When will I see the lights?

[EMfirst]

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Hello all,
I've seen some really helpful advice given here, so I'm hoping to get some of that love from you all since I have no where else to turn to!

Here's my story:

My wife and I graduated from med school in June 08. She's an American grad with great scores, doing her peds internship at a university program.

I did basic science in UK and 2 years of clinicals in US because I transferred to this Carib med school. My scores: 178/208. I got pulled from the match last year b/c my ECFMG was not certified on time. I did have 3 interviews out of 10 applications. The scramble was a nightmare with no success. I am now doing research at the same hospital where my wife is. I might get my name in 2 publications in a month. The group that I'm doing research with is "trying" to help me, but still no interviews yet. I had applied to 10 IM, 10 FM, 10 Neurology, 2 Peds. So far, I have 1 FM interview, 1 FM rejection. I also found out that ALL the programs at this hospital that I'm at now are "competitive" including peds and FM. My wife's Program Director said she doesn't like Carib grads.

So we are freaking out and I feel complete hopeless and guilty for dragging my wife into my mess, while she is already stressed out from internship. We are fighting and stressing out alllllllllllll the time! I've never felt so desperate to be in a residency or anything as I am now. I have done very well during rotations with great LORs, but on paper, I'm a terrible candiate. If I apply to a program in NY, where I think I will have a better chance, what would my wife do to get a PGY2 spot? and we prefer NOT to be in 2 different states, so either it's me being off for another year (bad idea) or her starting all over in NY?

How do people deal with something like this? Have you seen something like this worked out? Am I paranoid for not hearing from programs? I know it's not late, but not early either. I called the programs that interviewed me last year to ask if they would interview me again, still NO answers yet!

I would appreciate any advice/thoughts anyone has on this. Please help me!
Thanks

 

[dragonfly99]

Wow you are in a really tough situation.
As far as matching, it seems that your problems are
a) being IMG or FMG (?possibly not a US citizen, so needing a VISA?)
b) low USMLE scores

other problem
c) fighting with wife and stressing

As far as matching, if you are working at a U. program, and they have told you their residencies are all "competitive" that means they are telling you you won't get in there. That's not a personal value judgment against you - they are just being honest. I don't know...if you are a US citizen and you did OK on your clinical rotations in the US and didn't fail any classes in med school, I would think you can get a spot somewhere in the match. You haven't even really been through the match one full time yet, so I don't think it's totally time to press the panic button yet. I guess at this point I would try to get any and all faculty who know you, like you, and have worked with you clinically to pull strings for you. I'd also try to get your lab PI to pull strings for you, if he/she is an MD...not at your current program b/c it seems that is fruitless, but somewhere else where he/she knows people. If you are feeling desperate to start SOME kind of residency, of any type whatsoever, next year, then how about applying to a few medicine prelim years? It might give you a cushion/extra places to interview, and then you wouldn't be committed to anywhere for >1 year. I'll bet if you apply to one/some of the places you did your clinical rotations, and they are familiar with your med school, you might be able to match there. One thing I've found helpful in the past if I really wanted a particular program was to personalize the personal statement to the place, by just altering the last paragraph ("I am interested in the medicine program at Hospital X due to having rotated there in past, knowing its excellent reputation in the community, particularly for GI and geriatrics, and having several family members who live in the area."). Also, if you know ANYONE at the place (chief resident, any faculty, etc.) who you think would put the good word in for you, try to contact him/her and politely ask them to do so. You can generally do this without being a pest if the person knows you fairly well...

Having scrambled and failed to get a spot isn't that surprising...the scramble is sucky and there are a ton of people in it, and if you are an IMG with lowish USMLE scores, it's not surprising that you got lost in the shuffle. What you want to do is avoid the scramble this year...

consider signing up for Openspots.com on the NRMP web site. My friend found a spot on there. They keep it pretty up to date and it isn't very expensive to sign up for 1 year if you are registed for the Match....

You don't tell us where you are living. Is there not a FM residency or IM residency nearby that you can get in to? It seems like asking your wife to switch programs and repeat her intern year b/c of your situation would be asking a lot of her. Perhaps you could do an intern year somewhere, then see if you can transfer somewhere nearby, or perhaps you could commute to visit her. I know it's not ideal at all, because you are married, but her switching programs, if she likes her current one OK, might be "out of the frying pan, into the fire" for your marriage and for her career.

The fighting a lot with your wife has got to be about more than just your residency situation, IMHO (as a female). I can't comment on how to make it better, except to just try to make life as nice for each other as you can (i.e. make the apartment nice, cook dinner, etc.). As an intern she is definitely sleep deprived, which makes people cranky, but things WILL get better as a PGY2 or 3.

 

[EMfirst]

Thank you Dragonfly! I knew that YOU would give great advice with such compassion! as you always are with your posts. I appreciate it.

I am American, so that makes me IMG. All the places that I did clinical rotations at liked me, as in, the attendings told me that they would SECURE a spot for me last year. Unfortunately, my wife being an AMG can not do prematch, and we made the mistake of me NOT taking one of the pre-matches. And you are right, if I ask her to start all over for me next year, it would be rough! She kind of (in my opinion) gave up a competitive field like Optho and went into Peds so that we would match well last year, so I can not ask her to leave her current program which she likes, to start all over.

I guess I need some thing to convince me to go to another state for residency, which I believe that I will have a good chance at, despite my bad scores. I would love to be in a prelim program, but they are also difficult to get for someone like me.

The PI that I am working with is a big name MD in this hospital. I have every intention of asking him for help, but I am realistic that with my bad scores, only a miracle would help! I did meet one resident in this hospital, who said that she is a FMG with similar score, so she thinks I have a chance as she did, especially b/c I work with my current PI. So who knows what kind of "front" people are putting out about their programs. But regardless, I think the most viable option is to be away from my wife for residency, but it is a difficult decision to make.

Things are great with my wife, we are both just overly stressed and overly sensitive, other than that, we don't fight about anything "major"

Thanks again for your help!

 

[Winged Scapula]

I don't have time for a long answer but it appears that you only applied to 32 programs. That's a bit on the low side for someone who is:

1) a Caribbean grad
2) who is a year out of medical school
3) who has a very low Step 1 score and a lowish Step 2 score

You'll find many of your colleagues in such strifes apply to 2 or 3 times as many programs as you are. I'd suggest applying to more.

You are also applying all over the place. Is it possible that your letters do not support your candidacy or that programs are aware that you are applying for any and every specialty?

 

[OldMD]

Yikes, sorry to hear this problem...
I would personally just try to pull all the strings I could to somehow match around your area. If that doesn't work... I have to say that I'd stick around with your wife. I value my spouse and marriage so highly that I'd give up my dream of being an MD rather than live away from them for a year (or longer). Maybe that's not an option, but if you both are stressed and fighting already (even if it's situational), living apart isn't necessarily going to help things. I hope you are successful in your quest.

 

[Nebraska1]

.

 

[EMfirst]

Thank you WS and OLDMD,

I applied to 32 programs because these are ALL the programs with in 2 hrs of where my wife is. I told her that I love her more than med school, so it's hard to pick up and go to another state that might be easier for me. I highly value my wife and my marriage, but it is becoming more like a move is in order since I have only 1 interview so far. We have to discuss this more with in this week and decide whether we have to start applying to other states NOW.

WS, maybe my letters are not helpful, or is one of many negative factors. I used 3 letters for IM: 1IM, 1OB, 1Neurology. These are "general" letters, But for Family and Peds, I add one additional letter in each field. I applied all over the place b/c we wanted to increase my chances at these less competive programs such as FM and IM. The Peds program is at my wife's program. We were hoping that her program would consider me because she is IN it.

Thank you all for your help!

 

[bluealiendoctor]

Yeah, Dragonfly rocks...always has good advice. If you haven't, I would definitely pepper every FM program within a reasonable driving distance. Living far away from your wife will be a mistake if you love your wife more than being a doctor. I have a similar situation..wife has better scores, she's started and I'm matching....but we have a child also. Hammer those FM spots and follow the advice of Dragonfly as well. Good luck buddy, I feel for ya man.

 

[dragonfly99]

Perhaps with the letters from different specialties, some of the IM programs felt you would not be dedicated to their particular field, and thus rejected you? Can you not get a dean's letter + two medicine letters to use? Can you get in contact with your med school and/or faculty who were your ward attendings and wrote your LOR's, before they forget who you are? You need to try hard to get in this year...
The fact that attendings were telling you during 3rd and/or 4th year that they would help you get a residency spot is a good sign. I don't know...I know it can be hard for IMG and FMG's to get a spot, but I would think that being a US citizen and having graduated from med school and passed all the steps on first try and then having attendings that liked you should be good enough to get a residency...
Have you thought about trying for psych? They have more "refugees" from other specialties and sometimes they don't care as much if doing psych wasn't your original intention, as long as you can make a good case for why you want to do it now.

 

[EMfirst]

Thank you dragonfly!

When I applied last year (only to IM programs), I used all IM letters. One from a chairman and 1 from ward attending, 1 from ID elective. Perhaps it's my wrong doing this year, I used that same chairman letter, 1 from neurology and 1 from OB, which I had a chance to see and they are both long and give real insight to me as a future physician and how I was a good student. So I have to figure out a way to replace those letters, which have already been downloaded by programs!

My plan is to wait for 1 more week to see what comes up, then maybe call the program where I did IM at to ask for a "prematch" or something (this program is in NY) one more thing, there is one program in close enough distance said if I will pass step 3, they'll consider me, but again, nothing is for sure. I am taking step 3 as soon as i'm ready.

Thanks again dragonfly! I really appreciate your help!

 

[Winged Scapula]

Thank you WS and OLDMD,

I applied to 32 programs because these are ALL the programs with in 2 hrs of where my wife is. I told her that I love her more than med school, so it's hard to pick up and go to another state that might be easier for me.

I understand. These decisions are hard and I've seen several people make them, with various outcomes (leave medicine, divorce after time apart, stayed together). I wasn't sure you realized that 32 programs is on the low side but thank you for clarifying the reasons behind that number.

WS, maybe my letters are not helpful, or is one of many negative factors. I used 3 letters for IM: 1IM, 1OB, 1Neurology. These are "general" letters...

Why OB? I can't imagine that would be very helpful for anything but OB (and would actually hurt for surgery, but that's another topic not relevant to you).

But for Family and Peds, I add one additional letter in each field. I applied all over the place b/c we wanted to increase my chances at these less competive programs such as FM and IM. The Peds program is at my wife's program. We were hoping that her program would consider me because she is IN it.

Thank you all for your help!

Understandable.

Perhaps with the letters from different specialties, some of the IM programs felt you would not be dedicated to their particular field, and thus rejected you? Can you not get a dean's letter + two medicine letters to use? Can you get in contact with your med school and/or faculty who were your ward attendings and wrote your LOR's, before they forget who you are? You need to try hard to get in this year...

I agree with dragon..letters from multiple different specialties seems unfocused to me. IM subspecialties are ok, but the vast majority of your letters should be from IM, CC, etc.

Thank you dragonfly!

When I applied last year (only to IM programs), I used all IM letters. One from a chairman and 1 from ward attending, 1 from ID elective. Perhaps it's my wrong doing this year, I used that same chairman letter, 1 from neurology and 1 from OB, which I had a chance to see and they are both long and give real insight to me as a future physician and how I was a good student. So I have to figure out a way to replace those letters, which have already been downloaded by programs!

So your letters are a year old? That can be a problem in addition to being out of medicine for a year and submitting a letter from OB to IM, FP, etc. programs.

My plan is to wait for 1 more week to see what comes up, then maybe call the program where I did IM at to ask for a "prematch" or something (this program is in NY) one more thing, there is one program in close enough distance said if I will pass step 3, they'll consider me, but again, nothing is for sure. I am taking step 3 as soon as i'm ready.

Thanks again dragonfly! I really appreciate your help!

It wouldn't hurt you to take Step 3, especially if there is a small chance that a program nearby will accept you. Plus, the test is easier the sooner you take it.

Do you have faculty members who can call programs and plead your case for you? They would need to rave about how good you are clinically, how much better you are in person than on paper. Its time to pull out the big guns, all the favors, etc.

 

[EMfirst]

WS, thank you for taking the time to advice me in such details.

1. My letters are from the same attendings from last year, but they are "updated" last month. They all still remember me b/c I graduated in Jun of this year. I used the OB one b/c that attending knew me very well and wrote extensively on my "character", which is now I see as a possible mistake. I thought the first time around all the IM letters did not help, so I'm trying to bring in something new. Now I don't know how to reverse this!

2. yes, I agree with you about the Step3, that's why I'm taking it ASAP. I just want to make sure that I'll do well and NOT fail to make things worse.

3. My goal by the end of this week is to call everyone who ever liked me to help out. I think that might work, as many of them have connections and did say that they would help me when I was a student 6 months ago!
My wife and I agree that if I get something in this other state, we'll find her a PGY2 spot, as she is an AMG, good candidate, and the state we're thinking about is her home state/school. We agree that it is detrimental for me to be unmatched another year!

4. I'm hoping my current PI will do some major things, I just haven't had seen him this week!

Thank you so much again for your time! WS and dragonfly, you guys are like the Mother Teresa of this place, THANK YOU! You both are making such a positive impact by being on here, I hope you know that!

 

[EMfirst]

So thus far, I have 3 interviews: 1 peds, 1 IM, 1FM. My wife and I are officially in the panic stage. I'm planning on applying to NY programs, which is definitely more FMG friendly, but even that, is it too late?

Please give me any advice! We are so desperate right now and don't know what to do!

Thanks.

 

[exPCM]

Would it be out of the question for you to wait two more years so your wife can finish her current residency and then you start residency somewhere? Your wife could then get an attending job in the place you do your residency? I know this would delay your residency but you could try and get a prematch spot since you are not a US senior and maybe do some additional research to beef up your CV.

 

[EMfirst]

Thanks for your advice, although tempting, I did talk to a PD here and he said that I NEED to be in a program, or 2 years away from med school would make me look like "there's something wrong"

My research is going well, I will publish something this year, but I don't think anyone is going to care about my research because my scores and FMG status are/will make me undesirable anyway!

Has anyone ever seen a candidate with 3 interviews in 3 different specialties get match???

 

[kralwok]

If you match elsewhere, your wife may be able to get a PGY-2 spot where you match. The trouble with this is that if you don't find out where you match until March, it will likely be too late for her to sign a contract at another program (unless someone drops out in the Spring). I thought of taking a PGY-2 spot this year at a different program than my PGY-1, and they wanted me to sign a contract in December. If you are able to pre-match she might be able to find one before it is too late. Otherwise she will have to take a year off then try to find an open PGY-2 spot the following year. NY is big so hopefully she can find a spot. It can get tricky with funding and openings in a particular program, though programs have been known to create spots if they have the resources and want a particular candidate. You matching somewhere else, being apart for one year, and her switching at PGY-3 will not work either b/c I believe there is a rule that you must complete your last two years at the same program.

I sincerely hope everything works out for you, and you are able to match at a program near your wife. My husband and I are facing similar issues, though I am the one unmatched and he is matched. It sucks. There is so much planning, are so many "what if" scenarios, and one person always feels like they are sacrificing for the other.

It is not too late to apply for other programs. I actually have not submitted ERAS yet, but that is another story. You will be at a distinct disadvantage having submitted late (which is probably not good with a weaker application), but it is still possible to get interviews. After November 1 may be too late. If you have someone willing to advocate for you, perhaps they can call NY programs to try to get you more interviews.

 

[jettavr6]

So thus far, I have 3 interviews: 1 peds, 1 IM, 1FM. My wife and I are officially in the panic stage. I'm planning on applying to NY programs, which is definitely more FMG friendly, but even that, is it too late?

Please give me any advice! We are so desperate right now and don't know what to do!

Thanks.

As blunt as I can be for your own good. Panic isn't going to get you a position, and isn't going to help your relationship. Keep your eye on the ball, and concentrate on your goal.

Aside point: Two friends last year each with only one interview-- each matched into their sole interview program. It's rare but happens; and it isn't much discussed.

 

[dragonfly99]

Yes you could match with only 3 interviews, and those from different specialties. Try to think of each interview as a separate opportunity, and act eager, but not desperate, when you go to the interviews. It's not just the quantity of interviews that determines whether someone matches.

At your interview, I would emphasize
a) what it is you like about that specialty and why you want to do it
b) your research (especially if there are pending publications)
and
c) that you want to go THERE (i.e. there geographically) and will be willing to move.
If you do these 3 things it will increase your chances of matching. You might have to consider being away from your wife for a year...hopefully close enough for frequent visits. She'll have a better schedule as an upper level than you will have as an intern.

As mentioned above, waiting a year or two and then matching might not be impossible. It's true that certain people might think "there's something wrong" but I think you could explain to most of them that your wife was in a residency and you had to either take a residency where she was, or move far away, which you didn't want to do. Waiting more isn't the strategy I'd pick, but to each his own. I'm also not married so it's hard for me to project myself into your situation.

 

[ERzone]

It can be done!!🙂

 

[EMfirst]

Thank you all for your advice and encouragement. I really appreciate it! I will focus on my 3 interviews and hopefully something will work out!

Is there a thread on how to appear eager, but NOT desperate? what would I do/say to make me sound desperate?

Thanks again!

 

[maceo]

i bet you if you divorce your wife your all your problems will disappear right? so divorce her.. thats my advice

 

[sheetu]

I am an IMG with scores of 241 and 235(99 and 97) and am awaiting CS results..I applied to 80 programmes and have not heard back from a majority as yet. I got 13 rejections and application hold at one place...Is it that majority of the places take so much time to send out calls or rejections? Am i ever going to get any calls?🙁

 

[Winged Scapula]

I am an IMG with scores of 241 and 235(99 and 97) and am awaiting CS results..I applied to 80 programmes and have not heard back from a majority as yet. I got 13 rejections and application hold at one place...Is it that majority of the places take so much time to send out calls or rejections? Am i ever going to get any calls?🙁

I'm sorry you're having such a hard time.

While your USMLE scores are excellent program do look beyond this.

What specialty are you applying for?

Do you have PR or US citizenship?

Any USCE?

Any US LORs?

What school did you go to?

Did you apply to a wide variety of programs in your chosen specialty, ones with a track record of taking IMGs?

 

[sheetu]

I graduated in India and have a year of post graduate experience and some research experience as well but no USCE...Need a visa but am ready for a J1 as well...I have applied only to IM...and to all programmes that accept international grads...

 

[EMfirst]

I just want to thank you all for giving me some hope during the last few months!

But I also want to update this post to encourage anyone who is in a similar situation like me to NOT lose hope.

I ended up having the following interviews: 2 peds, 5 family med, 1 internal medicine, all at university programs or university affiliated. During my first interview of the season, I was offered a pre-match. Since then, I've told most of the other programs that invited me for interviews about my prematch, and 2 of them are considering giving me a prematch, as well. However, the first prematch has a deadline, which I am gladly accepting if the other programs do not offer me anything soon. My point of posting today is that you hear horrible stories all the time, but even with scores like mine, you will get something and there is hope!

I do think being prepared for the interviews really helped me. I researched the programs extensively and talked to the programs about something I have in common with them. I did the usual thing that everyone here suggested, being super nice and friendly to everyone I meet during the interviews. I also tried to clearly express my desire to be at their program (for me, staying in the area is most important)

So if anyone has any questions, feel free to PM me. But thank you all of you who gave me so much advice and hope!

Happy Holidays!

 

[dingleberry007]

congratulations.... its nice to hear such success stories!

btw... without SDN, I think my mind would go insane due to despair. I'm really glad we have it. I can't imagine how people managed without it back in the day...