US IMG vs. IMG coming to US for residency

[indya]

Hi,
I am a US citizen who is in high school. Due to circumstance, luck, hard work, etc., it will be possible for me to be attend medical school in the UK at top-15 school. I am wary of accepting it because I want to eventually settle back in the US. I have relatives who have come to the US recently from abroad after getting their medical degrees and have obviously had a hard time landing even uncompetitive residencies. Each of them came from Indian medical schools and each were not US citizens. How much easier will it be for a US citizen, coming from a well-established, western European school?
I, as a high school student, am in little position to predict which field of medicine I want to go into, however, both of my parents are physicians, so I have a much more in depth view of the profession than most. From what knowledge I have, I don't want to go in to the hyper-competitive specialties like ortho, plastics, derm, urology, etc. I know how stereotypical it is for young student to say that they know they want to be a <insert specialty>. I am most interested in general surgery. (My father happens to be a general surgeon, so I have a lot of exposure to the field.) How competitive are general surgery residencies for USIMGs?
I'm not looking for a bashing on why I shouldn't be thinking about this as a high school student, because my situation is uniquely urgent.

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[Winged Scapula]

Why not just stay here in the US, go to college here and apply to medical school here?

What's the rush? What's so "uniquely urgent" about your situation?

The reins are tightening on the number of non-US grads that will be able to get residencies, even US citizens, as the number of US grads increases without a corresponding increase in residency positions. You may find yourself without a position.

While "UK Top 15 school" sounds fancy-schmancy, I venture to say that if it ain't Oxford, no one here will have heard of it or care. There are very few foreign schools that make US faculty sit up and take notice, so your "UK Top 15 school" might as well be "UK Top 50 school or Top 100 school".

Training outside of the US only makes it harder on yourself. Why not attempt to get into medical school here *first* and then if you can't get in, go abroad (providing the gates for foreign trained MDs are still open by that time).

As for competitiveness, it really doesn't matter what is competitive now, because these things change. GS is currently moderately competitive with very few IMGs/FMGs getting Categorical positions in the match. But who knows...that could change in a few years when you're ready.

Finally, the Gen Res forum is for issues and topics of interest to residents and attending physicians. Questions from HS students and pre-med students are best placed in their respective forums, so this thread is being moved back to hSDN where residents and attendings can answer your query.

 

[indya]

It is uniquely urgent because I have to decide on whether to go the traditional route or to the UK within the next few months. My main motive in going is converting 3 years of schooling into 3 years of practice, as medical school takes 5 years there. Thanks for the reply!

 

[Winged Scapula]

It is uniquely urgent because I have to decide on whether to go the traditional route or to the UK within the next few months. My main motive in going is converting 3 years of schooling into 3 years of practice, as medical school takes 5 years there. Thanks for the reply!

Again, what's the rush?

It doesn't make much sense (to me at least) to go abroad for medical school to save yourself a mere 3 years, when the downside is a very real bias against you as an IMG and a possibility of never getting a residency position. When you add in the fact that you will then not even have a useable undergraduate degree, it makes even less sense from a Plan B standpoint.

There are integrated undergrad-med school programs in the US, and although not 5 years, there are some that are shorter than 8. Have you thought about those?

There are not going to be any guarantees. You could go to school in the UK and find yourself without a residency position. You could stay here and be unable to get into a US medical school (in which case, the schools abroad will still be there as an option). Or you could be wildly successful in either scenario.

I know I sound like an old fart, but really...3 years is not much in the grand scheme of things. College is fun and there is a real benefit to its experience. Life is about living; its great to have goals but take the blinders off about being a surgeon and consider the other aspects that a true undergraduate education gives you. I hate working in the OR with colleagues who lack a rich life experience. You'll have 30+ years to practice; is 33 years really any better?

 

[SitraAchra]

Why would you ever want to do the European system? Medical school directly out of high school is such a waste.

I am so happy I had fun in college and didn't do the typical pre-med things. I could never imagine doing the European system and skipping out on college.

And ON TOP of that, you are putting yourself at a very real risk of not being able to practice in the US. So those are two strong negatives in my book. Why are you moving to England anyways, do you have the option of going to college in the US? If you have the option of college in the US and you are entertaining this idea of UK med school right out of US high school, I think it's a terrible idea.

There's absolutely no rush. Are your parents pushing this agenda on you?

 

[indya]

Why would you ever want to do the European system? Medical school directly out of high school is such a waste.

And ON TOP of that, you are putting yourself at a very real risk of not being able to practice in the US. So those are two strong negatives in my book. Why are you moving to England anyways, do you have the option of going to college in the US? If you have the option of college in the US and you are entertaining this idea of UK med school right out of US high school, I think it's a terrible idea.

There's absolutely no rush. Are your parents pushing this agenda on you?

If I or an external force is devoted to having me 'rush through college', would you suggest that I attempt to complete US college a year or two early rather than going to the UK? I will have enough college credits through summer courses, AP, IB, CLEP, etc. to finish college in the US in about 2 years with less than 20 credits per semester.

 

[Law2Doc]

If I or an external force is devoted to having me 'rush through college', would you suggest that I attempt to complete US college a year or two early rather than going to the UK? I will have enough college credits through summer courses, AP, IB, CLEP, etc. to finish college in the US in about 2 years with less than 20 credits per semester.

There is no good reason to go abroad -- if you want to stay in the US, the ideal route is always to attend med school in the US -- you will be a much much much more competitive residency candidate for US programs coming out of a US med school. Period.

And no, there is no advantage to completing college early. If, as you are implying, there's a financial reason to "rush through college" (which is never really advantageous, because it cuts down on your ability to make yourself well rounded, to do lots of interesting ECs and the like, and thus you will be a less competitive med school applicant), then finish up college and get a job for a few years, earn some bling, and make yourself an interesting nontrad in the process. There simply isn't a straight faced argument that you need to rush through college so you can incur $200k+ in debt by going straight into med school so you can end up practicing at the attending level at 30 instead of 32. It's not a convincing argument. Others have tried to make it (assuming you aren't them with a new username) and got easily shot down. No good reason to rush, ever. And rushing is the single biggest reason folks don't succeed on this path -- they rush through college without taking the time they need to (a) do well and (b) get decent ECs, then they rush to take the MCAT before they are ready or before they have all the core courses completed etc, or they rush to apply even though their stats aren't there, simply because of some imagined time-table that doesn't actually exist. The person who gets their ducks lined up in a row, and does things slow and steady succeeds on this path. The rest, not so much. This is a path of lifetime learning, which gets harder the further along you go, and there simply isn't any point rushing. The light at the end of this tunnel is a train, and it will get to you soon enough. Stop, enjoy college life, and broaden your horizons. Or if there truly is a legit pressure to finish college earlier, then get out and get a job.

To summarize: (1) you don't want to go to med school outside of the US if your goal is to practice in the US. (2) There is no real benefit to rushing through and graduating college in less than 4 years, only the detriment of damaging your competitiveness by not giving yourself the same time period to rack up ECs and interesting life experiences as everyone else. Take a step back and decide if you actually want to be a doctor in the US, or simply want to take your own, wrong path.

There's a simple reason that the US path takes longer than the European system -- we rejected theirs when designing ours. So don't kid yourself that you are going to be looked at positively either going overseas or rushing the program here.

 

[Law2Doc]

...
For your reference, here are the NRMP statistics for 2010: http://www.nrmp.org/data/resultsanddata2010.pdf

Refer to page 5, you'll see that hundreds of U.S. IMGs have matched into surgical fields, including General Surgery. Also, contrary to what was inferred or otherwise stated above, there are many notable and excellent universities in the UK and Ireland.

I don't think anyone inferred that there aren't notable and excellent universities elsewhere -- simply that you don't do well in this process going to places residency directors are not familiar with and learning in a system which doesn't exactly coincide with our own. You could go to a great school in the UK, but if the residency director has to choose between you and someone from a local program he's familiar with (which is always going to be the case), you are SOL.

As for the NRMP statistics, I guess you are simply ignoring the fact that 93+% of US seniors match while less than 50% of folks educated overseas do. That there are hundreds of US IMGs matching is meaningless unless you take into account the greater hundreds that don't. Also bear in mind that there are more and less competitive residency slots -- matching into a malignant prelim surgery slot at a small community hospital in the middle of no-where is not the same as matching into a well regarded categorical general surgery slot.

 

[Winged Scapula]

For your reference, here are the NRMP statistics for 2010: http://www.nrmp.org/data/resultsanddata2010.pdf

Refer to page 5, you'll see that hundreds of U.S. IMGs have matched into surgical fields, including General Surgery.

Where are you getting "hundreds" from? There are:

General Surgery 51
Neuro Surgery 3
Orthopedics 3
ENT 1
Integrated PRS 0
Urology 0
Integrated Vascular Surgery 1
Integrated Thoracic Surgery 0

That's 59 positions for US IMGs in surgical fields out of over 2400.

Are you counting Preliminary Surgery? In most cases, that is a dead-end position desired by no one...the IMGs who match into Prelim Surgery have no guarantee of getting a position after that 1 year. It should not counted as any semblance of a desirable residency position with the rare exception of someone who is using it for a Prelim year prior to Anesthesia, Rads, etc. Even if you did include Prelim Surgery, it only accounts for 81 positions out of nearly 1200 where US IMGs match.

Also, contrary to what was inferred or otherwise stated above, there are many notable and excellent universities in the UK and Ireland.

Since I assume this was in reference to my post above, I never said there weren't notable and excellent universities in the UK and Ireland. The fact is, for US medical faculty, if it isn't Oxford or the Royal College, they haven't heard of it and have no idea about the quality. When it comes down to it, she's still an IMG - whether she went to a Top 15 UK school or the Caribbean. That is what her application will be filtered for.

As a US-IMG educated in a British colony, I can tell you that *yes* in some cases it will make a difference over someone educated in the Caribbean, Mexico, etc. But for programs that filter for IMGs, it doesn't make a darn bit of difference where she went - she will be seen as an IMG through and through. AND if it is found that she skipped US undergrad and didn't even try to get into a US medical school, then her sensibility will be called into question (fair or not).

 

[SitraAchra]

If I or an external force is devoted to having me 'rush through college', would you suggest that I attempt to complete US college a year or two early rather than going to the UK? I will have enough college credits through summer courses, AP, IB, CLEP, etc. to finish college in the US in about 2 years with less than 20 credits per semester.

Why do you have to finish college/start med school by the time you're 20?

Admissions committees will see you as immature and you will lack 2 years of extracurriculars that other applicants will have. Even with excellent grades you will lack the life experience of others.

I did IB/AP in high school and had 46 college credit hours before I set foot on campus. You know what I did? I took nice leisurely semesters 12-14hours and did well while having fun. No one ever mentioned during iterviews why I didn't kill myself and take 18-20 hours each semester. As long as you have a good GPA, MCAT, and ECs who cares how long it took you?

Stay in the US and have fun in college and if you can't afford it take out loans. You'll be ok.

 

[Acherona]

In general you should always try to go to medical school in the country you intend on doing residency. Believe me, you will just make your life harder by going elsewhere. People do it and they succeed but they have to be better then their peers who trained in the same country. The US is probably the most open to accepting foreigners (in france for example you basically have to redo medical school) but you'll be at a disadvantage. Why would you want to start out with a disadvantage if you have a choice? I went to med school in Canada, the graduates from which are actually considered AMG for purposes of residency application, but even so, and even despite the fact that I and many of my classmates were US citizens, we were still at a disadvantage. So listen to what people are telling you on this board.