US IMG graduate didn't match in 2018, repeat applicant: need residency advice

[sosalubrious]

Okay so I'm a US/Caribbean grad from 2016, ECFMG certified. Here is my time-line:

Step 1: 218, Step 2 ck: 205; 235. CS: pass on 2nd attempt; Step 3: 208
Had scheduled ck and cs to be right after finishing surgery and IM back to back in 2 different states-did not receive timely/decent advice telling me it was a bad idea
failed cs then ck 2 weeks later due to extreme circumstances- could not cancel in time
then advised by school to extend rotations/grad/take time off to retake exams since cannot graduate without passing ck/cs-I decided to keep continuous schedule, retook cs and ck weeks apart like before and passed both; raised ck by 30 points.

Applied too late in 2016 match-no interviews/scores in time. No Match/SOAP in IM/FM. Started clinical research after grad
Graduated and passed step 3; interviewed but no match, no SOAP in 2017 IM/FM. Continued research, no publications.
Continued research and started online healthcare MBA; interviewed in IM/FM but still no match/SOAP in 2018.

I'm debating whether/not I should reapply-I've been doing volunteer research since and I need a job/career and these loans are growing. I'm interested in psych and I have a BS in neuroscience but don't have a psych letter.

Any advice is deeply appreciated!

Thank you!

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[NeurologyHopeful2018]

There is no other way to put it - your medical career is over. I am sorry.

 

[AdmiralChz]

interviewed in IM/FM but still no match/SOAP in 2018.

How did you do this cycle - as in how many interviews? Did you have any bites during SOAP, and did you include prelim surgery positions?

Each year of graduation behind you without clinical work (even your research - no publications pending?) makes it harder and harder to match. Did you consider applying straight up to prelim surgery positions in the main match?

I feel sorry for you, I really do, but unfortunately stories like this aren't all that uncommon and is why I tell people to be very, very wary of caribbean education for medical school.

 

[NotAProgDirector]

Psych has become much more competitive over the last few years. As a carib grad with poor scores and no psych LOR's, your chances there are nil.

 

[Goro]

Okay so I'm a US/Caribbean grad from 2016, ECFMG certified. Here is my time-line:

Step 1: 218, Step 2 ck: 205; 235. CS: pass on 2nd attempt; Step 3: 208
Had scheduled ck and cs to be right after finishing surgery and IM back to back in 2 different states-did not receive timely/decent advice telling me it was a bad idea
failed cs then ck 2 weeks later due to extreme circumstances- could not cancel in time
then advised by school to extend rotations/grad/take time off to retake exams since cannot graduate without passing ck/cs-I decided to keep continuous schedule, retook cs and ck weeks apart like before and passed both; raised ck by 30 points.

Applied too late in 2016 match-no interviews/scores in time. No Match/SOAP in IM/FM. Started clinical research after grad
Graduated and passed step 3; interviewed but no match, no SOAP in 2017 IM/FM. Continued research, no publications.
Continued research and started online healthcare MBA; interviewed in IM/FM but still no match/SOAP in 2018.

I'm debating whether/not I should reapply-I've been doing volunteer research since and I need a job/career and these loans are growing. I'm interested in psych and I have a BS in neuroscience but don't have a psych letter.

Any advice is deeply appreciated!

Thank you!

Very sorry to hear of your woes OP. Can you enlighten us as to why you chose the Carib route? It's a teaching moment.

 

[GoSpursGo]

I don't think it would be totally unreasonable to apply one last time to FM only and see what happens; you're not competitive for psych or IM, so if you apply I would focus solely on FM.

However, if you decide to apply again you need to have a really good, concrete idea of what will be different this time around. As others have said, while your scores are not good, the further you get from graduation the more people are going to question how your clinical skills may have waned from a lack of patient interaction, particularly with a fail on CS. If your current research job gives you an "in" to have some patient contact, figure out how to do so and get new letters that can speak to your patient interactions.

Frankly, you also need to publish this year. If the "big thing" you've been doing since graduation is research 24/7 for 3 years, it is not acceptable for you to not have something published during that time. Even if you're doing some crazy bench research that just isn't working (which it did not sound like), you need to find some low hanging clinical chart review project and write it up.

I really think the MBA is worthless, and probably a distraction from your other activities because it neither gives you patient contact nor validates the 3 years you've put into research. If you can't get patient contact, and/or you can't finally get some payoff from this research you've been doing, I think you need to bite the bullet and move on from medicine--your odds are extremely slim now, and will be 0 if you can't address those two issues.

 

[sosalubrious]

How did you do this cycle - as in how many interviews? Did you have any bites during SOAP, and did you include prelim surgery positions?

Each year of graduation behind you without clinical work (even your research - no publications pending?) makes it harder and harder to match. Did you consider applying straight up to prelim surgery positions in the main match?

I feel sorry for you, I really do, but unfortunately stories like this aren't all that uncommon and is why I tell people to be very, very wary of caribbean education for medical school.

Thank you for your reply-yes I learned this the hard way. I am applying to opportunities to gain more clinical experience. I applied to pre-lim surg during soap. 5 interviews in match, none in soap. Same last year.

 

[sosalubrious]

I don't think it would be totally unreasonable to apply one last time to FM only and see what happens; you're not competitive for psych or IM, so if you apply I would focus solely on FM.

However, if you decide to apply again you need to have a really good, concrete idea of what will be different this time around. As others have said, while your scores are not good, the further you get from graduation the more people are going to question how your clinical skills may have waned from a lack of patient interaction, particularly with a fail on CS. If your current research job gives you an "in" to have some patient contact, figure out how to do so and get new letters that can speak to your patient interactions.

Frankly, you also need to publish this year. If the "big thing" you've been doing since graduation is research 24/7 for 3 years, it is not acceptable for you to not have something published during that time. Even if you're doing some crazy bench research that just isn't working (which it did not sound like), you need to find some low hanging clinical chart review project and write it up.

I really think the MBA is worthless, and probably a distraction from your other activities because it neither gives you patient contact nor validates the 3 years you've put into research. If you can't get patient contact, and/or you can't finally get some payoff from this research you've been doing, I think you need to bite the bullet and move on from medicine--your odds are extremely slim now, and will be 0 if you can't address those two issues.

Thank you for your reply-I am considering FM since most of my clinical experience is general medicine. Regarding the research, I will have to accept those losses because as a research coordinator the nature of the work is very different. I did round with attendings and got letters based on bedside exams/discussions but I am working on clinical experience. What options do I have? Observerships don't count.

 

[sosalubrious]

Psych has become much more competitive over the last few years. As a carib grad with poor scores and no psych LOR's, your chances there are nil.

Thank you for your comment- I will not apply to psych without gaining relevant experience and a letter first.

 

[Osminog]

Would you be willing to move to Missouri? Missouri law allows doctors to practice without residency

 

[sosalubrious]

Would you be willing to move to Missouri?

Yes, I have heard about that but don't know much about it. I didn't match in Missouri but it's something to look into; thank you for your comment.

 

[MastahRiz]

I would try a different research position first before giving up. No point in hanging out at the one you're at now unless they're tangibly helping you in some way. A research experience should get you an LOR, interview, publication, clinical experience, phone calls of support, or something else. Right now you're able to account for your time on your CV, but that's the absolute bare minimum. If you aren't getting any of the other bonuses, move on (asap).

If you stick with the shotgun approach and just blindly apply to places then nothing will change. Your chances will depend on what you do with the rest of your application, which needs to scream that you have overcome your setbacks. Right now it doesn't do that at all.

People with worse stats than you have matched, including in the latest cycle. You still have a chance until you've tried everything.

 

[sosalubrious]

I would try a different research position first before giving up. No point in hanging out at the one you're at now unless they're tangibly helping you in some way. A research experience should get you an LOR, interview, publication, clinical experience, phone calls of support, or something else. Right now you're able to account for your time on your CV, but that's the absolute bare minimum. If you aren't getting any of the other bonuses, move on (asap).

If you stick with the shotgun approach and just blindly apply to places then nothing will change. Your chances will depend on what you do with the rest of your application, which needs to scream that you have overcome your setbacks. Right now it doesn't do that at all.

People with worse stats than you have matched, including in the latest cycle. You still have a chance until you've tried everything.

Thank you for your comment. You are right-I only held onto this place so I wouldn't have a gap in my CV. I've been searching for something better but will need their references. The problem is that this hospital/residency program is not IMG-friendly so even though I got letters (including from the assoc PD) I can't progress here. I am ready to move on and even considering health admin jobs.

 

[Osminog]

Do you regret not going to NYCPM?

 

[GoSpursGo]

Thank you for your reply-I am considering FM since most of my clinical experience is general medicine. Regarding the research, I will have to accept those losses because as a research coordinator the nature of the work is very different. I did round with attendings and got letters based on bedside exams/discussions but I am working on clinical experience. What options do I have? Observerships don't count.

Going on rounds I think is better than nothing. Keep going on rounds and directly interacting with the patients as much as possible.

Again, the underlying question you need to answer is what is going to be different about your application this year from the past three where you didn't match. As others have said, if you're not going to publish or be able to get anything else to further your career here, you should move on to something that will give you an opportunity for more clinical experience and publications (not a health admin job... that sounds like another "account for your time" filler that won't advance your career)

Thank you for your comment- I will not apply to psych without gaining relevant experience and a letter first.

Not trying to be rude, but trying to save you some time and money--you aren't going to match in psych 3 years from graduation with a step 2 CK and CS failure. You need to focus on FM and/or general surgery prelim.

 

[rokshana]

Thank you for your reply-yes I learned this the hard way. I am applying to opportunities to gain more clinical experience. I applied to pre-lim surg during soap. 5 interviews in match, none in soap. Same last year.

then you need to re-evaluate what you are saying or how you are coming off in those interviews...your app is getting you the interviews...but

maybe do a mock interview with someone who can critque your interview skills.

 

[HeartCardsDO]

There is no other way to put it - your medical career is over. I am sorry.

Not at all, start working with a primary care doctor at a program that has a residency. I agree with the other poster who said psych is unlikely, FP is your best option

 

[littleemma]

try pathology if still want to be a doctor, it takes tons of IMG. do research and elective on path now and reappply next cycle. good luck.

 

[Stagg737]

A lot of good advice here, especially about needing to do something different this time around. I second the Missouri Assistant Physician program if you're able to do it. They just had their first person go through the process match this year (I also believe she was a fellow Carib grad). I also agree your chances at psych are dead, individuals with far better stats and fewer red flags failed to match or even SOAP this year. Stick to FM and consider adding pathology as well. Just keep in mind the more times you apply with nothing new on your app, the closer your chances of matching get to zero (and they're already to close to that as it is).

 

[sosalubrious]

then you need to re-evaluate what you are saying or how you are coming off in those interviews...your app is getting you the interviews...but

maybe do a mock interview with someone who can critque your interview skills.

thanks for your advice!

 

[doctakay]

thanks for your advice!

Where did you end up??

 

[Robin-jay]

Okay so I'm a US/Caribbean grad from 2016, ECFMG certified. Here is my time-line:

Step 1: 218, Step 2 ck: 205; 235. CS: pass on 2nd attempt; Step 3: 208
Had scheduled ck and cs to be right after finishing surgery and IM back to back in 2 different states-did not receive timely/decent advice telling me it was a bad idea
failed cs then ck 2 weeks later due to extreme circumstances- could not cancel in time
then advised by school to extend rotations/grad/take time off to retake exams since cannot graduate without passing ck/cs-I decided to keep continuous schedule, retook cs and ck weeks apart like before and passed both; raised ck by 30 points.

Applied too late in 2016 match-no interviews/scores in time. No Match/SOAP in IM/FM. Started clinical research after grad
Graduated and passed step 3; interviewed but no match, no SOAP in 2017 IM/FM. Continued research, no publications.
Continued research and started online healthcare MBA; interviewed in IM/FM but still no match/SOAP in 2018.

I'm debating whether/not I should reapply-I've been doing volunteer research since and I need a job/career and these loans are growing. I'm interested in psych and I have a BS in neuroscience but don't have a psych letter.

Any advice is deeply appreciated!

Thank you!

Honestly, I know you were accepted to podiatry school 6 years ago before you went to the islands, but maybe reapply to podiatry if you want to be a physician.

You'll probably be 1 million dollars in debt total going through undergrad, overseas medical school, taking 3 gap years, and then going to podiatric medical school...

....but what options do you have left (in terms of practicing medicine)?