What specialties are considered off limits for IMGs?

Started by commonwealthMD
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commonwealthMD

commonwealthMD

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Ortho, Plastics, Derm... what else? Assuming you have competetive results that wouldn't limit what specialty is open to IMGs.

I mean fresh out of med school, not landing some research position in the US for 3 years then applying. Is gen surg achievable?

And yes I know it is technically possible to match anything, I mean realistically...
 
EM. You must get SLOE from a US program and IMGs can’t access the online portal we use to apply for rotations. Some programs don’t use this portal but there aren’t that many of them.
 
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Depends on US IMG vs non-US IMG. Neurosurgery is another specialty out of reach for most. For example, according to the 2018 Charting the Outcomes, 0/11 US IMGs matched into neurosurgery, but 11/32 non-US IMGs did, and the ones that did had insane research and publication experiences.

Gen surg is more achievable, but the chances of matching are 1/3 to 1/4, on average. Similarly, the non-US IMGs had a buttload of research and publication experiences.

 
commonwealthMD said:
Ortho, Plastics, Derm... what else? Assuming you have competetive results that wouldn't limit what specialty is open to IMGs.

I mean fresh out of med school, not landing some research position in the US for 3 years then applying. Is gen surg achievable?

And yes I know it is technically possible to match anything, I mean realistically...
Click to expand...
According to the Program Director's survey (http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf)
at least 30-50% of PDs NEVER interview/rank IMGs, and another 25-70% seldom do so. Thoracic surgery has the best odds, but I suspect that these are sweatshops or malignant programs.

Dermatology
Otolaryngology
Radiation Oncology
Transitional Year
Plastic Surgery
Thoracic Surgery
Orthopaedic Surgery
 
Agree with Goro. I'm a carib IMG and from my experience...

Basically impossible: Derm, ENT, Rad/onc, plastics, Urology, optho, interventional radiology - If you see someone match this usually they have very good connections

Gen surg is doable however the issue is getting a good program. I am an IM resident so I don't know all about surgical training but I would imagine the quality of your attending is much more important in surgical training than medical. The top IMGs can land a solid mid level university IM program but only lower tier university or community surgical programs. A lot of people (probably most who apply surgery) end up doing a preliminary year which may work out but is still a stressful gamble.
 
I think it’s an important distinction to make between Carribean students and studs from other countries. The latter will always be welcome in pretty much any specialty as long as all their paperwork and CV are in order. Carribean IMGs (or US students that didn’t get into any US schools) will always get the side eye from programs even if they have high step scores. Feel like even a specialty like RadOnc will refuse to take a USIMG
 
CidHighwind said:
I think it’s an important distinction to make between Carribean students and studs from other countries. The latter will always be welcome in pretty much any specialty as long as all their paperwork and CV are in order. Carribean IMGs (or US students that didn’t get into any US schools) will always get the side eye from programs even if they have high step scores. Feel like even a specialty like RadOnc will refuse to take a USIMG
Click to expand...

Where did you get this information? Students from ANY non-US country have at best a 50% chance of matching at all in the US regardless of field choice. The published outcomes reflect this.
 
OneTwoThreeFour said:
Where did you get this information? Students from ANY non-US country have at best a 50% chance of matching at all in the US regardless of field choice. The published outcomes reflect this.
Click to expand...

It’s not uncommon for some excellent residencies in competitive specialties to take a foreign student or two that was a stud in their countries. Almost never see it with Carribean students. Never mentioned anything about overall match rates
 
My plastics program doesn't rank IMGs from Caribbean schools regardless of research. Unfortunately, we will interview 1-2 if someone makes a call on their behalf or if they rotate with us, which I think gives false hope and wastes everyone's time and money.

We will and have, however, highly rank FMGs if they're from a prestigious school (like Oxford, etc) and they've done a few years in a lab in the US.
 
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CidHighwind said:
I think it’s an important distinction to make between Carribean students and studs from other countries. The latter will always be welcome in pretty much any specialty as long as all their paperwork and CV are in order. Carribean IMGs (or US students that didn’t get into any US schools) will always get the side eye from programs even if they have high step scores. Feel like even a specialty like RadOnc will refuse to take a USIMG
Click to expand...

This is not true. US born IMGs who do rotations in the USA are better off than true FMGs generally speaking.
 
shouldigomd said:
This is not true. US born IMGs who do rotations in the USA are better off than true FMGs generally speaking.
Click to expand...

No USIMGs matched neuro last year, 12 Non-US imgs did. Is the stigma associated with caribbean schools greater than the hastle of getting a visa? Maybe, who knows.
 
commonwealthMD said:
No USIMGs matched neuro last year, 12 Non-US imgs did. Is the stigma associated with caribbean schools greater than the hastle of getting a visa? Maybe, who knows.
Click to expand...

If they’re just talking about people matching FM/IM sure. But overall, good programs would rather take a capable person with visa issues than someone from the Carribean
 
CidHighwind said:
If they’re just talking about people matching FM/IM sure. But overall, good programs would rather take a capable person with visa issues than someone from the Carribean
Click to expand...

I feel there is a lot of stigma attached to going Carib route rather than reapplying or even going DO. We have a similar situtation in the UK where students who don't get into UK schools go to europe to study, it doesn't really affect their career prospects though.
 
commonwealthMD said:
No USIMGs matched neuro last year, 12 Non-US imgs did. Is the stigma associated with caribbean schools greater than the hastle of getting a visa? Maybe, who knows.
Click to expand...

Where are you getting that data? If you look at the SGU 2019 match list there are more than 12 who matched neuro.
 
CidHighwind said:
If they’re just talking about people matching FM/IM sure. But overall, good programs would rather take a capable person with visa issues than someone from the Carribean
Click to expand...

Based on what?

Sure there will be scattered "elite" FMGs at your top tier programs but that is the extreme minority. If you want to make a general statement you have a much better chance at getting a residency as a US IMG (having done rotations in the USA) than a true FMG. Just look at IMG heavy resident programs and the many students from top foreign programs (just go to the website and see where they trained). These people are at low tier often community programs. At SGU we had hundreds of clinical "tutors" of whom many are from solid foreign programs trying to get residency. They would switch places with one of us in a heartbeat. The "line" of true FMGs from respectable training programs trying to get into the USA is incredible.

A huge part is not being able to standardize these candidates. You will accept a resident without having stepped foot in a US hospital, without English being the first language, without knowledge of the US system, translated letters of rec?, interpreting foreign exams?, lack of clinical rotation / shelf exams?, VISA, etc etc etc. The Step exams used to essentially be the only way to standardize things but now that it is pass / fail it may be even more difficult for FMGs.

I just went through the cardiology match process and the same goes for this. Looking at the stats about 50% of people didn't match with a huge chunk being true FMGs.
 
commonwealthMD said:
Neuro meaning neuro surgery, of which only 1 person matched. Dad was probably the PD lol
Click to expand...
Yes definitely add NSGY or NS (shorthand for neurosurgery haha) to the virtually impossible list for IMGs. Interestingly a couple people matched into urology last cycle from SGU. Lucky SOBs !
 
shouldigomd said:
Based on what?

Sure there will be scattered "elite" FMGs at your top tier programs but that is the extreme minority. If you want to make a general statement you have a much better chance at getting a residency as a US IMG (having done rotations in the USA) than a true FMG. Just look at IMG heavy resident programs and the many students from top foreign programs (just go to the website and see where they trained). These people are at low tier often community programs. At SGU we had hundreds of clinical "tutors" of whom many are from solid foreign programs trying to get residency. They would switch places with one of us in a heartbeat. The "line" of true FMGs from respectable training programs trying to get into the USA is incredible.

A huge part is not being able to standardize these candidates. You will accept a resident without having stepped foot in a US hospital, without English being the first language, without knowledge of the US system, translated letters of rec?, interpreting foreign exams?, lack of clinical rotation / shelf exams?, VISA, etc etc etc. The Step exams used to essentially be the only way to standardize things but now that it is pass / fail it may be even more difficult for FMGs.

I just went through the cardiology match process and the same goes for this. Looking at the stats about 50% of people didn't match with a huge chunk being true FMGs.
Click to expand...

Lol you clearly don't know what you're talking about. FMGs will generally get US CE before they apply, and there is Step 1 and 2CK to standardise the candidates. Some even take step 3. Most foreign med schools are taught in english I believe, I am from the UK so I guess that doesn't apply. And FMGs also get letters of rec when they get their US CE. I'm definitely at an advantage being from EU as I have the funding to get lots of US CE, people in India likely don't. Win for me I guess.
 
commonwealthMD said:
Lol you clearly don't know what you're talking about. FMGs will generally get US CE before they apply, and there is Step 1 and 2CK to standardise the candidates. Some even take step 3. Most foreign med schools are taught in english I believe, I am from the UK so I guess that doesn't apply. And FMGs also get letters of rec when they get their US CE. I'm definitely at an advantage being from EU as I have the funding to get lots of US CE, people in India likely don't. Win for me I guess.
Click to expand...
How many months of USCE can you do? I’m just curious. On another note, did you consider practicing in Australia? It’s really common for UK docs to end up there. The process might be easier and I heard the pay isn’t bad.
 
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commonwealthMD said:
Lol you clearly don't know what you're talking about. FMGs will generally get US CE before they apply, and there is Step 1 and 2CK to standardise the candidates. Some even take step 3. Most foreign med schools are taught in english I believe, I am from the UK so I guess that doesn't apply. And FMGs also get letters of rec when they get their US CE. I'm definitely at an advantage being from EU as I have the funding to get lots of US CE, people in India likely don't. Win for me I guess.
Click to expand...
About that...
 
commonwealthMD said:
Lol you clearly don't know what you're talking about. FMGs will generally get US CE before they apply, and there is Step 1 and 2CK to standardise the candidates. Some even take step 3. Most foreign med schools are taught in english I believe, I am from the UK so I guess that doesn't apply. And FMGs also get letters of rec when they get their US CE. I'm definitely at an advantage being from EU as I have the funding to get lots of US CE, people in India likely don't. Win for me I guess.
Click to expand...

I guess not. Just an IMG who has lived through the system.
 
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Prehealth1011 said:
How many months of USCE can you do? I’m just curious. On another note, did you consider practicing in Australia? It’s really common for UK docs to end up there. The process might be easier and I heard the pay isn’t bad.
Click to expand...

I can probably do at least 6 months US CE. Summer is a 2 month break, 3 years of clinical at my med school, would allow 9 months total of USCE but that's not that realistic. I also have the opportunity to do a lot of research at my school and at other schools that are affiliated.
 
shouldigomd said:
Based on what?

Sure there will be scattered "elite" FMGs at your top tier programs but that is the extreme minority. If you want to make a general statement you have a much better chance at getting a residency as a US IMG (having done rotations in the USA) than a true FMG. Just look at IMG heavy resident programs and the many students from top foreign programs (just go to the website and see where they trained). These people are at low tier often community programs. At SGU we had hundreds of clinical "tutors" of whom many are from solid foreign programs trying to get residency. They would switch places with one of us in a heartbeat. The "line" of true FMGs from respectable training programs trying to get into the USA is incredible.

A huge part is not being able to standardize these candidates. You will accept a resident without having stepped foot in a US hospital, without English being the first language, without knowledge of the US system, translated letters of rec?, interpreting foreign exams?, lack of clinical rotation / shelf exams?, VISA, etc etc etc. The Step exams used to essentially be the only way to standardize things but now that it is pass / fail it may be even more difficult for FMGs.

I just went through the cardiology match process and the same goes for this. Looking at the stats about 50% of people didn't match with a huge chunk being true FMGs.
Click to expand...

Even in IM, the top and upper-mid tier programs will only take non-US IMGs. Non-US IMGs have made it into the most elite programs including JHH and MGH. And especially in fellowship where research is the main priority, non-US IMGs with a lot of research regularly make it into tip top programs. My program has never interviewed a US-IMG but interviews select non-US IMGs, and the 1 we had this year just interviewed at most the top fellowships in a competitive field (and matched at a top program). There is a lot of variation, but at the top, residency programs much prefer the stellar non-US IMG over the stellar US-IMG.
 
Dwan said:
Even in IM, the top and upper-mid tier programs will only take non-US IMGs. Non-US IMGs have made it into the most elite programs including JHH and MGH. And especially in fellowship where research is the main priority, non-US IMGs with a lot of research regularly make it into tip top programs. My program has never interviewed a US-IMG but interviews select non-US IMGs, and the 1 we had this year just interviewed at most the top fellowships in a competitive field (and matched at a top program). There is a lot of variation, but at the top, residency programs much prefer the stellar non-US IMG over the stellar US-IMG.
Click to expand...

PDs favor applicants that go to med schools in their own countries, many of them don't have the option of studying in the US. However, US-IMGs do, and that's why it is frowned upon, they are expected to get into an MD school if they want a top residency.
 
Dwan said:
Even in IM, the top and upper-mid tier programs will only take non-US IMGs. Non-US IMGs have made it into the most elite programs including JHH and MGH. And especially in fellowship where research is the main priority, non-US IMGs with a lot of research regularly make it into tip top programs. My program has never interviewed a US-IMG but interviews select non-US IMGs, and the 1 we had this year just interviewed at most the top fellowships in a competitive field (and matched at a top program). There is a lot of variation, but at the top, residency programs much prefer the stellar non-US IMG over the stellar US-IMG.
Click to expand...


Yes, at the top elite programs and the <1%...... I am making a general statement referring to the bulk of residency training in the USA (which is low to mid level programs which SDN makes it hard to believe).

I agree with you that if you want one of the "off limit" specialties or your Harvard's ... it may be advantageous to be from an elite FMG program and deal with the many struggles that FMGs have to deal with.... Many of these candidates spend years doing research / etc.

But if you want one of the other specialties carib IMG is a much better position to be in than your FMG. Part of that is simply because the carib IMG's are generally US citizens and the other part is the big advantage of doing rotations in the US system.

Another example that many people don't recognize is that there are a decent chunk of Caribbean students who go to SGU / Ross over your "elite" Caribbean programs for a better opportunity at matching a US residency.
 
I can attest a true FMG with good scores and research is always ranked higher at the top programs than a US IMG because it’s felt the latter games the system while there are many FMG all stars, some who even rank top in their nation.
 
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shouldigomd said:
Yes, at the top elite programs and the <1%...... I am making a general statement referring to the bulk of residency training in the USA (which is low to mid level programs which SDN makes it hard to believe).

I agree with you that if you want one of the "off limit" specialties or your Harvard's ... it may be advantageous to be from an elite FMG program and deal with the many struggles that FMGs have to deal with.... Many of these candidates spend years doing research / etc.

But if you want one of the other specialties carib IMG is a much better position to be in than your FMG. Part of that is simply because the carib IMG's are generally US citizens and the other part is the big advantage of doing rotations in the US system.

Another example that many people don't recognize is that there are a decent chunk of Caribbean students who go to SGU / Ross over your "elite" Caribbean programs for a better opportunity at matching a US residency.
Click to expand...

FMGs can get away rotations you realise? And their medical school is 6 years vs your 4, which leaves much more time to get US CE and study for STEP. Generally med school is split into 3 years preclinical, 3 years clinical. So if you want to do really well in step as an FMG, it is more than possible. Also I'm not aware of any carribean schools that offer research opportunities? Whereas most respected fmg schools, at least in europe, have a lot of oppotunities for research etc...

I agree that it is seen as a cop out, cheat the system type move to go Carib MD. Even if it isn't it's seen as you being lazy or not smart enough to get into USMD, whereas FMGs never had that option in the first place so the PDs can't make that assumption.

If your username is asking whether you should go MD, then yes you should. Just not carribean MD, reapply if you don't get in, you'll thank yourself for it in 30 years. If you want to match a top specialty your going to have a very hard time. There's no rush, an extra year of reapplying is insignificant when you are a 40 year old attending. If that's not what it is asking then ignore the above.
 
commonwealthMD said:
FMGs can get away rotations you realise? And their medical school is 6 years vs your 4, which leaves much more time to get US CE and study for STEP. Generally med school is split into 3 years preclinical, 3 years clinical. So if you want to do really well in step as an FMG, it is more than possible. Also I'm not aware of any carribean schools that offer research opportunities? Whereas most respected fmg schools, at least in europe, have a lot of oppotunities for research etc...

I agree that it is seen as a cop out, cheat the system type move to go Carib MD. Even if it isn't it's seen as you being lazy or not smart enough to get into USMD, whereas FMGs never had that option in the first place so the PDs can't make that assumption.

If your username is asking whether you should go MD, then yes you should. Just not carribean MD, reapply if you don't get in, you'll thank yourself for it in 30 years. If you want to match a top specialty your going to have a very hard time. There's no rush, an extra year of reapplying is insignificant when you are a 40 year old attending. If that's not what it is asking then ignore the above.
Click to expand...

Im a carib MD doing my cardiology fellowship at my #2 spot.... not sure what you are saying there.

Anyway once you start moving through your training or try and come the USA you will see reality.
 
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