Is it unwise to pursue IM simply for fellowship?

[thecalccobra]

I have done a quick research which can be used for future reference..
The NRMP data does not show the full picture, as it only shows match statistics for candidates who registered with NRMP (ie got interviews). I took ERAS application submitted data and NRMP match data to show a more clear picture.

1. Cardiology
Total Applications 1780; Positions 1045 (58.5%)
USMD 689; matched 549 (79.6%)
DO 204; matched 103 (50.5%)
IMG 887; matched (43.8%)

2. GI
Total Applications 1034; Total Positions 590 (57%)
USMD 436; matched 352 (80.7%)
DO 139; matched 66 (47.5%)
IMG 459; matched 166 (36%)

3. Hematology-Oncology
Total Applications 1009; Total positions 638 (63.2%)
USMD 412; matched 336 (81.5%)
DO 92; matched 64 (69.5%)
IMG 505; matched 237 (58.3%)

4. Pulmonary-Critical Care
Total Applications 1357; Total positions 657 (48.4%)
USMD 461; matched 323 (70%)
DO 228; matched 92 (40.3%)
IMG 668; matched 240 (35.9%)

Even though PCCM looks very competitive overall, I am unsure if the average candidate applying to cardiology/GI candidate is very stronger/selective with better resume OR if PCCM is becoming more competitive.

*NRMP provided separate data for US-IMG and FMG but ERAS data only has IMG, hence I added NRMP US-IMG and Foreign together as IMG

mind sharing the source for the data? Want to run the numbers myself.

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[blue.jay]

mind sharing the source for the data? Want to run the numbers myself.

NRMP https://mk0nrmp3oyqui6wqfm.kinstacd.../2020/12/MSMP-Match-Results-Report-AY2021.pdf
ERAS ERAS Statistics

 

[Nespresso]

After matching GI this year, I’ll say this. In retrospect, I would only apply to IM again with the intent of doing a competitive fellowship like GI if I rank mid/high tier Academic university programs with strong names and research. I would have scrapped all the community IM programs and honestly applied to general surgery as a backup plan because I would rather have just been a surgeon than a general IM doc. I just wasn’t as passionate about social work and working up creatinine bumps as my IM colleagues.

 

[Kaustikos]

Still all enlightening for me as a fourth year med student.

I'm on a PCCM elective right now, and honestly, I've been enjoying it immensely. It's making me excited as a possible sub-specialty. The ICU can at times be depressing if the patient is gonna die no matter what we do otherwise the variety has been a welcome experience and I feel like patients actually care about your opinion. In contrast, when I have been in the ED I often desired a more meaningful relationship or even just conversations that were meaningful beyond "is your pain better?" or "we are gonna admit you overnight for observation". For example, today a patient with metastatic lung cancer wrote down everything the doc was explaining about his plan -- she was invested in her care. These interactions were something I didn't even realize I wanted until *after* doing several EM rotations.

I loved critical care. I was one of the few lucky ones who during residency almost spent half his time on critical care these past three years. The cases are interesting. It's acute. And exciting.
Yes, there are depressing cases but not entirely the fault of your doings. It makes it challenging. Basically, it's great, and if it interests you, I'd also look into ID/Crit. They've started to realize ID backgrounds are definitely an advantage in critical care which is why these programs have started to open up. There are few, but definitely worth looking into.

 

[Deecee2DO]

After matching GI this year, I’ll say this. In retrospect, I would only apply to IM again with the intent of doing a competitive fellowship like GI if I rank mid/high tier Academic university programs with strong names and research. I would have scrapped all the community IM programs and honestly applied to general surgery as a backup plan because I would rather have just been a surgeon than a general IM doc. I just wasn’t as passionate about social work and working up creatinine bumps as my IM colleagues.

this is what ive been saying on this thread and then i was being bombarded with how community IM is a better route to GI than Academic/uni IM which I couldnt wrap my head around. Congrats on matching GI thats a huge accomplishment

 

[Kaustikos]

Just curious, Are ID/crit and neph/crit less competitive than 2 year CCM programs?

ID/Crit is competitive because of the low number of programs and because people only wanting critical care apply to these programs to increase their odds.

 

[deleted1082375]

Quick question for someone wanting to do IM with a fellowship:

Will taking only COMLEX hinder me? Applying in a very DO friendly state. I don't really get the hype for USMLE other than it's a more widely used metric.

 

[Drrrrrr. Celty]

this is what ive been saying on this thread and then i was being bombarded with how community IM is a better route to GI than Academic/uni IM which I couldnt wrap my head around. Congrats on matching GI thats a huge accomplishment

No, we were saying not saying that community IM is a better route than a real university program. We are saying that a IM program with inhouse GI that offers you a high chance of internally matching into GI is nothing to scoff at. A lower rung university program doesn't mean you'll get a GI fellowship, in house that will accept you pending you're not a horrible human being does. Obviously if you can get into a solid mid tier university program go for it. But I wouldn't rank a lower university programs with poor GI match rates above solid community programs with in house GI programs if I wanted to do GI.

 

[Prehealth1011]

No, we were saying not saying that community IM is a better route than a real university program. We are saying that a IM program with inhouse GI that offers you a high chance of internally matching into GI is nothing to scoff at. A lower rung university program doesn't mean you'll get a GI fellowship, in house that will accept you pending you're not a horrible human being does. Obviously if you can get into a solid mid tier university program go for it. But I wouldn't rank a lower university programs with poor GI match rates above solid community programs with in house GI programs if I wanted to do GI.

Couple of my community IM invites has in house fellowships but they have 2 spots at max AND they haven't taken a DO in years. As a DO, is it worth it to rank these places high? It's pretty unlikely they'll take me down the road.

 

[Drrrrrr. Celty]

Couple of my community IM invites has in house fellowships but they have 2 spots at max AND they haven't taken a DO in years. As a DO, is it worth it to rank these places high? It's pretty unlikely they'll take me down the road.

Were they individuals from the program? If not then it's not then I wouldn't really consider it a pro. Talk to the residents at the program and ask what is up.

 

[Deecee2DO]

No, we were saying not saying that community IM is a better route than a real university program. We are saying that a IM program with inhouse GI that offers you a high chance of internally matching into GI is nothing to scoff at. A lower rung university program doesn't mean you'll get a GI fellowship, in house that will accept you pending you're not a horrible human being does. Obviously if you can get into a solid mid tier university program go for it. But I wouldn't rank a lower university programs with poor GI match rates above solid community programs with in house GI programs if I wanted to do GI.

I never said it was anything to scoff at. I was basically saying that if you can match at mid tier university IM program (many of which have strong in-house fellowships) as a DO by having higher board scores it can be more advantageous than matching community IM with in-house fellowships due to access to academic faculty, better research opportunities etc. Academic IM programs just have more resources which there is no denying is many times an advantage. thats what i was trying to get across in my original post

 

[Prehealth1011]

Were they individuals from the program? If not then it's not then I wouldn't really consider it a pro. Talk to the residents at the program and ask what is up.

Not from the program either. Maybe I just got dealt a bad hand with community IM invites. I have some university-affiliated invites with no fellowships that I'm considering ranking higher than these.

 

[Drrrrrr. Celty]

I never said it was anything to scoff at. I was basically saying that if you can match at mid tier university IM program (many of which have strong in-house fellowships) as a DO by having higher board scores it can be more advantageous than matching community IM with in-house fellowships due to access to academic faculty, better research opportunities etc. Academic IM programs just have more resources which there is no denying is many times an advantage. thats what i was trying to get across in my original post

Again. Real University programs are better. But if you interview at a IM program with GI in house and they tell you its a straight shot into that program that's a bird in the hand. Only 50ish % of DOs matched GI. Those are ****ty odds.

But like I said. I'm just trying to explain that there is nuance. That's all.

 

[Drrrrrr. Celty]

Doesn't sound like great programs.

Not from the program either. Maybe I just got dealt a bad hand with community IM invites. I have some university-affiliated invites with no fellowships that I'm considering ranking higher than these.

 

[Deecee2DO]

Again. Real University programs are better. But if you interview at a IM program with GI in house and they tell you its a straight shot into that program that's a bird in the hand. Only 50ish % of DOs matched GI. Those are ****ty odds.

But like I said. I'm just trying to explain that there is nuance. That's all.

Those are for sure ****ty odds but how many of the DOs coming from real academic/unis matched GI that applied? I would like to see that stat but i dont think it exists

 

[Nespresso]

Doesn't sound like great programs.

I keep seeing you say this here. The problem is when there is 1-2 spots in the said community GI program. You’re never the only applicant from your home IM program trying to get GI. You have to be very very lucky to be the only person in your IM class shooting for GI. I interviewed at too many COMMUNITY IM programs and all of them had at least 1/5 of their classes interested in GI. Most of them either don’t get it or decide not to do it given the odds or life. Another factor is when people go to a community IM program that has a GI program that likes its own, they have to hope to god there’s not going to be a chief that year with them who wants GI since most of the time those community GI programs just take their own chief. I STILL think the odds are better for getting GI at university IM above all, but if you get insanely lucky at a community IM (you’re the only one in the class somehow interested in GI, with no chief who wants GI) then you may have a shot.

 

[rokshana]

I keep seeing you say this here. The problem is when there is 1-2 spots in the said community GI program. You’re never the only applicant from your home IM program trying to get GI. You have to be very very lucky to be the only person in your IM class shooting for GI. I interviewed at too many COMMUNITY IM programs and all of them had at least 1/5 of their classes interested in GI. Most of them either don’t get it or decide not to do it given the odds or life. Another factor is when people go to a community IM program that has a GI program that likes its own, they have to hope to god there’s not going to be a chief that year with them who wants GI since most of the time those community GI programs just take their own chief. I STILL think the odds are better for getting GI at university IM above all, but if you get insanely lucky at a community IM (you’re the only one in the class somehow interested in GI, with no chief who wants GI) then you may have a shot.

Why do you continue to belabor the point...he thinks his opinion is right and you think your opinion is right...you are not going to change each other’s minds and have made it very clear to those looking for advice...maybe take it to PM if you two want to keep going back and forth.

 

[Deecee2DO]

I keep seeing you say this here. The problem is when there is 1-2 spots in the said community GI program. You’re never the only applicant from your home IM program trying to get GI. You have to be very very lucky to be the only person in your IM class shooting for GI. I interviewed at too many COMMUNITY IM programs and all of them had at least 1/5 of their classes interested in GI. Most of them either don’t get it or decide not to do it given the odds or life. Another factor is when people go to a community IM program that has a GI program that likes its own, they have to hope to god there’s not going to be a chief that year with them who wants GI since most of the time those community GI programs just take their own chief. I STILL think the odds are better for getting GI at university IM above all, but if you get insanely lucky at a community IM (you’re the only one in the class somehow interested in GI, with no chief who wants GI) then you may have a shot.

This is what I have been saying as well (how academic/uni IM is more advantageous for fellowship)

 

[Doctor_Strange]

After matching GI this year, I’ll say this. In retrospect, I would only apply to IM again with the intent of doing a competitive fellowship like GI if I rank mid/high tier Academic university programs with strong names and research. I would have scrapped all the community IM programs and honestly applied to general surgery as a backup plan because I would rather have just been a surgeon than a general IM doc. I just wasn’t as passionate about social work and working up creatinine bumps as my IM colleagues.

This is sort of my logic -- I applied IM & EM, but I only sent my app to internal medicine residency programs w/ solid fellowship match rates, including for DOs. I've gotten about 6 invites to programs that meet this criteria. If I had gotten silence, I likely would have just gone with EM. I kinda like hospital medicine, but it's not something -- currently -- that I desire to train to be. Cards and PCCM have the procedural components that stimulate me.

But, as the other comment illustrates -- it's a bit demoralizing seeing the poor fellowship match outcomes for DOs. I'd like to think those #s are such due to DOs from not reputable programs attempting to match fellowship, but I could be wrong. There just could be that much widespread anti-DO vibe going on at programs...

 

[gutonc]

This is sort of my logic -- I applied IM & EM, but I only sent my app to internal medicine residency programs w/ solid fellowship match rates, including for DOs. I've gotten about 6 invites to programs that meet this criteria. If I had gotten silence, I likely would have just gone with EM. I kinda like hospital medicine, but it's not something -- currently -- that I desire to train to be. Cards and PCCM have the procedural components that stimulate me.

But, as the other comment illustrates -- it's a bit demoralizing seeing the poor fellowship match outcomes for DOs. I'd like to think those #s are such due to DOs from not reputable programs attempting to match fellowship, but I could be wrong. There just could be that much widespread anti-DO vibe going on at programs...

I suspect it's a little from column A and a little less from column B.

 

[Doctor_Strange]

I suspect it's a little from column A and a little less from column B.

Well what's the answer that can explain it the most ? Like I'm curious to understand what barriers I may need to overcome or at least anticipate that are not as obvious as anti-DO bias or DOs not producing enough scholarly work.

 

[Prehealth1011]

@Nespresso opinion on my situation?
Couple of my community IM invites has in house fellowships but they have 2 spots at max AND they haven't taken a DO in years. As a DO, is it worth it to rank these places high? It's pretty unlikely they'll take me down the road considering the spots and the bias. I'm considering ranking uni-affiliated programs higher than these.

 

[Nespresso]

@Nespresso opinion on my situation?
Couple of my community IM invites has in house fellowships but they have 2 spots at max AND they haven't taken a DO in years. As a DO, is it worth it to rank these places high? It's pretty unlikely they'll take me down the road considering the spots and the bias. I'm considering ranking uni-affiliated programs higher than these.

I don’t really know your situation as well but do the uni-affiliate programs have their own GI fellowship or a robust GI faculty who is willing to mentor residents? How often do those uni-affiliate programs send to GI?

if you somehow don’t match GI are you okay with General IM routes like hospitalist or PCP or would you otherwise rather do something else like radiology or surgery over general IM if GI were to not become an option?

 

[gutonc]

Well what's the answer that can explain it the most ? Like I'm curious to understand what barriers I may need to overcome or at least anticipate that are not as obvious as anti-DO bias or DOs not producing enough scholarly work.

The big names like research. As a DO, you probably have little/no research opportunities as a student. And then, the big names in fellowship like to see people from the big names in residency.

It's not a problem unique to DOs, MDs from low tier schools (like me...back in the day) run into it as well. You do the best you can and make the most of what you've got.

 

[sloh]

The big names like research. As a DO, you probably have little/no research opportunities as a student. And then, the big names in fellowship like to see people from the big names in residency.

It's not a problem unique to DOs, MDs from low tier schools (like me...back in the day) run into it as well. You do the best you can and make the most of what you've got.

The other issue with DO schools is the time that could be spent on research is diverted towards OMM. Ugh.

 

[Doctor_Strange]

I don’t really know your situation as well but do the uni-affiliate programs have their own GI fellowship or a robust GI faculty who is willing to mentor residents? How often do those uni-affiliate programs send to GI?

if you somehow don’t match GI are you okay with General IM routes like hospitalist or PCP or would you otherwise rather do something else like radiology or surgery over general IM if GI were to not become an option?

Speaking for myself, although I think I a similar to the other user, I think I would find hospital medicine mostly enjoyable. A lot can change, but as a M4, I feel if I begin developing my CV to apply to Cardiology during residency and I don't match, I'd be more inclined to either take a paid research positron or become a hospitalist and do research / beef up my resume to try again. It's almost a sunk cost fallacy -- I will have conceivably put in so much effort & for it to not materialize would just make me try again. Luckily, I don't have to worry about student debt so I'm not under any pressure to earn an attending salary immediately.

 

[Doc Doc Doc Goose]

This was my mindset and it worked well for me and i am sure many others. It is pragmatic and logical. IM is flexible, if you change your mind on fellowship you have PCP and hospitalist work to fallback on, both of which are far less brutal than EM work.

I started residency desiring pulm/ccm but realized how burnt out I would be and chose hospitalist work and I could not be happier.

Why do you say burnt out from PCCM? Don’t they work a similar on-off schedule. If not less, if they cut back some on clinic?

 

[Doctor_Strange]

Well, for what it's worth folks -- I ended up matching (thankfully) at my number #1 rank choice which is at a university hospital system with every fellowship under the roof, and even some sub-fellowships as well.

After some more IM electives this past year, I really can't see myself doing hospital medicine as my career because I think a happy medium of outpatient clinic and inpatient medicine is what I want in my professional life. I definitely 100% understand the appeal of being a hospitalist -- I actually think it offers perhaps some of the best work-life balance ratio out there (not perfect, but pretty damn good). Still, I think I will get more professional fulfillment from a career in either Cards or PCCM — albeit the work-life balance will certainly be something for me to consider moving forward.

 

[FutureDoctor5000]

As mentioned above most people, especially U.S. grads, go into IM with the intent of doing fellowship. A lot of it comes from perceptions in med school that general IM, whether it's PCP or hospitalist, are not only the least paid, but also the least respected and you're essentially looked down by the specialists and in some cases you're the "super-senior resident" for the specialists, and in in the inpatient setting have to deal with the patients no one else wants to take. The prestige aspect is still true these days and as hospitalists and PCP there's still a lot more scut, but the pay difference between hospitalist and specialties like pulm-crit and non-interventional cards is much narrower than you think once you factor in the long hours you need to work as a cardiologist and the 3 extra years of training).

Many people will change their mind during residency and not pursue fellowship or switch to a different fellowship. Besides the shorter training period and true change of interest, another common reason is that residents find that they're simply not competitive for the subspecialty they're going for or apply and don't match so are essentially forced into doing general IM (even if they don't like it, since many have loans to pay off). Remember that any IM subspecialty that on average pays more than general IM will be competitive to get into with far more applicants each year than spots. Cards, Heme-onc, and Pulm/Crit all have match rates in the 70s% and for GI it's in the 60s% overall, but for DOs those numbers are much lower. DO with a 243/237 is decent but far from certain into matching into cards or pulm/crit and for GI the match rate is around 42%. If you're a D.O. and want to ensure getting into a competitive fellowship after IM, the strategy that many take is to go to an IM program with that respective in-house fellowship and try to do a chief resident year, since at most programs being a chief nearly guarantees you an in-house fellowship spot. Of course the 2 major downsides of being chief is that you need to be well liked at your residency program to get it, and you're taking a huge paycut during chief year (even if your program allows you do do some more moonlighting) compared to being a full-year attending

So bottom line is: as a DO, go into IM only if you're okay if you end up not matching into a competitive fellowship and have to do hospitalist or primary care, or are okay with a non-competitive IM fellowship like Palliative Care, Geriatrics, ID, or Nephrology.

your really mistaken, just met a guy from my school(USDO) who only took comlex and went to a low-mid tier university IM program and had no issues matching GI.. key is to go to a university program with the resources to help you match, your step scores play very very little role, no one is looking at how you performed on a test like 5 years ago when applying to fellowship, but you must get into a university IM program for GI/Cards otherwise it is a uphill battle even for USMD and DO for GI/cards from a community program with no in house fellowships, also I dont have the data but the numbers you threw out don't quite sound right...

 

[shouldigomd]

your really mistaken, just met a guy from my school(USDO) who only took comlex and went to a low-mid tier university IM program and had no issues matching GI.. key is to go to a university program with the resources to help you match, your step scores play very very little role, no one is looking at how you performed on a test like 5 years ago when applying to fellowship, but you must get into a university IM program for GI/Cards otherwise it is a uphill battle even for USMD and DO for GI/cards from a community program with no in house fellowships, also I dont have the data but the numbers you threw out don't quite sound right...

Unfortunately it does still matter for many programs but who knows how that will change come the pass/fail STEP 1. Every program is different but in my experience interviewing at about 10 mid tier academic centers for cardiology .... it very much mattered.

The unfortunate truth is that there is no measure of the quality of physician you are during residency nor does it really play any role. The name of your program, the research, connections, chief year and LORs are what get you into fellowship. None of those things require you to actually be a good physician.

 

[FutureDoctor5000]

Unfortunately it does still matter for many programs but who knows how that will change come the pass/fail STEP 1. Every program is different but in my experience interviewing at about 10 mid tier academic centers for cardiology .... it very much mattered.

The unfortunate truth is that there is no measure of the quality of physician you are during residency nor does it really play any role. The name of your program, the research, connections, chief year and LORs are what get you into fellowship. None of those things require you to actually be a good physician.

Yea thus it is important to be at a University program or at a similar caliber program such as Cleveland Clinic, Ochsner etc, the differences between the university programs in nuanced, there really isn't too much of difference between say University of Mississippi vs University of florida vs Wake forest or Cinci or Georgetown, the latter are upper mid tier while the former are lower tier, you can still match into any fellowship from any of those university programs...

 

[Deecee2DO]

Yea thus it is important to be at a University program or at a similar caliber program such as Cleveland Clinic, Ochsner etc, the differences between the university programs in nuanced, there really isn't too much of difference between say University of Mississippi vs University of florida vs Wake forest or Cinci or Georgetown, the latter are upper mid tier while the former are lower tier, you can still match into any fellowship from any of those university programs...

Agreed. Contrary to what I had initially thought UF is actually a really solid program more mid-tier-ish. Regardless 100% agree with you here. Uni programs for IM really can give u a bit of an advantage for subs like Cards and GI

 

[FutureDoctor5000]

Agreed. Contrary to what I had initially thought UF is actually a really solid program more mid-tier-ish. Regardless 100% agree with you here. Uni programs for IM really can give u a bit of an advantage for subs like Cards and GI

Yea Uf Gainesville is better than UF Jacksonville but either program would set you up well for fellowship overall..

 

[Deecee2DO]

Yea Uf Gainesville is better than UF Jacksonville but either program would set you up well for fellowship overall..

Yeah Gaines>Jax

 

[Wolvvs]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to apply to these programs/that the programs prefer IMGs?

 

[Deecee2DO]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to apply to these programs/that the programs prefer IMGs?

Honestly no clue lol but thats an interesting thought!

 

[FutureDoctor5000]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to apply to these programs/that the programs prefer IMGs?

It’s competitive but i would argue that it’s no where close to as competitive as matching neurosurgery, ortho, derm etc. straight out of medical school. It’s still very much doable if you go to a decent IM program that’s known to put people into fellowships.

 

[Prehealth1011]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to apply to these programs/that the programs prefer IMGs?

They probably just prefer the best candidate and don't care about the AMG/IMG status

 

[Doctor_Strange]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to apply to these programs/that the programs prefer IMGs?

I'll take a crack at this too but obviously welcome more expert opinions:

IMGs that match into Cardiology generally have extremely strong CVs. Years of research in some cases. A former chief at Rutgers (IIRC) who is an IMG has like three full pages on her Google Scholar profile. My one bias which may get backlash is that programs that have IMG faculty tend to look out for their own. The same is true for DOs and is sure as s**t true for Ivy League MDs.

It all revolves around one fundamental truth: connections and how you know matters. Medicine is not as much a meritocracy as it is perceived.

Edit: Also, some IMGs and applicants in generally will take a non-ACGME Cardio fellowship at these sites or at well-known programs to buff up their CV if they did not match the first time around. Some also pursue a hospitalist job at those sites to get more research accesss.

 

[blue.jay]

I have a question. A lot of you have mentioned that cardiology is very competitive, even for USMDs, and that makes sense. But when I took a look at some of the current fellows at locations in New England that are not in big cities (UConn Farmington, Hartford Hospital, UMMS-Baystate, UVM), these programs are mostly or entirely IMGs. I don't want to downplay how hard they worked to get where they are, but is there a reason USMDs or DOs wouldn't want to hop to these programs/that the programs prefer IMGs?

One of my IMG colleague matched into cardiology last year:
He did 2 yr research prior to residency, has good scores, won ACP junior researcher award in residency but didn't match. He then did heart failure fellowship (unaccredited) but didn't match again. He started as a hospitalist (in an academic institution and volunteered seeing patients in cardiology clinic for no pay on his day off) did research and got his MPH. After getting his green card he applied and still didn't match. Three months after the match, a spot opened in a program where his mentor gave a grand rounds presentation; and that's what finally gave him a spot.

It's true that almost 50% cardiology fellows are IMGs but they mostly have a combination of great score, research, publications, chief yr, extra fellowship, masters degree (public health/clinical research).

Also like a poster said above, some programs with IMG faculty tend to prefer strong IMG candidates. I've known stellar IMG candidates not matching (Like my friend who didn't match thrice but got lucky) and also average IMG matching based on gender, work ethics during residency (in program with in-house fellowship) and contacts.

 

[Nespresso]

To echo above, yes even AMGs are turned down for interview at places that are IMG friendly because the IMG fellows there are very accomplished and coming from more impressive residency programs than the AMGs even.

 

[Wolvvs]

Thank you all so much for your responses! Definitely a lot to consider here. Those word replacements are absolutely ridiculous XD

I was curious because I wanted to know if there was a particular reason US students might not be choosing these programs. I have a preference for that area for family reasons and I'm also at a medical school that's weirdly between IMG and USMD, so I'm trying to get a sense for all of this stuff earlier rather than later. It sounds like the programs I highlighted are attractive to/target IMGs who have truly put in the work to stand out. I also noticed that many fellows at those programs did their residencies at the same place as their fellowship or at one of the other IM residencies in the region, so the idea about the importance of connections makes a ton of sense.

Thanks again everyone!

 

[rokshana]

Thank you all so much for your responses! Definitely a lot to consider here. Those word replacements are absolutely ridiculous XD

I was curious because I wanted to know if there was a particular reason US students might not be choosing these programs. I have a preference for that area for family reasons and I'm also at a medical school that's weirdly between IMG and USMD, so I'm trying to get a sense for all of this stuff earlier rather than later. It sounds like the programs I highlighted are attractive to/target IMGs who have truly put in the work to stand out. I also noticed that many fellows at those programs did their residencies at the same place as their fellowship or at one of the other IM residencies in the region, so the idea about the importance of connections makes a ton of sense.

Thanks again everyone!

It can also be that these historically I/FMG heavy programs know that the USMD is looking at them as a backup and rank other cards programs higher and match into them... also they may take from their own IM programs, which are I/FMG heavy