Program with only foreign graduates

[Egghead34]

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Hello, I'm an American IMG who is currently in a community IM residency program. I've been combing through cardiology programs in preparation for application season 2018 and saw a number of them whose entire fellowship class was made up of foreign medical graduates. Not Americans who studied in a Caribbean medical school (like me), but non-Americans who studied in foreign medical schools and did residency in the US. With the touted competitiveness of cardiology, I'm wondering how these situations arose? Please clarify my thinking because I may be totally off on this, but my impression was that PDs rank AMG > American-IMG/DO > foreign-IMG in terms of desirability (everything else being the same). Given that I'd be willing to go anywhere, it only stands to reason that there are other IMGs who'd feel the same. But if that's the case, why aren't you seeing IMGs in these homogeneously FMG programs? Is it because...

1) Cardiology is very, very competitive. So much so that even "low-tier programs" in remote, community settings get their choice of applicants. They're not getting US grads to apply, but certainly can pick between highly accomplished foreign born applicants and strong US-IMGs..and they prefer the former.
2) Cardiology is not as competitive as I thought. Nobody wants to go to these programs in "undesirable" locations. These programs aren't filling with even US-IMGs and must make the best they can with foreign grads?

I apologize if the tone came across as derogatory towards FMGs. Let me assure you that I have nothing but respect for those people who have worked so incredibly hard to forge a medical career in the US despite being from abroad. This is more to understand the competition that's out there and the reality that us less competitive residents have to face..

 

[ROBINHO]

Your observation of having lots of IMGs at community programs actually doesnt end only there. The top programs in the country like Cleveland clinic, Hopkins, Brigham, Mayo, MGH etc have more foreign IMGs fellows than Caribbean IMG. The link to the fellows profile of some of these programs are posted below.

Some of the Foreign IMGs tend to have PHds, extensive research experience, or previously attendings prior to coming to USA hence have some achievement in wuteva field they applying to. This can put them in a competitive advantage over Carribean IMGs (who unfortunately sometimes carry a stigma)

Cardiovascular Medicine Fellowship | Cleveland Clinic
Cardiology Fellows
Current Fellows

By the end of the day cardiology is competitive and very strong candidates (strong academic residencies, research and publications, letters of recs from known mentors) have a very good chance of matching irrespective of nationality or medical school.

 

[NYknicks44]

Most cardiology PD's are looking for talented fellows who can handle rigors of cardiology fellowship. Many of the IMG's come from top schools in their home countries, have done research before residency and often proven themselves in residency. By the time of application for fellowship, most of the applicants start from the same baseline, as they have all done residency in the US and medicine PD's can attest to their worth.

For the OP, cardiology is very competitive and a lot of candidates who would go anywhere don't end up matching. There is a bias against IMG's, but for the most part the IMG's you see in community programs are highly accomplished.

 

[Trisphorin]

I know of one the foreign IMG linked above who matched at top-ranked cardiology program. she has multiple first author publications in top cardiology journals and did a chief year in a University-based program.