Dec 9, 2010
Post Doc
hey guys..i m an IMG graduated 4 yrs ago with scores(All in 1 st attempt)
92 step 1
81 step 2
CSA passed
77 step 3

i hv 5 month USCE in IM.I was almost luking for airtickets to go back to India permanantly bcoz i ddint get any iv's in IM FM or peds.But suddenly some how thru some connection I could manage to get an iv at maimonides hosp for surg prilim.I hv no dreams of getting into cat surg..I m sure they will not even open my application.But my plan is to get into FM or Peds the next year with this 1 yr USCE in sugery.Do u think this prilim surg exp would be of any help for my peds or FM next year i.e while applying in sept 2011 for ther 2012 match? bcoz after going thru most of the answers abt maimonides surg prilim here ..(some one calling it malignant..n some one saying some suicides earlier..) i feel i am going deep into **** ?

so basically wht r my chances of getting into FM or Peds next yr? Will I look like a fool infront of Peds n FM PD's in the interview when i say I am interested in Peds or FM but now I am doing prilim surg? Do u think it will work? Bcoz I basicaly ran out of options now...either going back to India or signing a prematch ....

Wht do u say?
Dec 19, 2009
Right here
Post Doc
First, a very important suggestion-Do NOT write in text speak, EVER! Always, and I mean, always, use appropriate language.

Second, no one, here or anywhere, can ever answer your "what are my chances" question. If you have read SDN T&Cs, you will know that it is actually not allowed to post WAMC threads.

Having said that, I shall try to address some of your queries. I am not in a position to offer definitive advice regarding whether or not you should sign your prematch, but I hope you might be able to find your own answers after my post (and other experienced posters who I hope will respond).

It is important to figure out the things stacked against you to see why you didn't get any interviews, that alone will help you to gear towards the next application cycle. So your cons:

1. Below average USMLE scores-You cannot rectify that.
2. 4 years out of medical school-You cannot do anything about this either. Have you completed PG training in India in the meantime? If so, in what specialty? If not, what were you doing in these four years? CV gaps are a big no-no.
What are you doing in USA job-wise right now? Your SDN status says Post-doc. If you are working as a postdoc, you cannot just decide to go back to India because you didn't match into a residency! You have to at least try to finish your project/s.

Now the cons that can potentially be rectified, at least for the next cycle:

3. Did you have 5 months of USCE or Observership? And where-Academic powerhouse, small community hospital, or something in between? In what specialty/ies?
There is a big difference in both. USCE is for medical students only, you cannot actually handle patients in any way or form once you have graduated from any medical college in the world without being in a US training program (GME). If you did USCE, that would have been over 4 years ago, so I presume very old dated LORs. If you did an Observership, you just "lurk", you are not involved in anything as such, so though your LORs might be current, they would be lukewarm at best. How can anyone write anything awesome about you when you cannot (medico-legally) show them how awesome you are?

4. You seem to have applied to IM, FM, Peds, and Surgery-all across the board. If you have applied to these specialties in the same hospital/s, and if the different programs come to realize that you are applying everywhere, each might wonder what you really want to do. That is something you have to answer yourself too. Do you want to do a medical or a surgical residency? Or do you just want to do "a residency in America"? Did you tailor your PS appropriately to each specialty? What about LORs? Do you have specific LORs for each specialty you applied or did you just submit your IM LORs?

5. Did you apply on 1st Sept, 2010, with all your paperwork, and all over USA? In other words, did you limit yourself geographically?

#s 3 and 4 can be rectified if you first identify, at least broadly, what you want to do-medical or surgical stream; the latter is going to be (almost) impossible. For the next cycle, make sure that you have different and appropriate LORs and PS for each specialty you are applying for, maybe do another observership somewhere to generate current LORs, and keep your medical experience current. As for #5-apply on 1st Sept., 2011, with your completed application, everywhere across USA. I do understand that these might not be financially feasible options. But I shall come to that later.

So if we work with the scenario that you will (hopefully) match into IM/FM/Peds in this or the next cycle, then the worthiness of a Surgical Prelim comes into question.

You have only been offered an interview, not a prematch, as far as I understand from your post. If you are offered, and you sign the pre-match, you won't be able to scramble into any IM/FM/Peds positions that might be unfilled after the match. I am not sure how many these are and how fast they fill, but historically there are a lot of surgical prelims available in the scramble. It depends on you what you want to gamble on-wait till March, 2011 or not.

If you go ahead with taking up the Surgical Prelim position, you will be an extremely busy scut-monkey, with little to no OR time, and you may even find it difficult to get time off for attending interviews next cycle. Again, what I am writing is what I have heard and read on SDN, no personal experience on this. You might have an altogether different and pleasant experience.

The added fact would be how to explain your Surgical Prelim when interviewing for FM/IM/Peds, etc. Either you have to make up some convincing story of how you felt that having some surgical background would help you gain US GME experience as well as truly appreciate the "intellectual care" medicine provides in treating the whole patient whereas surgeons just concentrate on fixing the problem at hand rather than the whole patient or along some such lines. Or just be truthful and tell them that for you for in the last cycle, it was Surgical Prelim or bust. As far as looking like a fool, it depends on how convincing you can be. However, do not lie, ever.

The other thing I wanted to suggest to you is to try to obtain a research position in any capacity. This is based on my presumption that your SDN Postdoc status is inaccurate, and that you are not working in USA. I apologize if I have mistakenly assumed stuff. If my assumption is correct, you might have to start off as a volunteer in some lab for 1-3 months, and if you are a good learner, and the lab has funds, you could have a job. You will have 3 advantages if you start this search ASAP:

a. If you choose not to sign the prematch, and take your chances in the scramble with IM/FM/Peds/Surger Prelim, whatever position, you will still be able to learn some basic lab/research stuff by March, 2011. It will always help you in future, you are also building contacts.
b. If you do #a., but do not manage to scramble, that will still give you about 3 months of research experience, by which time your lab PI could make a decision whether s/he wants/is able to hire you as an SRA. You would be able to make a commitment of 12-15 months till July, 2012. That would mean a salary and benefits, so you will be financially safe for a while, and it will ease your next application cycle financially. Even if your PI is unable to hire you, s/he might be able to recommend you to colleagues who have funding. This can also generate another LOR for the next cycle.
c. If you get an SRA position, you can generate a much better current LOR, and if you manage to get a poster/publication, it could strengthen your application for the next cycle too.

So I would suggest you take your time to review everything I have said, and make an informed decision that would/could work best for you. Though finances are important, that should not be the only reason to do anything, ever. Good luck.

If you wish some advice/directions about research positions, you can PM me. Again, if i have been presumptive about your Postdoc status, I apologize.