New guy here - general questions.

[RustedFox]

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Hello everyone, I've been a silent observer on this forum for a bit, but I don't get to read/follow as much as I'd like. I have some general questions about residency. Thanks for being patient with me.

1. I'm a US-citizen who went to a well-known Caribbean med school. I have a great STEP1 score (240+), and I expect to do about as well on the remaining steps. (I'm not turbo-competitive, I just take standardized exams really well) but I haven't made up my mind on any sort of specialty yet. My question is: I know that coming from a Caribbean school will close some doors for me, but are there any specialties that really have a moratorium of sorts on US-citizens who went to the Caribbean?

2. I'm confused about the number of "residencies" and applicants. I just did a search on FREIDA for Emergency Med. residencies, and I was surprised at how some states have only one or two programs. Example: Only ONE emergency med. residency spot in ALL of Washington/Colorado... TWO in Arizona ? I mean, people get acutely ill/injured all over this nation - what gives ?

3. Last question: I'm a Pennsylvania native. Are there any geographical restrictions when it comes to applying to residencies like there were when I was applying to medical schools? (Example: applying to some western schools was out of the question if you weren't from the region, etc.)

Thanks.
RustedFox.

 

[drbon]

Hello everyone, I've been a silent observer on this forum for a bit, but I don't get to read/follow as much as I'd like. I have some general questions about residency. Thanks for being patient with me.

1. I'm a US-citizen who went to a well-known Caribbean med school. I have a great STEP1 score (240+), and I expect to do about as well on the remaining steps. (I'm not turbo-competitive, I just take standardized exams really well) but I haven't made up my mind on any sort of specialty yet. My question is: I know that coming from a Caribbean school will close some doors for me, but are there any specialties that really have a moratorium of sorts on US-citizens who went to the Caribbean?

2. I'm confused about the number of "residencies" and applicants. I just did a search on FREIDA for Emergency Med. residencies, and I was surprised at how some states have only one or two programs. Example: Only ONE emergency med. residency spot in ALL of Washington/Colorado... TWO in Arizona ? I mean, people get acutely ill/injured all over this nation - what gives ?

3. Last question: I'm a Pennsylvania native. Are there any geographical restrictions when it comes to applying to residencies like there were when I was applying to medical schools? (Example: applying to some western schools was out of the question if you weren't from the region, etc.)

Thanks.
RustedFox.

I don't know if I can answer all your questions, but I'll give you some answers...like you I am also a USIMG from a Caribbean school (the same one perhaps?). Specialties that are pretty easy to get into for us are IM, Peds, and FM. The other main ones are doable, but you just have to be a very good applicant. Judging from your Step I, this may not be a problem for you. The ones I would forget about unless you have tons of published research or are buddies with some big name program director are Derm, ENT, possibly ortho and uro. The areas that know us the best and will be easiest to get a residency in are NY and NJ. But, I know people who are all over the country, so no matter where you want to go, it is possible to get it. One area of trouble is California. Before you can get a residency, you need a "California Letter" which you cannot get until you graduate and have a diploma in your hand. Most programs out there won't even interview you until you have that letter, thus making it difficult as you can imagine. If you do somehow finagle your way into that state, it'll be for FM or maybe IM. Hope this helps. Maybe others can fill in details. Oh, and yeah, EM programs are few and far between, which is reeeally annoying.

 

[awdc]

2. I'm confused about the number of "residencies" and applicants. I just did a search on FREIDA for Emergency Med. residencies, and I was surprised at how some states have only one or two programs. Example: Only ONE emergency med. residency spot in ALL of Washington/Colorado... TWO in Arizona ? I mean, people get acutely ill/injured all over this nation - what gives ?

Emergency Medicine is a relatively new specialty and there are new EM residencies and positions popping up every year. When EM wasn't around, you had physicians and residents from other specialties covering the ED. In fact, there are still many IM and FM physicians working in ED's across this country, especially in more rural areas. You also have to remember that some states aren't as populated with as many people as say, California or New York. There are also at least a few residents at any given program that come from all over the U.S. and are likely to move back to their home state or elsewhere once they finish residency. In reality, there is a so much that has to come together for a new residency to start and so many factors regarding physician distribution. There's no way I'm going to do it justice... especially in one forum reply.

3. Last question: I'm a Pennsylvania native. Are there any geographical restrictions when it comes to applying to residencies like there were when I was applying to medical schools? (Example: applying to some western schools was out of the question if you weren't from the region, etc.)

Not really although I'm sure some programs would like to at least have some residents who have a dedication to staying in the same state or region.

 

[Winged Scapula]

Hello everyone, I've been a silent observer on this forum for a bit, but I don't get to read/follow as much as I'd like. I have some general questions about residency. Thanks for being patient with me.

1. I'm a US-citizen who went to a well-known Caribbean med school. I have a great STEP1 score (240+), and I expect to do about as well on the remaining steps. (I'm not turbo-competitive, I just take standardized exams really well) but I haven't made up my mind on any sort of specialty yet. My question is: I know that coming from a Caribbean school will close some doors for me, but are there any specialties that really have a moratorium of sorts on US-citizens who went to the Caribbean?

In general, for any IMG (Caribbean or not), there are some specialties which are more difficult to get a position in. As noted above, this would include Derm, Plastics, most of the surgical subspecialties. Obviously there are IMGs from the Caribbean with good scores who do get into competitive specialties every year and you should not let the location of your medical school determine your residency lot in life if you absolutely MUST be a Dermatologist. However, you MUST be reasonable and have a Plan B, because in all likelihood you will not be "that guy" who matched into Derm from the Caribbean.

2. I'm confused about the number of "residencies" and applicants. I just did a search on FREIDA for Emergency Med. residencies, and I was surprised at how some states have only one or two programs. Example: Only ONE emergency med. residency spot in ALL of Washington/Colorado... TWO in Arizona ? I mean, people get acutely ill/injured all over this nation - what gives ?

Well, people in this country actually receive most of their medical care from community settings, some even without residency programs!😱

Obviously people have emergency medicine needs all across the country; they do not necessarily have the need to be treated by a resident in a training program. Residency programs are not necessarily a function of community need, but rather a complex interaction of need, money, interest, resources, etc. You will find many places with tons of residencies (ie, Philly, NYC) and many with very few.

3. Last question: I'm a Pennsylvania native. Are there any geographical restrictions when it comes to applying to residencies like there were when I was applying to medical schools? (Example: applying to some western schools was out of the question if you weren't from the region, etc.)

Thanks.
RustedFox.

The geographic restrictions for residency are not as compelling as they are or medical school. As noted in the response above, for California residencies, you will need the "California letter" and you must ascertain which states your medical school is approved in (there are some medical schools which do not have all US state approval, therefore you would not be eligible to do a residency there). If you are interested in returning to PA, bear in mind that any elective rotations you do in the state, cannot be counted toward the required rotations need to be eligible for a PA state license. Therefore, do any electives outside of Pennsylvania (but at an ACGME accredited program) to avoid any problems.

Otherwise, the general rules about programs in geographically desirable places (the beach, near skiing, etc.) are more competitive and for that reason, will be harder to match into, regardless of your state of origin or location of medical school.