[Need advice]

[Itsmonday]

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[mszzeta]

Hello everyone, I plan to apply for the 2021 Match, I recently got my step 1 score: 246, and honestly I’ve been panicking ever since. I was hoping a 250 would save my application. My YOG was 2017 (April) and I took about 2 years of just plain procrastinating, mismanaging my depression, while struggling to study. I should’ve asked for professional help earlier, but it’s done and I can’t change that.
I’m going to start a part time job at a clinic in my home country next month, and is very flexible with time for me to study, get another part time job and schedule observerships/externships.
I did one Observership in 2015 in Cleveland Clinic Florida, with no LOR.
I’m hoping to match in a University program in the NJ, NY area since my fiancé lives there (mid or low tier), and eventually a Nephrology Fellowship.
I don’t have a Visa, and if I marry my fiancé on a visitor’s Visa I’m afraid they might see it as immigration fraud.
I’ve also checked charting matching outcomes and reddit to get some awareness of where I stand.
I’m asking for advice from you guys on where should I focus my efforts besides trying to get a 250-260 CK score. I’ve barely done any research (waiting on acceptance of one paper) or voluntary work.
I would really appreciate your ideas and opinions on how to make my application have a chance in those competitive states and how to try to manage my red flags, and please try to be as specific as you can.
Thank you so much for you help and time in advance.

I am also a non-US IMG who competed IM residency and is currently doing fellowship. I even did my residency in NYC

First, Your score is Ok and you will have decent chance in matching into US system
Second, I highly doubt marrying your fiancé with visitor visa is considered an immigration fraud. But I am not a lawyer and I would suggest you to ask for professional opinion. Getting a green card will SIGNIFICANTLY increase your overall package
Third, please be realistic about your goal. Matching into a university program is overall very difficult for any location, let alone NY area (this is true even your scores are 260+ with good USCE and LoR). If you want to do nephrology fellow, based on its current condition (not very popular due to lower salary, market and lifestyle factors. But things may change and especially that Trump just started some kidney project), you can easily match into TOP nephrology fellowship from simply a regular community program. Thus, going to a university dose not make much difference. There are also some strong community with is compatible with a low-mid tier university program regarding fellowship placement and please be realistic about your expectations.
Fourth, You should focus on getting a CK 250-260 or higher. Unless it is super top journals (something like first-author JAMA), the research will not add as much for you compared to a high CK score
Overall I don't think you have much red flag to worry about.

 

[mszzeta]

Thank you so much for your help.
I’ve tried FREIDA to find only university programs, but you’ve given me some piece of mind about the community programs. I’ll stay out of NY, and apply broadly to NJ, including community programs. I’m somewhat glad about the situation you describe regarding nephrology fellowships, so thank you for the insight. Do you happen to know if Hackensack is mid or low tier?

Again, thank you!

I am not very familiar with Hackensack program. All I know is that it used to be a community program until very recent when it is affiliated with Seton Hall University' new medical school. Not sure if their fellowship placement is available online and that is typically how I would evaluate a program (Of course there are much more other factors to consider).

There are lots of strong community programs in NYC, which is not inferior to many mid to low tier university program

 

[rokshana]

Thank you so much for your help.
I’ve tried FREIDA to find only university programs, but you’ve given me some piece of mind about the community programs. I’ll stay out of NY, and apply broadly to NJ, including community programs. I’m somewhat glad about the situation you describe regarding nephrology fellowships, so thank you for the insight. Do you happen to know if Hackensack is mid or low tier?

Again, thank you!

Hackensack isn’t really a uni program...maybe uni affiliated at best.