worst year for IMGs in general surgery?

[lenalid]

Is this the worst year in a while for IMGs applying to gen surg? I've spoken to a couple secretaries/PDs who have said the number of applications doubled or tripled in their programs. I'm an IMG going for gen surg and have been pretty dissapointed with my interview invites. I have strong step scores (99 step 1, 96 step2CK, pass CS -- all passed on first attempt and all done before Aug 2007), good clinical rotations + LORs from US attendings, and, despite my poor grammar, English is my first language . I'm also in my final year of med school so I don't have my ECFMG certificate yet.

All of this equated to 4 categorical invites, not a single one from a university program. I applied to nearly 90 programs. Anyone experiencing this pain? Please share your experiences here.

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[maverick_pkg]

Is this the worst year in a while for IMGs applying to gen surg? I've spoken to a couple secretaries/PDs who have said the number of applications doubled or tripled in their programs. I'm an IMG going for gen surg and have been pretty dissapointed with my interview invites. I have strong step scores (99 step 1, 96 step2CK, pass CS -- all passed on first attempt and all done before Aug 2007), good clinical rotations + LORs from US attendings, and, despite my poor grammar, English is my first language . I'm also in my final year of med school so I don't have my ECFMG certificate yet.

All of this equated to 4 categorical invites, not a single one from a university program. I applied to nearly 90 programs. Anyone experiencing this pain? Please share your experiences here.

from my experience last year, >70/80% of IMGs on interviews had 99 on both steps. LORs were not that common. Those who matched who I know had LORs from big name places. All were ECMFG certified. So hope it gives u some more info about the process.

 

[europeman]

This two digit score honestly should be eliminated. There are *SO* many people I have run across who are under the impression that this is a percentile. I was just reading over a faculty applicant at my institution (it was lying around because it's interview day for him), and in his CV he has "99th percentile in Steps1 and 2".

WRONG.

Likewise, my mentor asked me "What percentile was your board score?" I said, appropriately that I don't know, but I gave her my score.

The next week she was assigned to interview students for surgery residency, and she told me how one of them "Must have been really smart; he had a 99th percentile on his boards. He didn't have very good letters though, but he must be really smart."

hu?

When I interviewed, on more than one occasion the interviewers said to me "I see you scored in a very high percentile on your boards...."

This is honestly widespread confusion I think.

 

[SocialistMD]

When I interviewed, on more than one occasion the interviewers said to me "I see you scored in a very high percentile on your boards...."

Not to take away from your point, but if your 2-digit score is a 99, you did score a high percentile, even if it isn't the 99th.

 

[Pollicis]

This two digit score honestly should be eliminated. There are *SO* many people I have run across who are under the impression that this is a percentile...

europeman - I must admit I'm scratching my head a bit about this comment. I've re-read the original posting and those that have followed, and, you seem to be the only one who makes reference to a 'percentile'.

lenalid - We seem to be in the same boat. I have very similar stats to you, including a 99 <cough> on Step 1 and I received 6 invites. Best of luck in the match!

Pol

 

[mosfet]

Lenalid & Pollicis....Just wondering, which foreign school are you guys from. Did you guys do your clinical rotations here in the states?
I am also an FMG and have similar stats as Lenalid but I fortunately ended up getting 4 times as many interviews as Lenalid. My LORs from US attendings are pretty decent. No research or publications. After going through this process I realized how important it is to do clinical rotations in the US.

 

[Pollicis]

I'm at school in Europe so all my clinical rotations are here. I was able to do 2 rotations last summer in the USA which got me some LORs from US surgeons.

Also, I should mention I only applied to categorical. This is an important distinction because I know plenty of people getting 10+ prelim invites. When you say you had 4x more interviews, does this mean categorical or prelim or both? What was the mix?

Pol

 

[TrabNY]

I'm at school in Europe so all my clinical rotations are here. I was able to do 2 rotations last summer in the USA which got me some LORs from US surgeons.

Where are you from in Europe?? Cause it makes a huge difference if you are from Poland or from England!! Honestly, Europe doesn't mean much when it comes to medical education!

Cheers and good luck with the match!

 

[mosfet]

I'm at school in Europe so all my clinical rotations are here. I was able to do 2 rotations last summer in the USA which got me some LORs from US surgeons.

Also, I should mention I only applied to categorical. This is an important distinction because I know plenty of people getting 10+ prelim invites. When you say you had 4x more interviews, does this mean categorical or prelim or both? What was the mix?

Pol

I applied for 70 Categorical Programs and no prelims. Ended up getting 19 categorical interviews. I am currently a 4th year student at a carribean med school and am a US citizen. What school in europe are you from? I have a couple of friends at a polish med school, so I am wondering. Lenalid, are you a US citizen because that make a world of difference.

 

[maverick_pkg]

I applied for 70 Categorical Programs and no prelims. Ended up getting 19 categorical interviews. I am currently a 4th year student at a carribean med school and am a US citizen. What school in europe are you from? I have a couple of friends at a polish med school, so I am wondering. Lenalid, are you a US citizen because that make a world of difference.

It makes a huge difference if you r a citizen/green card vs if u require a visa

 

[lenalid]

I applied for 70 Categorical Programs and no prelims. Ended up getting 19 categorical interviews. I am currently a 4th year student at a carribean med school and am a US citizen. What school in europe are you from? I have a couple of friends at a polish med school, so I am wondering. Lenalid, are you a US citizen because that make a world of difference.

Hi mosfet. I go to school in the UK and I'm a Canadian citizen, so I'm not exactly a complete 'foreigner'. I do understand what you mean about being a US citizen and going to an eastern vs western european school. But I would have thought that being North american and going to a western european school would make some difference. Apparently not. How did you friends in Poland do with respect to interviews?

 

[ESU_MD]

This two digit score honestly should be eliminated. There are *SO* many people I have run across who are under the impression that this is a percentile. I was just reading over a faculty applicant at my institution (it was lying around because it's interview day for him), and in his CV he has "99th percentile in Steps1 and 2"

If you see someone with a 99 thats pretty damn good. it must be pretty close to the true percentile anyway. complaining about it makes you look jealous.

can someone explain what the 2 digit score really means, since it isnt a percentile?

 

[Dr. Dukes]

can someone explain what the 2 digit score really means, since it isnt a percentile?

Some states have laws that say to be licensed to practice medicine you must have gotten a 75 or better on your licensing exams (2 digit score on USMLE), so I think the two digit score is a percentage not a percentile (you got 75% of the questions right, you didn't beat 75% of the people who took the test). It might be some random number the calculate somehow and not be a percentage, but it exists for those handful of states out there that require a 75 to get licensed.

 

[XoQo]

Some states have laws that say to be licensed to practice medicine you must have gotten a 75 or better on your licensing exams (2 digit score on USMLE), so I think the two digit score is a percentage not a percentile (you got 75% of the questions right, you didn't beat 75% of the people who took the test). It might be some random number the calculate somehow and not be a percentage, but it exists for those handful of states out there that require a 75 to get licensed.

It is not a percentage nor a percentile. From NBME:


http://www.usmle.org/General_Information/general_information_FAQs.html#score


On the 3-digit scale, most scores fall between 140 and 260. The mean score for first-time examinees from accredited medical schools in the United States is in the range of 200 to 220, and the standard deviation is approximately 20.


The 2-digit score is not a percentile.The 2-digit score is derived from the 3-digit score. It is used in score reporting to meet requirements of some medical licensing authorities that the passing score be reported as 75. The 2-digit score is derived in such a way that a score of 75 always corresponds to the minimum passing score.

 

[lenalid]

umm, not that this 2-digit stuff isn't interesting but could we please get back to the original topic. IMGs in general surgery. Anyone out there? Please post your experience and if you can/want to, let us know if it was categorical/prelim. (and by the way europeman, I never misinterpreted what my 2 digit score meant in the first place...)

Thanks.

 

[mosfet]

Hi mosfet. I go to school in the UK and I'm a Canadian citizen, so I'm not exactly a complete 'foreigner'. I do understand what you mean about being a US citizen and going to an eastern vs western european school. But I would have thought that being North american and going to a western european school would make some difference. Apparently not. How did you friends in Poland do with respect to interviews?

My friends in Poland are 3rd year students doing rotations here in the US. It's too early for them to apply. But yes, I think being a US citizen definitely gives you more opportunities. Are you applying for H1B or J1 or both?

 

[lenalid]

J1 here. I figured H1b would make dig me in a deeper hole (not to mention I haven't graduated yet thus no Step3)

 

[mosfet]

J1 here. I figured H1b would make dig me in a deeper hole (not to mention I haven't graduated yet thus no Step3)

I think J1 is a better choice anyway if you don't mind going back to your home country and practicing for a little while.

 

[meddoctor]

hey mosfet, what school in the carribean are you from? is it one of the big four (AUC, St. George, Ross, Saba)? Because I want to do Gen Surg. and I will be starting at Saba in May so i wanted to see how realistic is it for me to get a Gen Surg. residency. Thanks

 

[dmitrinyr]

A friend of mine who is a 4th year at SGU is applying this year for categorical general surgery spots. He had approx. 90-93 on step 1 and 2. He's a US citizen. He applied to 80+ programs and got 10-11 categorical interviews. He had good LORs and good grades. I'll try to post an update after the match.

 

[rox]

Here's the NRMP data for genral surgery spots for the past 5 years. It shows that 2007 was the best year for non-US seniors. There was a significant drop in the number of applicants, specially US Seniors, and more spots(around 5%) were occupied by non-US Seniors.

Year........Offered......%U.S.....%TOT Filled

2003........1,049........82.7........99.0
2004........1,044........84.8........99.8
2005........1,051........80.4........99.3
2006........1,047........83.3........99.9
2007........1,057........78.1........99.8

The number of applicants in 2006 was 1522 for US Seniors and 932 for "All others".
in 2007, there were 905 US Seniors applicants and 704 "All others".

 

[Celiac Plexus]

Here's the NRMP data for genral surgery spots for the past 5 years. It shows that 2007 was the best year for non-US seniors. There was a significant drop in the number of applicants, specially US Seniors, and more spots(around 5%) were occupied by non-US Seniors.

Year........Offered......%U.S.....%TOT Filled

2003........1,049........82.7........99.0
2004........1,044........84.8........99.8
2005........1,051........80.4........99.3
2006........1,047........83.3........99.9
2007........1,057........78.1........99.8

The number of applicants in 2006 was 1522 for US Seniors and 932 for "All others".
in 2007, there were 905 US Seniors applicants and 704 "All others".

Remember that although the number of US senior applicants is a useful bellwether of competition, there are plenty of US MD reapplicants that make up the non-"US senior" group. Thus the 78.1% match rate for US seniors in 2007 may be due in part to a large number of US MD grads from the previous year reapplying as there were nearly 600 US seniors who did not match that year.

Don't assume that in 2007 21.9% of the categorical positions went to FMGs. I don't think that figure is available, but I would guess that it's far less...

 

[mosfet]

Thus the 78.1% match rate for US seniors in 2007 may be due in part to a large number of US MD grads from the previous year reapplying as there were nearly 600 US seniors who did not match that year.

Don't assume that in 2007 21.9% of the categorical positions went to FMGs. I don't think that figure is available, but I would guess that it's far less...

I understand what you are saying, but what makes you think that those US seniors that couldn't get in the first time around would be competitive enough to match again.

 

[Celiac Plexus]

I understand what you are saying, but what makes you think that those US seniors that couldn't get in the first time around would be competitive enough to match again.

I didn't say that they are, just that they are reapplying. But, in most cases, the unmatched people who still want to do general surgery will take a prelim year and reapply. A good prelim year at a lot of programs will make up for a weak application, and a lot of these folks wind up matching the second time around.

 

[mosfet]

hey mosfet, what school in the carribean are you from? is it one of the big four (AUC, St. George, Ross, Saba)? Because I want to do Gen Surg. and I will be starting at Saba in May so i wanted to see how realistic is it for me to get a Gen Surg. residency. Thanks

Yes meddoctor, I AM from one of the "big four" carib schools. It is definitely possible to get into General Surgery from Saba. Just make sure you kill the boards and do well in your rotations. Now that you are a foreign grad, you need to work twice as hard and show twice the results as a US grad and only then will you succeed. But even after all that, there will be a few programs (only a minority of 'em) where you will be looked down upon as an FMG on the interview day despite your academic credentials. But don't let that get you depressed....just be proud of your accomplishments and move on. I will let you know how my match went.

 

[rox]

Don't assume that in 2007 21.9% of the categorical positions went to FMGs. I don't think that figure is available, but I would guess that it's far less...

Here's a quotation from the NRMP match outcomes for 2007:

"U.S. allopathic medical school seniors constitute 54 percent of the applicants in this report. The next largest group is non-U.S.
citizen students and graduates of international medical schools (25%)."

U.S. Citizen Students and Graduates of International Schools constitute 10% of all applicants.

Accordingly, most of the 21.9% of the positions should have been filled by FMG's.

 

[Celiac Plexus]

Here's a quotation from the NRMP match outcomes for 2007:

"U.S. allopathic medical school seniors constitute 54 percent of the applicants in this report. The next largest group is non-U.S.
citizen students and graduates of international medical schools (25%)."

U.S. Citizen Students and Graduates of International Schools constitute 10% of all applicants.

Accordingly, most of the 21.9% of the positions should have been filled by FMG's.

Interesting. Thanks for these figures.

Those numbers you quote are percentages of "applicants", not "matched applicants". If there were 1609 applicants for the available spots, then 10% of this amount is ~161. Therefore there were 161 "US citizens & graduates of international schools" and ~403 FMGs in the 2007 match. Considering that there were ~231 spots filled by these groups, their match rate was ~41%. But that's assuming that the two groups had equal success. I'd venture to say that the US group may have received more consideration than the non-US group... But make of it what you will.

 

[rox]

Interesting. Thanks for these figures.

Those numbers you quote are percentages of "applicants", not "matched applicants". If there were 1609 applicants for the available spots, then 10% of this amount is ~161. Therefore there were 161 "US citizens & graduates of international schools" and ~403 FMGs in the 2007 match. Considering that there were ~231 spots filled by these groups, their match rate was ~41%. But that's assuming that the two groups had equal success. I'd venture to say that the US group may have received more consideration than the non-US group... But make of it what you will.

I believe you misinterpreted my previous post. The point was that (1) the number of applicants has decreased and (2)the 21.9% of filled position by non-US seniors went mostly to FMG's since they make the biggest share of non-US seniors which include canadians, fifth pathway....etc.

 

[Celiac Plexus]

I believe you misinterpreted my previous post. The point was that (1) the number of applicants has decreased and (2)the 21.9% of filled position by non-US seniors went mostly to FMG's since they make the biggest share of non-US seniors which include canadians, fifth pathway....etc.

No, I understood the point you were making. However just because there were more FMG applicants than "US citizens and graduates of international schools" doesn't mean that FMGs had more success matching. It could just mean that there were more unmatched FMGs than the US citizen group.

 

[Blade28]

No, I understood the point you were making. However just because there were more FMG applicants than "US citizens and graduates of international schools" doesn't mean that FMGs had more success matching. It could just mean that there were more unmatched FMGs than the US citizen group.

Good point.

 

[SLUser11]

But even after all that, there will be a few programs (only a minority of 'em) where you will be looked down upon as an FMG on the interview day despite your academic credentials.

Ok.

 

[mosfet]

Ok.

Hey....it's not in my nature to exaggerate the truth.

 

[rox]

No, I understood the point you were making. However just because there were more FMG applicants than "US citizens and graduates of international schools" doesn't mean that FMGs had more success matching. It could just mean that there were more unmatched FMGs than the US citizen group.

My point was not about that there were more FMG applicants than "US citizens and graduates of international schools". I didn't say that.

The number of offered positions and percentage of filled positions have not changed much over the past 5 years(around 1,050, 99.8%, respectively). However, the match rate in general surgery for US Seniors was lowest in 2007. I can't see why this should not mean that non-US seniors were more successful in 2007 match than previous years.

Plus, the match success percentage in general surgery for non-US seniors was 40% in 2005 , while it was 48% in 2007.

 

[Blade28]

OK, I had to mine through the NRMP data since I'm now curious about the truth.

Foreign-Trained Physicians Matched to PGY-1 Positions by Specialty, 1999-2007

(http://www.nrmp.org/data/resultsanddata2007.pdf , page 17, Table 9)

General Surgery:

1999: Cat 55, Prelim 135
2000: Cat 73, Prelim 146
2001: Cat 92, Prelim 153
2002: Cat 124, Prelim 164
2003: Cat 107, Prelim 188
2004: Cat 81, Prelim 201
2005: Cat 112, Prelim 202
2006: Cat 99, Prelim 238
2007: Cat 130, Prelim 259

Now I wasn't able to find out exactly how many IMGs were applying each year, so we don't know what each year's match rate is.

Edit: I should add that these "IMGs" include US IMGs, that is, US citizens who studied abroad.

From http://www.nrmp.org/data/resultsanddata2007.pdf , page 27, Table 15:

Matches by Specialty and Applicant Type, 2007

General Surgery (Categorical):

Number of Positions: 1,057
Number Filled: 1,055
US Senior: 826
US Grad: 68
5th Pathway: 0
US IMG: 56
Osteopathic: 30
Canadian: 1
IMG: 74


General Surgery (Preliminary):

Number of Positions: 1,262
Number Filled: 781
US Senior: 481
US Grad: 19
5th Pathway: 2
US IMG: 55
Osteopathic: 20
Canadian: 0
IMG: 204

 

[Blade28]

I did also find the following:

Match Results for U.S. Seniors and Independent Applicants Who Chose One Type of Specialty, 2007

(http://www.nrmp.org/data/resultsanddata2007.pdf , page 23, Table 12)

General Surgery:

Matched: 762 (US), 189 (Other)
Unmatched: 84 (US), 315 (Other)

So it looks like for those who only applied to G Surg, the match rate for US seniors was 762/(762+84) = 90.0%, and for all others it was 189/(189+315) = 37.5%. Note that this does not differentiate between IMGs, Fifth Pathway students, etc.

 

[Blade28]

in 2007, there were 905 US Seniors applicants and 704 "All others".

"U.S. allopathic medical school seniors constitute 54 percent of the applicants in this report. The next largest group is non-U.S.
citizen students and graduates of international medical schools (25%)."

If foreign-born IMGs made up 25% of all applicants to Categorical General Surgery, then there were approximately (0.25)(905+704) = 402 IMG applicants.

As I posted above, there were 56 foreign-born IMGs who matched into Categorical General Surgery, thus making their match rate 56/402 = 13.9%.

 

[mosfet]

As I posted above, there were 56 foreign-born IMGs who matched into Categorical General Surgery, thus making their match rate 56/402 = 13.9%.

You mean 74 foreign-born IMGs. The 56 you mentioned are US IMGs.

 

[mosfet]

Here's a quotation from the NRMP match outcomes for 2007:

U.S. Citizen Students and Graduates of International Schools constitute 10% of all applicants.

So according to rox, if US IMGs made up 10% of the applicant pool, then the total number of USIMGs that applied would be (0.1)(905+704)=160 USIMG applicants

If 56 USIMGs matched in 2007, their match rate is (56/160) = 35% USIMGs matched

And as a USIMG myself, I will take that percentage any day.

 

[Blade28]

You mean 74 foreign-born IMGs. The 56 you mentioned are US IMGs.

My bad, you're right.

So 74/402 = 18.4% match rate for foreign-born IMGs.

I was dealing with too many numbers there.

 

[rox]

Your analysis is pretty accurate and it shows an important fact, that is, "U.S. Citizen
Students and Graduates of International Schools" are about two times(35% vs 18%) more likely to match than "Non-U.S. Citizen Students and Graduates of International Schools" in general surgery.

However, one should be aware that the 10%(percent of USIMG applicant) and 25%(percent of foreign-born IMG applicant) used in the calculation above were given for all applicants regardless of the speciality(http://www.nrmp.org/data/chartingoutcomes2007.pdf , page 2). So, the 35% and 18% would be valid only if 10% and 25% also apply for general surgery. That is because we have the absolute figures about the type of matched applicants(56, and 74), but we don't have absolute figures about the type of all applicants to general surgery. I don't know personally if their should be a reason not to apply these figures.


My main concern was whether 2007 was a better year for IMG's or not. Knowing the fact that the total number of applicants in general surgery was 2,454 in 2005 (vs 1,636 in 2007) and taking a look at the following figures, posted by Blade28, one could conclude that 2007 was better than 2006 for IMGs.

1999: Cat 55, Prelim 135
2000: Cat 73, Prelim 146
2001: Cat 92, Prelim 153
2002: Cat 124, Prelim 164
2003: Cat 107, Prelim 188
2004: Cat 81, Prelim 201
2005: Cat 112, Prelim 202
2006: Cat 99, Prelim 238
2007: Cat 130, Prelim 259

All the data is available thru: http://www.nrmp.org/data/index.html

 

[Blade28]

My main concern was whether 2007 was a better year for IMG's or not. Knowing the fact that the total number of applicants in general surgery was 2,454 in 2006 (vs 1,636 in 2007) and taking a look at the following figures, posted by Blade28, one could conclude that 2007 was better than 2006 for IMGs.

1999: Cat 55, Prelim 135
2000: Cat 73, Prelim 146
2001: Cat 92, Prelim 153
2002: Cat 124, Prelim 164
2003: Cat 107, Prelim 188
2004: Cat 81, Prelim 201
2005: Cat 112, Prelim 202
2006: Cat 99, Prelim 238
2007: Cat 130, Prelim 259

I agree that there were more IMGs (foreign-born and US-born) matched into General Surgery in 2007 versus previous years.

Unfortunately, we don't know how many applicants there were, so we don't know if the match rate was higher, lower, or the same. I couldn't find that data anywhere.

 

[rox]

Unfortunately, we don't know how many applicants there were, so we don't know if the match rate was higher, lower, or the same. I couldn't find that data anywhere.

This report gives you an idea about 2005 NRMP
http://www.nrmp.org/data/matchoutcomes2006.pdf , but yes, no enough data to figure out the match rate and success rate. It only shows the number of applicants that year, which was higher than 2007.