My family practice elective and good news for all

[MrScottyMD]

I started my family practice elective last week. My personal friends know where I am but I am not at liberty to publish the location or name of the residency program. This elective literally came up last minute as I was headed off to a different elective in a different state. (Sounds ridiculous I know, but true) , but unless you are in a coma youve heard of this program) The reason for this post is if you go to Saba and score well on the boards there is not a single hospital in this country that wont give you some sort of an oppurtunity regardless of what medical school you go to. The one thing I will say is that this program has never taken a foreign student to date for residency nor have they offered a foreign graduate an elective before. And the Answer to your next question is that NO< I DONT KNOW ANYONE or have any inside contact. As a matter of fact they out right rejected me as I inquired about an elective about a year ago before I had board scores in hand. It made absolutely no difference in what foreign school I attended. I could have gone to medical school on a pirate ship for all they cared. They want good scores because they want high scorers on their inservice speciality exams as do all programs. Now Im not saying I could get Derm at this program, to think so would be ridiculous, but what I am saying is that there is not a program out there that is out of reach. (Yes , Ivy League Schools Included) (esp. if you are considering Family or Int. Med). Study hard and get good scores and you will be blessed with many interviews at programs you would have deemed impossible. Trust me its not impossible, I have interviews at some of these programs and have already interviewed at one of them. Out of 37 programs so far I have 10 interviews and only one rejections and that is because they needed a transitional year to have applied. I have gotten interviews at programs so prestigous I am literally rethinking family medicine and considering internal med with a speciality down the road. Good luck to all, Scott Jones DC MS IV (And to think I considered transferring to a US school and losing a year's time and 60K in tuition and expenses) Thank god I rethought that. Maybe for DERM or ORTHO it would have been necessary but those programs are tough even for US grads.)

[DSMMD]

Scott,

You have had some good posts and some good insight that you have offered on these forums; however, at times, you are also off base...this being one of them. You state that there should be no programs that are off limits if you have good scores...well, obviously this is wrong.

First off, there are some states that are still off base.

Next, There are some hospitals affiliated with certain medical schools that will not allow you to rotate through them regardless of board scores, letters of rec, etc. One of these institutions told me they were looking for cultural diversity (they would take US residents from US schools and Foreign grads that went to school in their country of origin; however, not those that are US residents that go to a foreign medical school). There is nothing you can do to get around this. In addition, I had one rotation set up at a very well known hospital for an elective in Emergency Medicine that was approved by the ED director; however, the medical school squashed it because despite having my step I scores, they could not "evaluate the quality of my medical education". Furthermore, I had another residency director tell me he would love to have me do a rotation; however, the medical school would not allow it. He recommended that I apply for residency because he too started off at a foreign medical school and was not as "narrow-minded" as some of his counterparts.

So, the fact is this: No matter what your board scores are, no matter who you know, there are still rotations that are not available. Also, despite what people may say, there are still programs that will see you are an IMG and will not grant you an interview regardless of other things.

[MrScottyMD]

Yes there are residencies out there that will not be accesible to foreign grads at this time and perhaps never. I never said that ALL residencies will consider foreign grads, but barriers will be broken, perhaps one at a time. There are many programs that dont consider foreign graduates despite just being mediocre programs themselves. My post was only to point out that many of the most respected names in Medicine will not only interview an FMG with good credentials but also give him or her a residency. My post was not meant to say every program takes FMG's. If that is how my pervious post was interpreted I stand corrected.

Sincerely, Scott Jones DC MS IV

[GucciMD]

I agree that passing step one with a good score does not open every door. I found a green hospital that also wanted to offer me a rotation but the medical school rejected the rotation because I am an IMG.

Many hospitals have rules that only students from LCME schools (AMG) can do rotations at the hospitals.

So the best thing you can do is to go to the hospitals that your medical school has a contract with and hospitals with residency programs are the best choices.

I am currently doing rotations at a hospital with medical residents and they treat everyone the same whether you are AMG or IMG.

As a Sint Eust. student they set up all my clinicals and I have had all green book thus far.

Good luck Scott and I hope your rotation in FP goes well, I am sure it will.

I am surprised that FP is an elective at Saba, all Statia students must do 6 weeks of FP rotations. Many states require a FP rotation and I did IM rotation first and much later did FP rotation. I found it very helpful to do FP after IM, OB/GYN, and PEDS.

[MrScottyMD]

Yes I have personally run into 2 well know University programs that have never allowed an FMG to do a rotation because of American Medical School pressure to which the particular hospitals were affiliated with or internal policy that flat out rejected me when I applied for electives late last year stating that essentially FMG's were not welcome nor had they ever been. However with a Step 1 and Step 2 in hand ( with a good showing) with a CSA completed and a stated interest in their program both offered electives. (Unfortunately I could only accept one as my schedule was already built). So it aint over till the fat lady sings. I attribute the FMG situation getting better to the fact that the economics of medicine are so bad due to managed care, that frankly attacking the credibility of FMG's just isnt as high on the priority list of most practicing physicians as it once was. Economic survival is the main concern among physicians these days and that cannot be blamed on foreign graduates. After practicing 12 years and billing insurance companies for 12 years for 3 offices the reimbursement situation is horrific and steadily worsened, and most physicians are banding together and hardly worrying about where anyone went to school. Podiatrists, and especially chiropractors were some of the hardest hit (hence why many are back in medical school, myself included) Compound this with the escalating malpractice rates for which my partner saw an increase from 11,000 to 21,000 dollars this year in FP with no claims. (There are bigger fish to fry than FMG's). Not to mention Program Directors with no time for FMG's dont necessarily live forever. Add to this the current cash crunch for most hospitals and what 200-300 dollars per week per student can do if they merely bring on students for electives. I once saw a check from one of the 4 big Carribean schools that represented a months worth of electives for approximately 14 students for a core. (the check was labeled with the particular rotation and student number and dates). It was a big number and for that One core rotation alone would be worth close to 75K per year. ( and this was just for 1 core assuming it was offered thru the year which it was ) This school also had all the other cores going on at this particular hospital so the money is mind boggling. This is another reason that FMG's have continued to thrive. If the market was so bad for FMG's they wouldnt be trying to build a med school on every rock in the carribean. Good Luck To All. Scott Jones DC MS IV

[MrScottyMD]

Family Practice is now a required rotation at Saba. It is considered a "required elective" at this time and must be at least 4 weeks in duration. I am not sure for what states that FP is required but my first bet was that it was for TX or PA. I contacted Harrisburg in PA because of my interest in PA licensure and it is NOT required there nor is it required in NJ. Regardless however it is certainly an elective that all should have. Neurology is also another one of those electives that is required by some states for licensure and is probably a good one to take regardless. Best of Luck, Scott Jones DC MS IV