Pre-match situation today/IMG

[deleted877019]

I was clued into what the situation was, some years ago for an IMG, a few years from graduation, average scores, and it was bleak.

I've had plenty of experience since, and some additional qualifications- all of course, overseas.

Is there any scope at all, for prematch, for an IMG nearly a decade from graduation. Interest is Anaesthesia now. No dedicated Anaesthesia experience but reasonable Critical Care experience.

Can someone please shed light on how things are now? Thank you.

---

Members don't see this ad.

 

[bashwell]

I was clued into what the situation was, some years ago for an IMG, a few years from graduation, average scores, and it was bleak.

I've had plenty of experience since, and some additional qualifications- all of course, overseas.

Is there any scope at all, for prematch, for an IMG nearly a decade from graduation. Interest is Anaesthesia now. No dedicated Anaesthesia experience but reasonable Critical Care experience.

Can someone please shed light on how things are now? Thank you.

1) I don't think pre-match offers are even made any more, are they? At least generally speaking, my understanding is there are no more pre-match offers in specialties that participate in the NRMP which includes anesthesia. Maybe there are some exceptions somewhere, but I kind of doubt PGY1/PGY2 anesthesia positions are one of these exceptions. I'd be happy to proven wrong, but that's my understanding.

2) Also, while anesthesia isn't as competitive as it used to be, that's really only true if you are a US MD. Something like 67% of the positions are filled with US MDs. I think the majority of the rest of the positions probably go to DOs, and probably then US-IMGs and IMGs.

3) Regardless, it's going to be very competitive for an IMG with average USMLE scores and 10+ years out, even though you have clinical experience in your home country. The exception is unless you are an attending in your home country, which would be a huge help for you.

4) Do you have any US clinical experience? If not, then you should probably try to get some. Maybe even an observership at this point is better than nothing because at least you have the possibility of making connections with people who might be able to help you. I know it's not much, but I don't know if you have any good choices left right now.

5) If you took Step 1 and 2CK/CS more than 7 years ago, then you will have to do the exams over again, but maybe that could work in your favor if you score really high this time.

6) Another option is you could apply to PGY1 prelim years in surgery which are less competitive, though somewhat surprisingly seem to be getting more competitive as more US MDs fill these positions which used to be filled by non-US MDs. Anyway, PGY1 prelims in surgery will most likely be a dead end, but maybe you could get lucky, and it could lead to good LORs or meeting someone who can help you get into anesthesia somehow. It's an extremely long shot though. But again I'm not sure what other good options you have now.

7) I think it might be best for you to try for a less competitive specialty. Perhaps IM at a community program? Then if you do well in your IM residency, you could match into critical care. Critical care only is currently easy to match into. And it has a good future if you like the work and can tolerate the lifestyle.

8) Maybe you can try asking this question on the anesthesia forum too?

Good luck!

 

[AdmiralChz]

I was clued into what the situation was, some years ago for an IMG, a few years from graduation, average scores, and it was bleak.

I've had plenty of experience since, and some additional qualifications- all of course, overseas.

Is there any scope at all, for prematch, for an IMG nearly a decade from graduation. Interest is Anaesthesia now. No dedicated Anaesthesia experience but reasonable Critical Care experience.

Can someone please shed light on how things are now? Thank you.

It is going to be very, very difficult to get into a US-based residency these days with almost a decade of time since your medical school graduation. What have you been doing since then, did you complete a residency in another country and are working as a physician? If you haven't been working in the medical field, I would find it extremely surprising for you to get into any US residency, definitely not something on the more competitive side.

Even if you have been working and completed a residency and working as a staff physician, it's not a great outlook. In residency we look to build upon knowledge foundations established in medical school - with almost a decade since you've graduated, most of your knowledge is either gone, outdated, or potentially suspect depending on what school you attended (there are some really dubious foreign schools out there).

To be frank, unless you have held back something I don't see a possible way for you to break into Anesthesiology. You might be able to somehow get into another specialty (FM/IM/Psych?), but it'll take a lot of work and you will probably need to re-take all of the Steps and spend an inordinate amount of money as Bashwell said above. I'm not sure it's worth it.

Anesthesiology is a little different as well since it's common for residents to switch into from another specialty which increases the applicant pool beyond just MD/DO graduates. As Bashwell said probably 2/3 are USMD grads, with over half the remaining transfers from other specialties, then DO. The few spots left mostly go to US citizens who graduate from Caribbean schools, and then some exceptional applicants from well-regarded foreign schools in Europe/Australia/etc. Not much left after that.

 

[deleted877019]

Thank you. Your responses are much appreciated. I also wanted to ask if IMGs who have not done their residency from the U.S. are eligible to apply to U.S. fellowships.

Thanks.

 

[bashwell]

Thank you. Your responses are much appreciated. I also wanted to ask if IMGs who have not done their residency from the U.S. are eligible to apply to U.S. fellowships.

Thanks.

Yes, you are eligible to apply, you still have to pass the USMLEs (Step 1/2CK/2CS/3), but no guarantee you'll be accepted.

 

[deleted877019]

Yes, you are eligible to apply, you still have to pass the USMLEs (Step 1/2CK/2CS/3), but no guarantee you'll be accepted.

Thanks bashwell.

 

[rokshana]

Yes, you are eligible to apply, you still have to pass the USMLEs (Step 1/2CK/2CS/3), but no guarantee you'll be accepted.

I thought that to do an acgne fellowship you have to now have done an acgme residency? Did that not go through?

 

[bashwell]

I thought that to do an acgne fellowship you have to now have done an acgme residency? Did that not go through?

Sorry, you probably know better than I do, because I hadn't heard of that! If that's true, then I'm wrong and stand corrected.

This might help OP (search "international graduate" in these files):

ACGME Resident/Fellow Eligibility

 

[the argus]

1) I don't think pre-match offers are even made any more, are they? At least generally speaking, my understanding is there are no more pre-match offers in specialties that participate in the NRMP which includes anesthesia. Maybe there are some exceptions somewhere, but I kind of doubt PGY1/PGY2 anesthesia positions are one of these exceptions. I'd be happy to proven wrong, but that's my understanding.

There are still pre-match programs out there but they seem to be dwindling every year. Specialty doesn't matter, the program just has to be either all-in (all positions filled through NRMP) or all-out (all positions filled outside the match). Here's at least one anesthesia program that remains outside the match (doesn't even use ERAS apparently), Brooklyn Methodist Hospital (previously New York Methodist) in Park Slope.
Anesthesiology Residency Program - NewYork-Presbyterian Brooklyn Methodist Hospital

 

[Mad Jack]

I was clued into what the situation was, some years ago for an IMG, a few years from graduation, average scores, and it was bleak.

I've had plenty of experience since, and some additional qualifications- all of course, overseas.

Is there any scope at all, for prematch, for an IMG nearly a decade from graduation. Interest is Anaesthesia now. No dedicated Anaesthesia experience but reasonable Critical Care experience.

Can someone please shed light on how things are now? Thank you.

When did you take the USMLE? Do you have any recent exposure to the US health care system?