Position Wanted US citizen, working as physician in Neurology in UK, hoping to reunite with family in USA, seeking PGY1 residency in Neurology or Internal Medicine

Oct 15, 2020
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  1. Resident [Any Field]
Greetings from London. I have been feeling invisible for some time now, so here I am trying to reach out into the void. I am a US citizen, and for 11 years, I have been excluded from residency selection in the US mainly because of my age. I currently work as a physician in the UK.

My age, and years of clinical experience in another country make me a non-traditional applicant, My age has no bearing on my capabilities. I have clocked in more service hours and nights at my hospital than any other doctor. I am now 50 years old but I have a tremendous capacity for hard work. Yet many programs exclude me from applying because of my year of graduation. This is overt ageism. I have been told by residency advisors that most residency directors will not consider me “trainable”. I have trained in the subspecialty of stroke medicine since 2017, and also worked as a locum emergency medicine doctor for many years before that. There is still much for me to learn in the field of neurology and internal medicine, and as evidenced from my recent training, I can indeed be trained.

I passed all three USMLE Steps on the first attempt and received a marginal score on Step 1 (195) and a decent score on Step 2 (231). I regret my low step 1 score, but that was many years ago and is not representative of my abilities today. The highest ranked neuro-stroke program in the UK is happy to employ me, but US residency programs will not even grant me an interview. I have very favorable letters, from UK and USA but I don’t think they have ever been read. With all my training in COVID care, I thought it very likely that residency programs would seek out candidates with that skill set this year, but this was not the case at all. I know candidates with repeated Step 1 attempts, who have gotten residencies. I never failed a Step. Research, US clinical experience, I have all that, so I can only conclude that I have been excluded this year again due to my age.

I cannot begin to describe the professional, financial and emotional damage that repeated failed matches have caused. It has torn me from my family and taken me from country to country in search of permanent employment.

The reason behind my pursuit of a US residency, when I am finally professionally well settled in the UK, is personal. My wife and son, who has a diagnosis of autism, reside in the US. It can be catastrophic for a child with autism to break routine and move to an unfamiliar place. Although my family made an effort to move to London, my son was not able to adjust to life in the UK. His special educational needs were also better served in the US. As my son ages, it is critical to have both parents present during his transition from childhood through adolescence. There should not have to be a choice between one’s medical career and marriage to a US citizen.

I will be applying for SOAP positions and just wanted to get my story out there. I have not been able to beat ERAS filters and I need a helping hand. I will appreciate any leads or advocacy at this juncture. I am ready to be a dedicated, hardworking and reliable member of any residency team that will welcome me. If you have gotten this far, thanks for reading my story.


Senior Member
10+ Year Member
May 24, 2006
somewhere always warm
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  1. Attending Physician
This is sad. Sorry that you are going through this. I would normally say, why, why, why, but in this case it makes sense.
Of course I have no answers. I doubt you will ever get in unless you make the right connections. However, do you think that a different location besides London could potentially serve your son better? That’s a crazy busy, large, town. Maybe a smaller one?
That’s the only suggestion I have. Because I highly doubt you will get anywhere unfortunately.
Mar 21, 2021
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  1. Medical Student
I look a picture of this so that I can remember this when I become a physician. No one should have to deal with this type of turmoil because of a couple numbers. We talk about growth, trends, and to not focus on single absolute measurements or lab results in medicine, yet that is exactly what we do with Step scores. The whole system is ridiculous. honestly, if I had matched this year I probably would have been oblivious to these stories. I wonder if you'd have more luck once step 1 is made pass/fail. Also, isn't there some time limit for step scores, after which you can retake? I would reach out to program directors and see if there is anyone who'd look past your age.


2+ Year Member
Jul 16, 2017
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  1. Resident [Any Field]
Hi, have u tried getting a license from Maine? They accept UK residencies if u have your usmles. Then you can use your Maine license to work for the VA in whichever state you like
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