to all IMGs....

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I thought this thread was locked. Did Kim Cox (or someone else) unlock it?

Either way, this is clearly a stupid thread that contains a lot of misinformation. Buyer beware.

-Skip

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El Duderino said:
I think a lot of the emotion invested in this issue stems from the failure to distinguish between two different contentions regarding American citizens who go abroad for medical schools (FMGs) and foreign citizens who complete medical training in their homecountry and decide to go to the US for residency (IMGs):
You got it wrong -Americans who go abroad for medical schools are IMGs
foreigners who complete medical training in their homecountry and go to the US for residency are (FMGs) :cool:
 
You got it wrong -Americans who go abroad for medical schools are IMGs
foreigners who complete medical training in their homecountry and go to the US for residency are (FMGs)


I don't think that anyone outside of this forum is using the I vs the F to make that distinction (whichever way around).

ECFMG in their reports only knows 'International medical students/graduates' and lists their performance separate for 'U.S. Citizens' and 'Foreign Citizens' (don't know how they treat permanent residents).
 
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El Duderino said:
I think a lot of the emotion invested in this issue stems from the failure to distinguish between two different contentions regarding American citizens who go abroad for medical schools (FMGs) and foreign citizens who complete medical training in their homecountry and decide to go to the US for residency (IMGs):

1) FMGs receive superior training vs IMGs receive superior training.

2) FMGs are more attractive to PDs vs IMGs are more attractive to PDs.

Personally, I must say either debate is pretty stupid, but 1) even more so than 2).

I agree (1) is especially stupid in light of the fact that some countries are taking a large number of international students -- who are presumably getting the same education as the local students.

I have also heard the terms IMG and FMG used the other way around. Anyway, is there any official distinction between the two. By official I mean differences under ECFMG, differences in licensing requirements, etc. (not some individual's elevated sense of self-worth).

I am under the impression that you are either a graduate of a US medical school or you are ECFMG.
 
f_w said:
(If I ever had to choose between an aussie who got into an aussie medschool the regular way and an american exilee, guess who I would choose ?)


Remember, now you are the "exilee"! (At least the plight of an exilee doctor in the US is much better than that of an exilee doctor in Australia.) And as such, your opinions in regard to such matters probably won't count for much anyway.

As for your "tough" decision above, if you are in the US and that's the only criteria, you don't have much of a choice. :laugh: Check out the relevant law.

Years of post-graduate experience in the US being equal, from an educational standpoint, I'd consider both groups equally subpar when compared with those who graduated from US (or even the better Carribean) schools. Two years of residency in the US vs. 2 years "pre-vocational" JMO dilly dally in Australia -- I'd take the person with the US experience. I'd make sure I was complying with US law though.

We also need to remember that the Australian system is two-tiered in respect to its local students -- with the sharp ones entering medical school after high school and the lower-ranked ones going through 3 years "pre-med" and then applying to so called "graduate entry" medical programs (where the most important factor in admission is being able to sufficiently yap your way through an interview). While we're at it, may be we should distinguish between those two groups of Australians.

Do Americans have an advantage in America? Sure, they do.
 
Do Americans have an advantage in America? Sure, they do.

And they need it, to make up for the overall weaker USMLE performance ;)
 
IMGDoc2b said:
im not sure which caribbean school students you have rotated with, but the majority will NOT allow them to start clinical clerkships until they have taken and passed step 1. At a max they may be allowed one clerkship while waiting for pending results, but if they do not pass they are not allowed to continue with clerkships.

for detailed info about the various schools you can visit www.valuemd.com,
theres a whole wealth of information there about the different caribbean schools.

Majority of my friends and I all scored 215 or above on step 1, on first attempt and studied between 3 weeks and 10 weeks max for the exam.

Ross University allows starting 3rd year clinical rotations in the USA, while the student is waiting for the step 1 score. But there is a minimum GPA requirement to be qualified for this.
 
Hi!!
I veiw you as a optimist. Please can you help me. I have many attempts in my USMLE steps. How much chance do I stand for securing a residency in Ob/Gyn. I have research experience in US and I practiced in my home country.
 
For all its worth, my limited experience too suggests the same as f w.

The quality of non US IMG applicants as compared to US citizens who have gone to Caribbean & Europe for med school tends to be better inspite of them having no visa issues and better information as compared to the rest of the applicants.

Also, I am yet to come across of a convincing reason for US students to do their Med School outside US and esp in caribbeans and Eastern Europe other than to save money or not being able to land up in an US med school in the first place.

There, I said it..

That being said, at the end everybody does get inside the US residency system.
 
Santiago said:
The quality of non US IMG applicants as compared to US citizens who have gone to Caribbean & Europe for med school tends to be better inspite of them having no visa issues and better information as compared to the rest of the applicants.

Are you comparing apples to oranges? I think most "non-U.S." IMGs probably have a far longer/greater clinical experience than any fresh-out-of-school recent med grad, be they a Carib (or other) or even a U.S. allo/osteo grad. It's an unfair comparison to make between, say, a non-U.S. IMG who has 10 or so years experience (as is usual) as a practicing attending in their home country who then decides to come to the U.S. and is required to complete a compulsory residency.

(And, if you choose to respond to that point, please at least try to be intellectually honest.)

Santiago said:
Also, I am yet to come across of a convincing reason for US students to do their Med School outside US and esp in caribbeans and Eastern Europe other than to save money or not being able to land up in an US med school in the first place.

File that one under the "Duh!" heading. :laugh:

-Skip
 
The people I know, don't have too long clinical experieces. That being said, I would also accept that they have have taken much longer prep times for taking Usmle Step 1 & 2's, sometimes as much as six months.... while I do beleive AMG's take their Steps after just 6 to 8 weeks of prep. But, non US IMG's also have to reoerient themselves to american syllabi and Usmle styles questionnaire. I guess you too would agree that there are far too many variables to make a valid and pertinent observation.

Regarding your 10 or more years of attending experience for most non US Img's, please get your facts straight. You are doing the same things which you have been accusing others of.

Finally, instead of giving a "duh" heading which is a very informative response, I stand by my experince. It may be wrong, but thats what I encountered.

Your landing a Gas residency doesn't make Ross a great school. Give yourself more credit and less to your school.

Btw, what was the clinching factor for you regarding your choosing Ross over any med school in mainland US?

Regards..
 
Santiago said:
The people I know, don't have too long clinical experieces. That being said, I would also accept that they have have taken much longer prep times for taking Usmle Step 1 & 2's, sometimes as much as six months.... while I do beleive AMG's take their Steps after just 6 to 8 weeks of prep. But, non US IMG's also have to reoerient themselves to american syllabi and Usmle styles questionnaire. I guess you too would agree that there are far too many variables to make a valid and pertinent observation.

I would agree that your original statements, that you've since clarified above, were incomplete and inaccurate. There are, in fact, studies that have been done that demonstrate clearly that "true" IMGs have superior scores in certain areas of standardized tests (i.e., Anatomy) and perform poorly in others (e.g., Behavioral Science). There are also many other reports, some observational and others quantifiable, that demonstrate many non-U.S. IMGs perform poorly in doctor-patient relationships, an incredibly important factor from the patient's perspective.

In other words, your toss-away statement that overall in comparison that on the whole a non-U.S. IMG "tends to be better" than a Caribbean/European-trained U.S. IMG is the type of meaningless, anecdotal, unsupported opinion that I object to. It depends on who you ask and what parameters you are looking at, in which case your blanket opinion means nothing in the grand scheme of things.

Santiago said:
Regarding your 10 or more years of attending experience for most non US Img's, please get your facts straight. You are doing the same things which you have been accusing others of.

Ah! So you agree that it's unfair to make general, broad-sweeping statements that aren't supported by facts? Can I infer that from your objections to my statement? Do you get the point? ;)

Santiago said:
Finally, instead of giving a "duh" heading which is a very informative response, I stand by my experince.

Thank you, Captain Obvious. My only point of responding to your point was that it was self-evident and doesn't need stating. Maybe that idiom doesn't translate well to your native tongue.

Santiago said:
Btw, what was the clinching factor for you regarding your choosing Ross over any med school in mainland US?

Circumstantial ad hominem that doesn't deserve a thoughtful response.

-Skip
 
- 10years of experience abroad would be a handicap in passing the USMLE's rather than a benefit.

- Maybe ECFMG has some stats on this, but most of the FMG's I have encountered during residency either came fresh out of their medschool back home or had maybe 1-2 years of residency training under their belt (yes, anecdotal evidence. If you have study demonstrating 10yr attending experience for the average non-citizen-IMG come back).

Imho, the poorer performance of US-IMGs compared with non-US-citizen-IMGs is a reflection of the selection bias that got people into the position they are in. Admission and graduation from medical school is a competitive process in most countries. The graduates have proven that they are good test takers before they even get to take the USMLE. The US-IMG crowd otoh got into the position they are in by being not so great test-takers in undergrad and MCAT. A difference in performance on a standardized test like the USMLE is therefore not suprising.

(With the overseas IMG schools, you can observe an interesting 'Lake Wobegon' phenomenon: All schools are above average! Even though 4 schools represent 60% of the US-IMG pool, all of them claim pass rates for step1 in the 90%+ range. I did the math once. With an overall pass rate of 57%, this claim leaves something like a 5% pass rate for people from places like Ireland the UK and Australia.....)

Santiago,
don't insult Ross ! You could have said something really nasty about skips mom, but mentioning his/her alma mater in anything but a praising manner will get you a 'shock and awe' type response. ;)
 
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f_w said:
(With the overseas IMG schools, you can observe an interesting 'Lake Wobegon' phenomenon: All schools are above average! Even though 4 schools represent 60% of the US-IMG pool, all of them claim pass rates for step1 in the 90%+ range. I did the math once. With an overall pass rate of 57%, this claim leaves something like a 5% pass rate for people from places like Ireland the UK and Australia.....)

No offense, but I'm skeptical about your numbers.

What are your sources and how did you go about calculating this?

For 2002, the ECFMG lists the following numbers for US citizen first time takers for Step 1:

3,942 first time USIMG takers;
1,657 passing (42%)

As for the standard certificates issued that year (yes, I know it is not the same, but I don't have better numbers);

-Grenada (SGU): 379 non-Grenadians of about 90% are US citizens = 341 USIMGs
-Dominica (Ross): 389 non-Dominicans of about 90% are US citizens = 350 USIMGs
-Netherlands Antilles (which in addition to AUC, contains a number of other schools with lower pass rates): 258 non-Antillians of about 90% are US citizens = 232 USIMGs

Add these up: 923 successful USIMGs from the Big 3, plus a number from 'lesser schools' hidden among that number

Divide 923 by 1,657 = 55.7%

No Lake Wobegon effect by my very crude calculation. If you've got better numbers, please feel free to post them.

Miklos

NB Australia did not make that year's list with less than 50 IMGs getting certified. Ireland barely made the list, with 64 IMGs of whom 52 were non-Irish. The UK also barely contributed with more citizens going abroad (probably to the Carib.) with 44 UK grads and 60 UK citizens.
 
http://www.ecfmg.org/annuals/2002/certstan.html#appprof

If you look in the 'Certification' section, right under the table that you pulled your numbers from, you will find a section titled :' U.S. Citizens Pursuing ECFMG Certification' (paragraph #2)

In 2002, ECFMG registered 4,186 U.S. citizens for Step 1. The number of U.S. citizens registered for Step 2 in 2002 was 2,520. U.S. citizens comprised 20.0 percent of the total Step 1/Step 2 registrants in 2002. The largest numbers of U.S. citizen Step 1 and Step 2 registrants were students/graduates of medical schools in Mexico (837), Dominica (821), Grenada (798), Netherlands Antilles (738), and the Dominican Republic (398).


This is where I got my numbers for 'registrants' from (this probably includes step1 + step2 )

If you look at the numbers for the dutch antilles, it is particularly interesting. 738 US citizens registered for one of the steps, but only 259 (or by your math 232 US citizens) became ECFMG certified. Either the 'steady state' theory was violated by some major increase in their class size in 02, or a good number of folks got mysteriously 'lost' between step1 application and certification...
 
While I desparately hope this thread just dies away ... I just had to say something. :D

Since most US grads think we are all dirt anyway, what is the point fighting amongst ourselves about who is better: Carribean dirt vs. other foreign dirt? Medicine is not so much about the splendor of one school, rather it is about the abilities of the individual. So ... there are great Carribean docs, there are great US grad docs, there are great "other grad" docs. Conversely, there are bad docs everywhere.

There is a tremendous selection bias for FMGs: only the better ones enter residency. And yes, we tend to have a much stronger clinical background than US students and carribean grads. Doesn't mean we are smarter or better ... just means we have had more (ie longer) training. By the end of residency, we are all, in theory, equally good.
 
f_w said:
http://www.ecfmg.org/annuals/2002/certstan.html#appprof

If you look in the 'Certification' section, right under the table that you pulled your numbers from, you will find a section titled :' U.S. Citizens Pursuing ECFMG Certification' (paragraph #2)

In 2002, ECFMG registered 4,186 U.S. citizens for Step 1. The number of U.S. citizens registered for Step 2 in 2002 was 2,520. U.S. citizens comprised 20.0 percent of the total Step 1/Step 2 registrants in 2002. The largest numbers of U.S. citizen Step 1 and Step 2 registrants were students/graduates of medical schools in Mexico (837), Dominica (821), Grenada (798), Netherlands Antilles (738), and the Dominican Republic (398).

This is where I got my numbers for 'registrants' from (this probably includes step1 + step2 )

If you look at the numbers for the dutch antilles, it is particularly interesting. 738 US citizens registered for one of the steps, but only 259 (or by your math 232 US citizens) became ECFMG certified. Either the 'steady state' theory was violated by some major increase in their class size in 02, or a good number of folks got mysteriously 'lost' between step1 application and certification...

I'll look over the data in more detail later.

However, the problem with the Netherlands Antilles is that it is full of medical schools, unlike Dominica and Grenada (one school each). See the IMED listings. I would not be surprised if AUC accounted for the lion's share of the successful applicants.

Miklos
 
4,186 US citizens applied for step1 OR step2. If we assume that 90% of the medical students in the dutch antilles, domenica and grenada are US citizens, this represents 2121 candidates (--> 51% of US citizens going abroad apply for a USMLE step from one of these three countries).

Now, as we don't have the results separate for step1&2 we have to lump the US citizen pass-rates together (42% step1, 68% step2) to a combined 55%. This leaves us with 2302 'pass' grades.

If the 2121 candidates from the three countries mentioned indeed have a pass rage of >90% (like some people try to make us believe), that would use 1908 'pass' grades.

For the 2075 people struck with the misfortune of not being able to get to the pinnacle of US overseas medical education in the caribbean, this leaves 2302-1908=394 'pass' grades --> 19% pass rate.

These numbers are of course incomplete, as they don't account for the difference in # step1 adminstrations vs step2. Somebody smarter than me can probably pull that out of the ECFMG reports and weigh the pass rates accordingly. How 4186 registrations for one of the steps can whittle down to 1400 odd certificates getting issued is up to anyones guess.

I would love to see the pass rates plotted out per country of medical school, or even better for each school. This would give people contemplating to pay 150k+ for a medical education to a private vendor overseas a benchmark to decide whether it is a good investment.
 
f_w said:
4,186 US citizens applied for step1 OR step2. If we assume that 90% of the medical students in the dutch antilles, domenica and grenada are US citizens, this represents 2121 candidates (--> 51% of US citizens going abroad apply for a USMLE step from one of these three countries).

Now, as we don't have the results separate for step1&2 we have to lump the US citizen pass-rates together (42% step1, 68% step2) to a combined 55%. This leaves us with 2302 'pass' grades.

If the 2121 candidates from the three countries mentioned indeed have a pass rage of >90% (like some people try to make us believe), that would use 1908 'pass' grades.

For the 2075 people struck with the misfortune of not being able to get to the pinnacle of US overseas medical education in the caribbean, this leaves 2302-1908=394 'pass' grades --> 19% pass rate.

These numbers are of course incomplete, as they don't account for the difference in # step1 adminstrations vs step2. Somebody smarter than me can probably pull that out of the ECFMG reports and weigh the pass rates accordingly. How 4186 registrations for one of the steps can whittle down to 1400 odd certificates getting issued is up to anyones guess.

I would love to see the pass rates plotted out per country of medical school, or even better for each school. This would give people contemplating to pay 150k+ for a medical education to a private vendor overseas a benchmark to decide whether it is a good investment.

I don't think anyone would give the benefit of a 90% pass rate to the entire Netherlands Antilles USIMG body, precisely because it is peppered with schools of different quality and sizes.

Regarding Grenada and Dominica, the successful candidates with ECFMG certificates are close to 50% of those registered for Step 1 and Step 2; so for those year, it is not all inconcievable that the pass rate was close (if not precisely 90%), especially if one postulates a slight increase in following class sizes.

The ECFMG states somewhere (I don't remember where) that it does not break down pass rates by school or country for public distribution. IMO, by this they are doing a great disservice to the potential IMG.

Miklos
 
I don't think anyone would give the benefit of a 90% pass rate to the Netherlands Antilles, precisely because it is peppered with schools of different quality and sizes.

It's back to the 90% thing. The majority of the registrants from the dutch antilles are probably from AUC and SABA. ( I believe that some of the other schools listed on the database are re-incarnations of each other, with competing websites trying to discredit each other and each others administrators :laugh: I am not sure how many students they actually graduate)

(I wouldn't give the benefit of a 90% pass rate to any of these enterprises until the day ECFMG plots out boards performance/school.)
 
f_w said:
I don't think anyone would give the benefit of a 90% pass rate to the Netherlands Antilles, precisely because it is peppered with schools of different quality and sizes.

It's back to the 90% thing. The majority of the registrants from the dutch antilles are probably from AUC and SABA.

(I wouldn't give the benefit of a 90% pass rate to any of these enterprises until the day ECFMG plots out boards performance/school.)

I won't dispute that AUC and Saba account for a fair share of the succesful certificates, but what of the other schools?

Saba lists about 90 people with residency appointments from the class of 2002 (I'm assuming that they got ECFMG certificates that same year), AUC's website (after a cursory search) does not list 2002 match results.
 
isnt the only school that even claims a 90% pass rate sgu? i actually believe that one...i would be surprised if the others were above 80% though...
 
f_w said:
I would love to see the pass rates plotted out per country of medical school, or even better for each school. This would give people contemplating to pay 150k+ for a medical education to a private vendor overseas a benchmark to decide whether it is a good investment.
There is currently a great deal of pressure on them to do just that for the reason you mention. Basically to stop the scams. It will probably happen under current disclosure guidelines. It may, if fact, be available for the asking if you make a formal request. Release of this information will no doubt cut off an important source of "income" for some medical schools. My guess is that it will happen sooner rather than later. The numbers they do release are very suggestive of some troubling trends. One country's number is particularly astonishing considering the number of their own citizens that go to the US for post-grad training (ie. fellowships) + the number of international students who chose schools in this country with the intention of working in the United States! Not a good sign.
 
The ACGME records the boards passing rates for residency programs. While they don't publish it for general distribution, the residency directors get a copy of the list.

There is currently a great deal of pressure on them to do just that for the reason you mention. Basically to stop the scams. It will probably happen under current disclosure guidelines. It may, if fact, be available for the asking if you make a formal request.

Well, things would be easier if ECFMG was a federal agency. You would just file a FOIA request and get the stats. ECFMG is essentially a private company, if they feel like disclosing some information they will, if they don't they don't. Or have you ever wondered why they haven't posted an annual report since '02 ? (I, and many other people wonder about their financials. They take in quite a bit of money from their testing business. If you ever went to the place in Phili, it looks more like an expensive law firm than a non-profit type organization. They either burn money in their furnace, or somebody is skimming of the cream there.)
 
f_w said:
The ACGME records the boards passing rates for residency programs. While they don't publish it for general distribution, the residency directors get a copy of the list.

That's awesome because it means that it is in the hands of federally or state funded institutions! (FOIA today.)
 
neilc said:
isnt the only school that even claims a 90% pass rate sgu? i actually believe that one...i would be surprised if the others were above 80% though...


SGU: St. George's has a five year average pass rate of 90% for first-time USMLE Step I examinees, virtually equivalent to the US pass rate on this examination, in fact, surpassing the US pass rate in the year 2000. The SGUSOM rate far exceeds the 62% average pass rate of all non-US schools during the same period.

Ross: The overall USMLE Step 1 passing rate for students completing the Basic Sciences curriculum from January 2001 to December 2003 is 92%.

Couldn't find any AUC claims after a short search.

Miklos
 
i guess i would buy those stats..sgu's claim seems believable to me. and, i think that ross is just saying that 90% of the students eventually pass step 1...factoring in second third and fourth tries, i can buy that too...but, i bet they have a first time pass rate far below 92%, and that should be factored in to your calcs...
 
xicapup said:
What speciality are you looking ?
New York, New Jersey, Ohio, Connecticut, etc are plenty of IMG's doctors.
myself now in pgy3 going to pgy4 ob/gyn

could you give advice on applying for ob/gyn which hospitals you applied and they were friendly img. i could not match this year .
please help your input appricitated
 
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