Usmle to Australia: a little confused....

[nguyen duc huy]

Hello everyone
I am an IMG coming from an Asian country. I have just passed all 3 steps of Usmle but didn't get high scores:

Step 1: 192
Step 2 Ck: 220
Step 2 Cs: pass
Step 3: pass

All are 1st attempt. Based on the data provided by Nrmp, I know my chance of matching a residency program in US is very slim, so I am considering Australia as another option. Usmle results are recognized in Australia via Competent Authority Pathway, however, I am confused after reading their criteria:
http://www.medicalboard.gov.au/Regi...al-Graduates/Competent-Authority-Pathway.aspx
- To become eligible for Competent Authority Pathway, I am required to complete 2 years in a residency program accredited by Accreditation council of graduate medical education (Acgme) besides Usmle scores (what the hell, how can I get it?)
- The note in eligibility for this pathway
" Australian clinical experience can be substituted for post-examination or post training experience for the purposes of meeting the criteria for eligibility for the Competent Authority pathway."
As I understand, the period of 2 years in a residency program can be replaced by one year of clinical experience in Australia. However, when my message was sent to ask AHPRA, their staff officials said that: I am still required to complete 2 years of residency.
What is happening? Please correct me if I am wrong. Are there anyone in the same situation?

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[bashwell]

Hello everyone
I am an IMG coming from an Asian country. I have just passed all 3 steps of Usmle but didn't get high scores:

Step 1: 192
Step 2 Ck: 220
Step 2 Cs: pass
Step 3: pass

All are 1st attempt. Based on the data provided by Nrmp, I know my chance of matching a residency program in US is very slim, so I am considering Australia as another option. Usmle results are recognized in Australia via Competent Authority Pathway, however, I am confused after reading their criteria:
http://www.medicalboard.gov.au/Regi...al-Graduates/Competent-Authority-Pathway.aspx
- To become eligible for Competent Authority Pathway, I am required to complete 2 years in a residency program accredited by Accreditation council of graduate medical education (Acgme) besides Usmle scores (what the hell, how can I get it?)
- The note in eligibility for this pathway
" Australian clinical experience can be substituted for post-examination or post training experience for the purposes of meeting the criteria for eligibility for the Competent Authority pathway."
As I understand, the period of 2 years in a residency program can be replaced by one year of clinical experience in Australia. However, when my message was sent to ask AHPRA, their staff officials said that: I am still required to complete 2 years of residency.
What is happening? Please correct me if I am wrong. Are there anyone in the same situation?

Assuming you passed all the USMLEs on your first try, and depending on the rest of your application (e.g., do you have USCE? decent LORs from US physicians?), you might still be able to go to the US if you are willing to do something like FM (aka GP), psych, peds, or IM, though for any of these it'd most likely be at undesirable programs (and for IM you might not be able to go on to fellowship). 192 is the bare minimum for passing Step 1, but your Step 2 is higher than the minimum (209), and you've passed Step 3 which many (most?) IMGs haven't taken at the time of application. It doesn't hurt (except your wallet) to apply to the US as long as you target realistic programs for yourself. Just a thought.

 

[NotAProgDirector]

Assuming you passed all the USMLEs on your first try, and depending on the rest of your application (e.g., do you have USCE? decent LORs from US physicians?), you might still be able to go to the US if you are willing to do something like FM (aka GP), psych, peds, or IM, though for any of these it'd most likely be at undesirable programs (and for IM you might not be able to go on to fellowship). 192 is the bare minimum for passing Step 1, but your Step 2 is higher than the minimum (209), and you've passed Step 3 which many (most?) IMGs haven't taken at the time of application. It doesn't hurt (except your wallet) to apply to the US as long as you target realistic programs for yourself. Just a thought.

Unfortunately, 209 is now the minimum pass for Step 2. But I agree with the rest, the OP certainly has some chance of matching in the US. A Plan B is definitely recommended.

 

[nguyen duc huy]

Unfortunately, 209 is now the minimum pass for Step 2. But I agree with the rest, the OP certainly has some chance of matching in the US. A Plan B is definitely recommended.

Yep, it is the reason why I still try hard to enhance my application in Us but also regard Ausie as a plan B. Could anyone give me understandable explanation for the note and Ahpra answer?

 

[blue0rchid]

Perhaps you can ask the question about residency in Australia in the australia forum. Maybe people there will know more about that process? Also look into the General International Discussion forum.
http://forums.studentdoctor.net/forums/australasia-and-oceania.88/

Are you a medical student about to graduate or are you a practicing physician in your country? Did you have any US clinical experience? What was your step 3 score? Will you able to get good letter of recommendations from US physician?

 

[blue0rchid]

Much more info about australian residency could be found here
http://pagingdr.net/forum/

 

[nguyen duc huy]

Perhaps you can ask the question about residency in Australia in the australia forum. Maybe people there will know more about that process? Also look into the General International Discussion forum.
http://forums.studentdoctor.net/forums/australasia-and-oceania.88/

Are you a medical student about to graduate or are you a practicing physician in your country? Did you have any US clinical experience? What was your step 3 score? Will you able to get good letter of recommendations from US physician?

Thank you so much, Blue Orchid, your links are certainly helpful.

With regards to my medical education and training, I have graduated from medical school since 2014, had 2-year clinical exp in the ICU of a national hospital, and just passed step 3 with 215. My current application has 2 LORs from the professors in my university but no ones from Us physicians. I don't know whether those LORs are helpful in Us but Ausie seemingly recognizes them to some extent (one of my colleagues has LORs written by the same professors, she passed Amc exams and now is working in Australia).

At present, I am still looking for some observerships/ externships to gain Us clinical exp and synchronously collecting info of Ausie residency for my plan B. The collected data, however, is still misunderstood

 

[blue0rchid]

Why not contact the colleague who is currently working in Australia? She certainly will know how to get there.

I've seen people doing observership at my home hospital. I'll send you a PM.

 

[nguyen duc huy]

The colleague follows the standard pathway and she doesn't know about competent pathway, of course. She advised me to ask Ahpra for the answer but they didn't explain my doubt thoroughly

 

[bashwell]

I'm in Sydney, Australia, and let me just say it's getting more difficult to get into BPT ie basic physicians training which is what Australia calls IM. There's now even pre interviews which are like interviews, people doing research projects to get in, or at least things like audits, etc. It's not as difficult as say surgery, and the further away you go from the popular hospitals the easier it'll be to get in, but even out west things are getting more difficult. The huge amount of new med school graduates is making it increasingly difficult to find a job at the end of training or even to get onto a training program in the first place. Also for most specialties to get a job as a staff specialist in an IM subspecialty in the major hospitals in Sydney you'll eventually need a PhD. Seven years is the minimum amount of time it'll take to finish IM training in Australia, but realistically it's more like 10 years or more ie for BPT and AT or advanced training.

But to try to answer your question a bit better, have you checked out Doctor Connect? http://www.doctorconnect.gov.au

 

[nguyen duc huy]

I'm in Sydney, Australia, and let me just say it's getting more difficult to get into BPT ie basic physicians training which is what Australia calls IM. There's now even pre interviews which are like interviews, people doing research projects to get in, or at least things like audits, etc. It's not as difficult as say surgery, and the further away you go from the popular hospitals the easier it'll be to get in, but even out west things are getting more difficult. The huge amount of new med school graduates is making it increasingly difficult to find a job at the end of training or even to get onto a training program in the first place. Also for most specialties to get a job as a staff specialist in an IM subspecialty in the major hospitals in Sydney you'll eventually need a PhD. Seven years is the minimum amount of time it'll take to finish IM training in Australia, but realistically it's more like 10 years or more ie for BPT and AT or advanced training.

But to try to answer your question a bit better, have you checked out Doctor Connect? http://www.doctorconnect.gov.au

I know it is increasingly difficult to apply to Ausie because their demand for IMGs is much smaller than Us.

In the case of my colleague: After finishing 3 years of residency (emergency medicine), she has continued to work in our department for 2 years. Then she passed both Amc exams and secured a job offer as an unregistered registrar in Adelaide. In my case, assuming Usmle is considered as competent as Amc, I would like to apply to Ausie after my residency (in my country) as well. However, Ahpra requires me to finish at least 2 years of a residency program accredited by Acgme. This requirement seems impossible for me to fulfil. When my colleague contacted Ahpra for my doubt, the staff officials refused to explain the note and said frankly: "Tell us why Australia has to open a door for IMGs who failed in applying to Us"

I will also post my question to the link you share. Hope to get a detailed explanation.

 

[bashwell]

I know it is increasingly difficult to apply to Ausie because their demand for IMGs is much smaller than Us.

In the case of my colleague: After finishing 3 years of residency (emergency medicine), she has continued to work in our department for 2 years. Then she passed both Amc exams and secured a job offer as an unregistered registrar in Adelaide. In my case, assuming Usmle is considered as competent as Amc, I would like to apply to Ausie after my residency (in my country) as well. However, Ahpra requires me to finish at least 2 years of a residency program accredited by Acgme. This requirement seems impossible for me to fulfil. When my colleague contacted Ahpra for my doubt, the staff officials refused to explain the note and said frankly: "Tell us why Australia has to open a door for IMGs who failed in applying to Us"

I will also post my question to the link you share. Hope to get a detailed explanation.

EM reg jobs are relatively easy to get here in Australia, especially in South Australia where Adelaide is, which is generally less popular than places like Sydney or Melbourne. (Although I'm not sure what you mean by "unregistered registrar"? Do you mean she got an unaccredited registrar job? If so then I'm not sure why she got an unaccredited registrar job rather than a normal accredited registrar job?) Anyway if you want to become an EM reg, it shouldn't be difficult, as long as you've done your intern/resident years here in Australia. What's difficult for EM is finding a job after finishing and becoming a consultant (aka attending), i.e., FACEM or Fellow. There's currently a greater need for EDs to be staffed with registrars and less of a need for staff specialists in the ED.

I'm sorry I don't understand all the ins and outs of applying as an IMG to Australia (I'm a citizen so happily don't have to worry), but perhaps you may have to simply go through the AMC exams (written and OSCEs) and start all over from the beginning as an intern? That's two years of your life (i.e., intern and resident), but it might not be horrible because you'll get to know the Australian system and also Aussie interns and residents are paid fairly well in comparison to many other nations. I have met IMGs in various hospitals in Sydney. Many of the ones I've talked to have told me that they started as interns despite more training in their own nations, though a couple of them were able to start as residents.

 

[nguyen duc huy]

EM reg jobs are relatively easy to get here in Australia, especially in South Australia where Adelaide is, which is generally less popular than places like Sydney or Melbourne. (Although I'm not sure what you mean by "unregistered registrar"? Do you mean she got an unaccredited registrar job? If so then I'm not sure why she got an unaccredited registrar job rather than a normal accredited registrar job?) Anyway if you want to become an EM reg, it shouldn't be difficult, as long as you've done your intern/resident years here in Australia. What's difficult for EM is finding a job after finishing and becoming a consultant (aka attending), i.e., FACEM or Fellow. There's currently a greater need for EDs to be staffed with registrars and less of a need for staff specialists in the ED.

I'm sorry I don't understand all the ins and outs of applying as an IMG to Australia (I'm a citizen so happily don't have to worry), but perhaps you may have to simply go through the AMC exams (written and OSCEs) and start all over from the beginning as an intern? That's two years of your life (i.e., intern and resident), but it might not be horrible because you'll get to know the Australian system and also Aussie interns and residents are paid fairly well in comparison to many other nations. I have met IMGs in various hospitals in Sydney. Many of the ones I've talked to have told me that they started as interns despite more training in their own nations, though a couple of them were able to start as residents.

Sorry, it's my fault. I only know she is working as a registrar under supervision. The required period of time is 12 months and then she will be able to apply for genereal registration. That is typical of standard pathway for IMGs

http://www.medicalboard.gov.au/Registration/International-Medical-Graduates/Standard-Pathway.aspx

In the case that my usmle is useless in Ausie, so I must sit Amc exams if I have an intention to work there. Amc seems not so difficult as Usmle but it is much more expensive. In addition, clinical internships and residency positions are very limited in number for IMGs. Applying for a registrar position as my colleague has a bigger chance of success but that requires me to finish a residency program in my country before passing Amc exams. This option takes a lot of time as well as money and all my efforts for Usmle will go to waste...

Hence, I need to figure out MB's note besides the validity of Usmle in Ausie before making a decision.

 

[LeoMartinipo]

This option takes a lot of time as well as money and all my efforts for Usmle will go to waste... Hence, I need to figure out MB's note besides the validity of Usmle in Ausie before making a decision.

Can you please let us know about your current situation?

I am thinking to do either USMLE 1-3 or AMC MCQ. I see that it is better for me to fully concentrate on USMLE 1-3 to get high marks. I opened a thread about my situation here.