On the interview, what were your general thoughts on img applicants?

[elaboratewithdodge]

Hi there, IMG here matched into Neurology on the previous cycle. I'm trying to help a couple of other IMGs to match into Neuro and for a part I wanted to gather some information about the general characteristics of imgs who received interviews and how were they viewed by their counterparts. Would be most thankful.

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[VacheronConstantin]

Neuro is the most IMG friendly field in medicine. Many mid-tier academic programs are 90%+ IMGs. You will be viewed as closely to, or even more desirable to US graduates!

 

[BlueBleck]

Hi there, IMG here matched into Neurology on the previous cycle. I'm trying to help a couple of other IMGs to match into Neuro and for a part I wanted to gather some information about the general characteristics of imgs who received interviews and how were they viewed by their counterparts. Would be most thankful.

DO here, so I was on the trail with a lot of IMGs. Everyone was nice. If you were wondering if we had any negative thoughts about y'all, I'd just confirm that I haven't heard a negative thing from any of my friends about IMGs. Personally, I'd have loved to work with anyone that I met on the trail.

Insofar as differences, it felt like IMGs were more extroverted than US grads. I assume that was a deliberate strategy. As US grads, there are fewer reservations about our cultural competency.

 

[Thama]

Neuro is the most IMG friendly field in medicine. Many mid-tier academic programs are 90%+ IMGs. You will be viewed as closely to, or even more desirable to US graduates!

These are low-tier, not mid-tier, academic programs. And that's because the bottom of the barrel neurology residencies are at academic hospitals, versus other larger specialties where the bottom tier residencies are at community hospitals.

 

[VacheronConstantin]

These are low-tier, not mid-tier, academic programs. And that's because the bottom of the barrel neurology residencies are at academic hospitals, versus other larger specialties where the bottom tier residencies are at community hospitals.

To recount just a few academic places that seemed all IMG:

U of Louisville
Temple
Suny Upstate
Stony Brook
Suny Downstate
UConn
Missouri
SLU

At those programs I felt like a horrible fit, since all of those are 90% IMGs with vast majority being South Asian. I did not click with any of them...why would they rank me highly compared to another South Asian IMG? Now are all those bottom barrel residencies??

 

[Thama]

I think there's a disconnect between the terms "IMG" and "FMG". I always took "IMG" to mean Americans who went outside the US to go to med school, usually because they were not good enough students to get into a US MD program, and usually ending up in the Caribbean. FMG I always took to mean people from other countries who went to med school in their own country (often very strong schools) and applied to residency in the US. The latter is usually regarded more favorably than the former, barring any visa issues.

The programs you listed are mid to low-ish tier places but not bottom-feeders. Just looking at one as an example - SLU - I see a lot of people that look like FMGs, and only a couple of US-IMGs from Caribbean programs.

What I've noticed is that neurology as a specialty has more international prestige than domestic prestige. Prestige in the US is much more weighted for how much money you can churn out, with people that can do 30 of the same simple, highly profitable procedure in a day being at the top of the heap. The bottom of the heap is the lowly cognitive worker that spends extra time with an undiagnosed problem seen by 10 specialists already and eventually comes up with an answer after being up all night thinking and reading, because nobody's paying for that ****. Internationally, where income and procedural volume are not as tightly connected as in the US system, neurology is more highly regarded.

 

[salemstein]

I think there's a disconnect between the terms "IMG" and "FMG". I always took "IMG" to mean Americans who went outside the US to go to med school, usually because they were not good enough students to get into a US MD program, and usually ending up in the Caribbean. FMG I always took to mean people from other countries who went to med school in their own country (often very strong schools) and applied to residency in the US. The latter is usually regarded more favorably than the former, barring any visa issues.

The programs you listed are mid to low-ish tier places but not bottom-feeders. Just looking at one as an example - SLU - I see a lot of people that look like FMGs, and only a couple of US-IMGs from Caribbean programs.

What I've noticed is that neurology as a specialty has more international prestige than domestic prestige. Prestige in the US is much more weighted for how much money you can churn out, with people that can do 30 of the same simple, highly profitable procedure in a day being at the top of the heap. The bottom of the heap is the lowly cognitive worker that spends extra time with an undiagnosed problem seen by 10 specialists already and eventually comes up with an answer after being up all night thinking and reading, because nobody's paying for that ****. Internationally, where income and procedural volume are not as tightly connected as in the US system, neurology is more highly regarded.

So how do you determine if a place is bottom-feeder? Doximity? What academic places are at the bottom?

 

[DerpyNeuroMD]

So how do you determine if a place is bottom-feeder? Doximity? What academic places are at the bottom?

I guess residencyexplorer.com is a good place to start if you don't want to buy freida? I guess doximity and usnews are also something to consider? That's about all we've got I guess

 

[Thama]

So how do you determine if a place is bottom-feeder? Doximity? What academic places are at the bottom?

Doximity, Freida is one way. Looking at things like number of faculty, subspecialty coverage, number of residents compared to hospital size is another. My favorite is the "yikes test", where you involuntarily think "yikes" on learning that someone trained in a particular program based on your previous experience with people from that program.

 

[xenotype]

I think there's a disconnect between the terms "IMG" and "FMG". I always took "IMG" to mean Americans who went outside the US to go to med school, usually because they were not good enough students to get into a US MD program, and usually ending up in the Caribbean. FMG I always took to mean people from other countries who went to med school in their own country (often very strong schools) and applied to residency in the US. The latter is usually regarded more favorably than the former, barring any visa issues.

The programs you listed are mid to low-ish tier places but not bottom-feeders. Just looking at one as an example - SLU - I see a lot of people that look like FMGs, and only a couple of US-IMGs from Caribbean programs.

What I've noticed is that neurology as a specialty has more international prestige than domestic prestige. Prestige in the US is much more weighted for how much money you can churn out, with people that can do 30 of the same simple, highly profitable procedure in a day being at the top of the heap. The bottom of the heap is the lowly cognitive worker that spends extra time with an undiagnosed problem seen by 10 specialists already and eventually comes up with an answer after being up all night thinking and reading, because nobody's paying for that ****. Internationally, where income and procedural volume are not as tightly connected as in the US system, neurology is more highly regarded.

Completely agree.

A few comments to add from someone from a 'middle of the pack' program (USMD background). Top tier does not mean your clinical training will be better. In fact, training in some brand name hospitals can result in patients/families unwilling to let residents do procedures on them, or even ignoring the resident and waiting for attendings without letting the resident come to their own conclusion about what is going on. FMGs are often fantastic and very smart especially if screened as well as possible by the program (ie, observorship or away rotation to evaluate work ethic, knowledge, temperment/reliability). My program was a mix of DO, USMD, and FMG. Usually the FMGs we took had family we already knew, rotated with us before and were well known quantities and turned out to be some of the strongest residents clinically and in exam scores consistently. I asked very specific questions on the interview trail for residency, and there are 'top tier' programs with very low resident autonomy (PGY2s not even doing stroke codes in some places by themselves), graduates coming out with no idea how to do basic headache procedures, graduates coming out having read less than 10 routine EEGs and essentially not knowing anything about EEG other than the basic patterns the boards test. Some programs due to their hospital structures have low volumes for high acuity patients like large vessel occlusions, or very low tPA treatment percentages. These are all bad for clinical training. They can be rectified to great extent with fellowships, but they aren't going to teach you botox in a stroke fellowship. Top tier really doesn't help you get a job either. As Thama states, how much revenue you can generate is the main question- even for academic departments.