Non-US IMG needing advice

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irish.medic237

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Hi guys,
Long time reader of this subforum, first time poster, need some advice on my situation and before I get started I know I'm in a tough, near impossible spot.
While I would happily do my anaesthetic training in Ireland, I've always dreamed of a US residency.
Currently a 4th year medical student (MS3 - equivalent) with an expected graduation date of May 2022.
I plan to complete my internship in Ireland, will expect to finish that in July 2023.

Step 1 didn't go to plan, timed NBMEs had been consistently in the mid-230s but then on the day I don't know what happened and ended up with 198.
I'm planning to sit Step 2CK this Summer, I know I'm going to need to knock it out of the park if I have any hope of matching.

After I finish my Irish internship, I would be looking to apply to a research post in the USA or a transitional year position.
This means the following year (2024) I would be applying for CA-1/PG-1 positions in the match against applicants with only a pass/fail step 1 score.

Do I have any hope or has my abysmal step one scored left me stuck.

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Can you expand on your desire to come to the US? If I were in your shoes, and wanted to leave Ireland, I would be looking to AUS/NZ, not the US.
 
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In terms of why the US, I've been multiple times in the past, I've always loved the atmosphere and environment of the cities and the country in general. I've spent time with Irish Consultants who trained in the US and now practice in Ireland and after speaking to them and hearing about their experiences I've wanted it more. The pace and quality of education/training that US residency programs provide is a massive attraction (While I know this may vary from program to program overall it is still high after speaking with some of the alumni of my college).
I've a lot of extended family a long the east coast, who I am very close with, and moving closer to them would be a big draw.
Lastly, the ability to stay on in the states longer term after a residency or have the ability to return to Ireland or go elsewhere is something I really like.

In terms of why I wouldn't want Aus/Nz, they're big spots for Irish and UK grads to head for 1-3 years after they finish their intern year. I've known a lot of people who have spent time there and while they sounded like they had an amazing experience, I've no desire to go down. It's a working holiday more than a permanent move, they all leave knowing they'll come back and do their training in Ireland. Also as the Australian Government / Medical council are making it harder for Non-Australian graduates to get onto residency there, making it a long term change is becoming harder and harder. Plus as it stands the Irish Medical Council doesn't recognise Australian training schemes for Irish posts. While that may change, I still would like to have the option to come home and practice in 10-15 years if I decided to.
 
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Come to canada!

Dont discount the uk/irish schemes. These guys talk a lot but if you do the training in uk/ire then come across for fellowship you will every bit as good if not better than us trained
 
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Come to canada!

Dont discount the uk/irish schemes. These guys talk a lot but if you do the training in uk/ire then come across for fellowship you will every bit as good if not better than us trained
I've absolutely nothing against doing the anaesthetic scheme in Ireland or the UK (if I was accepted of course), honestly one of the big things for me is I've spent my entire life in Ireland to date, so training in the US and living there long term is a massive attraction.
 
I’ve worked with a pediatric ophthalmologist who graduated from Trinity College Dublin, completed his ophtho training in Ireland and then repeated his entire residency and fellowship in the USA. When I asked him why he did that, he explained that in order for him to become a consultant ophthalmologist in Ireland, it would require one of the existing consultants in his district to die which would likely take about the same amount of time.
 
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I don't think a step 1 score under 200 will meet the cutoff required to even have your file reviewed. As a fellow non-us IMG I feel your pain, but acknowledge that a score under 240 will unlikely be sufficient in the current climate.
 
I agree you're not likely to have your file reviewed by programs that filter by step 1 cutoffs. But I don't know what will happen when step 1 officially becomes pass/fail in 2022 and step 2 effectively becomes the new step 1. If you crush Step 2, maybe you will have a chance? See NRMP match data for the official stats each year. Eg the program directors surveys.

I have heard from other docs in the UK and Ireland that consultant jobs in many specialties and in many locations (especially, no surprise, the most desirable places) are in short supply, overall pay has decreased, work conditions worsened. No wonder lots of junior doctors are fleeing.
 
Yeah my hope is that if I apply against students in the 2024 match who will have a pass/fail score that I might get past the Step 1 filter that residency programs apply as most students applying that year won't have a three digit score.
I'm working on step 2CK, I know I need to smash it regardless.
My plan is to apply for a research job after my intern year in Ireland in the US (hopefully in a centre with an anaesthesia program that I can apply to).

I know it's still a long shot but I'm not ready to give up just yet.
I appreciate all the advice guys
 
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I agree you're not likely to have your file reviewed by programs that filter by step 1 cutoffs. But I don't know what will happen when step 1 officially becomes pass/fail in 2022 and step 2 effectively becomes the new step 1. If you crush Step 2, maybe you will have a chance? See NRMP match data for the official stats each year. Eg the program directors surveys.

I have heard from other docs in the UK and Ireland that consultant jobs in many specialties and in many locations (especially, no surprise, the most desirable places) are in short supply, overall pay has decreased, work conditions worsened. No wonder lots of junior doctors are fleeing.
To be fair to Ireland, salaries here while on a training scheme are equivalent to US Residency salaries if not better. Plus trainees in Ireland get paid overtime which massively bumps up salary.
Training schemes are longer on average however, Anaesthetics is 6 years in Ireland post intern year (7 years post medical school, though the average age of graduates here is 24) compared to the US 4 year program.
The salary of public consultants in Ireland fell in 2008 and hasn't recovered yet. The government and the Irish medical organisation are in talks to raise the salary back but they've yet to reach a deal.
In terms of gaining a consultant job you are waiting for the minister of health to add a new position or for a current consultant to retire/die or you can move to private practice but you'll never find a consultant now without a fellowship if not two.
 
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