Unattainable Residencies for 99/99 US-IMG?

[medsRus]

---

Members do not see this ad.

For an US-IMG with double 99's, what fields are practically unattainable (i.e. Derm, ENT, Rad/Onc)? Thanks!

 

[DarthNeurology]

For an US-IMG with double 99's, what fields are practically unattainable (i.e. Derm, ENT, Rad/Onc)? Thanks!

Remember that a "99" is not the 99th percentile and can be anywhere from the 230s (around 80th percentile) to 260+ (above 95th percentile or so), so actually the three digit score is more important than the two digit score. Given that, those are pretty good scores for an IMG/FMG who tend to have lower scores on average than US students. If you also have excellent clinical evals in third year AND research experience you could try to get Rad/Onc, but realize that a lot of folks have "99's' when applying and your three digit score is what is important, but you would have a shot, and could more easily get ob/gyn, radiology, in terms of Derm and ENT again, an uphill battle especially if you don't have research and electives in those area, but possible.

Actually there are ten "independent" applicants who match in Rad/Onc and their median step 1 was 237 (may be a 99 or 98), but the folks who are "independent" who didn't match had a Step 1 of 224 which is not a 99, HOWEVER a lot this may be non-U.S. seniors but are american grads who did a year of research and then reapplied for Rad-Onc or something like that.

 

[jigga]

For an US-IMG with double 99's, what fields are practically unattainable (i.e. Derm, ENT, Rad/Onc)? Thanks!

Top tier programs: Can be any speciality if no USCE and lor's from american physicians and some research credentials. Even with these an uphill task without any networking & connections.

Middle tier programs: Ortho, Derm, Rad-Onc, Ent etc... atleast a year of research needed plus ofcourse usce & lor's. Other specialities are acheivable if overall the application is good even without research and minimal USCE.

Middle to Low Tier Programs: If a well rounded application is sent, sufficient programs are applied to, there are no red flags on the application & english speaking ability is good then you can get into almost any speciality. Still ORtho, derm & rad-onc will be competetive i think.

 

[Pinkertinkle]

Why are IMG's so focused on the confusing and silly two digit score?

 

[medsRus]

Why are IMG's so focused on the confusing and silly two digit score?

The score wasn't the focus of this thread, rather it was just meant to establish a high-scoring US-IMG. The real questions was, what fields are practically unattainable for US-IMGs, despite having top-notch scores. So, stop whining.

 

[tkim]

When you ask for help, you should be nice.

 

[Pinkertinkle]

The score wasn't the focus of this thread, rather it was just meant to establish a high-scoring US-IMG. The real questions was, what fields are practically unattainable for US-IMGs, despite having top-notch scores. So, stop whining.

With an attitude like that any residency may be unattainable. If you mean to say top notch scores, act like someone in the know and say 250+.

 

[medsRus]

With an attitude like that any residency may be unattainable. If you mean to say top notch scores, act like someone in the know and say 250+.

This thread is veering off course...

 

[silas2642]

This thread is veering off course...

Well, exactly what is the score? Is it a 235 or a 260? Also, what does the rest of the package look like? Is there research in your your CV along with publications? How are your third year grades and evaluations? What does your dean's letter look like? Any red flags?

You probably know the answer to your question-- fields like derm, plastics, optho, etc. are going to be really hard to match into if you're an IMG/FMG. These fields are hard to match into if you're an AMG. But it is possible, not necessarily likely, but possible.

No one can answer your question because there is more to an application than just a step I score, which we don't even know.

 

[howelljolly]

And if you must know.... a US-IMG matched into Derm this year.

 

[Law2Doc]

Well, exactly what is the score? Is it a 235 or a 260? Also, what does the rest of the package look like? Is there research in your your CV along with publications? How are your third year grades and evaluations? What does your dean's letter look like? Any red flags?

You probably know the answer to your question-- fields like derm, plastics, optho, etc. are going to be really hard to match into if you're an IMG/FMG. These fields are hard to match into if you're an AMG. But it is possible, not necessarily likely, but possible.

No one can answer your question because there is more to an application than just a step I score, which we don't even know.

Agreed. Top notch is not a definitional term - it is subjective. And there are other things of import besides the steps. An IMG is going to have to be a whole lot better than an AMG in a lot of categories (in addition to the steps) to get looked at for the more competitive things. And if you've got nothing going for you other than high steps, you may not be competitive for even some of the relatively less competitive things. This isn't a "by the numbers" system. The dude with solid research and strong letters/connections and who did solid away rotations is often going to blow you out of the water.

 

[DrJosephKim]

It's very difficult to make broad generalizations without knowing additional details. IMGs who have significant research and publication experience can get into many competitive specialties. If you invest your time and energy in the right places and you have stunning grades/numbers, then you can do very well.

 

[Tigerz_Fan]

And if you must know.... a US-IMG matched into Derm this year.

I saw that! And I was thinking that a certain poster on this forum must be going crazy from that!

 

[RussianJoo]

there is no specialty that's off limits to a US-IMG, just like there's no specialty that's off limits to an FMG. US-IMGs have matched into every single specialty so anything is possible. However, it's not very likely even if you have 280+ on your steps, considering that only a handful of them match every year out of hundreds that apply. but hey how likely it is wasn't your question. your question was are there any specialties off limits? and the answer to your question is NO, any specialty is attainable.

 

[RussianJoo]

also every score report has the mean score and the standard deviation and since the scores are in a normal distribution we can easily figure out what percentile each score would be.. my test had a mean of 218 and a SD of 23 thus a score of 241 would be 1 SD above the mean and thus the 84th percentile.

 

[Pinkertinkle]

also every score report has the mean score and the standard deviation and since the scores are in a normal distribution we can easily figure out what percentile each score would be.. my test had a mean of 218 and a SD of 23 thus a score of 241 would be 1 SD above the mean and thus the 84th percentile.

How do you know they're normally distributed?

 

[howelljolly]

How do you know they're normally distributed?

Since youre given the mean and SD for your particular test, on the score report, we can assume.....? Can you compute a SD for a skewed curve?

I suppose we really can't assume that. If the test scores were normally distributed, there wouldnt be a 97% pass rate for US students . And, there wouldnt be a 54% pass rate for US-IMGs. With the grasp of the English language held fairly constant, you wouldnt get just a huge difference in scores, given the big sample sizes.

The AAMC, FSMB, and the individual US med schools would burn the doors down at the NBME/USMLE if they werent told that nearly every one of their students was qualified to pass the USMLE. Think about it. If American med schools were putting students through the educational system, and their own, albeit separate, lisencing board decided that the students were unqualified.... that spells trouble.

So, the NBME arbitrarily inflates the scores of US students, and reduces the scores of US-IMGs... i.e. the redheaded stepchildren of the American medical system.... and the total numbers seem to have a relatively normal distribution.

 

[RussianJoo]

Since youre given the mean and SD for your particular test, on the score report, we can assume.....? Can you compute a SD for a skewed curve?

I suppose we really can't assume that. If the test scores were normally distributed, there wouldnt be a 97% pass rate for US students . And, there wouldnt be a 54% pass rate for US-IMGs. With the grasp of the English language held fairly constant, you wouldnt get just a huge difference in scores, given the big sample sizes.

The AAMC, FSMB, and the individual US med schools would burn the doors down at the NBME/USMLE if they werent told that nearly every one of their students was qualified to pass the USMLE. Think about it. If American med schools were putting students through the educational system, and their own, albeit separate, lisencing board decided that the students were unqualified.... that spells trouble.

So, the NBME arbitrarily inflates the scores of US students, and reduces the scores of US-IMGs... i.e. the redheaded stepchildren of the American medical system.... and the total numbers seem to have a relatively normal distribution.

isn't there a 97% pass rate for US students? or is it like 93% but it's definitely over 90%.. that's pretty close.. and yes i have never heard of someone giving a standard divination for a skewed curve and besides what would be the point? the fact that they give you an SD means that the scores are normalized.. that's the whole point of having a curved test is to normalize results.. and the USMLE is curved big time.

the thing with IMGs/FMGs is that well IMGs a lot of time aren't as smart, only a handful of those that truly deserve to be in US med schools don't get in and are forced to go to the carib, others just plainly don't deserve to be in med school and are poor test takers or don't work hard enough or are simply just not smart enough, cause if they were good test takers they'd get into a US school or have better GPAs or whatever.. so those people don't fit the normal distribution when plotted against something that assumes you're brighter than the average joe smith on the street, so the bar is set higher and naturally the average joe would do much worse on a test that's meant for people with higher IQs. as for FMGs a lot of them aren't masters of the English language and even though they might be geniuses in their home country they get screwed on the USMLE because they'll use weird vocab or terminology that only native speaker understand or have a slightly better idea of what they're asking, so FMGs even though they might know the info are at a huge disadvantage for that. and thus when you add those things together you get a passing % of ~60% as quoted by the USMLE people...

Also the averages and SD's that are reported on your scores only look at US med students to make those averages not IMGs/FMGs. and the passing grade is set by US med students too.. It's definitely a normal distribution..

and also the reason the normal distribution curve looks the way it does and how it was invented was because if you give a fair test like the USMLE to people who are ready to take it, the grades will automatically fall into the normal distribution graph, you just need enough people to take the test, and the USMLE has ten's of thousands of people taking it each year.

 

[RussianJoo]

ok i take that back the pass rates for US students are:

Step1:92%
step2ck: 94%
Step2CS: 97%
Step3: 94%

but still it's very close and i am pretty sure it's impossible to calculate an SD for a skewed cruve.

 

[howelljolly]

Also the averages and SD's that are reported on your scores only look at US med students to make those averages not IMGs/FMGs. and the passing grade is set by US med students too.. It's definitely a normal distribution..

.

Oh yeah, thats right.

So, 90something % of US students pass. That means you gotta be pretty foolish to fail....

 

[Pinkertinkle]

If they're so eager to give you a way to calculate percentiles, why don't they just give you the percentile? There is insufficient evidence to convince me that step scores are "definitely" normally distributed. You can certainly calculate average and standard deviations for non-normal data. Whether you can convert this to a percentile in this case is pure speculation. It's all quite mysterious how step scores are calculated and by what method they curve it.

 

[howelljolly]

Theyre mysterious about it so they can diddle with the scores to suit whomever they want, without people finding out. If pepole knew how the scores were calculated and distributed, it was be easier to check up on them.

 

[NotAProgDirector]

The USMLE is almost certainly normally distributed.

First of all, it's a multiple choice test. Scores should be normally distributed unless it is common for test takers to get all questions correct or incorrect.

More importantly, data from Charting Outcomes in the Match suggests it's normally distributed. Table 2 reviews all USMLE scores for all applicants. It's split by those who matched and those who didn't, but that shouldn't matter. For US grads who matched, for Step 1, the mean was 221, median 222, 25th percentile 206, and 75th percentile 236. Thus, the 50-25th is 222-206 = 16, and 75-50th is 236-222 = 14. Hence, the median = mean and the distance from the 50th to both the 25th and 75th percentiles are about equal -- this is a normal distribution.

I highly doubt that US grads are given extra points or IMG's automatically lose points on the USMLE. I think it's just likely that US grads tend to score better than IMG's -- IMG's may not have english as their primary language, and their training may stress different topics.

I do expect that US med schools would raise a stink if the USMLE were scored in such a way that large numbers of their students failed. However, the USMLE has relatively recently increased the minimum passing score, and the med schools didn't complain at all.

 

[RussianJoo]

If they're so eager to give you a way to calculate percentiles, why don't they just give you the percentile? There is insufficient evidence to convince me that step scores are "definitely" normally distributed. You can certainly calculate average and standard deviations for non-normal data. Whether you can convert this to a percentile in this case is pure speculation. It's all quite mysterious how step scores are calculated and by what method they curve it.

I don't really care if i convince you or not, but i am pretty convinced. for example most people use USMLE World to prep for step1.. my percentile on USMLE World was 62nd.. my step1 score was 227 the mean was 218 and SD was 23 so that's 9 points above the mean.. since 1SD is 34% that 9 points is about 12% above the mean thus if the mean is set to be the 50th percentile my score would correlate almost perfectly to the UW percentile...so i can say that i was about 62nd percentile on step1 ( not great but could be a lot worse).. why don't you do the same with your percentile from UW and your step1 score and see if you get the same results.

 

[Medstudentquest]

I saw that! And I was thinking that a certain poster on this forum must be going crazy from that!

If you are referring to me, that person who matched this time in derm and was an IMG had failed to match in the previous cycle AND had a year of research post graduation, as well as having someone they knew in the field. FYI.

Further, it's pretty pathetic of you to try to hope for bad outcomes for another poster, i.e.: me, especially given that you did not even go to school here in the US and that you matched into medicine, one of the easiest fields to match into, and had pretty poor scores. It would be more appropriate of you to have a good attitude and try to be helpful.

 

[LavenderLoraine]

With regards to Rad Onc, I know of 2 FMG's who have matched into Rad Onc in the last few years out of roughly 300-400 spots matched.

The first applicant was an MD who did a radiation oncology residency in his foreign country, came to the US and got a PhD.

The second matched this year but I don't know the details.


I just wanted to add that the foreign grad who matched into rad onc this year is a US-IMG who just graduated this June (no previous PhD) from an Irish medical school (RCSI). I believe she did summer research in rad onc, and of course a few rotations in it.