Urology Possibilities as an 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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[DoctwoB]

Honestly you've got a strong uphill battle. IMGs match in urology at rates ranging from 14-58% depending on the year, usually with rates in the 20s-30s. Your Step1 is significantly below average (likely around 240), step 2 closer to average. You have some research experience with a publication in a good journal but many other applicants do as well. I say this not to tell you that it's impossible, but that there is high likelihood of failing to match and delaying entering a residency program. If you are dead set on this, the best route is probably to obtain a research fellowship at a lower-end urology program to get a foot in the door. Alternatively you could do a perlim surgery intern year, and if you perform very well that could be a leg up to match either into a PGY-2 position if one opens up or again as a PGY-1.

 

[DarkHorizon]

No advice, just a comment, there’s a chance I suppose but with your scores, IMG status, and a failed CS, it’s exceedingly small. If I were you, I’d put my efforts elsewhere because you’re likely headed for years of research work with nothing to show for it. Many many US students with your scores won’t match, your score is good 20 points below average.

 

[daenschl]

I hate piling on with bad news, but this sounds like an incredibly hard uphill battle. Your step scores are well below average and a failed CS attempt, even with subsequent success, is a red flag. I'm at an admittedly solid middle tier program, but our step 1 scores for matched applicants have been ~250's and above for a number of years. The match rate for applicants overall and IMG's specifically has been high in recent years, but it is also very much a self-selecting cohort. I only know one IMG personally who matched and he had high step scores and did research for 3-4 for years at an institution, and then matched there. I would never say never, but your situation would likely take years of research with no guarantee.

 

[BlackLomein]

Honestly you've got a strong uphill battle. IMGs match in urology at rates ranging from 14-58% depending on the year, usually with rates in the 20s-30s. Your Step1 is significantly below average (likely around 240), step 2 closer to average. You have some research experience with a publication in a good journal but many other applicants do as well. I say this not to tell you that it's impossible, but that there is high likelihood of failing to match and delaying entering a residency program. If you are dead set on this, the best route is probably to obtain a research fellowship at a lower-end urology program to get a foot in the door. Alternatively you could do a perlim surgery intern year, and if you perform very well that could be a leg up to match either into a PGY-2 position if one opens up or again as a PGY-1.

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 residency program. I should not take it due to my profile and status as an IMG?

 

[DoctwoB]

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 residency program. I should not take it due to my profile and status as an IMG?

I can’t answer that question for you. The question is do you want to invest years of your life knowing there is a good chance it still doesn’t turn into a Urology spot? I love Urology and wouldn’t think that it is worth it. If you want to be a surgeon can go for a prelim or general surgery spot. If you want to be a proceduralist get an IM spot and do well enough to match in cards or GI.

 

[BlackLomein]

I can’t answer that question for you. The question is do you want to invest years of your life knowing there is a good chance it still doesn’t turn into a Urology spot? I love Urology and wouldn’t think that it is worth it. If you want to be a surgeon can go for a prelim or general surgery spot. If you want to be a proceduralist get an IM spot and do well enough to match in cards or GI.

Thanks for the advice

 

[cpants]

Agree with above advice. I would not waste years doing research toward a goal of urology. It's not going to happen. Better to accept that now, and find something else you can be happy doing. Consider GS or OB/GYN?

 

[mestielest]

@DoctwoB and @cpants : What are my chances as a 34 years old urologist (graduated in 2010 from med school. 2010-2016 residency. after then in practice) without any scores I mean can I find myself some spots if I can deal with the Step1, Step 2 CK, and CS.

 

[cpants]

@DoctwoB and @cpants : What are my chances as a 34 years old urologist (graduated in 2010 from med school. 2010-2016 residency. after then in practice) without any scores I mean can I find myself some spots if I can deal with the Step1, Step 2 CK, and CS.

There are potentially some pathways to practice urology within the US if you completed your postgrad training abroad. I know of 2 ways. The most difficult way would be to complete a urology residency in the US. I do know one urologist who did this as a practicing surgeon from abroad. He completed a urology fellowship first and then was able to leverage that into a residency spot. It's a long road and a lot of extra training.

Another possibility is also to complete just a year or two of any residency so that you can get licensed in the US. Urology is in such high demand, that there are hospitals (think middle of nowhere) who may be willing to accept a non-board certified urologist if you are licensed and can prove your qualifications/training. I know a urologist who was trained and practicing abroad and then came to US for a 1 year fellowship training in robotics. He was offered a position at a rural hospital as a urologist, but ultimately decided to leave the US. Chances are nil of practicing without board eligibility/certification in any kind of populated area.

With either of these routes you will need to pass the USMLE (not easy especially years out from medical school) and deal with visa/immigration issues as well.

 

[DoctwoB]

I’ll echo this and say that due to the shortage of urologists I’ve seen a few IMGs that did US fellowships get decent jobs a half an hour to an hour outside of a large city. If you’re looking to practice in the US without a 5-6 year commitment that may be a good option.

 

[mestielest]

@DoctwoB and @cpants thanks heartily for your responses. My main motivation is taking my children out of Turkey. I am also on the way to get GMC registration. On the other hand, I have an on-going Ph.D. that is thought to be finished next year. I may force some paths to get into the USA, however, as you have said, I am to aim some rural areas to be realistic.