Urology Matching/Career as a US IMG??

[BlackLomein]

I am a 24 year old 4th year medical student US IMG graduating this November. My goal is to match into urology, I have a 226 on Step 1 first pass, 239 on step 2 first pass and CS failed on my only attempt. I had always had my eyes on internal medicine and had been prepared to apply this match 2020-2021. I am pretty convinced I have a good shot of matching into IM with my medical profile, LOR's, and USCE; but frankly I have been captivated by a career in urology. I am currently looking for a research fellow/volunteer opportunity to improve my CV in order to apply for the match 2021-2022. I also have some research experience, having obtained 3 publications in some pretty good journals (Journal of Clinical Oncology) with the global surg organization as a co author and working as a research fellow for several months at my home institution. What are my chances really as of now or better yet what can I do to obtain my goal! Honestly from all the experiences I have had working in the states in rotations with several doctors, I have had very positive feedback, am a very hardworking and determined person! I believe if I were to obtain an opportunity, I would not fail to impress in a urology department despite my ok apparent board scores. I would really appreciate any advice or comments!!

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[ciestar]

Very low. You have a few major red flags: IMG, low step 1 and 2, board failure.

 

[Doggeronie]

Very low. You have a few major red flags: IMG, low step 1 and 2, board failure.

Nonexistent imo. OP isn’t even in the clear for IM or FM either

 

[ciestar]

Nonexistent imo. OP isn’t even in the clear for IM or FM either

Oh, I know. Matching won’t be easy and OP should be applying to both IM and FM.

 

[BlackLomein]

Very low. You have a few major red flags: IMG, low step 1 and 2, board failure.

Is CS even any relevant?

 

[BlackLomein]

Nonexistent imo. OP isn’t even in the clear for IM or FM either

What is IMO and OP?

 

[Goro]

What is IMO and OP?

In My Opinion

Original Post(er)

Set your sights a LOT lower. Like FM in a rural community program, or a sweatshop that likes IMGs.

 

[BlackLomein]

Oh, I know. Matching won’t be easy and OP should be applying to both IM and FM.

But those aren’t terrible grades either? Their about average! Not everybody gets excellent board scores, matching shouldn’t be impossible like that?

 

[ciestar]

But those aren’t terrible grades either? Their about average! Not everybody gets excellent board scores, matching shouldn’t be impossible like that?

Urology is competitive. Youre below average nationally for both and very much below average for urology. You needed stellar scores as an IMG for urology and you didnt do that.

I think CS is a pointless stupid exam, but it is still a failure for you and it is easy to filter people out for that

 

[Cauchy]

I’d definitely take the advice being given to you to heart and apply broadly. IMG, below average step 1 score, and board failures will all count as red flags against you.

If I was I your shoes, I’d be doing everything I could to make sure I could secure a spot at all, not going for a one in a million moonshot.

 

[BlackLomein]

In My Opinion

Original Post(er)

Set your sights a LOT lower. Like FM in a rural community program, or a sweatshop that likes IMGs.

wdym a sweatshop lol, I don't think the my current situation would only lead to that! Are you mad at IMG's because they compete with US graduates or what? hahah
Personally their are many many IMG's who are as qualified as US Graduates, there's just a disadvantage due to the system and such! My father is an interventional Cardiologist in Texas and he was an IMG.

 

[BlackLomein]

wdym a sweatshop lol, I don't think the my current situation would only lead to that! Are you mad at IMG's because they compete with US graduates or what? hahah
Personally their are many many IMG's who are as qualified as US Graduates, there's just a disadvantage due to the system and such! My father is an interventional Cardiologist in Texas and he was an IMG.

In other words its not like I got a 200 or a 195, for urology I can see what everybody says but I disagree about the IM. Regardless, thank you all for the answers!

 

[ciestar]

wdym a sweatshop lol, I don't think the my current situation would only lead to that! Are you mad at IMG's because they compete with US graduates or what? hahah
Personally their are many many IMG's who are as qualified as US Graduates, there's just a disadvantage due to the system and such! My father is an interventional Cardiologist in Texas and he was an IMG.

Yeah, he’s mad lolol

But the statistics are out there for you to see them and you can see that IMGs only have a 50% match rate over all specialties.

 

[BlackLomein]

Yeah, he’s mad lolol

But the statistics are out there for you to see them and you can see that IMGs only have a 50% match rate over all specialties.

It seems like he is lmao, the competition

Correction 57%*

But I understand

 

[gyngyn]

The number of IMG's who matched into urology this year was in the single digits.
A significant number of programs screen out those with a step 1 score <240, IMG's, or any failed steps, an unfortunate trifecta.

 

[libertyyne]

You have a standard deviation below the median step 1 for US applicants.
You have zero uro research where as the median is 5 pubs
You are an IMG with a board failure.

I would peg your chances of matching in Urology at less then 5% and I am being generous. Does you dad have a urology program director as a close friend? or do you have some dirt on some PD that will take you ? Because short of those two situations your chances of matching in URO are essentially non-existent.

I am not even applying uro, so i dont have a horse in the race.

 

[candbgirl]

It seems like he is lmao, the competition

Correction 57%*

But I understand

He isn’t your competition! He’s faculty and ADCOM at a DO medical school! You seem pretty cocky for someone totally focused on a very competitive speciality with average, at best, stats! Your father was an IMG years ago . You are not in the same place he was when he graduated! Things have changed drastically for IMGs.

 

[BlackLomein]

He isn’t your competition! He’s faculty and ADCOM at a DO medical school! You seem pretty cocky for someone totally focused on a very competitive speciality with average, at best, stats! Your father was an IMG years ago . You are not in the same place he was when he graduated! Things have changed drastically for IMGs.

No I’m not cocky at all, my apologies if I Came off in that way. I just didn’t appreciate the term sweatshop, don’t expect for that comment to be taken lightly.

 

[BlackLomein]

He isn’t your competition! He’s faculty and ADCOM at a DO medical school! You seem pretty cocky for someone totally focused on a very competitive speciality with average, at best, stats! Your father was an IMG years ago . You are not in the same place he was when he graduated! Things have changed drastically for IMGs.

But yeah the situation for IMG’s is very negative, it’s a shame.

 

[Doggeronie]

OP will not match urology. It’s just not possible.
But he will match IM. His father being an interventional cardiologist guarantees that.

Oh the power of connections...

 

[BlackLomein]

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You have a standard deviation below the median step 1 for US applicants.
You have zero uro research where as the median is 5 pubs
You are an IMG with a board failure.

I would peg your chances of matching in Urology at less then 5% and I am being generous. Does you dad have a urology program director as a close friend? or do you have some dirt on some PD that will take you ? Because short of those two situations your chances of matching in URO are essentially non-existent.

I am not even applying uro, so i dont have a horse in the race.

What if I happen to acquire a research year as a fellow and that results in about 6 or 7 pubs. Would that do any change for me?

 

[BlackLomein]

OP will not match urology. It’s just not possible.
But he will match IM. His father being an interventional cardiologist guarantees that.

Oh the power of connections...

Maybe my understanding has been erroneous, but to my knowledge with my profile I had always thought I would be a solid candidate for IM. I know people who have failed the boards, no pubs and matched. Regardless of my father being a doctor, I thought I’m good for IM. You don’t need a 250 for those specialties, I had thought.

 

[libertyyne]

What if I happen to acquire a research year as a fellow and that results in about 6 or 7 pubs. Would that do any change for me?

If you had a step 1 score of 250 , a research year would have been beneficial. As it stands, you are likely to be screened before any human even looks at your application. Screened because you have a step score below 230, IMG, and a board failure. Productive research would alleviate one screen but the rest remain.
You would have to spend years at a program doing research and convince that program to take you. It is not an easy or straight forward path and usually FMGs go through it.

I honestly dont see a clear pathway for a URO match for you.

 

[BlackLomein]

If you had a step 1 score of 250 , a research year would have been beneficial. As it stands, you are likely to be screened before any human even looks at your application. Screened because you have a step score below 230, IMG, and a board failure. Productive research would alleviate one screen but the rest remain.
You would have to spend years at a program doing research and convince that program to take you. It is not an easy or straight forward path and usually FMGs go through it.

I honestly dont see a clear pathway for a URO match for you.

Ok I understand, I had that in mind because im 24 y/o I could've dedicated 1-2 years of research without much hesitation. Thanks again for the reply, I appreciate it!!

 

[RJ McReady]

OP, the odds are definitely not in your favor
But if you take a couple of years to do research and build connections in urology then who knows? Only you can decide if it’s worth the time and effort to pursue your dream and possibly, and likely, not match and then you’ve lost 2 years during which you could have been 2/3 done with an IM residency.

 

[IMGASMD]

Maybe my understanding has been erroneous, but to my knowledge with my profile I had always thought I would be a solid candidate for IM. I know people who have failed the boards, no pubs and matched. Regardless of my father being a doctor, I thought I’m good for IM. You don’t need a 250 for those specialties, I had thought.

What school?
Why did you not go to a us med school?
Have you done any research into how YOUR stats against all your competitions?

 

[Goro]

What school?
Why did you not go to a us med school?
Have you done any research into how YOUR stats against all your competitions?

Answer is a clear "no" to the last question.

OP, the term "sweatshop" is used to mean a malignant program; many of these rely on IMGs for labor because it's a seller's market and they know people are desperate.

 

[IMGASMD]

Answer is a clear "no" to the last question.

OP, the term "sweatshop" is used to mean a malignant program; many of these rely on IMGs for labor because it's a seller's market and they know people are desperate.

“How dare you telling me that I will not make it!”

 

[RJ McReady]

“How dare you telling me that I will not make it!”

OP is just asking for advice on pursuing his goal.Nothing wrong with asking the question.

 

[AnatomyGrey12]

But those aren’t terrible grades either? Their about average! Not everybody gets excellent board scores, matching shouldn’t be impossible like that?

In other words its not like I got a 200 or a 195, for urology I can see what everybody says but I disagree about the IM. Regardless, thank you all for the answers!

What if I happen to acquire a research year as a fellow and that results in about 6 or 7 pubs. Would that do any change for me?

Maybe my understanding has been erroneous, but to my knowledge with my profile I had always thought I would be a solid candidate for IM. I know people who have failed the boards, no pubs and matched. Regardless of my father being a doctor, I thought I’m good for IM. You don’t need a 250 for those specialties, I had thought.

Unfortunately it appears you don’t really understand how behind the 8 ball you really are as an IMG with a board failure.

You will be lucky to match at all. That’s the reality of the situation. Matching IM or FM isn’t impossible, but not the walk in the park you seem to think it will be. Forget about Uro completely, that is off the table.

 

[RJ McReady]

Forget about Uro completely, that is off the table

Ouch.
OP, a dose of reality is sometimes a good thing.

 

[DO2015CA]

Your step 1 and 2ck scores are decent for FM and community IM as an IMG. It’s the failure of CS that sinks that ship. Honestly since usmle is stopping CS during the pandemic then your best chance of matching at all is if the CS score are blacked out of NRMP. This means no one would know who actually took CS or not. Idk if they are even thinking about doing that btw. Uro is absolutely out of the question

 

[BlackLomein]

Answer is a clear "no" to the last question.

OP, the term "sweatshop" is used to mean a malignant program; many of these rely on IMGs for labor because it's a seller's market and they know people are desperate.

Oh I see, I had never heard that term.

 

[BlackLomein]

OP is just asking for advice on pursuing his goal.Nothing wrong with asking the question.

I mean that's what were here for aren't we? I'm just seeing what's up

 

[BlackLomein]

Unfortunately it appears you don’t really understand how behind the 8 ball you really are as an IMG with a board failure.

You will be lucky to match at all. That’s the reality of the situation. Matching IM or FM isn’t impossible, but not the walk in the park you seem to think it will be. Forget about Uro completely, that is off the table.

I had always thought that the step 2 CS wasn't all that relevant as a board. From personal experience, even program directors have expressed to me how unimportant that test was. Thats why I thought it was like that and I wasn't in that bad of a position; thanks for the clarification.

 

[BlackLomein]

Your step 1 and 2ck scores are decent for FM and community IM as an IMG. It’s the failure of CS that sinks that ship. Honestly since usmle is stopping CS during the pandemic then your best chance of matching at all is if the CS score are blacked out of NRMP. This means no one would know who actually took CS or not. Idk if they are even thinking about doing that btw. Uro is absolutely out of the question

Yeah that probably not likely, through eras it will definitely show on my usmle transcript.

 

[Doggeronie]

Alright. OP seems to be a nice guy so let's all ease back on attacking him and try to maintain courtesy.

To OP- Urology is unfortunately not possible for you due to a myriad of factors. IMG status, below average step scores, and CS failure make you basically ineligible.
These same factors will hurt you when applying for IM residency as well. Board failure is a serious red flag, even if it is CS. But you WILL match IM if you apply very broadly.

 

[BlackLomein]

So last question,


If I happen to have an opportunity presently to volunteer at first, and obtain a research fellowship position. Which would primarily involve working with a Urologist heavily involved in research at a program such as Houston Methodist. I should not take it due to my profile and status as an IMG?

 

[BlackLomein]

The DOs on this board use the term sweatshop alot and losely when a program has a large number of IMG and only a few USMDs and USDO grads. Check out Cottage Hospital IM Residency Program in Santa Barbra. UCSB is my undergrad and I assure you Cottage IM residnecy program is not a sweatshop. You might want to consider applying there as your Steps scores are decent, regardless of being IMG. GL.

Thanks for the support, i'll look into that!!

 

[Goro]

The DOs on this board use the term sweatshop alot and losely when a program has a large number of IMG and only a few USMDs and USDO grads. Check out Cottage Hospital IM Residency Program in Santa Barbra. UCSB is my undergrad and I assure you Cottage IM residnecy program is not a sweatshop. You might want to consider applying there as your Steps scores are decent, regardless of being IMG. GL.

I got the term from the MD residents in the General Residency forum.

 

[BlackLomein]

What school?
Why did you not go to a us med school?
Have you done any research into how YOUR stats against all your competitions?

UNIBE Medical School in Santo Domingo, Dominican Republic

I did not go to a US med school because I grew up with my father who is an interventional cardiologist having studied as an IMG, it seemed like a good option due to graduating at the age of 24 which is now honestly.
I have done research on that, but I seemed to find many articles, some from the NIH surveying urology program directos expressing that a step score of 220 or less would be what would be detrimental to your chances.

 

[BlackLomein]

UNIBE Medical School in Santo Domingo, Dominican Republic

I did not go to a US med school because I grew up with my father who is an interventional cardiologist having studied as an IMG, it seemed like a good option due to graduating at the age of 24 which is now honestly.
I have done research on that, but I seemed to find many articles, some from the NIH surveying urology program directos expressing that a step score of 220 or less would be what would be detrimental to your chances.

I was never really conscious of what a great disadvantage being an IMG puts you in. Due to my fathers success I believed it was a great option lol

 

[DO2015CA]

I was never really conscious of what a great disadvantage being an IMG puts you in. Due to my fathers success I believed it was a great option lol

Ya it’s a really over the past 15-20 years that it started to worsen. Really just due to opening up of more US medschools that outstripped residency development (which is a good thing residencies didn’t grow at the pace schools opened but that’s another topic) and the fact that the stigma for DOs/more awareness of DOs to the general premed student made Carib schools less desirable.

Likewise I had a mentor who was an AUA grad of ‘94 tell me that if you didn’t get into a USMD school you just went off shore which was fine for that generation.

 

[AnatomyGrey12]

The DOs on this board use the term sweatshop alot and losely when a program has a large number of IMG and only a few USMDs and USDO grads. Check out Cottage Hospital IM Residency Program in Santa Barbra. UCSB is my undergrad and I assure you Cottage IM residnecy program is not a sweatshop. You might want to consider applying there as your Steps scores are decent, regardless of being IMG. GL.

Lol no. A sweatshop is a program that preys on IMGs knowing they will take any amount of abuse because if they leave the program they won’t ever get to me a doctor. Simply being all IMGs is not, in and of itself, the defining characteristic.

 

[gyngyn]

Ask here: Urology Resident - AMA!