Prospects For US IMG Unsuccessful Matches

[AA_5628]

If approximately 50 percent of U.S. IMG's get into a U.S. residency what happens to the other 50 percent? What percent of these people eventually become practicing physicians in the United States and how?

It seems to me that if you only have a 1 in 2 chance of getting a residency it would be to risky to take on so much debt.

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[crotchrocketer]

Consider what percentage of those applicants have red flags on their application. Failed steps, failed coursework, gaps in education, low step scores, non-big 4 graduates are some examples. The number we will never know but something to think about.

 

[the argus]

If approximately 50 percent of U.S. IMG's get into a U.S. residency what happens to the other 50 percent? What percent of these people eventually become practicing physicians in the United States and how?

It seems to me that if you only have a 1 in 2 chance of getting a residency it would be to risky to take on so much debt.

Much greater than 50% of US-IMGs get a residency. Quoting the 53% from the NRMP data reports is a misinterpretation of what that data actually represents. I've explained in detail why this is the case in another thread and copied it below if you want to read it

If you look at the ECFMG report from 2013,
http://www.nrmp.org/wp-content/uplo...tional-Medical-Graduates-Revised.PDF-File.pdf,
you will see that the average time since graduation for the unmatched cohort of US-IMGs is 5.7 years.

When people say "match rate", they usually mean the chances of a recent graduate who is in the match for the first time. This is exemplified by the fact that the NRMP data reports actually breaks up US allopathic applicants into US seniors vs. US grad.

But when quoting that 53% you are not actually describing US-IMGs in the match for the first time, you are describing all US-IMGs in the match regardless of how many times they have applied. The NRMP data reports don't differentiate US-IMG senior vs US-IMG grad. There is without a doubt a percentage (~10%) of US-IMGs that manage to graduate from school, but are poor applicants (semester failures, step failures, etc) and are not able to ever match. This small yearly cohort continues to apply every year, builds up over time (hence the 5.7 years above), and drastically skews the US-IMG "match rate".

If you want to include those reapplicants when describing true US-IMG "match rates", then you also have to include all the applicants from those previous years that did successfully match. If you don't do this (like the NRMP data reports), you are way oversampling the poor applicant/unmatched cohort. The NRMP does actually recognize this because they split US allopathic applicants into those 2 groups, they just don't do it for IMGs for some reason.

People try to say the US MD vs US-IMG match rates are 94% vs 53%, which is in fact comparing 2 completely different data sets. The yearly match rates for NRMP defined US grads (i.e. non-matched applicants from previous years) are actually 40-50%, showing that poor applicants, regardless of where they come from, do not do very well in the match.

The first-time match rate for the big 3 caribbean medical schools is between 80-90%. Granted this does not take into account students lost to attrition before graduation, which is no doubt substantial.

But when people say caribbean grads have a ~50% chance of matching, they are grossly misinterpreting the data.

 

[Skip Intro]

What the argus said.

More simply, all IMGs are lumped together. Many of these are physicians who have been practicing in their home country. They might have been trying to secure a residency spot in the U.S. for years and repeatedly show-up in the Match statistics. There's no way to really specifically discern this.

But...

At least anecdotally, it appears that if you don't get a spot the first time around in the Match it becomes progressively more difficult (if not impossible) to get a spot afterwards. To that end, everyone coming from a Carib school should do the following things:

• Apply far and wide: I sent applications through ERAS to 30+ programs. That was for 2005. I went on 11 interviews. Today, that might not have been enough. Also, don't limit yourself geographically.
  
• Go back to the well: There are programs who have a history of accepting quality Carib graduates. Make sure you apply to these programs (many in NY, NJ, MI, etc.)
  
• Be realistic and have a back-up plan: If you want a more competitive residency (radiology, ER, anesthesia, etc.), be sure you apply to several back-up programs in IM or FP. You can rank those at the bottom on your rank list. No one will ever see your rank list except you. It's better to have something (and maybe switch programs later) than to have nothing at the end of the Match.

Good luck!

-Skip

 

[Jagon]

If approximately 50 percent of U.S. IMG's get into a U.S. residency what happens to the other 50 percent? What percent of these people eventually become practicing physicians in the United States and how?

It seems to me that if you only have a 1 in 2 chance of getting a residency it would be to risky to take on so much debt.

The number of IMG's getting US residencies will drop very very low in the coming years with all the new U.S. medical schools opening up. Going Carib now would be a death sentence.

 

[FutureMDiA]

Is there a limit on # of programs you could apply for, for your residency?

 

[gyngyn]

Is there a limit on # of programs you could apply for, for your residency?

No, but ranking programs that didn't interview you is remarkably low yield (with the exception of some surg pre-lims...).

 

[Goro]

Even lower with changes coming to loan criteria. The money spigot is going to be turned off, according to one of my Deans.

The number of IMG's getting US residencies will drop very very low in the coming years with all the new U.S. medical schools opening up. Going Carib now would be a death sentence.

 

[the argus]

The number of IMG's getting US residencies will drop very very low in the coming years with all the new U.S. medical schools opening up. Going Carib now would be a death sentence.

This idea that there will be no residency positions for IMGs, US or otherwise, in the immediate coming years has been disproven time and again on these forums (even by some of the most anti-caribbean people). Yes US enrollment (MD +DO) is increasing, but it is not increasing at a rate that would make going to a caribbean school now a "death sentence." You don't have to take my word on it, you can look up the number of PGY1 positions vs. the US first year matriculant data. Using the 2014 data, you will see that there there will still be ~4500 "open" positions in the 2018 match, and that doesn't even take into account the attrition rate for AMGs (2-5%) and the small increase in PGY1 positions that occurs every year.

I'm not saying that we won't ever reach a point where there will be no spots for IMGs, I don't know because I was never very good at predicting the future. But what I do know is that it is not going to happen soon enough to make "going carib now" a "death sentence"

 

[Jagon]

This idea that there will be no residency positions for IMGs, US or otherwise, in the immediate coming years has been disproven time and again on these forums (even by some of the most anti-caribbean people). Yes US enrollment (MD +DO) is increasing, but it is not increasing at a rate that would make going to a caribbean school now a "death sentence." You don't have to take my word on it, you can look up the number of PGY1 positions vs. the US first year matriculant data. Using the 2014 data, you will see that there there will still be ~4500 "open" positions in the 2018 match, and that doesn't even take into account the attrition rate for AMGs (2-5%) and the small increase in PGY1 positions that occurs every year.

I'm not saying that we won't ever reach a point where there will be no spots for IMGs, I don't know because I was never very good at predicting the future. But what I do know is that it is not going to happen soon enough to make "going carib now" a "death sentence"

Fortunately I am good at predicting the future and in 4-5 years the crunch will be severe and no one in Carib schools will be coming back. Also, many of those open spots are dead end surg prelim spots

 

[the argus]

Fortunately I am good at predicting the future and in 4-5 years the crunch will be severe and no one in Carib schools will be coming back. Also, many of those open spots are dead end surg prelim spots

1. There are ~900 dead end prelim spots total in the match. >500 of these 900 positions are filled in the SOAP each year, and >80% of SOAP positions are filled by AMGs. You can look at the match lists of the caribbean schools, dead-end prelim spots make up a very small percentage of their matches.

2. The match in 4-5 years will be from people matriculating this year and next year. There is no way US enrollment will increase enough over the next 2 years to fill those >4500 spots. The math just doesn't work out for you on this.

It seems that you, like the rest of us, are not actually that good at predicting the future.

 

[Skip Intro]

Fortunately I am good at predicting the future....

There are a lot of people in the world who believe they can spot trends. Some are lucky and get it right, and others have lost mind-boggling amounts of money on Wall Street. You don't often hear about the latter.

http://forums.studentdoctor.net/threads/really-lost-need-advice.981187/#post-13859440

-Skip

 

[laricb]

1. There are ~900 dead end prelim spots total in the match. >500 of these 900 positions are filled in the SOAP each year, and >80% of SOAP positions are filled by AMGs. You can look at the match lists of the caribbean schools, dead-end prelim spots make up a very small percentage of their matches.

2. The match in 4-5 years will be from people matriculating this year and next year. There is no way US enrollment will increase enough over the next 2 years to fill those >4500 spots. The math just doesn't work out for you on this.

It seems that you, like the rest of us, are not actually that good at predicting the future.

He's a Carib hater

 

[bedevilled ben]

Our final numbers are still trickling in, but based on what I've seen so far, this cycle appears to be SGU's most successful Match to date. Perhaps everyone was so concerned about the impending residency crunch that they worked harder and applied wider and more intelligently to maximize their chances. Wouldn't that be a terrific irony.

 

[the argus]

Our final numbers are still trickling in, but based on what I've seen so far, this cycle appears to be SGU's most successful Match to date. Perhaps everyone was so concerned about the impending residency crunch that they worked harder and applied wider and more intelligently to maximize their chances. Wouldn't that be a terrific irony.

I think the more likely scenario is that "the great residency crunch of 2015/16" was a complete fallacy that was started by a few people using faulty data and then propagated by many people who were too lazy to actually verify the claims. It didn't take a genius to look at the 2011 first year AMG matriculant data back in late 2011/early 2012 and see that this "crunch" was not gonna happen in 2015.

It's just like as of today, you can look at the 2014 first year AMG matriculant data and see that this crunch is not gonna happen in 2018 either. But that doesn't stop many people on this forum from making completely unsubstantiated claims like above (and those claims being liked by others).

One of the things that has surprised me the most since joining SDN 2 months ago is the number of physicians, future physicians, and people involved in medical school admissions that are apparently comfortable forming opinions based on data such as "according to one of my deans" or something they randomly read on the internet. Also, the inability of highly educated people to competently analyze numerical data reports is striking.

 

[bedevilled ben]

I think the more likely scenario is ...

Perhaps, but I'm not sure I'd call it a complete fallacy. I actually think that there is some evidence that the NRMP is becoming more hostile to IMGs and FMGs in general. I think the rate at which it's happening has been grossly over-exaggerated, and I think the artificially-induced competitiveness of the Match makes it easy to place blame on IMGs. Also, the schools themselves aren't just going to rest on their laurels and watch their match rates drop over the next 5 years. Indeed, the schools worth going to are already taking steps to ensure that students that sit the Steps will score well to stay competitive.

That being said, my previous post was mostly tongue-in-cheek.

 

[Medstart108]

I think the more likely scenario is that "the great residency crunch of 2015/16" was a complete fallacy that was started by a few people using faulty data and then propagated by many people who were too lazy to actually verify the claims. It didn't take a genius to look at the 2011 first year AMG matriculant data back in late 2011/early 2012 and see that this "crunch" was not gonna happen in 2015.

It's just like as of today, you can look at the 2014 first year AMG matriculant data and see that this crunch is not gonna happen in 2018 either. But that doesn't stop many people on this forum from making completely unsubstantiated claims like above (and those claims being liked by others).

One of the things that has surprised me the most since joining SDN 2 months ago is the number of physicians, future physicians, and people involved in medical school admissions that are apparently comfortable forming opinions based on data such as "according to one of my deans" or something they randomly read on the internet. Also, the inability of highly educated people to competently analyze numerical data reports is striking.

This is what I've been saying since I joined in 2012. I looked at the links and I immediately noticed a massive discrepancy. People were saying US MD grads = US Residency spots in 2015 and yet even the data they cited said 1st year US MD students = US residency spots in 2015. That would automatically mean the crunch would at the earliest be in 2019. Then they failed to account for the growth in residency spots by saying "theres no funding due to the recession" except there clearly is and residency spots continue to increase. Add to that the rapid expansion in US spots has not been as fast as predicted. That doesn't all of a sudden mean everyone should hop overseas, but it also doesn't mean hoping overseas is a death sentence.

 

[Skip Intro]

Our final numbers are still trickling in, but based on what I've seen so far, this cycle appears to be SGU's most successful Match to date.

I actually got an email from Ross (alumni email) stating that this was their most successful Match cycle this year. Ever! Over 800 spots.

I think the more likely scenario is that "the great residency crunch of 2015/16" was a complete fallacy that was started by a few people using faulty data...<snip>

They didn't really use data. They used a fear-mongering editorial published in the NEJM that was more opinion than fact. And, the rest of your post as given, some of us all along have possessed cooler heads and have been advocating a slightly more rational analysis:

http://forums.studentdoctor.net/threads/really-lost-need-advice.981187/#post-13848849

-Skip

 

[W19]

Back up plan is the key here... Psych, FM and IM in rural Oklahoma, North Dakota or Nebraska....

 

[Skip Intro]

Back up plan is the key here... Psych, FM and IM in rural Oklahoma, North Dakota or Nebraska....

If you actually aggregate and look at "who-matched-where" from Ross this year, a better strategy would be to apply to programs in the top 10 Matching states, in this order:

1) New York (150 spots)
2) Michigan (75 spots)
3) Florida (56 spots)
4) Illinois (52 spots)
5) New Jersey (50 spots)
6) California (49 spots)
7) Pennsylvania (43 spots)
8) Texas (41 spots)
9) Ohio (36 spots), and
10) Connecticut (24 spots)

Only 2 people found spots in Oklahoma, 2 in North Dakota, and 2 in Nebraska, respectively.

Source: http://www.rossu.edu/medical-school/2015residencyappointments.cfm

So, not sure the exact advice or information you were trying to convey, but Ross grads (at least) don't necessarily need to end-up in BFE to train. Quite the contrary. And, again based on this year's data, I'm not sure your's is a "sound" back-up plan.

-Skip

 

[Gfliptastic]

Agreed!

As a wise senior resident (IMG) told a lot of us as medical students, our goal shouldn't be to "blaze a trail", it's better to trod where others have already trodden. YES there will usually be a "rare gem" out of the IMG pool who will get an "exotic/sexy" residency - not to burst your bubble but that rare gem probably isn't you!

Following that resident's advice along w/ Skip's, apply where you already have alum. Speaking from experience, I'm starting where other Rossies already are. No shock/surprise at all!

 

[W19]

@Skip Intro My post was not to disparage IMG at all. I was just trying to say that people should have a plan B. I saw someone that I know went to the whole IMG 'disadvantage scenario' because he failed step 1 once...

 

[sso_blasted87]

Agreed!

As a wise senior resident (IMG) told a lot of us as medical students, our goal shouldn't be to "blaze a trail", it's better to trod where others have already trodden. YES there will usually be a "rare gem" out of the IMG pool who will get an "exotic/sexy" residency - not to burst your bubble but that rare gem probably isn't you!

Following that resident's advice along w/ Skip's, apply where you already have alum. Speaking from experience, I'm starting where other Rossies already are. No shock/surprise at all!

Blue is the color. Ktbffh.

 

[Skip Intro]

@Skip Intro My post was not to disparage IMG at all. I was just trying to say that people should have a plan B. I saw someone that I know went to the whole IMG 'disadvantage scenario' because he failed step 1 once...

Fair enough. But, "Plan B" shouldn't include guessing what are the "easy" states that are presumed to be so desperate for doctors that they will give anyone a residency spot.

-Skip

 

[Medstart108]

If approximately 50 percent of U.S. IMG's get into a U.S. residency what happens to the other 50 percent? What percent of these people eventually become practicing physicians in the United States and how?

It seems to me that if you only have a 1 in 2 chance of getting a residency it would be to risky to take on so much debt.

Those who fail just end up making ends meet for the rest of their lives, but if you think about it, its completely their fault.