Souidan

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Aug 24, 2014
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Hello all,
First, excuse me if I use wrong terminology or ask some naïve questions since I have a lack of information on this topic.
I am a non-US (Med I) student, and wanted to know about the pathways to surgery residency (i.e: Cardiac Surgery) in the States, which I know is insanely competitive. I have heard that there are other routes to these programs if a student didn't get matched, such as doing a research for one or two years (not sure if they call it fellowship?), then getting a residency spot in surgery. What I would like to know is that if I did these one or two years of research . does that grant me a spot in the residency I want? Moreover, do students in research programs get paid during these years, and what are the average salaries in such case? and finally what is the duration of such routes (Cardiac Surgery, or Research followed by residency)
I would really appreciate answering these questions, and I would be happy if someone could provide me with more details in-depth.

Thank you.
 

dyeguy21

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Sep 1, 2009
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Hello all,
First, excuse me if I use wrong terminology or ask some naïve questions since I have a lack of information on this topic.
I am a non-US (Med I) student, and wanted to know about the pathways to surgery residency (i.e: Cardiac Surgery) in the States, which I know is insanely competitive. I have heard that there are other routes to these programs if a student didn't get matched, such as doing a research for one or two years (not sure if they call it fellowship?), then getting a residency spot in surgery. What I would like to know is that if I did these one or two years of research . does that grant me a spot in the residency I want? Moreover, do students in research programs get paid during these years, and what are the average salaries in such case? and finally what is the duration of such routes (Cardiac Surgery, or Research followed by residency)
I would really appreciate answering these questions, and I would be happy if someone could provide me with more details in-depth.

Thank you.
So its not so much a route as it is an alternate option when it comes to research. Basically, someone that failed to match into Cardiology (to do interventional) or Gen Surgery/Thoracic/Transplant surgery wants to make themselves a better applicant the next time the cycle comes round. So they go and do research for a year or two to enhance their application and then reapply to get a residency. OR they do the internal medicine/general surgery portion of their career, fail to match in the fellowship match, then go do research to enhance their application for the next cycle of fellowship match.

For terminology here we start as a medical student, then become a resident, then we do a fellowship in a specialty if you so choose. After medical school you have a Medical Degree, during residency you get your medical license and are effectively endorsed by your program to work independently, then if you do a fellowship you gain a further endorsement that states you are capable of performing advanced tasks independently.

Generally, if you end up doing research, there can be a stipend or a wage offered for your assistance somewhere in the region of minimum wage or ~20-25k for a full year.

Interventional Cardiology Fellowship goes like this (Edited):
Internal Medicine Residency: 3 years
Cardiology Fellowship: 3 years
Interventional Fellowship: 1-2 years

For Cardiothoracic Surgery (Edited):
5 years of gen surgery
2-3 years of thoracic fellowship
then 1-2 years if you want to subspecialize

http://www.nrmp.org/ will have a lot of information on the residencies as a whole.

Either way research isn't going to grant you any spot that you want. It will enhance your application come residency and fellowship time no matter what, but don't bank on it as an escape valve.
 
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ThoracicGuy

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So its not so much a route as it is an alternate option when it comes to research. Basically, someone that failed to match into Cardiology (to do interventional) or Gen Surgery/Thoracic/Transplant surgery wants to make themselves a better applicant the next time the cycle comes round. So they go and do research for a year or two to enhance their application and then reapply to get a residency. OR they do the internal medicine/general surgery portion of their career, fail to match in the fellowship match, then go do research to enhance their application for the next cycle of fellowship match.

For terminology here we start as a medical student, then become a resident, then we do a fellowship in a specialty if you so choose. After medical school you have a Medical Degree, during residency you get your medical license and are effectively endorsed by your program to work independently, then if you do a fellowship you gain a further endorsement that states you are capable of performing advanced tasks independently.

Generally, if you end up doing research, there can be a stipend or a wage offered for your assistance somewhere in the region of minimum wage or ~20-25k for a full year.

Interventional Cardiology Fellowship goes like this:
Internal Medicine Residency: 3 years
Cardiology Fellowship: 2 years (or 3 years with a dedicated research year)
Interventional Fellowship: 2 years (or 1 more year if you did a dedicated research year the year before)

For Cardiothoracic Surgery:
1 year of internal medicine intern year
4-5 years of gen surgery
2 years of cardiac fellowship
then 1-2 years if you want to subspecialize

http://www.nrmp.org/ will have a lot of information on the residencies as a whole.

Either way research isn't going to grant you any spot that you want. It will enhance your application come residency and fellowship time no matter what, but don't bank on it as an escape valve.
Surgeons do NOT do an internal medicine year. You have 5+ years of general surgery depending on if you do research and then 2-3 years of thoracic surgery depending on the individual program.
 

Law2Doc

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It's possible by "research" the OP means coming to the states and working with people to make connections BEFORE applying to residency. I've seen foreign grads do that plus an externship of some sort to give themselves a better shot. This usually is unpaid. And your success largely depends on the country of schooling we are talking about. It's hard to match into a US residency at all as a foreign educated person, and categorical surgery is currently in the moderately competitive basket. Unless you are a top grad from a major western European school, you'll probably have to do an externship and maybe research here for free to make connections and get exposure to the US system, score amazingly well on the steps and prove yourself in a prelim surgery year to get onto the path you want. And even then the odds are long. Setting your goals on just being a physician in the US (rather than a surgeon in a particular geography or program) tends to be a better approach for foreign schooled people. Depending on your background and numbers becoming a hospitalist in an underserved part of the country may be much much much more realistic than cardiothoracic surgeon in a coastal city. I think your question asking if you do research are you guaranteed a residency of your choosing is the most naive. You would be doing research/externship just to get lucky enough to be considered by any residency in a Given field. There is no shortage of US applicants for the more competitive fields and more desirable geographic locations, so in most cases the non US people are competing for the scraps leftover.

And I think a Focus on salary is probably premature. You have to do what will put you in a position to get a residency, even if it's for free for a year or two. Thereafter Most residencies start you at $45k-$50k and it gies up a few thousand each year, so you'd probably be living modestly for the next 7-10 years on this road.

So I guess the questions to really advise you are: what country are you coming from? What kind of credentials are you putting up (top grad with top step scores?)? Do you have useful research background? Do you have the ability to work/extern for free for a year or two to get some connections and exposure to the US system? And how flexible are you in terms of specialty?

If you tell us you are a top student from Germany with high step scores, research experience, and a willingness to do internal medicine in an underserved part if Wyoming, you'll get a very different answer than a graduate of a developing country's med school with average board scores, no research experience, and who only wants to do cardiothoracic surgery in Boston or SF.
 

typhoonegator

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I unfortunately see this all the time from people who think the cheat code into a U.S. competitive residency is to do a research fellowship. You cannot imagine how many emails I get per week from people who want to do a fellowship in our lab -- many of whom have outstanding CV's. That's who you'd be competing against for a research fellowship, so you need to be honest with yourself.

Some places might let a FMG work for free in a research position, but many do not allow unpaid internships or "volunteer" activities unless they have another source of simultaneous income (like TA'ing or something like that). It's too exploitative, and the last thing a place like Harvard wants to see is some expose in the Globe about some research volunteer who has to panhandle to get money for rent. Plus there are visa issues that might have to be addressed through the employer.

In my lab we often take research fellows with a foreign MD or MBBS who want to use the research position as a foothold towards medical residency in the US. It can be effective. However, we pay them from grant money, they'd better produce (meaning they need to come in with real research chops), and the onus is on me to try to help them get them into residency (or else I look like a bad mentor). So at least I look for people who are top graduates from legit medical universities (Europe, Asia, Middle East mostly), have prior research experience, and have a goal of a clinician-scientist track for their careers. Otherwise I get nothing out of the deal, and I have a hard time placing the fellow (or fail to do so entirely).

There are no guarantees that this position leads to a residency spot. All I can guarantee is a research track record, advice, and great letters if you deserve them. Regarding time of employment, we try for a two year commitment. It takes you six months to learn how to do the work, even if you have prior experience in my field. Then six months to get decent results. Then another 4 to publish if you're lucky, and then you're on the job market again looking for residency hopefully, or another post-doc if you can't hack it. For many fellows, the majority of the publications that come out with their name on it are after they leave, just because of the pace of the science and publication lag.

If you were first in your class in Hong Kong's number one medical university, can program in 4 languages, and worked through medical school in a major research lab that has written glowing letters on your behalf, you are in good shape. If you're coming from Our Lady of Perpetual Debt on some island off St. Kitts, with no prior research experience looking for a ticket into residency, the situation is very different. Like anything else, you will be remunerated according to the market. If you don't bring something to the research position, you aren't going to get much in return. The labs you want to work for are the ones that are hard to get into.
 
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Raryn

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Interventional Cardiology Fellowship goes like this:
Internal Medicine Residency: 3 years
Cardiology Fellowship: 2 years (or 3 years with a dedicated research year)
Interventional Fellowship: 2 years (or 1 more year if you did a dedicated research year the year before)
These numbers are off.

To be an interventional cardiologist you need a 3 year IM residency, a 3 year Cardiology fellowship (with the potential for an optional fourth year as research), and then a 1-2 year interventional fellowship (1 year by default, but 2 years is getting more common because they are integrating peripheral and structural training into interventional training).
 
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dyeguy21

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Sep 1, 2009
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These numbers are off.

To be an interventional cardiologist you need a 3 year IM residency, a 3 year Cardiology fellowship (with the potential for an optional fourth year as research), and then a 1-2 year interventional fellowship (1 year by default, but 2 years is getting more common because they are integrating peripheral and structural training into interventional training).
Surgeons do NOT do an internal medicine year. You have 5+ years of general surgery depending on if you do research and then 2-3 years of thoracic surgery depending on the individual program.
Both of you are correct, apologies for an early AM reply.