please don't think i'm stupid........

Discussion in 'General International Discussion' started by robin1, Feb 15, 2002.

  1. robin1

    robin1 Junior Member

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    I've got two questions that have been on my mind recently, but I've been kind of embarrassed to ask anyone for fear of looking completely ignorant. The first question is simple enough and considering how important it has been for IMG's it's probably something I should know, while the second question is a bit more complicated and I'm hoping that some of the really helpful administrators or moderators (or a really knowledgeable med student) can answer it for me.

    1. I know that alot of IMG's enter into internal medicine residencies once back inside the US, but I'm unsure of what exactly this field of study can lead to in terms of practice? Do graduates of these programs go on to enter only into private practice or primary care or can IM be a pathway for the doctor to enter into a more specific field of medicine such as cardiology or something else? If so, would this be the exception rather than the rule and would being an IMG limit one's ability to do this?

    The next one's a bit tricky because I don't know all that much about the ways in which residency programs operate and I not sure how many people (especially recent med school graduates) come into contact with the lesser known details of residency programs. Anyway, here goes...

    2. I understand that there are two ways in which one can get a residency place in the US. The first, and most common, is through the matching scheme that all US med school grads and most IMG's enter into. It's the second way that I'm curious about. I think this involves setting something up directly with the specific program, meaning that this would be outside of the matching scheme. Does anyone know when this type of an arrangement would be used? When I asked my cousin (a recent US grad) he at first looked puzzled and then said it probably applied to fully qualified foreign-trained doctors who although they have to undergo a period of training in the US, are given a resdiency that is "reduced or compressed" and therefore this is applied for outside of the matching system. If this is true than what would be the determining factor for which doctors can apply for this? The country and school/program of training???

    Thanks for the info.
     
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  3. Annette

    Annette gainfully employed
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by robin1:
    <strong>
    1. I know that alot of IMG's enter into internal medicine residencies once back inside the US, but I'm unsure of what exactly this field of study can lead to in terms of practice? Do graduates of these programs go on to enter only into private practice or primary care or can IM be a pathway for the doctor to enter into a more specific field of medicine such as cardiology or something else? If so, would this be the exception rather than the rule and would being an IMG limit one's ability to do this?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">You've got the right idea. Most IMG's go into IM, but there are no residencies that aren't open to IMG's. However, there are some very competetive residencies that most IMG's haven't got a chance of entering.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by robin1:
    <strong>
    2. I understand that there are two ways in which one can get a residency place in the US. The first, and most common, is through the matching scheme that all US med school grads and most IMG's enter into. It's the second way that I'm curious about. I think this involves setting something up directly with the specific program, meaning that this would be outside of the matching scheme. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">You are thinking of residencies set up outside the match. The way some of my friends have arranged these is submitting an application through eras, and then the residency program makes an offer. Most places want to know that you will have your ECFMG certification by the time you enter the program, and so want to know that you have passed all your exams (steps 1&2, CSA, and toefl).
     
  4. Notorious F.O.B.

    Notorious F.O.B. Junior Member

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    howdy... about the IM and IMG bit... here's my 2 cents regarding of the scenario. people go into IM either knowing that they want to do general practice in the end, or they think they may want to pursue a subspecialty, for example cardiology or pulmonology. well, when u apply for the IM residency, u have the option of applying for a community hospital residency and a university hospital residency- the latter requiring higher board scores to get into, the reason being that your chances for landing ANY kind of subspecialty from a university hospital IM program are much higher as opposed to your chances applying out of a community hospital. assuming an IMG gets good scores on the boards, then assuming the IMG gets into a university hospital IM residency, there are competitive fellowships such as cardiology which will still be painfully difficult for the IMG to get into. but hey- it doesn't hurt to try, and u never say never :D
     
  5. robin1

    robin1 Junior Member

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    Just out of curiosity then, do any US grads still go into IM or has it become pretty much the IMG branch of medicine?

    Also, what whould the route be for a trained renal specilist or cardiologist for example? If fully trained in a given field would they have to re-do an IM residency and then re-train in the field they've already specialized in? In another words, I know they would have to undergo further training once they got here, but would they have to start all over by beginning with IM and then train in renal medicine again? I'm sure there has to be a way for these qualified doctors to train in their given field without having to start from the very beginning. Maybe this is what my cousin was referring to?
     
  6. nyskindr

    nyskindr Senior Member

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    A large percentage of US med school graduates still do go into Internal medicine,and at the better programs the positions are mostly filled by US trained residents.A foreign trained physician generally has to repeat at least a part of his training in the US to be eligible for board certification.I know of a practicing dermatologist in India who had to repeat an entire internship and residency in the US.However there are exceptions and individuals who are recognized as experts in their field can be exempted from certain training requirements.
     
  7. NuMD97

    NuMD97 Senior Member

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    Hi:

    As all specialties ebb and flow what will probably be the determining factor for you is the point at which you actually apply. If you are an IMG the key primarily is to get into the system, ideally if IM is your calling you get a residency spot directly. These days most spots are filled during the Match process. I believe what you are referring to as being "outside the Match" is during the scramble process wherein programs that have not met their quotas for first-year residency positions are still seeking to fill those empty positions. (Sometimes more advanced positions become available as well, but that's a topic for another post. :) ) This occurs generally after the March Match results are out. Though some programs do rarely fill "off season", usually in January.

    As far as I am aware, even the most highly trained foreign national who wants to practice here in the US has to, unfortunately, begin from scratch and start residency training again and then to subspecialize. I have a friend who is currently a second year cardiology fellow who did seven years of training prior to coming to the US in her country. She told me that by the time she finishes her fellowship it would be twenty years since she first began medical school. But obviously worth it to her.

    I hope some of this helps. Good luck to you. :)

    Nu
     
  8. pimmar

    pimmar Member

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    Hi Robin,
    If one chooses to go into IM, one can then choose to go into just regular private/group/hospital practice after 3 years of IM, or one can do a fellowship in GI, nephro, endocrine, rheumatology, cardio, pulmonology, derm, etc...
    Depending on your USMLE scores I and II also will depends what kind of fellowship you go into. Cardio for example is very competitive and from what i hear you must have a 90% or better to even be considered. Most go into IM or Family Practice, but I know plenty that have gone into general surgery, peds, radiology, and ob-gynthere are a very select few into ortho programs. Thus it really does depend on how you do. IMGs are allowed to sign for a residency outside the Match if they choose, whereas US grads can't. So if a residency program wants you or wants to make sure they fill their spots they may offer you a spot outside the match. In terms of IMGs who have graduated outside the US who do abbreviated programs I have heard of this, but I don't know of the exact details, unfortunately I have only heard of this with psychiatry, which usually has the hardest filling its spots. I have heard of someone who already was a psychiatrist in his country and then came here I believe he was told he only needed to complete 2 years of residency to become a psychiatrist here. I haven't really heard of that in any other field.
     

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