To Dr. Cox and any1 browsing

[raidenxp2005]

hi,
I'm an IMG, without a green card, this year i finished my USMLE Step 1 exam with a score of 190/77 (2nd attempt), i have no USCE, but i do have some research work in my country. I'm doing my Step 2 next year and I'm graduating on the 5th December, 2007. I'm 23yrs old.
I want to do General Surgery as my residency, i have good LORs in General Surgery, Internal Medicine, Family Medicine and OB/GYN. My general surgery rotation was run by a US Medical Graduate from NY. Plus my grades during each rotation ranges from A (mostly in General Surgery) and B's for the Other specialties.
I need to know what are my chances of getting into a General Surgery residency in NYfor the 2009 match. I know it's a competitive field but it has been a passion for me since I have been minor surgeries and assisting with major ones.

Thanks

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[howelljolly]

Im not Dr Cox, but I'll chime in anyway. Questions starting with "What are my chances...." are tough to answer. There are a lot of factors, and a lot of exceptions to general trends.
Theres no way to tell, based on any information you provide, if you will match with GS.

Competitive programs with many applicants filter their applications based on USMLE scores. Your's may not get you an audience with the admission committee. Also, letters of rec from foreign institutions are sometimes less effective. Research experience, particularly publications will help you though. Limiting yourself to NY may complicate things.

Give it a shot, but have a backup plan. GS is one of the more competitive specialties.

 

[Winged Scapula]

I AM Dr. Cox and I don't have much more information for you.

Residency admissions are complicated and there really is no way we can tell you what your chances are. Obviously you've got some red flags (no USCE, no green card, low Step 1 score) but there's nothing you can do about that now unless you delay your graduation and do some USCE now.

Unfortunately, it really doesn't matter what your grades are...for FMGs, its almost all about Step 1 scores, USCE and connections. Your transcript will be almost ignored. Your letters for FM and Ob/Gyn will largely be discounted by surgeons in the US, especially if they are not from US faculty.

Some things you can do to improve your application:

1) score better than average on Step 2
2) consider taking Step 3 before you apply
3) delay graduation and get some USCE while you are still a student
4) get LORS from US faculty while doing the above
5) make sure you are trying to do something "medical" during your year off (it was unclear to me why you didn't apply for this cycle if you are graduating in two days)
6) get your ECFMG certification before you apply

All in all, NY is more friendly to FMGs and there are lots of programs, but you need to apply broadly and not restrict yourself geographically if you want to maximize your chances.

 

[Blade28]

Excellent post above.

Not much to add; just wanted to reiterate the importance of not limiting yourself to a single state (New York). If there's a critical reason you need to be there - family, etc. - then I understand, but otherwise it's always wise to apply broadly and widely.

 

[raidenxp2005]

Okay thanks for the well detailed reply

but suppose i'm unable to match into a Surgical program and i have a backup of internal med or family med, do PGY1 and reapply for a surgical residency

considering I have already finished step 3 and and some USCE in a residency

does this make my application look better??

and the reason why NY is because of my family

 

[Winged Scapula]

Okay thanks for the well detailed reply

but suppose i'm unable to match into a Surgical program and i have a backup of internal med or family med, do PGY1 and reapply for a surgical residency

considering I have already finished step 3 and and some USCE in a residency

does this make my application look better??

and the reason why NY is because of my family

If you're asking whether doing an intern year in an IM or FP program will help you get into a categorical Surgery position the following year (should you have failed to match into Surgery), in general its better to do a Prelim Surgery year. While the number of available positions are less as the popularity of Surgery increases, there are still plenty of Prelim Surgery positions open and I would recommend that over IM and especially over FM.

And yes, if you have some USCE in residency as well as passed Step 3, this will improve your application, but I do not recommend using residency in another specialty as a way to gain access into a Surgical program. Apply for surgery and do an IM year only as a back-up plan if you can't scramble into a Prelim Surg year.

 

[raidenxp2005]

Okay,
Firstly I don't know how to get into ro where to get to a prelimiary program for surgery,
May be if u can forward me to the proper website to sign up for one that would be great...

Next, if i do get into a prelimiary program is there any stipend available???( i know, i'm desperate for a residency but also I have mouths to feed)

How long does a prelimiary program last for?

 

[Blade28]

I'm sure the IM or FP program won't be thrilled to learn that you're only using them as a stepping stone towards a surgery residency.

This is unless you do a Prelim IM year, but then why not do a Prelim Surgery year?

Please check out the ECFMG and ERAS websites ( www.ecfmg.org and www.aamc.org/students/eras ) for more information. And read the FAQs.

 

[Winged Scapula]

Okay,
Firstly I don't know how to get into ro where to get to a prelimiary program for surgery,
May be if u can forward me to the proper website to sign up for one that would be great...

Next, if i do get into a prelimiary program is there any stipend available???( i know, i'm desperate for a residency but also I have mouths to feed)

How long does a prelimiary program last for?

It sounds as if you are confused about the differences in types of training.

Preliminary: these are usually a single year in length and if designated, serve as the required internship year for programs which require a year of general training in either IM or Surgery. Non-designated Prelim years are programs which are not necessarily designed for the person who is going onto an Advanced program.

Categorical: these are the tracks which lead to Board Eligibility in a specialty; ie, the full training schema

Preliminary years pay a salary just like Categorical years. You apply for them just as you would any other residency. However, because they tend to be much less competitive, many people only apply for them as back up.

Therefore, you could apply for both Categorical General Surgery and Preliminary Surgery, ranking the latter lower on your Rank List than the Categorical programs. So, you don't just "sign up" for a Preliminary program; as Blade notes, you still have to go through NRMP and ERAS to apply to them.

 

[Tired]

This is unless you do a Prelim IM year, but then why not do a Prelim Surgery year?

You mean besides the fact that it bites?

 

[raidenxp2005]

Blade28,
U make me sound like a heel.....i'd rather use the phrase "lifting me to higher greatness"......okay thats a lame phrase but they don't have to know my true intentions

Dr. Cox,
I will definitely do a prelimiary match in general surgery as a back up.....which might be my only option in the end.....i don't mind doing surgery even though it's not exactly on the road to the specialty itself.......are they alot of prelimiary surgical programs in NY??

but when i reapply for residency again, do i have to re-upload my dean's letter and LOR's, etc. ????.....me and my dean aren't really chummy-chummy-buddies....actually i hate the guy and just want my letter and get out of dodge

Please I know my questions are alittle redundent but I just want 100% clarification

Thanks

 

[howelljolly]

Blade28,
U make me sound like a heel.....i'd rather use the phrase "lifting me to higher greatness"......okay thats a lame phrase but they don't have to know my true intentions

Dr. Cox,
I will definitely do a prelimiary match in general surgery as a back up.....which might be my only option in the end.....i don't mind doing surgery even though it's not exactly on the road to the specialty itself.......are they alot of prelimiary surgical programs in NY??

but when i reapply for residency again, do i have to re-upload my dean's letter and LOR's, etc. ????.....me and my dean aren't really chummy-chummy-buddies....actually i hate the guy and just want my letter and get out of dodge

Please I know my questions are alittle redundent but I just want 100% clarification

Thanks

A Prelim surgery yeah might be your best bet, and it certianly is on the road to the specialty itself.... IM and FP aren't

I suspect that the ECFMG will save your file, and when you apply for a categorical GS, the process might be easier. Im pretty sure that when applying through the ECFMG, they have a standard letter that will take the place of your dean's letter. So, you won't need to deal with your ol' friend the dean.

Besides, your dean's letter wont serve the same purpose as one from a dean of a US school. Theres only +/- 130 med schools in the US, so the deans letter is almost a personal letter.

 

[Blade28]

Blade28,
U make me sound like a heel.....i'd rather use the phrase "lifting me to higher greatness"......okay thats a lame phrase but they don't have to know my true intentions

I'm not sure what you mean by this.

 

[Winged Scapula]

I'm not sure what you mean by this.

I think he/she was referring to your comment about FM/IM programs not being too happy to find out they were being used as a stepping stone to Surgery.

 

[howelljolly]

Okay,
Firstly I don't know how to get into ro where to get to a prelimiary program for surgery,
May be if u can forward me to the proper website to sign up for one that would be great...

Next, if i do get into a prelimiary program is there any stipend available???( i know, i'm desperate for a residency but also I have mouths to feed)

How long does a prelimiary program last for?

A prelim year is basically the same as the first year of residency, salary included. The difference is, that the contract ends that year, and you have to go somewhere else to comeplete the residency.

 

[mlw03]

i would recommend you try to talk to someone in person, as you seem to be confused about a lot of the terminology and the process you need to complete to reach your goals. while you've gotten some excellent advice above, a face to face discussion with someone would likely benefit you as well.

one thing i haven't seen (although i did just skim some of the replies) is that you should apply to every community program in the geographic area you want to be. these tend to be less competitive than university based programs, and as noted, your scores are much less competitive than those of most applicants. a community program, who depends on resident labor to keep their floors running, is likely your best chance to obtain a US residency.

hi,
I'm an IMG, without a green card, this year i finished my USMLE Step 1 exam with a score of 190/77 (2nd attempt), i have no USCE, but i do have some research work in my country. I'm doing my Step 2 next year and I'm graduating on the 5th December, 2007. I'm 23yrs old.
I want to do General Surgery as my residency, i have good LORs in General Surgery, Internal Medicine, Family Medicine and OB/GYN. My general surgery rotation was run by a US Medical Graduate from NY. Plus my grades during each rotation ranges from A (mostly in General Surgery) and B's for the Other specialties.
I need to know what are my chances of getting into a General Surgery residency in NYfor the 2009 match. I know it's a competitive field but it has been a passion for me since I have been minor surgeries and assisting with major ones.

Thanks

 

[raidenxp2005]

thanks alot guys !!!!!

too bad i don;t have your addresses i would have sent christmas cards to u all

really appreciate it thanks

 

[Blade28]

You mean besides the fact that it bites?

Normally, yes, but the OP wants to go into General Surgery.

 

[howelljolly]

Yesterday, my attending said this: Surgery is ridiculously competitive, and rightfully so. However, Preliminary surgical positions are not difficult to get.

Because:
Preliminary "non-renewable" positions are a win-win for the program.
They have a constant turnover of overzealous "Hollywood hopeful" extra hands to take some of the massive workload off of the Surgery team.
However, the elite few categorical surgery residents who stay with the program, get trained, and become board elegible.