Research and Residency Issues

[kitten8]

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[Blade28]

Hang on...you graduated from what last July? Surely not med school, if your Step 1 score is that old!

 

[NotAProgDirector]

I am assuming that you graduated from your PhD last July, now doing a post doc. You went to medical school outside the US, many years ago, as your USMLE's are >10 years old, and your scores are not good.

Several thoughts:

1. Your chances of getting a NS spot are zero. Unless you have amazing connections with a PD/Chairman here in the US, it's not going to happen with a distant med school graduation and poor scores.

2. Your chances of getting ANY spot in the US are not good. Most PD's will not care about your PhD, and this now puts you many years out from your medical school graduation. With a distant graduation and poor USMLE's, even the less competitive fields will be difficult.

3. You can't simply take the USMLE's again. You can only do so if a medical licensing board requires it. You'll need to apply for a medical license first, which you won't qualify for (because you have no GME training), so you won't be able to take the USMLE's again.

If you get a GME spot, when you finally get to the point of getting a license, then you may need to take the USMLE's all over again.

4. Reese's = candy. Rhesus = Monkey.

5. The Herpes you are discussing is the Herpes B virus, not the HSV/VZV virus we usually worry about. The B virus is endemic in Rhesus monkeys. The epidemiology of infection is unclear -- published reports (which document less than 40 cases in the last 50 years) suggest it is an aggressive infection which causes a meningoencephalitis similar to an HSV CNS infection. However, we have no denominator to compare this with -- it's quite possible that most humans exposed to B virus get a minor illness, or no illness at all.

The last published guideline on this from the CDC appears to be in 1987.

I find no reports -- case reports or otherwise -- of any documented infections in the last 10 years.

 

[Winged Scapula]

Interesting (on all accounts) aProgDirector...I learned a few things from that response.

I don't have much to add as I agree with everything he's said...chances are slim this far out from graduation. While connections can be important in some fields, it is not nearly as prevalent as you see in other countries. Neurosurgery is a very difficult proposition for any FMG, but for one who is 10 years (or more) out of school, has not had any US GME or USCE and has a poor Step 1 score, I'd say your chances are slim to none.

 

[DarthNeurology]

Here's the problem.......

I graduated last July and did a 1 year postdoc research fellowship in the field that I trained for. They told me in April that they didn't have funding for me after July 1st, so I started scrambling for another postdoc job. I landed a job at the University of Chicago, but it isn't related to what I studied at all and it involves monkey work. I didn't realize that working with reese's monkeys put you at a huge risk for Herpes - which will kill you if you are spit on, bit, scratched, etc. I've had many people tell me to not take the job and focus on studying for my Step 1 to take it (it expired, I am a FMG) and get in the match this coming year for residency. The only reason I took the U of C job was to help erase my FMG past, and thought it may help me match, as I didn't get very high scores on my other tests. Part of me is afraid to take the Step 1, because it has been almost 10 years since I've gone through that material - I think I may bomb it and then not match. On the other hand, I am getting older and know that the more I put off residency, the less likely I'll be able to get one. I am a MD/PhD who trained in Neuroscience. I really wanted to get into neurosurgery, but don't know if I will be able to. Any advice?

Why didn't you get a residency right out of medical school? Ten years ago the competition was much easier too than these days. I think generally they want people with high scores on Step 1 for Neurosurgery. Many residencies will not consider someone greater than 5 years out of medical school, end of story.

HOWEVER, I have seen some PDs look favorably on neurosurgery applicants if they have recently completed an MD/PhD at a U.S. institution, these folks are fresh from clinical work and have the perserverance to do a PhD as well (and these people had less than stellar Step 1 scores . . . )

The problem is that you haven't done clinical work in a long time and at this point would be at risk for failing out of an internship just for lack of clinical skills, i.e. you have probably forgotten everything, double true if didn't do well in clinical rotations at your past medical school.

Ask yourself seriously if you could take an H and P on a patient in ER, write Admit orders and follow their labs results and write orders and meds on your own. If you answer yes then you seriously underestimate the detrioration in your clinical skills. Would you even be able to write maintenance orders for IVFs for a patient or recognize say a dozen of the most dangerous EKG manisfestations?

You have to get clinical experience for a year or more and demonstrate you desire to *return* to medicine as you left the field for a decade. Research is good, but clinically being up to snuff trumps any research experience. Even an MD/PhD who is head of biochemistry and hasn't set foot inside a hospital for thirty years won't just be allowed to start internship at the drop of a hat no matter how many publications.

Overall Neurosurgery is for the best of the best, the brightest of the brighest and you need to seriously ask yourself if you would be up to snuff.

 

[DrDre311]

Overall plastic surgery is for the best of the best, the brightest of the bright

Fixed that for you. 😀

 

[Blade28]

Wow, aProgDirector, excellent, informative post! I also learned quite a bit from your bullet points!

To the OP, what was your Step 1 score? Did you at least publish anything during your time in the lab? Besides Neurosurgery, what other fields are you interested in?

 

[HCE]

I am assuming that you graduated from your PhD last July, now doing a post doc. You went to medical school outside the US, many years ago, as your USMLE's are >10 years old, and your scores are not good.

Several thoughts:

1. Your chances of getting a NS spot are zero. Unless you have amazing connections with a PD/Chairman here in the US, it's not going to happen with a distant med school graduation and poor scores.

2. Your chances of getting ANY spot in the US are not good. Most PD's will not care about your PhD, and this now puts you many years out from your medical school graduation. With a distant graduation and poor USMLE's, even the less competitive fields will be difficult.

3. You can't simply take the USMLE's again. You can only do so if a medical licensing board requires it. You'll need to apply for a medical license first, which you won't qualify for (because you have no GME training), so you won't be able to take the USMLE's again.

If you get a GME spot, when you finally get to the point of getting a license, then you may need to take the USMLE's all over again.

4. Reese's = candy. Rhesus = Monkey.

5. The Herpes you are discussing is the Herpes B virus, not the HSV/VZV virus we usually worry about. The B virus is endemic in Rhesus monkeys. The epidemiology of infection is unclear -- published reports (which document less than 40 cases in the last 50 years) suggest it is an aggressive infection which causes a meningoencephalitis similar to an HSV CNS infection. However, we have no denominator to compare this with -- it's quite possible that most humans exposed to B virus get a minor illness, or no illness at all.

The last published guideline on this from the CDC appears to be in 1987.

I find no reports -- case reports or otherwise -- of any documented infections in the last 10 years.

aProgDirector...loved your bullet number 4.

 

[kitten8]

Why didn't you get a residency right out of medical school? Ten years ago the competition was much easier too than these days. I think generally they want people with high scores on Step 1 for Neurosurgery. Many residencies will not consider someone greater than 5 years out of medical school, end of story.

HOWEVER, I have seen some PDs look favorably on neurosurgery applicants if they have recently completed an MD/PhD at a U.S. institution, these folks are fresh from clinical work and have the perserverance to do a PhD as well (and these people had less than stellar Step 1 scores . . . )

The problem is that you haven't done clinical work in a long time and at this point would be at risk for failing out of an internship just for lack of clinical skills, i.e. you have probably forgotten everything, double true if didn't do well in clinical rotations at your past medical school.

Ask yourself seriously if you could take an H and P on a patient in ER, write Admit orders and follow their labs results and write orders and meds on your own. If you answer yes then you seriously underestimate the detrioration in your clinical skills. Would you even be able to write maintenance orders for IVFs for a patient or recognize say a dozen of the most dangerous EKG manisfestations?

You have to get clinical experience for a year or more and demonstrate you desire to *return* to medicine as you left the field for a decade. Research is good, but clinically being up to snuff trumps any research experience. Even an MD/PhD who is head of biochemistry and hasn't set foot inside a hospital for thirty years won't just be allowed to start internship at the drop of a hat no matter how many publications.

Overall Neurosurgery is for the best of the best, the brightest of the brighest and you need to seriously ask yourself if you would be up to snuff.

This is the story........... I started medical school in the U.S., and had some issues due to racism. In the midst of all of that, I was doing my Ph.D. in Canada. After I finished up my Ph.D. and had the US school screw me out of my degree, I had to finish up at a Caribbean school. I finished up and graduated this past July. I started a movement disorders postdoc in September and my funding ran out. I wanted to do the physician-scientist track, but am thinking my chances are slim now. I know if I am not able to do residency soon, my chances will be even worse. As far as my Step 1 score - it was taken during my time at the US school, before my Ph.D. training, and also before my Chicago Caribbean rotations.

 

[OldPsychDoc]

...
4. Reese's = candy. Rhesus = Monkey.
...

Guess that explains why that bag of "Rhesus Pieces" from the dollar store tasted so funky....

 

[Winged Scapula]

Guess that explains why that bag of "Rhesus Pieces" from the dollar store tasted so funky....

 

[Blade28]

This is the story........... I started medical school in the U.S., and had some issues due to racism. In the midst of all of that, I was doing my Ph.D. in Canada. After I finished up my Ph.D. and had the US school screw me out of my degree, I had to finish up at a Caribbean school. I finished up and graduated this past July. I started a movement disorders postdoc in September and my funding ran out. I wanted to do the physician-scientist track, but am thinking my chances are slim now. I know if I am not able to do residency soon, my chances will be even worse. As far as my Step 1 score - it was taken during my time at the US school, before my Ph.D. training, and also before my Chicago Caribbean rotations.

Wow that's a terrible story. Were any further actions ever pursued against your original med school?

 

[kitten8]

Wow that's a terrible story. Were any further actions ever pursued against your original med school?

Yes, I've been involved in a court case against them for the past several years.