international students and residency

[tRNA]

my sister went to medical school oversees and she came to the US as an international student and took and passed the USMLE 1 and 2. She is looking to get accepted into a residency program in the US but was not accepted into any.
do you think the fact that she is an international student has anything to do with the fact that she was not accepted into any residency program?, ie. would it be easier for her to get accepted if she was a US citizen, or married to someone who is a US citizen?

Please help me out...wish you all the best

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[McGillGrad]

What did she score on the steps and what specialty did she apply for and how many residency programs did she apply for?

 

[tRNA]

I will get that info from her and contact you back ( i am in a totally different field of study so I don't know any of her info),.... but generally speaking, do international students have harder time getting accepted into residency than citizens? and would marriage to a US citizen help any bit??

thanks for your help

 

[Winged Scapula]

Although McGill is correct that there are many factors involved in residency matching, if we look at citizenship alone, it is indeed harder for foreign born, foreign trained applicants to obtain a US residency position. Many programs do not sponsor visas.

While becoming a US citizen would make it easier for your sister to get a US residency position, this is not an action which can be done overnight. During the years it will take to become a citizen, even if done by marrying a US citizen, she will be away from clinical medicine which will also decrease her chances of matching.

Without knowing more about your sister's application, it would be impossible to ascertain why she didn't match. Some factors which are deemed important (in no specific order):

- USMLE scores
- US clinical experience (did she do any rotations here as a med student?)
- Letters of recommendation from US medical school faculty
- time since medical school graduation
- ECFMG certification (some programs require it for matching)
- competitiveness of specialty
- number of programs applied to
- competitiveness of programs applied to
- need for visa
- personality/behavior during interview

Many international students do poorly during the match because they have not been educated on how to maximize their chances. Certainly there are some factors which are beyond their control but many also do not apply wisely (ie, only apply to a few programs), assume they are more competitive than they are, or do not complete the application process correctly. Overall, the match rate for FMGs is less than 50%, with it being much lower for some competitive specialties.

The fact that you are posting and not your sister leads me to believe that either her English comprehension/skills are poor or that she is not very proactive in her own life...neither of which bodes well for matching. Becoming a US citizen is a lengthy process and not one she is likely to have completed before the next round of match season starts (ie, September).

 

[Elfy]

tRNA,

You sister's immigration status certainly plays a role in her inability to find a residency position. Many program directors are hesitant to take on applicants who need visas, fearing that they will not obtain the visa by their desired start date.

There are certainly other factors that come into play, one of them being the strength of your sister's application, and the other some programs' distrust of women, foreigners, or both. This can be also quite specialty-specific and your sister should inquire into relatively family-friendly and foreigner-friendly specialties such as pediatrics, family medicine, psychiatry, and some community hospital programs in internal medicine. It can be hard matching as a woman with average credentials if one needs a visa as well.

If your sister has a long-time boyfriend who is a US citizen and whom she would end up marrying anyway, then if they are able to document a bona fide relationship generally she would become a US resident in anywhere from a few months to a year-plus, depending on where they file the paperwork (consulate abroad or specific US state, they can have very different processing speeds) and permanent residency would be a considerable advantage to her medical residency application. There is little difference between a US resident and a US citizen unless one plans to vote, run for office, take a federal job (which medical residency isn't) or spend extensive periods of time outside the US.

Your sister does NOT need to be a US citizen in order to match successfully. However, she will need to re-evaluate her application and goals for the next application cycle.

 

[Tigerz_Fan]

I am an IMG. I am a US citizen, but some of the process can be just as painful.

1. She must obtain an ECFMG certification. Almost no program will look at her application no matter the specialty.
2. She needs to apply to a program that is willing to sponsor a work visa (H1 or J1 I think).
3. She needs to obtain current clinical experience if she has been out of the field for more than 3 years.
4. If she does not have US clinical experience, she should try to get someone to sponsor her for a quick internship.
5. Her chances of matching greatly depend on what she is applying for. And some programs jsut won't look at IMGs no matter how nice the application looks just due to the large volume of AMGs.
6. She should have research experience +/- publication(s) to make care more marketable. My example-I am PGY-3 in internal medicine and will be starting a fellowship in critcal care. For a year between med school and residency, I did research in OB/GYN just for experience, publication, and a CV. May not have been pertinent to my field, but it showed I was interested in research and worked with the IRB and such.

Feel free to PM me if you have any questions.