 95 % of you american medical students/residents that i have been in contact with have a attitude that IMGs are *****s etc.

The only reason why i would like to do a residency is because i save probably 2 years on doing this. Unfortunately its not compatible with a normal life if i want to do a phd while iam working. It takes 6 years in norway to be full certified as an internist an 1.5 more years in a subspecialty for acceptance.
we work 40h a week and once a week we have a on call duty to serve thoe hospital and new admissions etc.
I think i will stay home and do a phd while i do my int med spec and then consider again later the possibility of doing a fellowship.

I wonder how you guys can believe that you become such great doctors bye working 80h a week, have time to family, relax and then after a year still have a healthy lifestyle and so on...
I know it doesnt matter but if you considered to vote more for the democratic party/opinions you might get a more healthy lifestyle bye time.

Ill just do the USMLEs and do my int med spec in norway and then consider to do the fellowship if its possible without an us based residency.

 

[mahadoc]

I've read that study before (when someone else was throwing it around) as proof that we Americans aren't "as smart as we think we are".

Please read through my BRIEF analysis before drawing conclusions from one study you were able to search for on pubmed.

People gave you honest advice and insight. SOme of it you probably don't like, but its better to have the truth told to you than have some BS.

And if you think so little of our "American system" (working 80 hrs a week, etc) than why bother to come here at all?

What is true, is that there are MANY places in the US and world to get a top notch graduate medical education. It does not have to be Hopkins or Mayo. In either case, good luck to you.







I briefly read through the paper. Some important things to keep in mind:

1) Who sponsored the study? FAIMER--Foundation for the Advancement of International Medical Education and Research..... just like a drug study sponsored by a pharm company, you got to consider bias here.

2) They picked some very specific measures and completely ignored others. Looking at in hospital stay and mortality for CHF and MI. They address things like in hospital mortality but fail to address post-hospitalization outcomes (--important measures of quality)

3) The sample sizes for the groups are most definitely not equally distributed (Figure 2). Number of patients cared for by USMG n=172,000....non-US IMG n=54,360......USIMG n=17,000. With this large number of cases and large difference in number of patients seen, the variability between cases cannot be completely captured by the numbers here (using a clinical severity score). USMG cared for more than 3x the number than non-US IMG, which I think could most def affect the analysis (should of been equally sized cohorts looked at).

4) This for some of you that don't have a strong statisical background. Their biggest argument is that non-US IMG have a statisically significant lower mortality rate than USMG 0.91 95% CI (0.86-.97). If some of you don't realize....if a CI crosses 1.0 it would be statistically insignificant.... with the numbers being so close.... you have to wonder if analytical bias came into the analysis. But, most other major factors such as overalll mortality had no significant differences between the groups.

5) Finally, my biggest problem with the study:

A) We tend to select for the BEST foreign IMG (aka think of the top 10% of a medical school class abroad) for US residencies. This could def speak volumes to the fact that IMG are not overall stronger or there is a better quality of education aboard. But, that the best students from other countries measures do tend to do well in our medical education system.

B) This study looks at mortality after these attendsing have passed USMLE Step 1-3, survived residency, fellowship, and specialty exams in a US training system. Aka survived a US training !!! *I could not believe this was inadequately addressed in the paper

Any IMG that came here that were not up to "snuff" would of been weeded out in internship, residency etc. (This happens way more often than most people think). So, these IMG have already proved themselves and been EDUCATED in medicine in the United States through our residency program Hence, I would not expect much of a difference in outcomes.


WHat does that say more about? The quality of graduate (residency) medical education here or the quality of IMG? I think it speaks volumes to the intensity and quality of residency training in the United States and our ability to weed out graduates that do not have what it takes.


Finally, to avoid misinformation. IN MOST other countries (e.g. India, where your parents can more easily buy you in), medical school admissions are NOT as strict. However, schools more actively fail people out.

Example of a difference:
US medical school admissions rate for School X: 15%
Those that fail to graduate in 5 years: 1-2%

International medical schoool admissions rate: 30-50%
Those that fail to graduate in 5 years: 10-20%

There is no doubt that Hopkins, Mayo and some other institutes are best in the world. Its a fact.

Other facts are
1. A top IMG (A) vs less than top US grad (B): B gets preferred over A. The reason being local graduates are preferred first. This is universal. Nothing to blame here.

2. To get into a top program an IMG should be, I would say 10 times better than above average local graduate.

3. The fact is no system is 100% fair. Everyone has to live with that

4. Smartness is a universal phenomenon. This is not restricted to particular geography.

5. Only very small fraction schools in India are private and you can bid for the spot. You can find the graduates from these schools very frequently in us. Its tougher to get into a competitive program in India than here. This is a fact.

 

[indiamacbean]

my new favorite thread on sdn

 

[kafkaontheshore]

lol. it tells you everything you need to know about the medical field, the responses to this goofball. 🙂

 

[WorkaholicsAnon]

http://content.healthaffairs.org/cgi/content/abstract/29/8/1461
😛
Just a note on how USA and its citizens view themselves in generall.
If you were that decents doctors you should be able to beat IMG on different metrics.
I know this is only one metric and maybe a bunch of others that that says otherwise but still its funny to see how 95 % of you american medical students/residents that i have been in contact with have a attitude that IMGs are *****s etc.

The only reason why i would like to do a residency is because i save probably 2 years on doing this. Unfortunately its not compatible with a normal life if i want to do a phd while iam working. It takes 6 years in norway to be full certified as an internist an 1.5 more years in a subspecialty for acceptance.
we work 40h a week and once a week we have a on call duty to serve thoe hospital and new admissions etc.
I think i will stay home and do a phd while i do my int med spec and then consider again later the possibility of doing a fellowship.

I wonder how you guys can believe that you become such great doctors bye working 80h a week, have time to family, relax and then after a year still have a healthy lifestyle and so on...
I know it doesnt matter but if you considered to vote more for the democratic party/opinions you might get a more healthy lifestyle bye time.

Ill just do the USMLEs and do my int med spec in norway and then consider to do the fellowship if its possible without an us based residency.

I am 100% with you on this (except that the democratic party has nothing to do with the medical culture and training here 😛). I feel strongly that residents here in the US are unnecessarily overworked to superhuman extents in the name of "better learning", which doesn't actually necessarily pan out to providing a good learning experience.

And you're totally right. The resident lifestyle here in the US is very VERY unhealthy and requires a lot, a LOT of sacrifice. I am quite bitter about this. By the time i was finishing residency I was completely burnt out, had to give up most of my hobbies, and dating? what the hell are you talking about?! Do you think the learning experience was that awesome? Heck yeah I got to see a lot of cases and sure i did learn a lot, however, working sleepless 30 hours shifts every 4 days, do you think i'm going to be absorbing what i'm seeing that well? Not to mention have time to read? Not to mention be able to absorb what i'm reading??

I would much much rather have done residency for longer, working less hours, and living like a more normal person. I guarantee that for all that i've learned in residency, I would have learned a lot more if i wasn't so heavily sleep deprived and pushed to physical limits almost every day for 3-4 years. And I would have been a lot more excited about being a doctor after I was done.

BTW, do you know why residency training is like this in the US? Because the residency training system in the US was modeled by a COCAINE ADDICT (Dr. William Stewart Halsted, yes in your favorite Johns Hopkins Hospital!). And it persists, why? because the medical system here is heavily rooted in "tradition" (nothing do to with politics). I think it's also been perpetuated because the medical resident workforce is a source of cheap labor, and the more you work them, the more expensive skill you can squeeze into the hospital machinery for a much lower price. And the residents HAVE to do it (they cant just quit or find another job, like in any other profession), if they want to be able to practice medicine as fully trained physicians. I hate to say it, but it's called exploitation and the hospitals are taking FULL advantage.

So, I highly recommend that you stay in norway for residency--the program sounds pretty sweet to me. You will thank yourself, believe me. Medicine is medicine. It's the same everywhere and in my experience, you really end up teaching yourself more than anything. The quality of the institution where you train is more about name, prestige, and knowing "big wigs" (again, for prestige), not so much where you will learn more. The medical training system here needs a major overhaul.


And yes I'm a little bitter. 😎