US-IMG from Australia looking at psych, i get 1 overseas elective where should in USA?

[GC-DR]

Hey guys long time lurker.
I'll start with my question more info on me below.
I have 1 overseas elective to gain USCE, where is the best place to goto with my stats which will help me match later on? My preference is West Coast over East Coast, i have Nevada residency.

I'm from Small Private Uni in Australia got 232 on step 1. My wife is american and i have a greencard, i think that make me a US-IMG, even though i spent my entire like in Oz.

Starting my rotations soon but they are asking us to put in requests now for the one spot we get to do an elective overseas. I have 4-6 weeks i believe.

I'm locked in on psych. Would love to do a combined program - FM/IM/Neuro/Peds, but not sure if my step 1 and US-IMG status will hold me back. Alternatively would love a Physician-Scientist PhD spot in psych

I currently have 2 first author original research articles in high impact orthopedic surgery journals and 1 2nd author review in an immunology journal. 1 National conference presentation.

Also worked as a physical therapist and have registration in USA for including work in mental health physical therapy, Dunno if that will help?

Thanks for any advise on optimising my chances to match

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[splik]

well you're not an IMG since you are a student, and you're not an american so even if you weren't a student you wouldn't be a US-IMG. That said, especially in the current climate much better to have a green card, I wouldn't recommend starting residency for foreigners without it. If you are "locked on psych" then why are you considering doing a combined program from quite wildly differing specialties? And that would be a completely different from a "physician scientist PhD spot" (are you a PhD or do you mean you want to do a PhD?) There is only one program I am aware of that has an in-built PhD for selected students but you have no significant research background, and no psychiatry/neuroscience research by the sounds of it. Some programs will let you do or start a PhD during the residency but you are essentially taking and additional 5-6 years out for that and you may or may not draw a resident salary during that time, and would have to apply separately and get into the PhD program having identified a subject you want your PhD in. All in all, it doesn't sound like you know what you want to do. Which is fine, but it's probably good to have a think of some specific goals bearing in mind nothing in written in stone.

As for which hospital to do an elective at - ideally one where you would like to end up, or in the geographic region you would like to end up, that will accept you. You ideally want to be doing inpatient psychiatry (adult), consultation-liaision psychiatry or emergency psychiatry since you will need letters of recommendation that will speak to your clinical skills. Now that so many US students are doing away rotations, it is much harder than it used to be for IMGs to get good electives, though certainly possible, especially if during the winter/spring months (Jan-April) when there aren't many US students doing away rotations.

 

[GC-DR]

well you're not an IMG since you are a student, and you're not an american so even if you weren't a student you wouldn't be a US-IMG. That said, especially in the current climate much better to have a green card, I wouldn't recommend starting residency for foreigners without it. If you are "locked on psych" then why are you considering doing a combined program from quite wildly differing specialties? And that would be a completely different from a "physician scientist PhD spot" (are you a PhD or do you mean you want to do a PhD?) There is only one program I am aware of that has an in-built PhD for selected students but you have no significant research background, and no psychiatry/neuroscience research by the sounds of it. Some programs will let you do or start a PhD during the residency but you are essentially taking and additional 5-6 years out for that and you may or may not draw a resident salary during that time, and would have to apply separately and get into the PhD program having identified a subject you want your PhD in. All in all, it doesn't sound like you know what you want to do. Which is fine, but it's probably good to have a think of some specific goals bearing in mind nothing in written in stone.

As for which hospital to do an elective at - ideally one where you would like to end up, or in the geographic region you would like to end up, that will accept you. You ideally want to be doing inpatient psychiatry (adult), consultation-liaision psychiatry or emergency psychiatry since you will need letters of recommendation that will speak to your clinical skills. Now that so many US students are doing away rotations, it is much harder than it used to be for IMGs to get good electives, though certainly possible, especially if during the winter/spring months (Jan-April) when there aren't many US students doing away rotations.

Thanks for the speedy reply. Yes i'm not an med graduate yet sorry its from reading so much I land up using the terminology incorrectly to get my point across. But i'll be a US-IMG i imagine on graduation.

I'm looking at the combined programs, for a few reasons. FM-psych because psych patients need a regular PCP that they can develop a therapeutic relationship that can get them appropriate screening and vaccination etc which quite often they fall between the gaps.
psych-IM/Neuro because I have a big interest in genetics/immunology and how it relates to psych and i think in 20-50 years from now we might have some amazing new treatments and I want to have those skills start working towards that gap.

I also want to do a PhD I love the academic side of things want the option to move into academia.

So I have broad interests. With all that said, i'd be extremely content and more than happy just matching to a good psych program and 1 step at a time is to get USCE to make sure i can match.

Do you think I should try do a paid away placement somewhere with a "name" or go somewhere more "community" "rural".
And if i apply just to psych with out the combined programs as a US-IMG do you think 232 with some non-psych research will get a me a place at a university program? And if yes, which ones would you recommend i try do to an away rotation at?

Thanks heaps

 

[wolfvgang22]

232 is fine, though not spectacular. If I were in your shoes I would focus first on getting into a psych residency and if you happen to get an interview for any residency position in the US, you should jump on it whether it is a community program or otherwise. Like splik says, do your away rotation where you would like to do residency if you can. Otherwise it doesn't matter much as long as it is in the U.S.
Regarding doing a residency in FM-psych, I don't recommend it. Most people end up doing FM or Psychiatry, one or the the other. Jobs combining both barely exist and hospitals and clinics will use you as one or the other.

 

[GC-DR]

So you think put the combined idea to bed.
focus 100% on getting any residency spot in psych.
This was some advice i previously i got which i was considering taking.

I've read the splik advice on the forums for maxing out psych application.

The aim at the moment is just get USCE and try get a psych paper published and conference poster maybe.

I know 232 isn't spectacular but do you think it will rule me out of getting interviews at university programs?

I terms of inpatient psychiatry (adult), consultation-liaision psychiatry or emergency psychiatry. If i only have 1 rotation and i need maximum LOR. Which one do you guys think is most likely to give me the opportunity to get multi LOR.

Also is SubI different from just a normal away elective. I've seen a few subI ones.

 

[wolfvgang22]

I am a U.S. IMG. Sub internships are generally meant for students who have already completed the core psychiatry rotation and basically want to show more interest and audition to be an intern next year. I did a child psych rotation as a sub-I at a well known academic program in the north east. It helped my application a small amount, but I only used one psych letter. You do not need two psych letters. I also submitted letters from FM, surgery, and peds. I did all clinical rotations in the U.S. If your letters are strong and mention your interest in Psychiatry you'll be fine.

232 is good enough to get interviews at both community and University based residency programs if the rest of your application is good and you apply broadly. If you limit yourself to big name academic programs or only to those in Nevada or California, you may be disappointed. Many good candidates fail to match every year because they refuse to look beyond a specific state or area. I recommend applying to and interviewing at many programs as a US IMG. Trust me, I was a very competitive applicant 9 years ago, but it has only gotten harder for US IMGs to match.

 

[GC-DR]

I am a U.S. IMG. Sub internships are generally meant for students who have already completed the core psychiatry rotation and basically want to show more interest and audition to be an intern next year. I did a child psych rotation as a sub-I at a well known academic program in the north east. It helped my application a small amount, but I only used one psych letter. You do not need two psych letters. I also submitted letters from FM, surgery, and peds. I did all clinical rotations in the U.S. If your letters are strong and mention your interest in Psychiatry you'll be fine.

232 is good enough to get interviews at both community and University based residency programs if the rest of your application is good and you apply broadly. If you limit yourself to big name academic programs or only to those in Nevada or California, you may be disappointed. Many good candidates fail to match every year because they refuse to look beyond a specific state or area. I recommend applying to and interviewing at many programs as a US IMG. Trust me, I was a very competitive applicant 9 years ago, but it has only gotten harder for US IMGs to match.

Thanks for the advice. I was always planning on applying broadly and across the whole US.
I'll have finished my core rotations including psych in Australia. So i'll probably try do a subI then and target a program i want to goto.

 

[SquibDell]

Hi all,

I'm in a similar position to the OP - medical student in an English speaking country trying to plan psych rotations in the US. I'm not a US citizen/Green Card holder however.

I was hoping someone could give me advice about approaching US programs for rotations. I haven't been able to find (m)any medical schools that say they accept foreign medical students for rotations, and a decent number specifically state that they do not. The places that do say they accept foreign medical students also tend to look a bit exploitative (e.g. $$$ for rotation/LoR, no real clinical experience provided), so I'd prefer to avoid those if possible.

Should I just send an email with my details and try to convince places to take me even though they say they won't? Or am I better off trying my luck with the places that say they will accept foreign students?

If it helps, my step 1 is mid-240s, I have decent psych-related research experience, my medical school has a good reputation in my home country, and I plan to sit step 2 CK/CS and step 3 before the match.

Thanks in advance.

 

[psychiatryhopeful]

Thanks for the speedy reply. Yes i'm not an med graduate yet sorry its from reading so much I land up using the terminology incorrectly to get my point across. But i'll be a US-IMG i imagine on graduation.

I'm looking at the combined programs, for a few reasons. FM-psych because psych patients need a regular PCP that they can develop a therapeutic relationship that can get them appropriate screening and vaccination etc which quite often they fall between the gaps.
psych-IM/Neuro because I have a big interest in genetics/immunology and how it relates to psych and i think in 20-50 years from now we might have some amazing new treatments and I want to have those skills start working towards that gap.

I also want to do a PhD I love the academic side of things want the option to move into academia.

So I have broad interests. With all that said, i'd be extremely content and more than happy just matching to a good psych program and 1 step at a time is to get USCE to make sure i can match.

Do you think I should try do a paid away placement somewhere with a "name" or go somewhere more "community" "rural".
And if i apply just to psych with out the combined programs as a US-IMG do you think 232 with some non-psych research will get a me a place at a university program? And if yes, which ones would you recommend i try do to an away rotation at?

Thanks heaps

Duke, UNC and the mid-west programs seem to take a number of talented IMGs. Have you tried looking at these programs?

 

[SquibDell]

Duke, UNC and the mid-west programs seem to take a number of talented IMGs. Have you tried looking at these programs?

The Duke website says they've stopped taking international medical students for rotations. UNC is a bit more expensive ($2500) than I was hoping but it could be an option, thanks.

 

[Celexa]

Duke, UNC and the mid-west programs seem to take a number of talented IMGs. Have you tried looking at these programs?

According to their website, UNC's residents are 100% american MDs. Not sure that's a good place for the OP to do an away rotation if the goal is to identify a program they would later have a chance of matching at.

 

[MrChance2]

Just look at the program websites to see which take FMGs by looking at current residents. You can find the programs here Map of Medical Residency and Fellowship Programs

 

[psychiatryhopeful]

According to their website, UNC's residents are 100% american MDs. Not sure that's a good place for the OP to do an away rotation if the goal is to identify a program they would later have a chance of matching at.

duke takes a number of international medical graduates. why is it that unc (a program that is of similar caliber and region) only has american mds?

 

[Celexa]

duke takes a number of international medical graduates. why is it that unc (a program that is of similar caliber and region) only has american mds?

Programs have different preferences. It may also have to do with Duke having a past reputation for malignancy (I have no knowledge of the current atmosphere at the program, but it's definitely been a topic of discussion in the past).

 

[cutetendon]

duke takes a number of international medical graduates. why is it that unc (a program that is of similar caliber and region) only has american mds?

Taking IMGs doesn't automatically make a program inferior, nor does it imply that it is less competitive. Yale for instance specifically allocates a specific percentage of slots for international graduates. But, Duke is an inferior program to UNC.

 

[MacDonaldTriad]

Taking IMGs doesn't automatically make a program inferior, nor does it imply that it is less competitive.

While I agree with you, the fact that MS4s believe IMGs are a sign of inferiority keeps this more true than it should be. Yale can sprinkle some IMGs in the mix with no harm no foul. When you get close to half your trainees IMG, suddenly no one wants you. It is a self fulfilling thing more than it is a PD bias.

 

[cutetendon]

While I agree with you, the fact that MS4s believe IMGs are a sign of inferiority keeps this more true than it should be. Yale can sprinkle some IMGs in the mix with no harm no foul. When you get close to half your trainees IMG, suddenly no one wants you. It is a self fulfilling thing more than it is a PD bias.

Yeah, I can see that being true. Which is a shame, really.

 

[SquibDell]

Thanks again for the tips.

I've read on other threads that the purpose of doing rotations at US med schools for international students is to 1) show that your clinical skills are of US standard and 2) get your face known at a place you'd like to match.

If a place you'd like to match doesn't accept foreign students for sub-internships/observerships/etc, is there any benefit to doing a rotation and getting a letter of recommendation from a program that's nearby (geographically)? I'm thinking that the people at different programs within a city are more likely to know each other and so the letter might carry more weight.

And what about doing a non-psych rotation at the same institution (e.g. would an internal medicine letter from the same institution as a psych program you're interested in be better than a psych letter from a different institution)?

 

[SquibDell]

no do not do this. people will think you want to do IM then. you should do psychiatry electives in the US. you should do the elective wherever you can. Ideally you should do 2 4-week electives as many of the better programs want you to have 8 weeks of elective experience. Inpatient, emergency psychiatry, and c/l psychiatry rotations are the best for this. your aim will be to obtain strong letters of recommendation from these experiences. You need at least 2 US letters of recommendation.

Ah, that makes sense, thanks.