US citizen IMG medical residency dynamics

[Endoxifen]

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Are US citizens pursuing medical school at top tier international universities at a disadvantage during the residency match? I looked up match statistics for US citizen IMGs and the statistics weren't encouraging (~58%). However, it's pretty obvious why that stat would be skewed significantly downwards.

I spoke to a foreign physician who went to the university I'm considering and practices here in the states. They had no difficulty landing a competitive residency spot where they wanted (given this was 10-20 years ago). What does everyone think? @Goro, @LizzyM, @gonnif, I'd really appreciate your input.

Thanks very much!

 

[JustaDO]

Yes.

 

[Endoxifen]

Here it comes

Did I just kick a hornets nest?

 

[Goro]

Are US citizens pursuing medical school at top tier international universities at a disadvantage during the residency match? I looked up match statistics for US citizen IMGs and the statistics weren't encouraging (~58%). However, it's pretty obvious why that stat would be skewed significantly downwards.

I spoke to a foreign physician who went to the university I'm considering and practices here in the states. They had no difficulty landing a competitive residency spot where they wanted (given this was 10-20 years ago). What does everyone think? @Goro, @LizzyM, @gonnif, I'd really appreciate your input.

Thanks very much!

Yes

 

[ciestar]

Major disadvantage.
New schools, both MD and DO, opening every year, some schools expanding class sizes but virtually no growth in residency slots and now a residency merger.

 

[Endoxifen]

Major disadvantage.
New schools, both MD and DO, opening every year, some schools expanding class sizes but virtually no growth in residency slots and now a residency merger.

How does the match work exactly? Am I correct in thinking that medical schools are required to consider all US students prior to evaluating international students? If so, how does this square with the reserved slots for international students? Is it just that they're required to look at them, not take them?

 

[Endoxifen]

Yes

How significantly? I ask because I'm already heading to this school for two graduate degrees. The MD would likely be fully funded and I would have the opportunity to continue my research with my old research group.

I'm not really tied to this option, but considering the potential benefits, I honestly think it'd be irresponsible to not at least ask around.

 

[Goro]

How significantly? I ask because I'm already heading to this school for two graduate degrees. The MD would likely be fully funded and I would have the opportunity to continue my research with my old research group.

I'm not really tied to this option, but considering the potential benefits, I honestly think it'd be irresponsible to not at least ask around.

Look at NRMP data and decide. Basically, if you want to practice Medicine int he US, go to an American medical school.

 

[Goro]

How does the match work exactly? Am I correct in thinking that medical schools are required to consider all US students prior to evaluating international students? If so, how does this square with the reserved slots for international students? Is it just that they're required to look at them, not take them?

NEW VIDEO - How the Matching Algorithm Works - The Match, National Resident Matching Program

 

[Mad Jack]

Are US citizens pursuing medical school at top tier international universities at a disadvantage during the residency match? I looked up match statistics for US citizen IMGs and the statistics weren't encouraging (~58%). However, it's pretty obvious why that stat would be skewed significantly downwards.

I spoke to a foreign physician who went to the university I'm considering and practices here in the states. They had no difficulty landing a competitive residency spot where they wanted (given this was 10-20 years ago). What does everyone think? @Goro, @LizzyM, @gonnif, I'd really appreciate your input.

Thanks very much!

Really depends on the university. Oxford and other truly top-tier international schools don't disadvantage you much in some specialties and will actually provide an edge vs DO but still hurt you versus US MD. Less prestigious and Caribbean schools generally put you at a strong disadvantage.

 

[Endoxifen]

Really depends on the university. Oxford and other truly top-tier international schools don't disadvantage you much in some specialties and will actually provide an edge vs DO but still hurt you versus US MD. Less prestigious and Caribbean schools generally put you at a strong disadvantage.

An edge relative to what? Is the distinction between an Oxford tier school and a T20 virtually irrelevant at that point or is it significantly magnified considering the hyper competitiveness of everyone at that level?

Edit: I just saw that you said "edge vs DO." Whoops!

 

[Endoxifen]

NEW VIDEO - How the Matching Algorithm Works - The Match, National Resident Matching Program

Thank you for posting this!

 

[gyngyn]

How does the match work exactly? Am I correct in thinking that medical schools are required to consider all US students prior to evaluating international students? If so, how does this square with the reserved slots for international students? Is it just that they're required to look at them, not take them?

We are not required to consider US seniors first.
They tend to be the best candidates, though.

 

[Endoxifen]

We are not required to consider US seniors first.
They tend to be the best candidates, though.

Why is that? Is it because they're better integrated into the US system, so they tend to be more efficient physicians early on, or are residencies trying to minimize the risk of taking students from schools they have less experience with?

 

[gyngyn]

Is it because they're better integrated into the US system, so they tend to be more efficient physicians early on, or are residencies trying to minimize the risk of taking students from schools they have less experience with?

Yes.

 

[Endoxifen]

Yes.

Ok, I understand. Any schools that would have a lot of experience accepting students from those top international schools will also be the ones with the most fierce competition, functionally eliminating any potential benefit to the applicant. That's really tough.

I would be remiss if I didn't mention that I'll have a PhD at that point. I only really plan on applying to academic medical centers for residency. My continued involvement with my research group during my MD would likely result in several more publications and conference presentations. Does the benefit of high research productivity suffer from diminished returns at some point or would the whole experience be valuable considering my ambitions?

 

[gyngyn]

Ok, I understand. Any schools that would have a lot of experience accepting students from those top international schools will also be the ones with the most fierce competition, functionally eliminating any potential benefit to the applicant. That's really tough.

I would be remiss if I didn't mention that I'll have a PhD at that point. I only really plan on applying to academic medical centers for residency. My continued involvement with my research group during my MD would likely result in several more publications and conference presentations. Does the benefit of high research productivity suffer from diminished returns at some point or would the whole experience be valuable considering my ambitions?

A PhD adds relatively little to a residency application. It does help a little in a couple of fields, though.

 

[Mad Jack]

An edge relative to what? Is the distinction between an Oxford tier school and a T20 virtually irrelevant at that point or is it significantly magnified considering the hyper competitiveness of everyone at that level?

Edit: I just saw that you said "edge vs DO." Whoops!

You're more likely to get into, say, Yale IM as an Oxford graduate than out of anywhere else but a decent US MD school, but DO graduates are completely shut out, for example.

 

[Mad Jack]

Ok, I understand. Any schools that would have a lot of experience accepting students from those top international schools will also be the ones with the most fierce competition, functionally eliminating any potential benefit to the applicant. That's really tough.

I would be remiss if I didn't mention that I'll have a PhD at that point. I only really plan on applying to academic medical centers for residency. My continued involvement with my research group during my MD would likely result in several more publications and conference presentations. Does the benefit of high research productivity suffer from diminished returns at some point or would the whole experience be valuable considering my ambitions?

PhDs are only good if you've got one in a niche that is in a field where that PhD might apply, and even then it's only buying you an edge at certain programs. Derm, psych, and neurology tend to like PhDs, for instance, but a PhD isn't going to get you much if you're going for IM.

 

[Endoxifen]

A PhD adds relatively little to a residency application (it does help a little in a couple of fields, though).

I'm primarily interested in oncology. This potentially includes radiation oncology, though it's still a bit too early to tell. Are either of these one of those fields?

I should stress that I'm getting the PhD because I genuinely want to be a physician-scientist.

 

[nimbus]

Unless you have a VERY compelling reason to attend school overseas, go to a US MD school. They provide the best opportunities for GME in the United States. And US MD/PhD programs are well funded so you can have tuition and living expenses covered.

 

[nimbus]

Ok, I understand. Any schools that would have a lot of experience accepting students from those top international schools will also be the ones with the most fierce competition, functionally eliminating any potential benefit to the applicant. That's really tough.

There aren’t any residencies in the US that have a lot of experience accepting students from top international schools. The top residencies get 99.9% of their residents from USMD schools. The residencies that have a signifant number of of IMG/FMGs are all considered lower tier.

 

[gyngyn]

I'm primarily interested in oncology. This potentially includes radiation oncology, though it's still a bit too early to tell. Are either of these one of those fields?

There were an insufficient number of successful international Rad onc applicants to be be evaluated: http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-IMGs.pdf
A Medicine residency is the pre-requisite to an Onc or heme onc fellowship. There were 10x more unmatched US IMG's with a PhD than matched.

 

[Endoxifen]

There aren’t any residencies in the US that have a lot of experience accepting students from top international schools. The top residencies get 99.9% of their residents from USMD schools. The residencies that have a signifant number of of IMG/FMGs are all considered lower tier.

Really? I'd expect that Mass Gen or Mayo would get a relatively large amount of travel from international students.

 

[Endoxifen]

There were an insufficient number of successful international Rad onc applicants to be be evaluated: http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-IMGs.pdf
A Medicine residency is the pre-requisite to an Onc or heme onc fellowship.

Well, that's not a very encouraging sign. This is looking more and more tenuous by the minute!

 

[nimbus]

Really? I'd expect that Mass Gen or Mayo would get a relatively large amount of travel from international students.

Look at their resident rosters. They are all USMD.

They may have visiting fellows, especially in their labs, but these are really unofficial positions.

This is the most recent MGH internal medicine intern class

https://www.massgeneral.org/medicine/assets/pdfs/MGH_Internal_Medicine_Interns_2017.pdf

 

[Endoxifen]

Alright, I think it's pretty clear that this isn't a wise option. Thank you to everyone who responded. I really appreciate all of your advice!

 

[Med Ed]

Alright, I think it's pretty clear that this isn't a wise option. Thank you to everyone who responded. I really appreciate all of your advice!

I would still like to know what international university you were considering.

 

[gyngyn]

I would still like to know what international university you were considering.

I think it's Oxford.

 

[mariposas905]

Are US citizens pursuing medical school at top tier international universities at a disadvantage during the residency match? I looked up match statistics for US citizen IMGs and the statistics weren't encouraging (~58%). However, it's pretty obvious why that stat would be skewed significantly downwards.

I spoke to a foreign physician who went to the university I'm considering and practices here in the states. They had no difficulty landing a competitive residency spot where they wanted (given this was 10-20 years ago). What does everyone think? @Goro, @LizzyM, @gonnif, I'd really appreciate your input.

Thanks very much!

Honestly, everyone says it's tough but idk if that's true all around. I've seen that a contact makes a huge difference. This year, a girl I knew from an unknown med school abroad got into a good IM residency with a ~220 step 1 score. She wasn't even above the US average like they say you should be as an IMG. I believe she got in because she knew someone from that hospital, but if connections have such a great impact then lots of IMGs could be getting in

 

[Endoxifen]

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