Surgery for foreign medical graduates

[socrates89]

hey I wanted to know how the prospects for residency look for USIMG's who graduated from medical school in Pakistan. I just have a few question if you could please answer them

Ok so I was born in the US and did all my schooling up till college (undergrad) in the US and now am deciding to go abroad to study medicine in Pakistan and then come back for residency in the US.

1. Lets hypothetically say that I get a 95 percentile or around a 240 on my step ones and do equally well on the rest of them. Plus do electives here in the US and publish like 3-4 clinical studies in America during the summer when not in medical school. Do I have decent prospects of getting a residency in Surgery (especially neurosurgery or cardiac surgery)? where I want to go?2. When it comes to residency does it matter what foreign college did you go to. For example I have a choice between two colleges in Pakistan King Edward Medical College and Allama Iqbal Medical college, both are well respected but the first has been around for along time and is better regarded. So I'm asking does it matter whcih med school you went to or is it regarded as the same?

3. In Pakistan people go to medical school without undergrad so the time I should graduate I will be 23 years, Will my age have any adverse effects on me getting residency here in the US?

4. Please tell me the reality regarding USIMG's getting residency in Surgery and Why I should or should not go to a foreign med school?

Please give an in depth reply.

If you have any links to information released on USIMG's please post them as added information. Thank You

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[Blade28]

Lots of questions there. I'll try to help...

First, you posted your question in 4 separate forums (General International, Internship/Residency Openings, General Residency, and here). Please do not cross-post. Likely this one will remain open and the others will be closed.

Please clarify - you completed your undergrad at a US institution, or you're about to start in Pakistan? You just finished high school?

There are some great FAQs on some of the topics you've mentioned, including matching into General Surgery as an FMG.

You should also know that with few exceptions, Cardiothoracic Surgery is a fellowship, not a residency. You go through General Surgery first. Please refer to my FAQ at the top of this forum for more information.

It's very hard to answer your question as so much - your medical school performance, your Step 1 score, your publications, etc. - is hypothetical. The best you can do is keep an open mind, do well in med school and on the USMLE Step 1 and 2 CK and see what you're interested in. The better you do, the more options you'll have available to you.

Why are you choosing to attend med school in Pakistan, if all your schooling thus far has been in the US? Out of necessity? Family? Cost? In general, IMGs face a tougher battle trying to Match into US residency spots than US medical school seniors. There are numerous threads on this in both the Pre-Allopathic and International forums.

Age doesn't affect anything. If you're 23 when you finish medical school, you will be young, but that's not an adverse thing.

As a general piece of advice, it's generally frowned upon to demand an "in depth reply" from others - any and all advice/help should be greatly appreciated!

 

[Winged Scapula]

As a general piece of advice, it's generally frowned upon to demand an "in depth reply" from others - any and all advice/help should be greatly appreciated!

Perhaps he was trying to engage in a little Socratic dialogue!

 

[Blade28]

Perhaps he was trying to engage in a little Socratic dialogue!

His (punny) name wasn't lost on me either!

(That's due to me being a nerd and, oh, by the way, also a Latin minor in college.)

 

[socrates89]

sorry about the cross posting I know I got carried away with that

But I've heard from nearly everyone that IMG, or USIMGs get really bad residences. By bad I mean they hardly get their first selection and choice. I really want to pursue surgery and I know that I shouldn't judge before I go to Med school and learn about what I like or dislike. But still is it a really tough time for USIMG's to get competitive residencies in their first choice of field, such as general surgery?

By the way I just finished high school and am in first semester of college but will transfer this coming year to a med school in Pakistan. So if any one has anything do add please do so.

 

[Blade28]

So here's the question: what would you do if we told you that, yes, it was very difficult for IMGs to get into a tough residency?

Would you stay in the US for med school?
Would you pursue a different residency?

Or would you just work harder?

 

[Blade28]

From my limited knowledge of the ECFMG certification, you need to pass the USMLE Step 1, 2 CK, and 2 CS. (Additionally, IMGs are required to be ECFMG to be eligible to take Step 3 later on.) ECFMG also will verify your medical education, transcript, grades, graduation, etc.

I don't know much about the visa process.

 

[socrates89]

Well thats why I'm asking you guys the question because no matter where I do med school here in the US or in Pakistan I'm going to give it all I got. So its not about being lazy the thing is that it takes 5 years there plus better clinical experience (more diversified cases). While over here when applying of residency I would have a better shot at Surgery. So i just wanted to know from anyone who is an IMG and got a spot in the surgery residency how hard it is for USIMG's to get a spot.

P.S. Visa shouldn't be a problem at all since I was born here

 

[Winged Scapula]

This is actually a really interesting question, because my initial gut reaction on reading the question was, "There's no way that anyone would take an FMG from Pakistan who had skipped out on an undergraduate education." However, the (relative) seriousness the Surgery folks are treating this question with makes me think I have made a very incorrect assumption.

Since medical education in countries other than the United States is commonly done right out of high school and is 6 years in length, they are not "skpping out on an undergraduate education" (especially since I could probably very easily argue that the typical secondary education abroad is much more rigorous than in the US, but since our OP is a product of the US secondary educational system, it is not fitting here), but rather following the usual course in their country. The vast majority of FMGs who match into a US residency have done their training the same way - ie, medical school in a 6 year program right out of high school.

So let me and ask this: What exactly are the requirements to get that FMG certification thingy everyone is always talking about? Do you just have to pass the Steps? Does it matter which country your medical school was done in?

To be ECFMG certified you must:

- have a medical degree from a school listed by FAIMER (formerly it was listed by WHO)
- be eligible to practice medicine in the country in which your medical school was located (this generally refers to countries which require a year or more of social service to obtain your degree)
- take and pass Steps 1 and 2 - CS and CK (the TOEFL is no longer required)


Therefore, no distinctions are made for the country in which you train other than the government must approve it as a medical school (which really says nothing ) and it must be listed by FAIMER. There are some states which restrict licenses for graduates from certain medical schools; Cailfornia is most notorious for doing this and mostly for certain Caribbean and Mexican schools. Some of the Pakistani medical schools (most notably KEMC) are well regarded.

Issues like visas or citizenship are not required for ECFMG certification but are generally required to enter GME in the US.

 

[Winged Scapula]

Well thats why I'm asking you guys the question because no matter where I do med school here in the US or in Pakistan I'm going to give it all I got. So its not about being lazy the thing is that it takes 5 years there plus better clinical experience (more diversified cases). While over here when applying of residency I would have a better shot at Surgery. So i just wanted to know from anyone who is an IMG and got a spot in the surgery residency how hard it is for USIMG's to get a spot.

P.S. Visa shouldn't be a problem at all since I was born here

General surgery is still relatively friendly to FMGs/IMGs. However, it would be ridiculous for us to postulate NOW on what the competitiveness will be like in 5-6 years when you are ready to apply for a US residency program. I do not have a crystal ball that goes that far into the future.

I am curious about why you would choose to attend a Pakistani medical school rather than one here in the US, especially after doing all of your other training here. You have effectively significantly reduced your chances of matching just by the fact of going to medical school abroad.

In addition, a PD is likely to look at your decision as rash and uninformed given that you didn't even try to get into a US medical school after going to college here.

 

[Blade28]

In addition, a PD is likely to look at your decision as rash and uninformed given that you didn't even try to get into a US medical school after going to college here.

Perhaps is was an attractive offer?

From my brief review of the OP's past several posts, it looks like he's completed 1-2 years of college here in the US, but is transferring to a 6-year BS/MD (equivalent) over in Pakistan.

I also wonder why you didn't choose to stay here for undergrad and med school.

 

[surgiwho]

Let me first warn you that this is a post you might not like.
My background: HAD to leave the US b/c visa issues and $$, so I went to a med school in South America. Just finished, and applying for GS residency. (As I am writing this I just got ANOTHER denial)

I would NOT recommend that you leave unless you MUST. First, if you think that it will be shorter, it probably wont. You have to take time for the USMLE steps, usually FMGs take 6 months for each (I did each in a month and I am paying the consequences). Then you have to wait for ECFMG certification, which will take a long time, and you must be ECFMG certified to apply for most surgery residencies. On average you will start residency 2 years after graduating from medical school, whereas a US graduate will finish medical school and start a few weeks later. So time wise, not a good investment.

Money: it is going to cost you more on the long run. Just add at least 2 years of taking the steps, interviews and match. You must also apply to 50 more programs than an average USMG. End of story, not worth it at the end.

As far as getting into residency, here is the hard part. If you can settle for a non competitive specialty, go for it. But if you want a competitive specialty (surgery is very competitive right now and probably will stay competitive) then you are in for a rough ride. Is it possible? I hope so, or else I am f064ed. Also, things are changing so by the time you come back who knows what would happen.

If you don't have to leave, DON'T.

 

[Blade28]

That's some blunt, sage advice.

To the OP, can you please explain your rationale for moving overseas for med school? It might help this discussion.

 

[shahroseamir]

Although op was born and raised in US but technically he is also a citizen of Pakistan. In pakistan, medical education is funded by government. So the student only have to pay for living expenses. Even if op is going there on an international student seat, the cost will be around 1% of what he will have to pay here in US.
OP......... for you the truth is that if you really want to do surgery, forget about KEMC or AIMC.
A friend of mine is a graduate of KEMC, 95/97 scores, MPH in US, 4 peer reviewed pulications, During MPH he was also doing lab research, Permanant resident in US, excellent LORs from US MDs and still no Interview from general surgery. This might help you decide.

 

[Blade28]

If money is a concern, then that's a plausible reason - though personally, I'd prefer taking out loans since it's so much tougher for IMGs to come back here for residency.

 

[socrates89]

I'm in my first semester of College (undergrad) and I've been accecpted to med school and I will start med school in December but I haven't made up my mind 100% on med school in Pakistan.

Money isn't a problem neither is me not getting into med school in the US I probably will. The thing is that my parents don't want me going to med school they think its too competitive and there's a chance I might not get in and they don't want to risk it . From Pakistan I'm sured to get my degree at the very least if not residency. Also they believe that its too hard for pre-med becasue you have to shadow, research get EMT good MCAT scores and etc. Its like your a slave where as its nothing like that in Pakistan.

Also I wish to learn about the culture there becasue after residency and like working in America for like 10-15 years I wish to go back to Pakistan and work there?

Med school in Pakistan is 5 years not 6. I was thinking of doing it like American med schools. Thereby taking my USMLE 2nd or 3rd year so by the time I'm done with med school Ill be set with the USMLE and with the two months in every summer I could probably come to the US and do research at the labs I'm already in and publish some stuff and do more of extra-curricular things. So how does it look do you guys think I could pull it off or will be shooting myself in the foot.

also shahroseamir can you tell me how many years your friend has done research after med school. Has he done research for 4 years and not gotten a residency spot thanks and please give me more info on your firend like recently what he is doing.

 

[Blade28]

Enlighten us - have you already accepted this med school spot, or are they still waiting for your decision?

Better question - do you already have your plane ticket to Pakistan for this December?

 

[Winged Scapula]

I'm in my first semester of College (undergrad) and I've been accecpted to med school and I will start med school in December but I haven't made up my mind 100% on med school in Pakistan.

December isn't too far away as I'm sure you know.

Money isn't a problem neither is me not getting into med school in the US I probably will. The thing is that my parents don't want me going to med school they think its too competitive and there's a chance I might not get in and they don't want to risk it . From Pakistan I'm sured to get my degree at the very least if not residency.

It sounds as if you and your parents believe that by going to school in Pakistan you are assured of graduating with a medical degree whereas if you complete your college education in the US, it is uncertain as to whether or not you will get into medical school.

Also they believe that its too hard for pre-med becasue you have to shadow, research get EMT good MCAT scores and etc. Its like your a slave where as its nothing like that in Pakistan.

Fair enough, as it is true that medical school in the US is competitive, that things beyond grades count and there are some "hoops" to jump through that you apparently will not have to do in Pakistan.

I doubt most pre-meds would consider the requirements for medical school "slavery" and in fact, having to work hard to attain something is a desirable quality in the US. BTW, don't become an EMT...if there ever was a Pre-Med myth about the requirements, this is it.

Also I wish to learn about the culture there becasue after residency and like working in America for like 10-15 years I wish to go back to Pakistan and work there?

Is that possible? Please research the requirements for medical training to make sure that if you obtain your residency training in the US and never do any in Pakistan (not even an internship) that you would be eligible to work there as a physician.

Med school in Pakistan is 5 years not 6. I was thinking of doing it like American med schools. Thereby taking my USMLE 2nd or 3rd year so by the time I'm done with med school Ill be set with the USMLE and with the two months in every summer I could probably come to the US and do research at the labs I'm already in and publish some stuff and do more of extra-curricular things. So how does it look do you guys think I could pull it off or will be shooting myself in the foot.

I think you are making it much more difficult for yourself to obtain a residency in the US, especially in a competitive field like surgery. What if you found you *really* wanted to do Derm, or Neurosurg or Plastics? Pretty much impossible as a foreign grad. You will significantly limit your choices unless you are considering a primary care field.

The question to ask yourself and your parents is:

given that I have a guaranteed acceptance to medical school in Pakistan, would I be willing to accept that I might not get to choose what field of medicine I could practice in the US by going abroad?

If you were to stay in the US, there is no:

guarantee that you would get into medical school
guarantee that you would do well enough to get into surgery

So its a tough situation. Do not go to medical school in Pakistan to:

save time
save money
learn about the culture (there are better ways)
because you think it won't make a difference when it comes to applying for residency

If you can accept that you might not be able to get into whatever field you want because of the issue of being an IMG, then go ahead. But I can imagine US PDs would still look askance at someone who didn't even try to get into a US medical school and took the "easy route" of a guaranteed Pakistani acceptance without fully understanding how it might cripple his future career in the US.

 

[socrates89]

Ok so I've already been accecpted to med school in Pakistan but haven't given them the thumbs up to go for sure. I have like a week or two before giving a decision.

But Kimberli Cox do you really mean it when you say that I have no chance of getting in surgery like 0, because I want to start out with general surgery but my real passion is Cardiac Surgery or neurosurgery since I'm already doing basal fore brain research. I was hoping that maybe if I worked my but off with 4-5 publications, 230-240 USMLE step scores and a lot of electives in college here in the summer. I might have a decent shot at surgery; any type. Speaking very hypothetically lets just say if all that happens how do my prospects look.

Is there anything I can do to improve my chances of getting into some form of surgery if I do choose to go to med school in Pakistan.


Also I've seen that some people one person at UMDNJ graduated from an Indian Med school an in order to get a competitive residency is now doing neuro-science research for like 3-4 years now. Does something like that have any bearing on helping a person get into surgery.

 

[Winged Scapula]

But Kimberli Cox do you really mean it when you say that I have no chance of getting in surgery like 0, because I want to start out with general surgery but my real passion is Cardiac Surgery or neurosurgery since I'm already doing basal fore brain research.

I don't recall ever saying you had NO CHANCE of getting into surgery, just that:

you have significantly decreased your chances (but not to 0) by training outside of the country

Neurosurgery has its own residency, BTW - you do not "start off " with general surgery except as a Designated Prelim in some programs.

I was hoping that maybe if I worked my but off with 4-5 publications, 230-240 USMLE step scores and a lot of electives in college here in the summer. I might have a decent shot at surgery; any type. Speaking very hypothetically lets just say if all that happens how do my prospects look.

Obviously excellent USMLE scores, publications and USCE will help your application but I will be honest and tell you that there ARE programs that will not accept anyone who is a foreign grad. By using ERAS filters, they can remove applications from anyone who is ECFMG certified, who doesn't have a Step 1 score of x, etc.

Is there anything I can do to improve my chances of getting into some form of surgery if I do choose to go to med school in Pakistan.

What you've described above: great USMLE scores, USCE, US LORs, research and publications (but these will be most important at research institutions. Community hospital x really doesn't care about your research.)

Also I've seen that some people one person at UMDNJ graduated from an Indian Med school an in order to get a competitive residency is now doing neuro-science research for like 3-4 years now. Does something like that have any bearing on helping a person get into surgery.

I'm not sure what you are saying here. Are you asking if doing several years of research during medical school will increase your chances of getting into a surgery residency (not sure if the guy at UMDNJ is a student or current resident and how he fits into the picture)?

If so, sure...it may increase your chances at programs with active research labs. Doing research just for the sake of it isn't necessarily a plus for some programs, especially those that do not have labs...they will figure they cannot provide you with the residency experience you are looking for.

Bottom line is that we cannot tell you how competitive general surgery will be in 5 years when you are ready to apply, although Neurosurgery is almost assured to still be competitive. Nor can we tell you what your chances will be. Its all very well and good to say you will "get a 230/240" on Step 1, but its all a pipe dream right now.

As I said earlier, there are no guarantees...you might stay here, go through all the pre-med machinations and not get in...or you might. You could go to Pakistan, finish medical school there and not match into surgery...or you might. But the fact is that regardless of your achievements during medical school, training abroad decreases your chances of matching and reduces it to zero at some programs that do not accept applications from IMGs.

Its up to you as to how much risk you wish to take and where you take it.

 

[Blade28]

I was hoping that maybe if I worked my but off with 4-5 publications, 230-240 USMLE step scores and a lot of electives in college here in the summer. I might have a decent shot at surgery; any type.
...
Is there anything I can do to improve my chances of getting into some form of surgery if I do choose to go to med school in Pakistan.

You're not listening to her wise advice.

It seems like you've already made your decision and just want us to validate it.

And how can you already be predicting your USMLE Step 1 score when you're barely a year out of high school and are planning on skipping the MCAT? Very premature, IMHO.

So tell us the truth - is this decision already made up in your mind? Is there anything we can say to change your mind at this point?

BTW, having the mindset of going to med school in Pakistan to "skip" the MCAT, common pre-med pre-reqs, etc. doesn't bode well for when you'll have to step things up come residency application time. You want the discipline, hard work ethic and self-motivation to be able to go through the rigors of medical training.

And you're trying to go back to Pakistan to save time and trouble...yet are considering taking time off (1-3+ years?) to do dedicated research? Wouldn't it just be easier to go to a US med school and avoid all that?

 

[surgiwho]

Are you shooting yourself in the foot? NO, you are shooting yourself in the head.

I don't know if anything we say will change your mind, I think you've made up your mind.

From someone coming from a similar position, I will tell you that I thought the same before I left. Granted I HAD to leave, I still thought it would be the same. 5 years of school + 2 years for steps, etc. You are at 7 y. at least. And if you think getting into medical school is tough, getting into surgery or neurosurgery, coming from a Foreign school is WAY TOUGHER!!! Your friend at UMDNJ has been doing research for 3-4 years. Add that to the tally and you'll see that you are 10 years in without a guarantee of getting into surgery. I got 93 and 99's and there are hundreds of people with steps higher than that, I only have 2 interviews so far ( John Hopkins and Mass General ). At least if you go to med school here and do well you are pretty much in the drivers seat, but if you go to Pakistan do well in school and in your steps, do research, etc., the only thing you are in the drivers seat is for a preliminary spot, and from what I hear you do not want that.

My advice, tough it up and stay here. Go to Pakistan after residency. Either way good luck and have a safe flight.

 

[TUANANH]

Sorry! I tried to find the training program for medical student of Vietnam ,I will graduate in 2009 but I don't know any way for studying in higher grade
Would someone help me? I know that my license is not regconized in US,UK.

 

[Winged Scapula]

Sorry! I tried to find the training program for medical student of Vietnam ,I will graduate in 2009 but I don't know any way for studying in higher grade
Would someone help me? I know that my license is not regconized in US,UK.

The process of getting into graduate medical/residency training in the US is the same for everyone who attends medical school outside of the US and Canada. It does not matter whether you studied in Vietnam, Korea, Brazil or Russia.

Your first stop should be ECFMG: http://www.ecfmg.org It will explain the steps you need to take to be ECFMG certified and to enter graduate training in the US.

US residency positions are almost all offered through some sort of centralized match service; usually the NRMP: http://www.nrmp.org Prior to applying for a position you should have completed at least USMLE Step 1 and preferably USMLE Step 2 CS and CK. Many would suggest you also have your ECFMG certificate prior to applying as some programs will request it. You cannot obtain your certificate until you have a final medical diploma, therefore for most people, this means a year lab between finishing medical school abroad and starting a residency in the US.

While you are still in medical school, if you are thinking about training in the US, you should consider the following:

- most programs will want a Dean's letter. Most foreign schools are not familiar with this concept. You will need to speak with the Dean of your school about writing a letter which summarizes your performance in medical school, class rank, excerpts from evaluations completed during your clinical rotations, etc. In addition, you will need letters of recommendation for application to US residency programs. If you are applying to surgery, these letters should come from surgeons.

- you should consider applying for final year electives in the US; most places want to see some US clinical experience and this can help you also get a letter from a US surgeon or two. These are discussed at length in the International Forums so I suggest you look there for further information.

Hope this helps...

 

[TUANANH]

thank Kimberli Cox so much,I will study your side

 

[surgiwho]

Also don't forget to look if your school is in the IMED directory. Website link in the ECFMG website.
Good luck

 

[peace zealot]

i am currently studying in medical school in pakistan and completed my 2nd year.from december i will start up my 3rd year.that is the year we will star going to wards and i will get an idea of how the hospital environment is and will get a close exposure of different speciality fields and then i might be able to made up my mind which speciality is attracting me.....up till now i have no idea and have not let my mind decide blindly....
i want to get a residency in US and well finally upto the question:should i make up my mind about any field and stick to it or should let my mind and options free till i take usmle and is through all the process......

 

[Jackofknives]

Reading through the above posts can be very discouraging. What Dr. Cox and co are trying to tell you is that your choice to study med in Pakistan would make your career path exceedingly twisted if you wish to obtain a residency for a competitive specialty in the US. So unless you don’t have to move, it is irrational to study abroad.

But can you still match if you were an IMG? Ofc you can. Is it going to require a lot of effort? You bet. There are numerous instances of IMG matching into competitive specialties like NS every year, some even got into high calibers like Hopkins and Baylor. So if you wanted to get in through the front door you d have to work you’re a** off and obtain a stellar credential, duel 250+, 4-5 first author papers, do SubI and impressive everyone with your work ethics, moral and knowledge. Even if you did’t match with this credential (which is unlikely) you can do pre-residency fellowship and be extremely passionate about it, no PD is goin to be this ignorant and fail to see this hidden gem.

All these come with a price tag, which means that you r not going to have a life for 6 – 9 years, it s all a matter of how much you want this.

 

[Winged Scapula]

i am currently studying in medical school in pakistan and completed my 2nd year.from december i will start up my 3rd year.that is the year we will star going to wards and i will get an idea of how the hospital environment is and will get a close exposure of different speciality fields and then i might be able to made up my mind which speciality is attracting me.....up till now i have no idea and have not let my mind decide blindly....
i want to get a residency in US and well finally upto the question:should i make up my mind about any field and stick to it or should let my mind and options free till i take usmle and is through all the process......

I see no reason to decide on your specialty now, before you have even started ward clinical rotations.

You can take the USMLE at any time. I recommend you see which field interests you, take the USMLE and other steps toward a US residency and apply for the field which you like.

 

[Blade28]

Agree with the excellent advice posted above.

I'm a big fan of keeping an open mind during your clinical rotations.

 

[peace zealot]

i will be able to take usmle after final year...although i can take it in 3rd year...but it would be a foolish act to take it before completing graduation because we dont get even a single month free of our school's assignments.
i am of the same opinion that before experiencing how can i say what are my interests....but till i will complete my graduation i will be able to decide......what i was trying to ask is that:is it good to decide speciality fields before having usmle score in hand as i would be an IMG.....or let the score decide what my chances would be....and decide accordingly...

 

[Winged Scapula]

i will be able to take usmle after final year...although i can take it in 3rd year...but it would be a foolish act to take it before completing graduation because we dont get even a single month free of our school's assignments.
i am of the same opinion that before experiencing how can i say what are my interests....but till i will complete my graduation i will be able to decide......what i was trying to ask is that:is it good to decide speciality fields before having usmle score in hand as i would be an IMG.....or let the score decide what my chances would be....and decide accordingly...

While it is true that USMLE scores can help determine what your career choices are, I would not necessarily use them to make that decision. I mean if your heart is set on Orthopedic surgery and your USMLE scores are less than average, would you not even try and apply? You should try and get the best score possible and apply for whatever interests you, knowing that if your scores are sub-par you may not match into your choice. But wouldn't you rather know you at least tried to get into your specialty of choice rather than resigning yourself to something else?

 

[CattleprodSurg]

I am a FMG in a surgery residency.
You pose a very interesting question. Many Americans would love to skip college to go directly to med school graduating at 22-23 years old.
Education in some of the schools in Pakistan is excellent. I have seen some excellent surgeons from there.
Problem is you will be biased against here in the US when you try and return. There are no guarantees or absolutes either way just chances and statstics and each person has a unique set of circumstances.
Roughly speaking, if you are in the top 10-20% of your class -I'm sure a dedicated guy like you will be there, an American graduate will most likely get as many intrerview he likes and match in the top 1-3 choices.
If you are in the same 10-20% from Paki you will scrape together maybe a handful of interview from small programs, a couple of interviews for prelim jobs and maybe an interview from one or two open minded big name residencies if they have a Pakistani on the staff.
You may or may not match in that case.
Statistically chances are slim but not impossible.

But travelling is fun, learning a new culture is interesting. Your education will likely be good. Keeping an open mind is important.
Your circumstances are unique - that's why you're getting lots of responses to this post. As a chief resident and involved with selecting students I would be interested in interviewing you.
Good luck

 

[peace zealot]

While it is true that USMLE scores can help determine what your career choices are, I would not necessarily use them to make that decision. I mean if your heart is set on Orthopedic surgery and your USMLE scores are less than average, would you not even try and apply? You should try and get the best score possible and apply for whatever interests you, knowing that if your scores are sub-par you may not match into your choice. But wouldn't you rather know you at least tried to get into your specialty of choice rather than resigning yourself to something else?

ya thats why i am asking if heart gets set once its too.....difficult to change mind....in case my heart gets stick to some highly competitive field then i will be all in fire, isnt it........secondly if i take usmle and dont match for a residency.....money investment will go to dump(for me paying for exam and applications would be a big amount)...so......???
another point i want to ask if i do speciality(postgraduation) from pakistan or UK(say FRCS),australia etc... and become a consultant would i be eligible to practice in USA.what would be the requirements then.....

 

[Winged Scapula]

ya thats why i am asking if heart gets set once its too.....difficult to change mind....in case my heart gets stick to some highly competitive field then i will be all in fire, isnt it........secondly if i take usmle and dont match for a residency.....money investment will go to dump(for me paying for exam and applications would be a big amount)...so......???

True. You would be taking a risk if you were to apply for a competitive residency without the typical academic requirements and it can be costly. But in some cases, the money is worth spending. However, if you can see yourself happy doing something else in which you have a better chance of matching, then you may choose not to try and apply for the more competitive field.

another point i want to ask if i do speciality(postgraduation) from pakistan or UK(say FRCS),australia etc... and become a consultant would i be eligible to practice in USA.what would be the requirements then.....

No. The requirements are the same whether or not you have just graduated from medical school abroad, or have completed a residency and are a consultant and perhaps a fellow of the relevant college. You still have to take USMLEs, get ECFMG certified, etc and enter a US residency.

In rare cases, such as someone who is recognized as an international authority in his field, you may be able to obtain a position of employment in the US - typically at academic centers - without repeating your basic and specialty training. These days this is pretty unusual.

For almost everyone else, you must repeat your residency training in the US if you want to work here. You are not generally given any credit for training abroad, being a fellow of a college, etc. You would go the same route to residency in the US as everyone else. NB: this is true for surgery (which I verified with both the College and Board of Surgery) - you must do your residency here to be considered BE. However, there may be certain circumstances in which you can be licensed and work without training here or being BE. Lastly, this may not be true (ie, having to train in the US to be BE/BC), so word to the wise: check with the relevant state medical boards and board of your chosen specialty before making decisions about training.

Remember that in the US, payors and employers are moving closer to requiring their physicians to be at least Board Eligible. To be BE, you must train in the US or Canada. Therefore, you should plan on training in residency in the country you wish to work permanently.

 

[peace zealot]

well socrates showed the intentions to settle in pakistan after 10 to 15 years....well i want to ask have you ever been to pakistan and are you aware of daily lifestyle of a pakistani....even i cant cater the cultural needs here...then you are an american.whats the motivation behind your coming to pakistan.......well if you are going to stay in hostel during your graduation it will all be clear to you soon how much goodness was there in your decision to graduate from pakistan.
now talking professionally you will take a long long time to adjust in your work place because of the conditions here.......in government hospitals the worst conditions are present.....its like working in a miny medical camp....or even worst than that(may be i am exgerrating but i have seen although not worked yet)....language problem will pose a big problem as most patients here cant even speak good Urdu(the national language) ,no question of english...as they belong to poors of our society and make a majority.....and you have to face that at least 2 years during your graduation.
and lastly cant you see majority pakistani doctors are running to US and other european country to get out of that hell.......are we mad...who dont wish to be there in his motherland.......
in short if i had been an american born and raised i would have gone for an american medical school whether it would take me 10 years to enter or i have to take millions of loans....but at least after knowing conditions in pakistan i would never opt for pakistan....
no means to discourage you but just make you aware of ground realities because we have many foreign companions in school and these problems are regularly faced by them.....if you have decided then make up your mind to face all that and make your spirits high.........plus get aware of conditions in hostels and make your room fairly comfortable because this is the very first spot that poses problems to foreign students.....

 

[GodoShingo]

May I hijack the thread?
My education in my university is already approved by WHO and other intitutes, which I have seen in the following links you have offered here.
If I do the USMLE tests and such necessary things (I would preferrably do them when I have fresh memory of what I have learned that covers them), will I be able to do my surgery residency in the US?

Let's list the factors up:

1)I write every necessary test with a high score
2)I know people that are known in certain hospitals that work there that could pull some strings
3)My med-school is certified and meets all expectations
4)The education in my med-school is entirely in English with English litterature (we have used Netter and such)
5)My education is complete before med-school

What do you think? For me it's not the world if I can't do my residency in the US, mainly it's because that there I have relatives and somewhere to stay that I want to go there.

Give me your honest answer. If any questions, you can ask.

 

[Blade28]

Let's list the factors up:

1)I write every necessary test with a high score
2)I know people that are known in certain hospitals that work there that could pull some strings
3)My med-school is certified and meets all expectations
4)The education in my med-school is entirely in English with English litterature (we have used Netter and such)
5)My education is complete before med-school

While the prestige of your med school MAY help (doubtful, though), in the end all that matters is the aforementioned factors:

*ECFMG certification
*Good scores on the USMLE Step 1, 2 CK, 2 CS (pass)
*Strong Dean's letter and letters of recommendation
*Research and other extra-curriculars are a plus

It always helps to "know" someone in the hospital to which you're applying, but of course how much pull do they really have with the residency program? Knowing a famous cardiologist, or pediatrician, etc. at X University Hospital won't help much.

Having a great command of English is also a plus.

 

[Winged Scapula]

Just to add onto the excellent advice given by Blade above:

"pullings strings" is a lot less a common practice in the US than it is abroad.

Obviously it does happen and can be important to know well-regarded people in small fields like PRS and Derm. However, by and large, from my experience abroad, it appears that things like pulling strings and "questionable" admits are much more common outside of the US than they are here. Such behavior can get universities sued here.

US Clinical Experience (USCE) is vitally important in maximizing your success. This means doing electives in the US while you are still a medical student. Observerships do not count. It is true that people do match without doing the same but even aProgDirector here has posted that without USCE he discards applications (and verifies the fact that observerships are worthless in the eyes of most PDs).

 

[Blade28]

US Clinical Experience (USCE) is vitally important in maximizing your success. This means doing electives in the US while you are still a medical student. Observerships do not count. It is true that people do match without doing the same but even aProgDirector here has posted that without USCE he discards applications (and verifies the fact that observerships are worthless in the eyes of most PDs).

Argh, how could I forget that?

I see that acronym thrown around SO often!

Usually the post is something like:

"Hi everyone, I've written the steps already, 91/93/pass (all first attempt), no GC, 6 months USCE, 4 observerships, 2 second-author publications in peer-reviewed journals, J-1, ECFMG-certified, one US LOR, what are my chances?"

 

[Winged Scapula]

You obviously don't spend enough time in the International Forums where the use of acronyms (and text-speak) is rampant!

 

[Blade28]

You obviously don't spend enough time in the International Forums where the use of acronyms (and text-speak) is rampant!

But I used to spend lots of time browsing a particular USMLE-based website where near 100% of the posts were of a similar nature.

 

[Winged Scapula]

But I used to spend lots of time browsing a particular USMLE-based website where near 100% of the posts were of a similar nature.

Thn no xcuz 4 u!

 

[Blade28]

Thn no xcuz 4 u!

I would try to respond but I don't even know where to begin!

 

[GodoShingo]

Thanks for responses Dr. Cox and Dr. Blade, they were helpful!

 

[TUANANH]

would someone tell me about scholaship Because My parents will not have enough money for me to learn in other countries outside Vietnam
I know medicine in US and UK is best but the spending for school,activities fees is too high for Vietnamese families to pay,because salary of Vietnamese just be 200-350$ every month.So that .....I hope someone help me !
I try to get much information,and I hope I can pass step I,II to be accepted.
Thank you so much!

 

[Winged Scapula]

would someone tell me about scholaship Because My parents will not have enough money for me to learn in other countries outside Vietnam
I know medicine in US and UK is best but the spending for school,activities fees is too high for Vietnamese families to pay,because salary of Vietnamese just be 200-350$ every month.So that .....I hope someone help me !
I try to get much information,and I hope I can pass step I,II to be accepted.
Thank you so much!

I am confused. Are you asking about scholarships for residency training in the US or medical school?

Residencies in the US are PAID; you get a salary, so scholarships are not available or necessary. There are no "school or activity fees" associated with graduate medical training.

You would have to have the money to get to the US for interviews, and to move here. There may be some scholarships or funds for these things available to you, but I would not know details about them because they would be private (ie, not offered through the university).

If you are asking about medical school (which seems unlikely since you list yourself as a medical student and comment about USMLE Steps), generally scholarships are for small amounts rather than full tuition and typically not available to non US citizens. Perhaps someone in your home country would have more information about such resources.

 

[TUANANH]

Thank Dr Kimberli Cox !
I knew some doctors who know information of USMLE but all information which I have is not clear.So I try to get much information.
thank you again!

 

[socrates89]

Question: which looks better about 4-5 Basic science research publications with a least 1-2 1st author publications

or

8-10 clinical research publications




What is the best combination that I should be aiming for to best the average pool of application's and set myself apart??