Odds of a UK IMG succeeding in the 2019 psychiatry match?

[938420]

Hello! I am applying to the 2019 match in psychiatry and just wanted some sort of feedback on how tough it might be for me the match. UK born and bread, attended a fairly well-known medical school (but not oxbridge).

Year of graduation: 2014

Main experience: in psychiatry as a locum

step 1: 237

step 2 CK: 253

Step 2 CS: pass

All on first attempt.

May do the step 3 just before I go, but sorting out the finances.

I also presented a poster (piece of original research, in psychiatry with me at the lead) a year or two ago at an international psychiatry conference, but I am not a researcher by inclination.
No USA experience unfortunately (did not have the finances for that!)

My apologies if this is one of many such posts trying to get some feedback on relative strength/weakness.

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[wolfvgang22]

Sounds like your qualifications are good. It definitely won't hurt to complete step 3. If you can get any U.S. experience that would definitely help. If you limit yourself to just the East coast your odds of matching will be much less. Therefore, apply as broadly as you can to programs to maximize your chances of matching. It can help if a program has already met you by doing a rotation or observership, though I know that can be hard to do. There are less available places in the Match than ever before for IMGs. Do you have a compelling reason for coming to the U.S.? If so, that may help also.
Also, it's bred, not bread.

 

[938420]

Thanks for the reply! So it seems like the East Coast is maybe a bit more competitive?

I have multiple smaller reasons, rather than one big reason (such as a family in US etc).
1) the training pathway appeals much more to me - I won't bore you with all the unpleasant things done to our training over the pond with re-validation, but increasingly clinical time and "doing a good job" is being devalued. We don't have anything such as a patient logbook, instead we must write multiple essays in our free time with full journal referencing that are called "reflections". My prediction is that this is likely to only get worse, and why I feel uncomfortable about this is also very clear if you happened to have heard anything about the current Bawa-Garba case going through our courts.
2) I also note there tends to be more flexibility in tailoring your experience in most residencies, particularly interesting since I have been toying with mixing it up with some occupational medicine in the mix, so I can become more of a specialist in occupational psychiatry.
3)The pay and conditions is also generally better from what my friends over there have told me (we junior doctors went on strike here about a year or so ago).
4) I think the USA is ahead of the UK in quite a few areas in psychiatry, given as most of the consultants I know go to the American conferences quite regularly
5) Lastly, and not the reason I am bringing up in my personal statement, I would really enjoy somewhere with two-season weather.


I feel somewhat chagrined about the spelling mistake! 🙁

 

[wolfvgang22]

I'm not saying that the East coast programs are better quality or not. I mean that many IMGs, or many applicants in general limit their opportunities by not applying broadly enough. Being geographically flexible increases your odds of matching a great deal. Every year I see people fail to match because they applied only to programs only in NY or only California. Broaden your horizons if you can.
Regarding your reasons, focus on number 2 and other positive reasons like the ability to do a fellowship in the U.S. and avoid revealing any complaints about the UK. Instead, be positive about what you can bring to the U.S. that you have learned from your international training.

 

[splik]

do you need a visa? Personally, I would not recommend at the current time trying to come to the US if you do not have citizenship or a green card. feel free to pm me. where do they have two-season weather? the tropics?! definitely do not put that in your personal statement. I am not sure the US is "ahead" of the UK in any positive ways...

the working conditions are much worse for residents in the US than they are in the UK btw. you have no rights, your superiors think you should be grateful to get paid at all, much less vacation, limited sick leave, you get paid the same whether you work 90 hours a week or 40 (luckily hours tend to be better in psych than other specialties). suicidal ideation and suicides in residents are not uncommon.

 

[938420]

I'm not saying that the East coast programs are better quality or not. I mean that many IMGs, or many applicants in general limit their opportunities by not applying broadly enough. Being geographically flexible increases your odds of matching a great deal. Every year I see people fail to match because they applied only to programs only in NY or only California. Broaden your horizons if you can.
Regarding your reasons, focus on number 2 and other positive reasons like the ability to do a fellowship in the U.S. and avoid revealing any complaints about the UK. Instead, be positive about what you can bring to the U.S. that you have learned from your international training.

I see, thank you! So far I am up to more than 60 programs that seem to be a personality fit, and for which I meet the application requirements. One advantage I have, I guess, is that I am not easily swayed by the glitz of city living, since I also love the space and freedom of the countryside. As an observation, on the online blogs people seem to have a perception that these places are particularly "IMG friendly", which I think can easily lead to a positive feedback-loop of lots of IMG applications, and with more excellent applicants more get in naturally.

So flexibility right at the top of my topics! If I am asked specifically about something like the BG case should I give a very brief and diplomatic answer, or should I just try to gloss over it entirely? Unlikely, but it has been reported in the US arm of the BMJ, so it's not impossible.

 

[938420]

do you need a visa? Personally, I would not recommend at the current time trying to come to the US if you do not have citizenship or a green card. feel free to pm me. where do they have two-season weather? the tropics?! definitely do not put that in your personal statement. I am not sure the US is "ahead" of the UK in any positive ways...

the working conditions are much worse for residents in the US than they are in the UK btw. you have no rights, your superiors think you should be grateful to get paid at all, much less vacation, limited sick leave, you get paid the same whether you work 90 hours a week or 40 (luckily hours tend to be better in psych than other specialties). suicidal ideation and suicides in residents are not uncommon.

A sharp HB pencil, a black gel pen to overwrite that, an exhaustive internet search, and I can get through any bureaucratic Kafkaesque LSD trip put before me! 😉 Maybe I'm overconfident, but I have slain 70 page government form beasts in the past and so am willing to do battle with US immigration forms.

Florida is much more 2 season than UK. My idea of two-season is that it doesn't often snow in winter.

I should take wolfvgang's advice and take my mind away from my push factors, so I'll keep my answer brief as to how thing's are here. The conditions BG faced were not considered unusual working conditions in the NHS. This in fact formed part of the prosecution's main argument against her - that these conditions were within the norm, therefore that a patient died must clearly be a fault on her part rather than a tragedy that was going to happen eventually. Morale here has taken a serious dive.

 

[wolfvgang22]

I see, thank you! So far I am up to more than 60 programs that seem to be a personality fit, and for which I meet the application requirements. One advantage I have, I guess, is that I am not easily swayed by the glitz of city living, since I also love the space and freedom of the countryside. As an observation, on the online blogs people seem to have a perception that these places are particularly "IMG friendly", which I think can easily lead to a positive feedback-loop of lots of IMG applications, and with more excellent applicants more get in naturally.

Don't worry about some fictional positive feedback loop. One thing you have going for you is that speaking English and understanding western idioms won't be a problem for you, which is sometimes a problem for IMGs from many other countries. It's a fact that US programs will generally be more biased in favor of IMGs from the UK than less developed countries due to a lot of shared culture between our countries. Splik is right that it is harder than ever to Match as an IMG, and you will want to be very careful you aren't suffering from thinking the grass is greener on the other side and compare carefully. But, there are a lot of very good reasons many doctors immigrate to the U.S., for sure.

 

[SmallBird]

do you need a visa? Personally, I would not recommend at the current time trying to come to the US if you do not have citizenship or a green card. feel free to pm me. where do they have two-season weather? the tropics?! definitely do not put that in your personal statement. I am not sure the US is "ahead" of the UK in any positive ways...

the working conditions are much worse for residents in the US than they are in the UK btw. you have no rights, your superiors think you should be grateful to get paid at all, much less vacation, limited sick leave, you get paid the same whether you work 90 hours a week or 40 (luckily hours tend to be better in psych than other specialties). suicidal ideation and suicides in residents are not uncommon.

I wonder if you could post more about how you think the cost-benefit calculation has changed for IMG's with the current immigration climate. I agree that it is worse. I don't know if I would recommend someone try and come or not. But in coming here 6 years ago, I have endured dramatic challenges in two distinct immigration programs, and the J1 waiver program seems to have been most dysfunctional last year (people this year seem to be having an easier time). And yet I feel very happy about the opportunities I had during residency, and my truly wonderful quality of life as an attending (although I've never been an attending in the UK; certainly, I'm doing a lot better than the options back home). Coming to the US got me to child board certification at 29, 6 years sooner than I otherwise would have. I continue to experience almost everyone I interact with as welcoming, and do not encounter stigma, in spite of changes in the macro-political climate.

However, I think the cost-benefit is very different to someone who is further along in life and training (I think part of why i loved residency was the complete lack of other responsibilities, whereas people with families seemed to be on the verge of breakdown), or who is likely to match into a program with fewer opportunities (some programs in the US are going to offer more unique opportunities than anywhere in the world I can think of, whereas some community programs would not be substantially different to clinical training available in many places). I think you and I both were fortunate here - perhaps that door is clos-(ing)(ed).

 

[tensin79]

It might be worth applying for this yr to see if you get any interviews and then try next yr with some US experience to get some LORs from US psych attendings.

I matched in 2012 from a Carribean school. I’m originally from the UK. For my clinicals I did 5 electives in the US (two in Chicago and three in NY).

I felt as though I would have been out of my element if I had no experience of is expected of me in the US.

I only got interviews at two programs so maybe so got lucky that year.

RG