Question Regarding Post-residency Fellowships

[rhystheprince]

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I was wondering if anybody knows what the deal is when IMGs apply to post-residency fellowships.

My cousin in finishing up his residency in Internal Medicine and subspecialty in Infectious Diseases in Iran, and is now trying to land a post-residency spot here in the US. He does not have a green card or any other kind of visa. Does anybody know if there are any ways to do what he wants?

I would sincerely appreciate any input. Thanks!

 

[erichaj]

If you cousin did his medical school and residency in Iran.

He will have to do the whole residency and fellowship all over again.

If he has applied he will be rejected.

The law in the United States is that you must take and pass USMLE I and II and III and do a residency in the Unites states or Canada to be able to practice medicine in the united states. He must also be a green card holder or a US citizen or get a J1 or H1 visa. However, with the current climate between Iran and United States this may not be very easy.

 

[Selznick]

If you cousin did his medical school and residency in Iran.

He will have to do the whole residency and fellowship all over again.

If he has applied he will be rejected.

The law in the United States is that you must take and pass USMLE I and II and III and do a residency in the Unites states or Canada to be able to practice medicine in the united states. He must also be a green card holder or a US citizen or get a J1 or H1 visa. However, with the current climate between Iran and United States this may not be very easy.

This is correct.

 

[leorl]

Are you sure he will have to redo residency again? Some people from here (UK/Ireland) after taking the USMLE steps and wanting to apply for a fellowship, do not have to repeat residency in the US. They just attend for the fellowship.

 

[f_w]

I know a philipina and a nigerian doc who came directly for fellowship. Both had considerable research experience in their home countries. (They started directly with the rheumatology fellowship and in the end they had to 'top off' with a year or two of regular IM residency in order to sit for the ABIM exam.)

The law in the United States is that you must take and pass USMLE I and II and III and do a residency in the Unites states or Canada to be able to practice medicine in the united states.

This is incorrect:
- Federal law requires that anyone entering the US 'to practice medicine' has to be certified by the ECFMG (or another organization determined by the secretary of health and human services). ECFMG certification requires usmle 1,2ck,2cs and verification of graduation by the medical school.

- Individual state laws are very variable in what you need to practice medicine. The standard is USMLE 1-3 and 2-3 years of 'graduate medical education'. While a few states require that one year is done as 'internship', most states just require 2 years of ACGME approved graduate medical education. This can have the form of a fellowship or can be achieved by doing a medicine and a surgery prelim year.

A good number of international physicians just come for a fellowship to the US. The majority of these physicians return to their prior job at home because they don't want to go through residency again (and sometimes, because they don't consider the US as the only place on the planet you can have a good life as a physician).

The current 'climate' between the US and Iran has only very limited bearing on someones plan to come here for a residency. The only step where the 'climate' comes into play is the depth of the background check when applying for a visa. US medicine is full of physicians of iranian heritage, your chances of getting a residency are probably not better or worse than let's say a candidate from india.

 

[erichaj]

I stand corrected. kinda.

He may be able to get a fellowship and practice without having to do a general residency.

However,
He still needs to pass USMLE step I/ II/ III and CSA to get that ECFMG certificate.

He could do all but the CSA from outside the USA.

So then he needs a visa to get into the USA in order to do the CSA.

Since he is from Iran and Iran is not giving any visa to go to USA, he need to go outside Iran to get the visa. Once he has done that he can come and take the CSA.

Next. Assuming a fellowship does accept him, he would need to get a visa to stay in the USA and practice medicine. J1 or H1 or Green card etc.

Again, given the current climate between Iran and USA I don't think this is going to be easy. None of it is going to be easy. But it is possible if he is very motivated and willing to do whatever it takes. It could take several years.
With all due respect to the earlier post, I must disagree:

Even though there are many Iranian doctors practicing in the USA, if you speak to them, as I have, you will find out that unless they came here several years ago, it has gotten increasingly harder to get out of Iran. certainly, most fellowship programs will ask the question from themselves: Why should I accept this applicant when I have 50 more that are easier to hire for the job. It's partly an employment issue.

Again, I don't think it's impossible, I just think it is a difficult task worthy of a strong and motivated individual.

Well, I think that about clears it up. Sorry for the mis-information earlier.

 

[f_w]

Nobody said it would be easy.

1.9% of physicians certified by ECFMG went to medical school in Iran. This is comparable to other educational power houses such as Dominica (1.6%) or Grenada (2.2%). They even have their own association:

Iranian American Medical Association
877 Park Avenue
New York, NY 100121
President: Masood A. Khatamee, MD
Phone: (212) 744-5500
Fax: (212) 744-6536



Getting the visa for the US will be a hassle with potential delays. As Iran doesn't have diplomatic relations with the US, iranians have to go to Amman or Turkey.

But again, it is not unheard of that physicians from whatever country come to the US to do only a fellowship (and yes, some of them will stay).

 

[leorl]

By the way, there is no more CSA. The old CSA is now incorporated into Step II CS. However, I think there is still a requirement to come to the US to complete the Step II CS.

 

[Miklos]

I know a philipina and a nigerian doc who came directly for fellowship. Both had considerable research experience in their home countries. (They started directly with the rheumatology fellowship and in the end they had to 'top off' with a year or two of regular IM residency in order to sit for the ABIM exam.)

This is incorrect:
- Federal law requires that anyone entering the US 'to practice medicine' has to be certified by the ECFMG (or another organization determined by the secretary of health and human services). ECFMG certification requires usmle 1,2ck,2cs and verification of graduation by the medical school.

- Individual state laws are very variable in what you need to practice medicine. The standard is USMLE 1-3 and 2-3 years of 'graduate medical education'. While a few states require that one year is done as 'internship', most states just require 2 years of ACGME approved graduate medical education. This can have the form of a fellowship or can be achieved by doing a medicine and a surgery prelim year.

A good number of international physicians just come for a fellowship to the US. The majority of these physicians return to their prior job at home because they don't want to go through residency again (and sometimes, because they don't consider the US as the only place on the planet you can have a good life as a physician).

See the AMA page on IMG licensure exceptions for more info.