Prelim med before surgery for IMG?

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May 22, 2003
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Hey all. I'm a US-FMG who came back home to do a primary care rotation. My FP supervisor liked me, gave me a good eval; my IM supervisor (mostly outpatient based) was not impressed w/my knowledge base. He compares me (rigtfully so) to US 4th years, and I don't match up in his eyes. My program obviously does not transfer well into a rotation here b/c we do most of our core rotations during 4th year (and I'm just starting mine), and also graduates of my program have a mandatory intern year (non-specialty tracked) during which they rotate thru EM, Med, Surg as interns. I am exempt from this intern year since I've chosen to match back here.

Here is the query. I'm going to match into surgery or procedure heavy medicine. That is what interests me and what I would be happy doing. If not gen sx then ob/gyn or EM. I know I don't like IM. However, I want to be a good doctor, obviously, and so I am thinking about a prelim med year just to refresh/to up my med knowledge. My dilemma is, that as an FMG, there is a decent chance I will have to match into prelim surgery after that. Can you even do that? It's an extra year and if I got into surgery and everyone else had forgotten their IM minutia, well then it's cool that i have extra knowledge but it wouln't help me for surg and I just spent an extra year of my life as an intern.

Thanks for your thoughts/experiences. I know I should'nt freak out over one bad eval, but I'm a good student at my program, and people from my program match here every year, so it's a bit troubling.


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The only thing I can think of that would be worse than doing a prelim surg internship would be doing a prelim medicine internship before a prelim surg internship. You'd be signing yourself up for additional flogging with no added benefit.

There is no point in doing the prelim med. Going straight into prelim surgery would be better if you don't match in what you wanted to do in the first place. If you're ok with Ob/Gyn that would be no problem to match into right away as far as I can tell. Gen surg and even EM would be harder.
Agree with the above, don't waste your time doing Prelim IM if you want to do surgery- while your IM knowledge may be below par, there is a steep learning curve and you'll do LOTS of medicine on your surgical patients. You will learn it because you HAVE to.
Thanks Wrigleyville, Dr. Cox. I appreciate both of your opinions and am happy to hear that I shouldn't waste a year doing prelim med. My supervisor has since said I'm not the worst student he's ever had (and he's only ever had AMGs before me), not exactly a compliment, but I'm less worried than i was. Although my IM knowledge is below avg, I learn pretty quickly, especially when I have no choice and I still think I'm going to be a great surgeon. For the match next year, I'll apply to categorical sx and some prelim sx as well for backup.

PS--wrigleyville...never thought, as a die hard Sox fan, I'd be taking a Cubs fan's advice..but desperate times call for desperate measures!!!