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USIMG vs IMG

Discussion in 'General Residency Issues' started by Squiggy, Dec 29, 2008.

  1. Squiggy

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    With many more domestic med students heading down the pipeline in the future, those educated in foreign med schools will undoubtedly feel the squeeze. My question is this:

    Is being a US citizen a benefit or stigma for acquiring residencies? How would a US citizen fare compared to a similarly qualified Canadian or someone from overseas?

    It seems that with more slots for US citizens opening up, fewer and fewer qualified Americans will be going abroad for med school. Will the matchability of USIMGS suffer more as a result of this due to the perception that they are less qualified for not getting into a domestic school?

    It seems that Canadians could be seen highly as there are armies of qualified Canadians students who aren't able to get into a Canadian school.

    Any ideas?
     
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  3. doc20

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    this has been discusses multiple times in the various threads including in the international forums, do some search
    but overall preception AMG>DO>USIMG>IMG will always hold up for residency match, including with the new increase in AMG spots
     
  4. RussianJoo

    RussianJoo Useless Member
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    people who need visas to do their residencies in the US like Canadians or others will get fewer interviews when compaired to a US citizen or perminant resident with the same stats. simply because the residency programs don't like to spend the time and money sponsering visas for their residents when they can simply accept a US grad with the same exact numbers. It's a pain in the arse to sponser a visa.
     
  5. BlondDoctor

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    Thought I might take over this thread here...
    I keep reading about USIMGs but they are usually from carib schools, which is more often than not to say they didnt get into a US MD school.
    Now my question is what about USIMGs that whent to really competitive schools? There dont seem to be as many that are dual citizens and chose for whatever reason (mine would be financial as well as family) to go to a very prestigious school in Europe. Would I really have no shot at a residency in general surgery? Starting to get a little freaked...
     
  6. med2UCC

    med2UCC Relentlessly Optimistic
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    I have 2 Canadian friends (former classmates) who are doing general surgery in the US. Both matched on the 1st round to their 1st choice program the 1st time they applied. Do electives in the programs you want to match to and do well on them. It is not impossible to match to general surgery as an IMG, even one who needs the program to sponsor a visa. Cheers,
    M
     
  7. RussianJoo

    RussianJoo Useless Member
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    the problem is, you can't do electives in the US as an IMG from european schools because you do all your clinical rotations in europe, you'd have to do observerships and those are kind of pointless because you can't do anything. that's one main reason Carib schools are better than European schools, because you do your clinical rotations in the US and get US clinical experience, US LOR's and learn how the US healthcare system works.
     
  8. BlondDoctor

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    Wait, why wouldnt I be able to do clinical rotations in the states? We have exchange programmes to US schools from my school and you can apply to electives independently...
     
  9. silas2642

    silas2642 silas2642
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    I was wondering if Canadians are different than say, the guy who graduated from the Caribbean or from an Indian med school. I mean, after all the quality of Canadian med schools is for the most part superb, and they can speak english flawlessly. Really all Canada is pretty much like the US-- just more boring.
     
  10. Saga1

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    Fewer guns as well :laugh:
     
  11. galactus

    galactus Devourer of WORLDS
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    You can. There are med schools that take IMG's from other countries to do their 4th year electives at certain schools.

    http://services.aamc.org/eec/students/

    Just search for schools that accept international students to go through their program. I was in a rotation once with someone from a japanese medical school, so it is possible pending if your school allows it.
     
  12. SoCuteMD

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    There are lots of nationalities you can use, but a Canadian who has attended an LCME-accredited school (such as all of the schools in Canada) has a huge advantage compared to a Carribean graduate at some of the "big name" institutions. It's the smaller institutions with fewer financial and political resources where they might be at a disadvantage secondary to visa issues.

    Canadian schools are LCME-accredited (like the US allo schools, I'm not sure about the osteo schools to be perfectly honest) so their education is considered equivalent to that provided in the US.
     
  13. rhmtascp

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    Where do you get your info from? Couldn't be further from the truth. I personally know lot of people doing ALL their rotations at US hospitals from European schools, getting US clinical experience, US LOR's and all the things you mention.
     
  14. Doctor Bob

    Doctor Bob EM/CC
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    The accrediting body for US/Canadian allopathic schools is the LCME
    The accrediting body for US osteopathic schools is the COCA
     
  15. RussianJoo

    RussianJoo Useless Member
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    really? well the ones i know of only allow maybe 1 or 2 months at most in the US, that's hardly enough time to get familiar with the US health care system and do audition electives to impress program directors.

    Can you provide the names of the schools that allow you to do your first 2 years in europe and then your 3rd and 4th year of med school in the US? the european schools i know of have their own teaching hospitals/clinical centers in their country and would lose money if they let their students do all their clinical rotations in the US. You can however, do rotations in the US after you graduate from european med school, but those will be observerships.
     
  16. rhmtascp

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    The only schools I'm aware of that offer 4-year MD programs are in Poland. There may be others, but the vast majority of European schools offer only 6-year programs, the last of which is an internship.

    I never said that schools allow students to go 3rd and 4th year abroad, have I?

    I didn't specify, which may have caused some some confusion on your part, but what I was saying is that people I know spend their whole 6th year at different US hospitals rotating, not doing observerships. The school still gets paid for that last year.

    Now whether you think one year is good enough or not, I can't say. But that's all they get. Better than nothing I guess...
     
  17. kash_711

    kash_711 SDN Donor
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    my anecdotal evidence tells me that foreign grads from europe, middle east, asia etc are doing good things in impressing PD's despite not doing 2 years of clinicals in the states.... I don't know how many are dual citizens, but despite limited USCE they are getting into some legit IM programs... but I could be wrong i just googled a few programs that I am familiar with. In the end I think PD's would look more favorably upon a dual citizen who didn't complete their undergraduate studies in the states and then go off to their other country of citizenship to complete medical school as I have done.


    http://residency.med.yale.edu/primarycare/housestaff.html

    http://gwmed.com/index.php?pagename=Where_are_Residents_from?

    http://www.bcm.edu/medicine/residency/?PMID=12014

    http://medicine.emory.edu/education/residency/residents/categorical2012.cfm
    http://medicine.emory.edu/education/residency/residents/categorical2011.cfm
    http://medicine.emory.edu/education/residency/residents/categorical2010.cfm
     
  18. med2UCC

    med2UCC Relentlessly Optimistic
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    The Irish schools certainly don't let you do this but I know several people who have matched in the US despite only being able to do electives the summer between 4th and 5th year. 2 matched to surgery recently (one last year, the other the year before) and one to IM. I also know of several who have matched to paediatrics, and Leorl, a long time poster on these forums, matched into EM in the US after doing her intern year in Ireland. I wasn't really keeping track of the US stats since I was planning to match to Canada (and did) but if I can come up with these examples, having basically ignored the whole US match through 5 yrs of med school, I am sure there are more.
    If you go to a reputable school, do a few electives in the US and do reasonably well on your boards, there is no reason why you shouldn't match in the US. It's certainly easier than matching in Canada from a foreign medical school! (although I am happy they've stoppped calling us FMG's - the F can be interpreted multiple ways ,few of which are flattering!).
    Cheers,
    M
    An FMG
     
    #17 med2UCC, Feb 28, 2010
    Last edited: Mar 1, 2010
  19. RussianJoo

    RussianJoo Useless Member
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    idk, i know many fmg's who are struggling with residencies, granted they're not from european med schools. would you really want to spend an extra 2 years in med school when you don't have to and can go to the carib.

    you guys can go where ever you want to school. i think you have better chances at a carib school, well i should specify you have a better chance at SGU, ROSS, AUC or SABA than european schools if you're a US citizen because you spend 2 years in the US hospitals. Also not to mention that carib schools are 2 years shorter than european schools. so carib schools allow you to spend less time away from your friends and family, allow you to get to know and work more in the US healthcare system, and graduate faster with the same results for residencies. in the end however, these options all suck when compared to US MD, Canadian MD or US DO if your end goal is to match in the US.
     
  20. Winged Scapula

    Winged Scapula Cougariffic!
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    To clarify:

    1) European students are eligible for US clinical electives just like any other foreign medical student, as long as they complete any prerequisites; they are not resigned to observerships

    2) there is no evidence or conventional wisdom that spending two years in the US is significantly better than spending a few months here in terms of learning about the US system, getting LORs, etc. especially if the person doing the rotations is American and already familiar with the system.

    Whether going to the Caribbean or a European school is better is a matter of personal preference however.
     
  21. rhmtascp

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    ...not only that, but you can to a EU med school right out of high school. That would actually be two years shorter than the US and Caribb.
     
  22. gutonc

    gutonc No Meat, No Treat
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    If your friends graduated from Canadian med schools, they are not considered to be FMGs. All Canadian med schools have LCME accreditation and count the same as US MD schools. If they're Canucks who went to the Carib, that's a different story. But if that's the case, bringing up Canada just confuses the issue.
     
  23. med2UCC

    med2UCC Relentlessly Optimistic
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    My friends went to medical school in Ireland, as did I. As such, they were not going to LCME accredited schools and so were IMG's. I thought that was explicit in my original post, and apologize for my lack of clarity.
    M
     
  24. BlondeDocteur

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    I would strongly disagree that an American/Swedish dual citizen should choose to go to the Caribbean over say, Uppsala. For starters, she would be reducing her tuition by approximately $50,000 a year.

    More importantly, Uppsala is a legitimately world-class institution. The brightest students in Sweden fight to win admission there, meaning her colleagues and professors would be top-notch. It's a "real" university medical center: the medical school has attached university hospitals, clerkship sites, supervising residents and attendings. It has a public duty to take care of the people of Sweden. Research opportunities abound as well, and every student is assured a uniform, respected training.

    This is in sharp contrast to the Caribbean medical schools, which are seen as diploma mills for foreign citizens, primarily Americans (yes, a certain number of native islanders are allowed to attend for free, but this is a goodwill gesture). Caribbean schools are for-profit institutions. Faculty are often foreign-trained MDs who are also attempting to enter residency in the US and have no particular expertise in the field on which they're lecturing. Very little to no clinical experience is on-island; instead students are shunted Stateside to cobble together clinical years at hospitals of varying quality. There are no "SGU" or "SABA" or "AUC" residents or attendings; needless to say there can be no standardization of curriculum, clinical experience or evaluation criteria from site to site. Very little clinical care is provided for the people of Grenada/Dominica/Saba, etc by these institutions.

    Lastly, should the OP fail to obtain a residency spot in the US after completing her training, she can always elect to stay in the Swedish system. That is not an option for Caribbean students.
     
  25. Saga1

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    Although Uppsula is a definitely a much much better option than any caribbean school with regards to quality/research you do seem to have a few misconceptions. At the Big 4 most of the professors are American/Canadian/European. At some schools like Ross you have exposure to a clinical setting from the 3rd semester. There are organizations on campus which also participate in providing free medical care to indigenous population of the island as well.
     
  26. galactus

    galactus Devourer of WORLDS
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    top notch medical schools in europe are >>>>> carib schools (no comparison)

    2 years more? try 2 years less. these people go straight to medical school right after high school. 2 years pre-med + 4 years proper. And the exams needed to get into these schools are extremely tough (insert random bash on the American HS education system here, haha)

    Foreign students can technically do their last year in the US, as I stated in the previous post with a link on schools that do. Some programs won't let carib students rotate through their system but will allow other IMGs.
     
  27. agranulocytosis

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    Edit: many programs.
     
  28. rhmtascp

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    If you like the cold (I kind of do), and have a European degree from any country in the union = lots of opportunities for VERY WELL paying jobs, with GREAT LIFESTYLES in the north of Sweden and Norway.

    Anyhow, many European schools have been around for HUNDREDS of years. They have long tradition of teaching; with many many schools having Nobel Laureates, so yes, I would say European degrees are much more well-regarded than any Caribbean.
     
  29. bluealiendoctor

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    Only basic sciences are done on the island. The first two years of medical school in the U.S. has limited clinical training as well. At Ross, quite a bit of clinical training is done on the island. 3 days a week after lecture is spent doing nothing but OSCE's, as well as patient interviewing every friday evening. We also spend every other weekend going to the main hospital and seeing patients with varying illnesses under the supervision of physicians, Britain trained as well as US trained. Carib schools will always take a beating, but it seems as though you have a few misconceptions that I just wanted to clarify. We also can do many,many rotations along side with US grads so I guess your implying US schools have rotations with varying quality as well. My surgery, OBGYN,PEDS, and PSYCH rotations were all done with US medical students. They certainly didn't feel their rotations were sub par.
     
  30. RussianJoo

    RussianJoo Useless Member
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    yeah but wasn't this discussion started as what's better for a US citizen who failed to get into a US med school? Carib Vs. Europe. well if you couldn't get into a US med school, "top notch" European med schools won't even look at your application, also a lot of these people will be college grads that will be applying, not straight from high school, so this isn't the discussion that was originally started. No **** Oxford is better than SGU, that's pure genius eater of worlds...

    As for other european schools that are in countries that don't speak english, many of them have special programs taught in english designed specifically for US students who failed to get into US med schools, those programs are there just to cash in on this market just like Carib schools are, and some even go as far as stating that if you complete your medical degree from this program it will not be recognized by their government and you will not be able to practice medicine in their country. I think some of the Prague schools have that statement.
     
  31. RussianJoo

    RussianJoo Useless Member
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    yeah at SGU we rotate with students from NYCOM, UMDNJ, Cornell, SUNY Down State and more, we go to the same lectures and are taught by the same attendings.
     
  32. RussianJoo

    RussianJoo Useless Member
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    if you're not a swedish citizen good luck staying in sweden after you finish med school. It's even harder for a foreigner to get post graduate training i.e. a residency in european countries than it is in the US.
     
  33. BlondDoctor

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    Thanks for the helpful post!
    (except no way i would go to Uppsala over the Karolinska institute ;) )
    is there anything else i can do to keep up with USMD students?
    Of course do well on the steps but I mean research, exhanges etc.?



     
  34. thedrjojo

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    The only places SGU and UMDNJ-New Jersey Medical School rotate together at a hospital are the St. Barnabus Network of hospitals (St. Barnabus, Newark Beth Israel are the main two, I don't think we have any rotations at Clara Maas), and St. Joseph's (not sure if that is in the same network...). These are all secondary hospitals for us, and for the most part are not desirable locations because the experience is very subpar compared to our other options of University Hospital, East Orange VA, and Hackensack (which is attempting to get SGU students and our schools administration is fighting it and is threatening to not allow our residents to teach the SGU students from what I have heard). I personally rotated at NBI for my second month of Internal Medicine (our school, IM is 4 weeks at UH, 4 weeks at one of our other hospitals, and then 4 weeks outpatient...). It was myself, one other student from my school, and then a large group of SGU students, a few NYCOM, and a few UMDNJ PA students. The education program there was poorly organized. Organized lectures were of varying quality (as they always will be) but overall poor, and many of them simply involved sitting with photocopied pages from MKSAP and going over a chapter of 10 questions in an hour and just reading the answers, not expanding on it or making me feel like I was gaining anything over just sitting and studying it myself. The residents were in large part FMG's/USIMG's, and did not offer much teaching of their own. The computer system was circa 1990, students were not allowed to put notes in charts so essentially never wrote notes. The chair of medicine at NBI, I forget his name, is a fairly well known guy (as he likes to point out), but his interaction is minimal and he really isn't a good teacher. Students at my school view it as a punishment to be sent there, and this is a main teaching hospital for SGU. I haven't personally experienced it, but have heard similar things about St. Barnabus and St. Joseph's. Another school that NJMS students rarely (I was the first one in like 3 years) rotate at is St. Michaels, which in my mind, actually makes NBI look good. They both have the same antiquated computer system, but on surgery, they had 1 attending who did any sort of teaching, the residents were farmed from other residencies (Bronx Lebanon and St. Joe's I believe) and were also a mix of IMG/DO. The SGU students, sorry to say, also looked poor when compared to the UNECOM students (which was not necessarily the case at NBI when the students when compared to the NYCOM and PA students...). So yes, RussianJoo, at times the SGU students rotate and are taught with the UMDNJ-NJMS students, and on those rotations we are "taught" by the same attendings, and I have experienced this first hand, which is why I can feel strongly in the fact that if my ONLY clinical experience came from hospitals of that quality, I would be a much poorer student than where I received most of my 3rd year clinical rotations at University Hospital.
     
  35. RussianJoo

    RussianJoo Useless Member
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    i never said it was a great place in terms of didactics, i just commented on the fact that SGU students rotate with other US med school students, and not at private community hospitals that only have private attendings and carib med students. also we rotate only at places that have ACGME residencies in those departments so whatever didactics the residents get at those places so do the med students, and if the ACGME thought those residencies were good enough to achieve accreditation than they're probably good enough to train med students.
     
  36. thedrjojo

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    RussianJoo, my appologies if my post seemed to call you out... I was more responding to bluealiendoctors post, but combinding it with your post about SGU rotating with AMG's... I still stand by my post, and that most of the students at my school do feel the rotations at those hospitals are sub par.
     
  37. dragonfly99

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    I want to know why the original poster wants to go to school abroad. Does she have any shot at US schools, MD +/- DO schools? Those would make practicing in the US much easier, as it will make getting prepped for a US residency much easier. After all those options are exhausted then only should she think about Carib schools or European schools, IMHO. If she is a dual citizen then it might be reasonable to go to a European school, but know that she has an uphill path to get back here and practice. If she just wants psych or primary care then I think she can get those, but she likely won't get residency at one of the more desirable US hospitals. The ones who take foreign grads, even European grads, tend to work people harder and have not as much/not as good teaching....at least in general.
     
  38. Bassix

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    Don't kid yourself. Visiting professors come from all over the place in the US to our carib school. On perm staff is a professor from Hopkins, Dartmouth, Stanford, University of Vermont (2) (1 writes for the step), UPenn, etc... We also have very few foreign physicians teaching who are trying to get into the US. Even then, those physicians bring a substantial wealth of knowledge to the table. Contrary to your AMG myths that float around, we tend to get a quality education for our buck. What we don't have is the pampering that you guys get. In the end, my MD = your MD, as much as you'd probably hate that.
     
  39. heathermed

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    I'm not doubting that US med schools probably get better clinical rotations as a whole. I think any Caribbean student would be foolish to think otherwise. Are there exceptions, of course, but they are just that.

    But in my humble opinion, the doctor is made in residency. The US students may go into residency better prepared (though not necessarily), but at the end of residency, I'm hoping all in the same program are at even footing. US students obviously go into more prestigious residency programs, but that's a different story all together.

    So in conclusion, if a US grad and a Caribbean are in the same residency program, then theoretically it should even out. So I just ask that you judge the schools by what residency programs the students attend for their training as opposed to the clinical years in medical school.

    I'm a student from Ross. Fair disclosure.
     
  40. MCYan

    MCYan Junior Member
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    :thumbup::thumbup::thumbup:

    I would even say top notch med schools in asia are >>>>> carib schools.
     
  41. thedrjojo

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    Love to see how two caribbean students don't even think the same way about it. To Bassix, you can refer to my posts above to why the clinical years of medical school are, for the most part, weaker at the Caribbean schools than it is at US Schools, and as far as medical school is concerned, the basic science years and how you get taught them/who taught them really makes little difference on your future doctoring. While logistically, yes your MD will give you the equal rights of my MD, if training programs believed in that the same way you were implying it, then being a caribbean grad wouldn't be such a negative on your chances... while some of it is unjust, some of the negative view of the caribbean schools is justified. And what pampering are you speaking of? You mean having admission standards lower than the US counterparts so that you even got into medical school? You mean having a built in 5th semester designed for board review and typically even more time to study for the boards then the avg LCME school which has no such prep (most US schools have no formal step review, once the last class ends, they say here is 6 weeks until your clinical rotations begin, you must sit for the boards before they begin)? You mean rotating at hospitals where you have essentially no role in the patient care, no responsibility, no real call, hours of like 7-8am til 2-3pm? (all of which I experienced while at Newark Beth Israel for Medicine and St. Michael's for Surgery, two SGU hospitals... compare that to my University Hospital experience where on medicine, when our team was on call, the entire medical student team was on call [straight q4] so hours was 7am(earlier to preround and get our notes in the chart) til 9-10pm, requirement for daily progress notes, actual responsibilities for getting stuff done for your patients... on surgery I had hours of 4:30am til 5-6pm typically, also daily progress notes, q5 for overnight call with having to stay til noon the following day, etc etc). Where are we pampered again? I know many Caribbean students have complexes and hatred for the US counterparts for "how easy they have it" but lets get real here.

    to heathermed, I agree to much of what you said in principle. You do really become a doctor in residency. US students are typically more prepared to enter residency. In the end all should have had an equal opportunity to thrive in the residency (but not everyone is of equal intellect/ability/dedication so not everyone will be equal coming out of the residency). While I believe it is two overlaping bell curves, the overall distribution is probably skewed slightly towards AMG's overall being of higher intellect/ability, because the system is designed that way that no one choices a caribbean school over a LCME school, so while there are plenty of smart individuals who would do well in LCME schools in the caribbeans, there are also some the would not there, and they skew the distribution. This has less to do with anyone one individual, but also goes back to my point above about some of the justification for Caribbean schools being looked at less than LCME school.

    You also contradict yourself in the post though heathermed, because you state that you judge the schools based on the residencies they get and not based on the clinical years, but previously you state that US students obviously go to more prestigious residencies, meaning you too are agreeing that these schools should be judged as inferior to US Schools (and while you might not disagree with this, Bassix entire point was that students at the Caribbean schools go to a school just as good and, unlike us grads, don't get pampered)
     
  42. md2010sgu

    md2010sgu Med STUD

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    So.......... I don't know you, you don't know me or alot of my classmates... but not all SGU students suck or have "weak" clinical experiences like you mention. We don't have a structured review course for Step 1 ( I studied 6 weeks on my own and spanked Step 1 as did a LOT of my classmates). What you describe does happen at some of our clinical training sites, but 50% of the training sites experience very rigorous hours like you did (some have it worse than you! Like at Lutheran Medical center in Brooklyn (where LOTS of SUNY downstate students are at as well) or Woodhall in the Bronx). Perhaps you had bad experiences with Carib studs, but by and far we do NOT have complexes nor do we have hatred to our US counterparts.

    I don't think you guys have it easy. Lots of my good friends from undergrad went to U.S. schools and we have compared our curriculum and clinical training, and it is spot on to what I experienced (hardwork and long hours). Oh yeah... I don't know who told you we only work 6 hours a day, but your very misinformed. I worked an average of 10-12 hrs a day on NON CALL days.

    I personally have worked with Cornell students and Univ Cal students. The only difference i could see is that some of the Cornell students thought they were better than us because they could quote statistics from papers, and they worked only 5 or 6 hrs a day and would just leave. I didn't take offense to it nor do I carry animosity towards them...why? Because I know this is only a subset of US students, I don't have a chip on my shoulder like you do...clinically, I know I am better than they were both in knowledge of management, and clinical skills, but I refrain from making them look idiotic.

    So my friend be very careful when you generalize.... because we are all not what you seem to characterize us as all being. If anyone has hatred it is probably you towards us. So peace be with you and I hope you all the best in your career.
     
  43. thedrjojo

    Physician 10+ Year Member

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    I am sorry if it seemed like I made a generalization and claimed all of your sites were like that or all of your students were like that. I base my experience solely from Beth Isreal Newark, St. Barnabus, and St. Michael's. I also base information like the review course on being told by an USIMG about what they called the required 5th semester which was a USMLE prep course. But I also in my response to heathermed said that it is two overlaping bell curves as far as students go... some of the AMG people are as dumb as a post, and some of the USIMG students stand toe to toe with the best students from the best US medschools.
     
  44. md2010sgu

    md2010sgu Med STUD

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    Hey man...it's all good... I just didn't want readers to get the general impression that we were all like that. :D
     

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