Residency application #2

[neulite30]

Hello all.

I posted on here last year during the 2013 application season. I received some very helpful (and encouraging) responses, so I thought I'd pose my current situation/dilemma.

I am a US citizen and I graduated from the University of Queensland in Australia this past December. I initially applied last year for a pathology resident position in the US and received quite a few interview offers. However, around the same time I received a job offer as an intern at a hospital here in Australia. I decided to take the position here because I felt the experience would be beneficial (it has been) and it is required for full registration in Australia as a physician. The system here is quite different than the US, and a bit more complicated.

In any event, I have decided that I would like to enter training as a pathologist in the states, rather than Australia. I plan on applying again to programs this year. Would this decision be a potential setback or problem for my app? (note: when I withdrew my application after interview offers I wrote a courteous and grateful response to each program).

My stats for 2014:
-USMLE Step 1: 244
-USMLE Step 2 CK: 265
-Royal College of Pathologists BPS exam: Pass (first pathology resident exam, final year medical students are allowed to sit this)
-Publications, including recent one as first author in genetics
-Journal peer reviewer
-Poster presentations (including pathology)
-Clinical work as a physician (intern)

While I feel the benefit of my clinical training thus far cannot be understated, I think specialist training in the states is more structured and directed, thus making this career decision easier.

My question is: How would this situation be viewed by a committee?

Thanks again for your help.

[for those interested: pathology training in Australia requires a general "intern" year where you rotate through clinical specialties. Unfortunately, a rotation in pathology as an intern is not approved by the Australian Health Practitioner Regulation Agency (AHPRA). Training in pathology is regulated by the RCPA, and is longer than that of the US. It is a minimum of 5 years, one of which must be away from your home lab. There is no AP/CP. Rather, you train in AP for 5 years (not including your general intern year). CP exists but is different than the designation in the states. Other programs include Haematology (Hematology), Genetics, Chemical Pathology, etc. All take 5 years (6, when including internship).]

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[mlw03]

You lost me on some of the logistics, but overall I think your application will be viewed fairly well. You've taken and done well on the USMLE, and while you're technically an FMG, you're going to be viewed differently than an American who did med school in the Caribbean. The clinical year in Australia will probably be viewed as a plus. The thing I would suggest stressing in your personal statement is your commitment to pathology, since you already applied once and withdrew. Talk about how your clinical time made you aware that your interests are in pathology rather than direct patient care, stuff like that. I suppose the other challenge will be the interview logistics - you can't fly back and forth each time. That said, I think if you can get yourself 8-10 interviews you'll likely match... wouldn't shock me if you were offered an out-of-match spot (if that's still allowed... not sure).

 

[jp123ok]

I have decided that I would like to enter training as a pathologist in the states, rather than Australia.

I can understand why you might want to come back to the States, given that you are a US citizen, but if you have the chance to stay in Australia and do residency there you should strongly consider it. They have a serious shortage of pathologists in Australia and so the job market is stellar. As a result, once you gain experience you will easily be able to earn $300k-$400k/yr (in either AP or CP). I've heard of pathologists earning $1Million/year over there. Plus it is a beautiful country.

 

[Sulfinator]

I think if you can get yourself 8-10 interviews you'll likely match... wouldn't shock me if you were offered an out-of-match spot (if that's still allowed... not sure).

No longer allowed. Any program that participates in the Match must take all its incoming residents through the Match.

 

[mlw03]

No longer allowed. Any program that participates in the Match must take all its incoming residents through the Match.

Thanks for the current info. I remember my PD saying that change was coming as I was finishing residency, so looks like that's gone into effect now. Has a fellowship match been instituted yet in the US for any of the subspecialities of path?

 

[jp123ok]

Has a fellowship match been instituted yet in the US for any of the subspecialities of path?

There was talk that cyto would move to a match system. However, the only path program listed on ERAS is Dermpath and only 17 (out of 54) programs are participating.

https://services.aamc.org/eras/erasstats/par/display8.cfm?NAV_ROW=PAR&SPEC_CD=100

 

[TMZ2007]

One year of internship will only be a plus. The only possible concern with your app (besides the med school in Australia thing) is a lack of US clinical and/or pathology experience. But since you got multiple interviews last year, even that should not be problem. No one will care that you withdrew from the match last year or backed out of interviews. Apply widely, and you will very likely get many interviews and a job from a very nice program.

If you don't want to come back right away, that's fine too. But beware, in many states as a FMG you cannot get a full medical license unless you do 3 years of US residency in something.

 

[KCShaw]

Having done more or less the same thing in Oz, minus the backing out of residency interviews part, I generally agree that the main negatives other than coming from overseas are the history of backing out (IF anyone even comes to know you did that), and the lack of a stated experience in pathology. This is somewhat balanced out by having a good USMLE Step I and being a U.S. citizen. Nobody is likely to have any understanding of what passing the BPS exam means; they'll hear a medical student can take it and think USMLE, which you already have. If there's anything to do, it would be trying to spend some time in an AP department if you can. And of course, assuming nothing has changed, finish everything else you can up to this point for ECFMG certification.

Assuming you are still in Oz, apply early, which will hopefully help you get interviews early, so you can schedule them at a time that will let you make one big trip back for all of them, unless you work it just right so you finish internship and "move" back straight into interviews -- it just might be late'ish in the interview season even if you take all your leave the last month of internship (again, if I remember the down under schedule right, with internship typically starting & ending in like mid January or something).

 

[skramer3786]

apply to Duke! One of our current residents went to your university
Steven

 

[pathrock]

Given your background and steps score, you are still a strong candidate for path. Apply more and I won't be surprised you'll get quite a few interviews. Somehow I heard Duke is very FMG unfriendly and consider malignant, no offense Steven.

 

[Purple.rose]

Hi...
I am a final year medical student who is currently studying in India...
Does anyone have any past year exam questions for BPS examination (RCPA BASIC Pathological Science) ...?
If yes, can you kindly send them to me...?

 

[nr-xxx]

I would not recommend pathology I would recommend Internal medicine I just went to a CME conference and it was pointed out that there is a critical shortage of Endocrinologist ( need about 1800 currently beyond the 2500 that currently exists and they only produce 295 per years) with 21 million diabetics plenty of work plenty of lab data if you want to do diagnostic work. also from experience where I live the Pulmonary people that do Sleep apnea studies ( more of a clinically physiology type of lab) are making $ 1500 to $2700 per case. one man does 30 a week and grosses at least $50,00o per week so rather than pathology I recommend IM with Endocrine or IM with Pulmonary and Sleep medicine boards. both do diagnostic work but far better cash flow than pathology at least think about it Webb Pinkerton if you read this there is no way you will make this type of money in pathology Wise up and stop acting like a 3 year old that didn't get what they wanted.