residency for non-US citizen

[vincentyim]

can a foreign citizen take residency in US? And how to obtain a green card while taking residency?

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[Stormreaver]

Of course, non-US citizens can get residencies in the US, on either a J1 or an H1 visa. Most programs offer J1 visas, but the H1 visa is the one which can be converted to a green card after the residency.

 

[will_lam]

The post <a href="http://www.studentdoctor.net/ubb/ultimatebb.php?ubb=get_topic;f=12;t=000765" target="_blank">Residency for UK student </a> is also from someone in the UK interested in residency in the US. It may be of help to you.

Someone mentioned in that post the possible visa problems that foreigners might experience now, but the idea was dismissed by another user. Interestingly enough I just watched a report on CNN that basically said the INS was going to be dismantled and broken up so that the DOJ could reform and control the entire process by which foreign nationals are allowed to enter the country. I don't know exactly what this will mean in practice, but the tone of the report certainly sounded like alot less people would be allowed to enter the country on training/education visas. So if you're looking to come to the US it's probably going to be lot easier now than after the changes to the INS have taken place.

 

[PCUMC00]

In general WASP UK or Australia FMG have a better chance of getting US residency than 3rd world FMG with similar USMLE I & II scores. However if you are Asian UK FMG, you have no better advantage over non-WASP FMG. Case in point, my son (US Chinese) graduated from an Ivy top 10 school with 250 in USMLE I and 263 in USMLE II and 4 Honors, 2 High Pass in clinical rotations don't even get IM residency interviews from UCFS, U Wash and UPenn. If you are not aiming for the top programs and have a 240+ I & II scores, you should be able to match in the US.

 

[will_lam]

PCUMC00, your statement is ridiculous. I am more than willing to admit that discrimination exists, but the example you provided is either completely falsified or an incomplete representation of your son's qualifications. Even if what you have written is factual, you have eliminated every conceivable and valid reason for why your son may not have been interviewed and boiled it down to pure racism. This is pure ignorance. Have you considered that for this year these schools may have received a high number of extremely qualified applicants and therefore stopped their interview process early? Probably not since it's easier for you to assume that it must be racism.

Program directors are human and are capable of holding the same prejdices as anyone else, but your insinuation that every PD at a top program is looking to fill his/her program with nothing but WASP's is an absolute insult. Medicine is without question one of the most diverse fields in the United States. There's no chance it could have gotten that way if your story or suggestions about American PD's were true.

By the way, your statement that Asian IMG's from the UK or Australia need a 240 minimum to match for residency in the US is just as ridiculous as your "racist program director conspiracy theory". Did your brilliant but wronged son happen to tell you what valid statistics are? If so, perhaps you could provide us with the stats and source on which you've based this fictional argument.

Is it just me or is anyone else having trouble believing this one??

 

[leorl]

LOL guess they guy holds a grudge. You know, for all the smarts it takes to get into med school, some things that people thinks are just incredibly dumb. And I know that's harsh and I don't mean to be insulting, but really...I can think of no other word for it. That's dumb.

It would make no sense for an Asian FMG who graduated from a reputable foreign school to be subpar to a Caucasian FMG, when there is no difference btw whites and asians in the US. I do not know how residency works, but having gone to an ivy league school, your son should be very well aware of quota restrictions and should be used to it by now. There must have been some other factor...and judging from your attitude, if it even rubbed off on him, I'm betting his interview might not have come off quite right. especially if the applicant pool that year was very competitive. You can't make these wild claims without any facts. Come on, show us stats that measure exactly the difference between Caucasian FMGs and Asian FMGs. And you know what, how many Asian FMGs are there to begin with??? not a hell of a whole lot. Btw, even your use of "WASP" is incorrect, because that implies that all caucasians who study overseas are conservative self-serving pricks, which of course is not true.

 

[Stormreaver]

As an Asian IMG, I can testify that PCUM's statement doesn't seem correct to me. Friends with scores in the 210s/220s matched at top 50 residency programs in IM--and that's no mean feat for an IMG. In fact, a friend who had 240+ even matched in general surgery. A senior from my college switched from IM to Ophth-- all of these are Asian IMGs.

 

[PCUMC00]

Will, I never claimed that PD are racist. My son did have interviews at Mayo , Duke, NY Hospital, Barnes Jewish, Michigan, U Chicago, HSS and a couple of others. In US top programs, as in top medical schools, Asian is over represented. Top programs have the luxury to pick and choose from a VAST pool of resident applicants to create a balanced and diverse group. Therefore competition among Asian applicants are fierce in top programs. Just look at the avg. MCAT scores of 11.x for JHU and Harvard matriculants and you could tell that an applicant with a MCAT of 40 may not guarantee an admission. Since my son doesn't have AOA and hasn't done research during medical school, it is not surprising that these may be the requisite for some top programs. Needless to say that for Asians FMG, the odds are definitely less favorable than White FMG with similar academic standing for Top US progams because are are fewer slots for Asians.

Leorl, I said my son hasn't even get a interview from the 3 hospitals. It has nothing to do with his interview performance.

Stormreaver, I know IM is not as competitive as general surgery. But do you know how many Surgical Residents get sleepless nights/weeks/months not just because of the work load but from accidental cuts during surgery. HIV and HVC make the profession even more hazardous. Not all bright and able students look for Surgery.

 

[vincentyim]

By the way, i want to ask that if there are many asian doctors or asian med students in USA? are they excellent?

 

[will_lam]

Now I'm confused. I honestly can't tell if PCUMC00's posts are meant as a joke just to get a reaction or if this person really is as clueless about the medical field as their posts clearly indicate they are.

There are just way too many absurd contradictions and ludicrous statements in your posts for me to ever take them seriously. But since I'm on spring break and am bored here goes....

•••quote:•••Top programs have the luxury to pick and choose from a VAST pool of resident applicants to create a balanced and diverse group. ••••How in the world can your theory that program directors prefer to fill their program with WASPs over minorities create the 'balanced and diverse group' you just spoke of? Your two statements are in complete opposition.

•••quote:•••However if you are Asian UK FMG, you have no better advantage over non-WASP FMG. ••••Since both of the groups you're speaking of here are Asian, (I'm assuming by non-WASP you mean Asian) your saying that a program director would see no difference between an Asian graduate from a highly-respected and well-established British medical school and another Asian medical graduate from the University of Angola (not a real school but you get the idea). PD's are ultimately judged on the qualtiy of their program, not its racial composition. 99.9% of program director's will take the applicants they feel are most qualified to help their program and become an active part of it. When it comes to IMG's the better the medical school you come from, the more likely they are to feel this way about you...regardless of your skin color.

•••quote:•••Since my son doesn't have AOA and hasn't done research during medical school, it is not surprising that these may be the requisite for some top programs.••••While they certainly may help, neither of these two things are 'requisite' for even the top IM programs. In fact there are no requisite requirements for obtaining an IM residency outside of a medical degree. If you think every IM resident, even at the top programs, has AOA and did research you're out of your mind.

•••quote:•••But do you know how many Surgical Residents get sleepless nights/weeks/months not just because of the work load but from accidental cuts during surgery.••••huh...?? Surgical residents easily work 100+ hours a week so an inability to sleep when given the rare opportunity is generally not a problem. Where did you possibly get this one from? By far most 'accidental cuts' come from needle sticks, which by your misguided logic should make IM less popular. This quote's a classic...oh and I'd like to see these surgeons that haven't slept for months. That's actually really frightening.

•••quote:•••I never claimed that PD are racist. ••••No, but you clearly implied it.

In addition, you have still not provided valid stats and sources for the numbers you threw out in your first post. Also, I completely understand that many parents take great pride in their children becoming doctors, but I've honestly never heard of any going so far as to cruise websites where pre-meds and recent grads hang out. Your son is what...at least 24 or 25 now...you're taking interactive parenting to a whole new level.

In answer to your question Vincent, yes there are alot of Asian doctors and medical students in the US. Their range in quality is the same as it is for every other ethnic/racial group. Some are excellent, some are poor...the majority are extemely competent and qualified physicians.

 

[BellKicker]

Will_Lam, I'd like your opinion on this.....

You seem to know a thing or two about the selection criteria. What is more important, board scores or which school you attended? I'm talking only FMGs here (I realize we get whatever the USMG don't want).

It seems like Europeans (ie. people that went to European schools; they could be blue, green or Asian) have a hard time with the USMLE because of our med school format. So I was thinking maybe that was outweighed by the reputation of one's school.

Or even better: When people talk of top 10 schools, I know that's in the US. But is there a way to rank foreign schools? Does anyone know?

With the risk of ending with a platitude:

PEACE OUT, both of you.

 

[Stormreaver]

•••quote:•••Originally posted by PCUMC00:
•Stormreaver, I know IM is not as competitive as general surgery.... Not all bright and able students look for Surgery.•••••But given that, surgery is STILL more competitive than medicine. Getting decent interviews is difficult enough, matching, even tougher.

Also, I know and have met IMGs from my country who interviewed at Barnes-Jewish, Mayo, Baylor, Emory, Duke, UW-Madison, Yale, U Chicago, Northwestern and other top schools. Their qualifications? top boards scores, US LoRs via electives, and honours. There's less prejudice than you think there is.

 

[will_lam]

DaneMD,

I not an expert on selection criteria by any means and I don't think the issue is as simple as USMLE vs. medical school reputation since the interview counts for alot and that's where the every applicant really gets to make their case. But to answer your question I would would say that board scores are somewhat more important in that the better the USMLE score the better the candidate looks regardless of where they went to school. If, however, we are comparing two candidates with approximately identical qualifications then I would say that medical school reputation (often generalized as the country of the medical school) definitely may have an influence and provide a slight advantage for one candidate over another. Although this is probably true in practice, technically it's all speculation as this type of policy is highly unofficial so as not to arouse claims of discrimination.

I think saying Europeans have more difficulty with the USMLE may be an over-generalization. Although someone wrote in another post that people from Asia get the highest IMG board scores I tend not to believe this. Primarily because I would say that the highest IMG USMLE scores probably come from US kids who are studying abroad as US-format medical schhols. Also because I don't think the USMLE or ECFMG actually publishes actual scores based on individual countries (I've certainly never seen it) so I don't know how anyone can claim that one country gets the highest USMLE scores. In think in terms of countries people usually refer to the countries that have the best USMLE pass rates as opposed to highest scores. In this case my understanding was that the UK, Israel, and Australia usually came out on top (excluding the previously mentioned US-style schools in the carribean). This I why I think using the term European is a bit misleading since UK (and also Irish) grads seem to do realtively well on the boards. The trend for these countires seems to be that the language of instruction is English in comparison to medical schools on the European continent which tend to teach in their native language. Again this is all spculative.

I don't think that there is a foreign ranking system which is why outside of a few well know schools (Oxford, Cambridge, Edinburgh) most people tend to base judgements on the country of the medical school.

Most of this is subjective information so take it with a grain of salt, but anyway I hope it helps.

 

[BellKicker]

Thanks a lot, Will_lam. I guess what you're saying is that it's really up to the PD what he/she thinks is important. Which makes a lot of sense.

 

[Stormreaver]

Will has pretty much got it all right. School reputation does count for a lot. I know for a fact that a handful of schools in the Indo/Pak region have very strong reputations, and a lot of PDs remarked on my college's reputation. I guess its up to the individual PDs--I have heard there are some who won't even look at an IMGs application, but by and large most will factor in various things. A VERY important factor is US work experience. LORs from US faculty obtained through electives, observerships or research tend to carry a LOT of weightage.

As for pass rates--its more dependent on schools than countries. I know for a fact that my school and another in Pakistan have been getting pas rates near 100% in recent times. Sackler in Israel tends to do well too, as do the Caribbean schools. Its pretty difficult to declare that "country A has the highest pass rate"

 

[Maran]

Not that many years ago I served on an admissions committee for a graduate school (in Sociology, not medicine.) Based on that experience, I am confident that TOEFL score and English fluency in the interviews are also major factors for most IMGs (obviously excepting IMGs for whom English is their native language and the language of their medical education.)

There is sure to be at least some language-based effect on the board scores as well, which tends to put IMGs at a disadvantage. Obviously English language fluency is an asset when practicing medicine in the U.S. However, there is also a great need for physicians who have fluency in two or three languages (the specific languages vary by specific community and location, though Spanish is also an obvious asset.)

And while I don't know of any school or residency program that uses a formal quota system, most programs do seek to promote diversity. So, for IMGs (as well as U.S. grads) this can mean that you are competing against all applicants in general, but also against other applicants from your home country (or, in the U.S., racial/ethnic group.)It's never a straight numbers game.

The most critical part is always the interview, but most applicants never get that far.

 

[PCUMC00]

vincent, First, condolence for your Queen mother. I don't care if they called me dumb or questioned my right to post here. The fact is that USA is not as someone claimed as color-blind. Reputation of your med school helps only if you back it up with your performance in the standardized tests (USMLE). If your med school has a topnotch reputation, you better have a +1 SD from the medium score. Of course LOR (letter of recommendation) from world renown professor is just as important. I was interested to map career strategy with my son. After all getting post graduate residency is like a game. One has to know where one stand (qualification, career outlook, what is the quality of life for certain specialty, the location of the hospital and what is ones probability of get ones top choice). Honestly, my son's academic qualification is at 99 percentile which means there are about 160 students (1% of 16,000 candidates) with better scores. Even with this performance, his faculty advisor told him not to apply to JHU (John Hopkins) and MGH (Mass. General Hospital), the top 2 programs. My son and I were surprised that UCSF (U. California at San Fransico), U. Wasghington and U. Penn., which are all top 10 Internal Medicine programs didn't give him an interview. This shows how competitive the top programs are. Good Luck.

 

[PCUMC00]

Will, What seems misguided logic to you because it counters to CDC or UCLA or UCSF publish studies in comparing risk between needle stick and a cut ? Even for a dumb non-medical person knows the probability of catching the HIV bug is proportional to the amount of blood exchanged with an infected. A hollowed bore needle will insert a
large quantity of blood than a small cut with a sharp blade. On this comparsion alone, the studies are right that a needle stick is more dangerous than a cut. However try just
to go one extra step. What if safety needles are used ? How much risk will safety needles reduce ? What if the hospital has a team for drawing blood or it is performed by nurses and MD are called only to perform on difficult cases ? Would that have a dilution of risk on the IM doctors ? Are the studies based on reported cases ? If it is based on total reported cases of needle stick and cuts and the number of sero conversion of each, I will take it with a big grain of salt. While an infection to IM doctor has less impact to his/her practice but that is not the same for a surgeon.

 

[will_lam]

PCUMC00, no one questioned your right to post here. The board should be open to all who respect it's rules and purpose.

To put it simply, however, I don't believe your story. You still have not provided any real statistics or sources to back up the numbers or claims you have set forth and have failed to address the many contradictions within your statements.

Out of curiosity though, was your son a graduate of a US school or a foreign program? If he came out of a foreign school, what kind of program was it (carribean-style etc..)?

Best wishes to you and your son.

 

[PCUMC00]

Hi Will. If you think I lied about my son's score, so be it because I cannot Prove his score to you. All I can say is I read it from the mailed results from USMLE. My son graduated from a US top ten Undergraduate and Medical School. Give you a hint about his medical school. His school is PBL based. It is Ivy but it is not Harvard. According to my son, his school Step I score distribution is binodal. One major cluster around 243 and the other minor cluster at 228 with 100% pass rate. I heard someone commented that PBL based schools don't perform well in Step 1 is totally untrue. There is no contradiction in what I posted. Too many high scored asians chasing the top programs.
Good wishes for your future match.

 

[Winged Scapula]

•••quote:•••Originally posted by PCUMC00:
•I heard someone commented that PBL based schools don't perform well in Step 1 is totally untrue. •••••What is true is that the average score on USMLE Step 1 for students from PBL schools IS lower than those from more traditional curriculums. It is not true that they don't do well - that is a function of the individual, but AS A GROUP, they perform worse.