US MD for $320k or IMG for $100k?

[maseezy]

I've been accepted to a foreign med school which will cost ~100k (I'd have IMG status).
I could start there in August OR go to an SMP program which will cost 320k after everything, but will give me a shiny US MD. All costs include living expenses, but no interest accumulation.

I would be fine with doing residency in Internal, but I would also be fine with gunning for anything more competitive if I went with the 320k US MD.

What does SDN think? Thanks for reading!

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[Lucca]

Do you want to be a doctor in the US? If yes: USMD For 320K.

If no: Go to the foreign school.

 

[TxC]

'Murica

 

[maseezy]

Do you want to be a doctor in the US? If yes: USMD For 320K.

If no: Go to the foreign school.

I can still come back to the US with an IMG, it will be more difficult but still possible. With this scenario I would be a physician in the US without the crippling debt. The foreign school has roughly a 75% first attempt match rate at US residencies, which is... decent enough? It's all step 1 score dependent.

 

[gyngyn]

I can still come back to the US with an IMG, it will be more difficult but still possible. With this scenario I would be a physician in the US without the crippling debt. The foreign school has roughly a 75% first attempt match rate at US residencies, which is... decent enough? It's all step 1 score dependent.

Actually, no. We expect a high Step 1 score from the Caribbean students who have (finally) been allow to sit for the exam. The higher the score, the more we suspect the usual reasons for a Caribbean choice.

 

[MrLogan13]

Actually, no. We expect a high Step 1 score from the Caribbean students who have (finally) been allow to sit for the exam. The higher the score, the more we suspect the usual reasons for a Caribbean choice.

While I probably have some idea, what are some of these usual reasons? Just out of curiosity.

 

[Mad Jack]

Hell, I'd go USMD for 500k over IMG for free.

 

[Mad Jack]

I can still come back to the US with an IMG, it will be more difficult but still possible. With this scenario I would be a physician in the US without the crippling debt. The foreign school has roughly a 75% first attempt match rate at US residencies, which is... decent enough? It's all step 1 score dependent.

Keep in mind that there are going to be more US graduates than ever by the time you're matching, which will push those first time match numbers way, way down. The number of US grads has expended by several thousand in the last 4 years.

 

[gyngyn]

While I probably have some idea, what are some of these usual reasons? Just out of curiosity.

I'm sure you can guess.
What would be the differential diagnosis of a person who scores well on tests yet chooses a low yield option?

 

[resiroth]

Actually, no. We expect a high Step 1 score from the Caribbean students who have (finally) been allow to sit for the exam. The higher the score, the more we suspect the usual reasons for a Caribbean choice.

Maybe I'm dense (don't look at Caribbean much) but what are the typical reasons? If someone shows up with a 270 step and a Caribbean MD how do you see that? Someone that is super awkward/antisocial?

 

[gyngyn]

Maybe I'm dense (don't look at Caribbean much) but what are the typical reasons? If someone shows up with a 270 step and a Caribbean MD how do you see that? Someone that is super awkward/antisocial?

Ok, I'll bite:
In addition to your observation: bad judgement, bad advice, ego/hubris, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems,weak research skills, high risk behavior...

 

[Mad Jack]

Ok, I'll bite:
In addition to your observation: bad judgement, bad advice, ego/hubris, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems,weak research skills, high risk behavior...

This also explains the general anti-DO bias amongst many PDs (not that I'm saying you are anti-DO, just that the same things crop up). Admittedly, I suffer from bolded. The former because I'm already old, the latter because I've always been working full time and never had the opportunity to do research.

 

[breakintheroof]

... the latter because I've always been working full time and never had the opportunity to do research.

I wonder if this was referring to research in terms of Google, rather than scientific inquiry?

 

[gyngyn]

This also explains the general anti-DO bias amongst many PDs (not that I'm saying you are anti-DO, just that the same things crop up). Admittedly, I suffer from bolded. The former because I'm already old, the latter because I've always been working full time and never had the opportunity to do research.

DO students are more likely to be viewed as "late bloomers" or those who don't do as well on the MCAT. Certainly they are less likely to be associated with any of the attributes I have listed compared to their US MD comparators. If they score well on Step 1, all is forgiven. The opposite is true for Caribbean grads.

 

[Make Or Break]

Just wondering but since OP got accepted to both us and Carib, doesn't that give him a story to tell to PD's? Considering he does well in the Carib of course.

 

[s5260205]

Just wondering but since OP got accepted to both us and Carib, doesn't that give him a story to tell to PD's? Considering he does well in the Carib of course.

OP did not get into US schools. He is only planning to do an SMP in the US and apply after one year.

 

[resiroth]

OP did not get into US schools. He is only planning to do an SMP in the US and apply after one year.

Or OP has guaranteed MD acceptance following SMP. They're a thing, not super common but they exist (usually offered to rejects as a way to make it in the next year without re-applying).

 

[SydSing]

 

[Goro]

Then you'll be unemployed with only $100K in debt!

The IMGs who float through these boards will wail and gnash their teeth about it, but the residency slots for them are going to be drying up. One way or another. That bus is coming.

I've been accepted to a foreign med school which will cost ~100k (I'd have IMG status).
I could start there in August OR go to an SMP program which will cost 320k after everything, but will give me a shiny US MD. All costs include living expenses, but no interest accumulation.

I would be fine with doing residency in Internal, but I would also be fine with gunning for anything more competitive if I went with the 320k US MD.

What does SDN think? Thanks for reading!

 

[Lucca]

I can still come back to the US with an IMG, it will be more difficult but still possible. With this scenario I would be a physician in the US without the crippling debt. The foreign school has roughly a 75% first attempt match rate at US residencies, which is... decent enough? It's all step 1 score dependent.

You should operate under the assumption that you cannot come back to the U.S..

 

[Doug Underhill]

Do not go to the Caribbean, the Isle of Misfit Pre-Meds. I'd go PA before I threw my life away for a useless degree that left me $100k in debt. With a PA degree, you can earn what is considered a really nice standard of living by most Americans.

The SMP sounds like it's your best bet

 

[collegestud2013]

The OP needs to look at a document called "Charting the Outcomes of the Residency Match" (or some similar name, Google it). It details that match statistics for most specialties such as Step scores, research, etc... and breaks it down into US seniors vs independent applications (which includes IMGs). You'll notice that the match the rates are significantly lower for the latter in a given specialty for a given Step 1 score and exactly how much more difficult it will be. For example, a US grad has a 90% chance of matching IM with about a 200 on Step 1, while for an independent applicant that chance with the same 200 is at a miserable 30%. To get the same 90% chance of matching, an independent applicant would need a 260 (which is not easy to get by any means). And this is just matching at all (not talking about the prestigious or highly desirable programs or locations), and for a specialty that's not very competitive to match in. Matching into competitive specialties will be even harder. And as mentioned before, this will become even more difficult for IMGs in few years since a lot f new US medical schools have opened and some existing medical schools have added more spots to their class. The number of residency spots has barely increased (due to funding issues from the government, but that's another story), so these new AMGs will get priority over IMGs in the match process. Also, if your medical school is not geared towards training physicians to practice in the US, you would have to plan on taking time off after medical school to study for and take Step 1 and go through the application process, since the foreign medical school may not have time built in to allow this. This, and not matching on your first time (which has a pretty high chance of happening), will lead to years of physician's salaries lost. That and the the even lower chances atmatching for the competitive, higher paying specialties (and thus making much less money as a PCP for your entire career) will easily negate the ~$220k you save by going to an international medical school.

 

[Glandzburg]

http://forums.studentdoctor.net/thr...t-the-caribbeans.1123345/page-7#post-16273718

 

[cs24]

Just wondering but since OP got accepted to both us and Carib, doesn't that give him a story to tell to PD's? Considering he does well in the Carib of course.

Sure. The story would be, "I made a huge mistake". But then again he wouldn't get the chance to tell the PDs because he wouldn't get very many interviews.

 

[DrShephardWannabe]

I'm sure you can guess.
What would be the differential diagnosis of a person who scores well on tests yet chooses a low yield option?

I'll take extremely smart but no common sense for $500

 

[youmed]

Another assumption playing here is that the OP will absolutely kill the Step I, which is the same as a pre-med saying he/she will absolutely kill the MCAT.

 

[BamaNicole]

I'll take US MD for 350K, Alex.

The answer is : residency

What is what I won't get as a IMG, Alex.

 

[IlDestriero]

Just wondering but since OP got accepted to both us and Carib, doesn't that give him a story to tell to PD's? Considering he does well in the Carib of course.

You don't get to tell the PD anything when he doesn't read your application and/or offer you an interview.
Competitive jobs may also use your fmg status to screen out your application. It happens in my field.

 

[IlDestriero]

One more thing to ponder, students that did well in undergrad and killed the mcat still found themselves, sometimes most distressingly, in the bottom third of the class and with below average step scores. Someone who didn't do stellar in school and/or crush the mcat probably shouldn't bet their careers on being able to do better than average in medical school and on the step exams.

 

[xffan624]

Another assumption playing here is that the OP will absolutely kill the Step I, which is the same as a pre-med saying he/she will absolutely kill the MCAT.

Having just taken Step 1, it's amazing how much studying one can do and have the test still make you feel stupid.

 

[ACSurgeon]

I've been accepted to a foreign med school which will cost ~100k (I'd have IMG status).
I could start there in August OR go to an SMP program which will cost 320k after everything, but will give me a shiny US MD. All costs include living expenses, but no interest accumulation.

I would be fine with doing residency in Internal, but I would also be fine with gunning for anything more competitive if I went with the 320k US MD.

What does SDN think? Thanks for reading!

No matter what the cost difference or time difference, US MD is 100 times better option than IMG.

 

[chipwhitley]

OP, you should also ask in a carribean forum for their opinion. I'm pretty sure they would also say US too, but that would certainly help you make a more confident decision. Most of all though, if you are about to take on 320k of debt, please be sure you can actually handle medical school, and want to practice medicine for the right reasons. Otherwise it is going to be a life-ruining decision.

 

[the argus]

I'll chime in as the ceremonial US-IMG (starting residency in July).

You should absolutely do the SMP and get the US MD. Anyone who tells you otherwise is giving you bad advice. 100K vs 320K might seem like a lot of money now, but over the course of a 30+ year career with yearly earning potential of $200K+, it really isn't that big of a deal.

That being said, as usually the comments being made about US-IMGs in this thread are bombastic and more personal opinion/bias than fact. This comment is probably the worst of the bunch,

DO students are more likely to be viewed as "late bloomers" or those who don't do as well on the MCAT. Certainly they are less likely to be associated with any of the attributes I have listed compared to their US MD comparators. If they score well on Step 1, all is forgiven. The opposite is true for Caribbean grads.

There's this idea, very prevalent on this forum, that DOs perform way better than US-IMGs in the match, which is by and large a fallacy. People will then say, "look at Charting the Outcomes, DO match rate is 77%, US-IMG is 53%," which is creating a false narrative and misuse of the data (I've explained why at length in other threads). In the NRMP, DOs and US-IMGs are limited to the same specialties and the same overall tier of program within a given specialty. A particular program, like gyngyn's obviously, might have a preference one way (it goes the other way to, some programs choose US-IMG over DO). But this idea that DOs perform much better than US-IMGs in the NRMP is just false, plain and simple. The advantage with DO is that they have the all the DO-only residency programs in the more competitive specialties.

But to return to the original question, US MD massively trumps everything, and to pass on that for any reason (time or money) is a bad idea.

 

[radiologyology]

Don't go to the Caribbean if you want to be a physician in the US.

 

[the argus]

The additional advantage of DO is that in fact, whether allopathic or osteopathic residency, they have an overall match rate as a ratio of graduates to seats, on par with US-MD and thus the ability to be licensed and practice in the US.

That's correct, but I was talking about the allopathic match.

I was specifically taking issue with the statement that if DOs do well on step 1 (hence, talking about the NRMP not osteopathic match), that "all is forgiven." This idea that the sky is the limit for high achieving DOs is just patently false. In the NRMP, DOs are second-class applicants just like US-IMGs, and if a program is open to taking a DO they are most likely also open to taking US-IMGs. This isn't my opinion, you can look at match lists for DO schools and match lists for the big 3 caribbean schools. There is a reason DOs are bunched into the "independent applicants" category along with US-IMGs/foreign-IMGs. Their match profile is much more similar to those groups than to US MDs.

Applicants from the big 3 caribbean schools with no major red flags (step/semester failures, etc.) match just as well in the NRMP as DOs.

Don't go to the Caribbean if you want to be a physician in the US.

Putting a cute GIF in your reply doesn't make it any more true.

Again, I have never argued that going to the caribbean is as good an option as a US (MD or DO) medical school, I in fact have repeatedly said the opposite. But the sensationalism about caribbean medical schools on this forum is silly.

 

[MyNameHere22]

In the NRMP, DOs and US-IMGs are limited to the same specialties and the same overall tier of program within a given specialty. A particular program, like gyngyn's obviously, might have a preference one way (it goes the other way to, some programs choose US-IMG over DO). But this idea that DOs perform much better than US-IMGs in the NRMP is just false, plain and simple. The advantage with DO is that they have the all the DO-only residency programs in the more competitive specialties.

The fact is that there is no way for you to know if DO or IMG is better in the match without knowing all the student and institution rankings. If a program has all IMGs, I can't say, "Wow! This program prefers IMGs to USMDs!" Because it may be that no USMDs applied.

We can know, however, that going to a DO school does give you a better chance of matching because of what you said - the DO match. But going to a DO school also gives you a better chance of matching NRMP because you have a better chance of making it to fourth year when you'll be applying for residency. No matter how you slice
it - the DO route is indisputably better for matching (DO match or MD match). You just don't have the information to say IMGs fair better (or even the same) in the match.

That being said. - we both agree - go US.

 

[DoctorSynthesis]

I'll chime in as the ceremonial US-IMG (starting residency in July).

You should absolutely do the SMP and get the US MD. Anyone who tells you otherwise is giving you bad advice. 100K vs 320K might seem like a lot of money now, but over the course of a 30+ year career with yearly earning potential of $200K+, it really isn't that big of a deal.

That being said, as usually the comments being made about US-IMGs in this thread are bombastic and more personal opinion/bias than fact. This comment is probably the worst of the bunch,



There's this idea, very prevalent on this forum, that DOs perform way better than US-IMGs in the match, which is by and large a fallacy. People will then say, "look at Charting the Outcomes, DO match rate is 77%, US-IMG is 53%," which is creating a false narrative and misuse of the data (I've explained why at length in other threads). In the NRMP, DOs and US-IMGs are limited to the same specialties and the same overall tier of program within a given specialty. A particular program, like gyngyn's obviously, might have a preference one way (it goes the other way to, some programs choose US-IMG over DO). But this idea that DOs perform much better than US-IMGs in the NRMP is just false, plain and simple. The advantage with DO is that they have the all the DO-only residency programs in the more competitive specialties.

But to return to the original question, US MD massively trumps everything, and to pass on that for any reason (time or money) is a bad idea.

If you look at the program director survey a vast majority prefer DO applicants over US IMG. Its no surprise GYNGYN favors DOs as statistically that is FAR more likely. DOs schools are performing very close to many US MD schools. The attrition/ match at some DO schools isn't that far off some US MD schools. Just look at the mercer and Pcom match lists in that very recent thread. Not very different. Obviously some US MD school will make a bigger difference.

If you take a look at the data 71% will interview DO applicants and 60% US IMG. So 11%. That's huge! Every indication is that the gap is growing.

This of course doesn't include DOs having their own residency and all the other problems with foreign schools that cater to US applicants.

 

[chipwhitley]

SGU does place more students in residency than any US medical school.

 

[aprimenumber]

SGU does place more students in residency than any US medical school.

Because their class size is literally 3-4 times as big as any US medical school, and they tend to count results from several combined graduating classes...

 

[chipwhitley]

Because their class size is literally 3-4 times as big as any US medical school, and they tend to count results from several combined graduating classes...

I think SGU has some back room deal with our IM program because we have a large number of SGU grads every year but barely any other IMGs or other Caribbean schools.

 

[JimmyB123]

SGU does place more students in residency than any US medical school.

Come on dude. You're smart enough to not fall for that argument...

 

[Goro]

They also lose more students per class than any US medical school. IF they were COCA or LCME accredited, they would be shut down over this.

SGU does place more students in residency than any US medical school.

 

[IlDestriero]

They also lose more student per class than any US medical school. IF they were COCA or LCME accredited, they would be shut down over this.

The big ones lose more students per class than the total number of students in most American medical school classes!

 

[chipwhitley]

Come on dude. You're smart enough to not fall for that argument...

I know I wasn't being serious. Although that is their marketing slogan. And technically it is true.

 

[WingedOx]

I'll chime in as the ceremonial US-IMG (starting residency in July).

You should absolutely do the SMP and get the US MD. Anyone who tells you otherwise is giving you bad advice. 100K vs 320K might seem like a lot of money now, but over the course of a 30+ year career with yearly earning potential of $200K+, it really isn't that big of a deal.

That being said, as usually the comments being made about US-IMGs in this thread are bombastic and more personal opinion/bias than fact. This comment is probably the worst of the bunch,



There's this idea, very prevalent on this forum, that DOs perform way better than US-IMGs in the match, which is by and large a fallacy. People will then say, "look at Charting the Outcomes, DO match rate is 77%, US-IMG is 53%," which is creating a false narrative and misuse of the data (I've explained why at length in other threads). In the NRMP, DOs and US-IMGs are limited to the same specialties and the same overall tier of program within a given specialty. A particular program, like gyngyn's obviously, might have a preference one way (it goes the other way to, some programs choose US-IMG over DO). But this idea that DOs perform much better than US-IMGs in the NRMP is just false, plain and simple. The advantage with DO is that they have the all the DO-only residency programs in the more competitive specialties.

But to return to the original question, US MD massively trumps everything, and to pass on that for any reason (time or money) is a bad idea.

aaaand the token defensive Ross grad has found the thread!

 

[Stagg737]

Just out of curiosity, does anyone know if IMGs match into prestigious residency programs like Mayo or Cleveland Clinic? I ask because I know multiple DOs from my school have matched at both places over the past 3 years into highly competitive programs (derm and path specifically) and was wondering if IMGs were indeed capable of the same.

 

[the argus]

aaaand the token defensive Ross grad has found the thread!

aaaaand the token AMG (DO probably) who resorts to personal insult instead of actually be able to disprove anything I wrote has found the thread!

You can call me defensive, I'll call it realistic. Again, I have never said caribbean is better than DO. All I've said is that on this forum when talking about NRMP outcomes, DO outcomes are made out to be better than they are in reality, and caribbean outcomes are made out to be worse than they are in reality. People by and large disregard the data and opt for personal opinion.

Just out of curiosity, does anyone know if IMGs match into prestigious residency programs like Mayo or Cleveland Clinic? I ask because I know multiple DOs from my school have matched at both places over the past 3 years into highly competitive programs (derm and path specifically) and was wondering if IMGs were indeed capable of the same.

I don't know about specific programs, but last year in the NRMP DOs had 3 derm matches, US-IMGs had 4. DOs had 51 path matches, US-IMGs had 41. DOs had 1 ortho match, US-IMGs had 5.

This goes to show exactly what I said above, that in the NRMP, DO and US-IMG outcomes are very similar. Maybe that makes me defensive and a shill, or maybe it just makes me someone who can look at data without any bias.

And yes, the attrition rates at the big 3 caribbean schools are very substantial (15-25%). But that doesn't change the fact that NRMP outcomes for US-IMGs are much better than people state on this forum.

 

[DoctorSynthesis]

aaaaand the token AMG (DO probably) who resorts to personal insult instead of actually be able to disprove anything I wrote has found the thread!

You can call me defensive, I'll call it realistic. Again, I have never said caribbean is better than DO. All I've said is that on this forum when talking about NRMP outcomes, DO outcomes are made out to be better than they are in reality, and caribbean outcomes are made out to be worse than they are in reality. People by and large disregard the data and opt for personal opinion.



I don't know about specific programs, but last year in the NRMP DOs had 3 derm matches, US-IMGs had 4. DOs had 51 path matches, US-IMGs had 41. DOs had 1 ortho match, US-IMGs had 5.

This goes to show exactly what I said above, that in the NRMP, DO and US-IMG outcomes are very similar. Maybe that makes me defensive and a shill, or maybe it just makes me someone who can look at data without any bias.

1) Wingedox is a US MD student

2) cherry picking data means nothing.
There are over 100 DO ortho spots so if the only option DOs had for ortho was acgme than they most likely would have matched more than US IMG. There is also some derm spots in AOA.

3) US IMG also includes sackler but that school is considered an american school in NY and that consists of 2 Derm US IMG matches. Take that out DO matched more Derm in ACGME.

4) the only reliable way to tell who is favored is asking the PDs. They say DO.

5) where did you even get that data.

6) how about every other specialty?

7) your school (Ross) and the best school (sgu) had zero derm/orthopedic/opthamology/urology/neurosurgery/ENT matches. That's out of 2000 students also.

 

[the argus]

1) Wingedox is a US MD student

2) cherry picking data means nothing.
There are over 100 DO ortho spots so if the only option DOs had for ortho was acgme than they most likely would have matched more than US IMG. There is also some derm spots in AOA.

3) US IMG also includes sackler but that school is considered an american school in NY and that consists of 2 Derm US IMG matches. Take that out DO matched more Derm in ACGME.

4) the only reliable way to tell who is favored is asking the PDs. They say DO.

5) where did you even get that data.

6) how about every other specialty?

7) your school (Ross) and the best school (sgu) had zero derm/orthopedic/opthamology/urology/neurosurgery/ENT matches. That's out of 2000 students also.

A couple points,

1. Sackler isn't considered a U.S. school in NY. I'm not even quite sure what that means.

2. 1 or 2 PDs on this forum say that, and then present their personal opinion as fact. That is not how my PD feels.

3. Data is from the NRMP reports. This is very telling that you don't even know this data exists. Maybe you should inform yourself before forming an opinion.

4. Every other specialty has DO and US-IMG being very comparable. Certainly DO is more similar to US-IMG than US MD.

5. This year Ross had 2 ophthalmology matches and 2 ortho matches, SGU also had 4 ortho matches I believe. And arguing over the most competitive specialties is silly anyway, I only said the numbers before because someone else brought it up. There are lots of US MD schools that don't have any neuro surgery, ENT, or urology matches in a given year.

 

[DoctorSynthesis]

A couple points,

1. Sackler isn't considered a U.S. school in NY. I'm not even quite sure what that means.

2. 1 or 2 PDs on this forum say that, and then present their personal opinion as fact. That is not how my PD feels.

3. Data is from the NRMP reports. This is very telling that you don't even know this data exists. Maybe you should inform yourself before forming an opinion.

4. Every other specialty has DO and US-IMG being very comparable. Certainly DO is more similar to US-IMG than US MD.

5. This year Ross had 2 ophthalmology matches and 2 ortho matches, SGU also had 4 ortho matches I believe. And arguing over the most competitive specialties is silly anyway, I only said the numbers before because someone else brought it up. There are lots of US MD schools that don't have any neuro surgery, ENT, or urology matches in a given year.

1) look at sacklers website they have NY accreditation as a US school. The letter is on their site.

2) no PDs overall say that. Look at the PD survey. 71% will interview DOs 60 will interview US IMG

3) the NRMP doesn't detail osteopathic students specifically. You're the one that doesn't know about the PD survey.

4) That's just flat out false.

5) not according to the match list on their website.