So, I was looking at the list of residency positions garnered by SGU alum and it looks like the majority of people were/are working in GP residencies. Is there anything else besides a good GPA and USMLE scores that would help with the possibility of getting into a more specialized residency (ie. research)? And if reasearch is one of those options, where would be the best place to go to start looking for opportunities?

THANKS SO MUCH!


PS - For all those looking to go to SGU....I've been here since February and it's FANTASTIC!

Plenty of folks go into "specialized" residencies. Problem with SGU's list is that it only lists where folks go in their PGY-I year... many specialized residencies require a year of "preliminary" or generalized internship. Off the top of my head, I know there are many folks missing from specialty residencies such as neuro, pm&r, rad, anesth...etc. And I know for sure 2 from my class went into Ortho...

Research as a post-doc is very easy to get as an MD grad. Plenty of IMG's who cannot obtain residencies go into "research".

P

__________________
Jean Luc Picard
Academic Hospitalist/Assist. Professor of Medicine, Star Fleet Medical, Earth, United Federation of Planets
Borg-Certified... Resistance is Futile.

In Glock, We Trust... Everyone Else... Keep Your Hands Where I Can See Them.

http://www.odmp.org/search.php?searc...=2001&cause=27
http://www.nypdangels.com/wtc.htm
http://www.hampsteadnh.us/police/A%2...ica%20Died.htm
http://longmontpolice.com/MEMORIAM.HTM

Hey Picard,

You mentioned that IMG's who cannot obtain residencies go into research. The sentence "IMG's who cannot obtain residencies" makes me very nervous. I am a Canadian who applied to St.George's recently and who wants to practice in the US. I am told that 99% of St.G graduates obtain a residency in the US. Should I be worried about not obtaining a residency if I pass my UCLME's and the appropriate exams and get an HI-B visa? Who are the IMG's that do not get residencies? What can I do to guarantee that I will get one? If I am accepted at St.G's I will be spending A LOT of money and the thought of not being able to get a residency afterwards makes me VERY scared. Should I be worried - what are my chances of not getting a residency? I am going for ER, is this shooting too high?

From Mike

PIcard has my spheil on sgu's faulty list of residencies down pat, however be clear that most sgu folks go into primary care (not GP by the way). 99+% of sgu grads who are us citizens get a residency.
As for being guarenteed a residency, you simply can't be guarenteed a residency. However if you get the appropraite visa (and some hosptials will help to sponsor one) then its generally ok. What you ought to do is call sgu and speak to the international office about the type of visa you need and how and when you should go about it. At the worst you could always take aresidency outside the match in an underserved area that really needs doctors. however if you take care of the visa thing you should be ok.

__________________
Steph
If you get a warning, put on yer manpants and stop whining about it.

I heard, though, you need to be careful with PGY-I, II years etc. due to the fact that sometimes you can get shuffled around and kept in prelims for a few years even before ever getting the chance to start with the "specialized" residency. Correct me if I'm wrong, I'm just trying to learn about the whole process.

[quote="DrRichMD"]I heard, though, you need to be careful with PGY-I, II years etc. due to the fact that sometimes you can get shuffled around and kept in prelims for a few years even before ever getting the chance to start with the "specialized" residency. Correct me if I'm

no this isnt right; you go through the match for both your pgy1 and 2 years at the same time so you know where youre going. The exception is when someone matches in a prelim only program and in that case the next years are totally up in the air. Thats the exception not the rule.

__________________
Steph
If you get a warning, put on yer manpants and stop whining about it.

I stress again to all the international students who are not US permanent residents:
THE BIGGEST PROBLEM is the visa!!! H1B is given only for employment and not generally to students (residency means you are a student)
H1B is given to people that have graduated and have been given a position as faculty or researchers (academia) or staff positions at US companies. eg all the chinese and indians coming in the US to do computer programming or medical research (nothing against either one of these populations). There are approx 70K positions each year given to companies and unlimited to Universities. the process used to take about a year (if you got the visa, nothing guaranteed) and now it takes about 6 months (assuming you clear the Dept of Labor).
Most residents or students are given J1 (which is what I had a few months ago) which has a catch for MDs. You HAVE to go back to your home country for 2 years (its called section 212) even if you married an american citizen.
If you are here to do medical research (like myself) then you are exempt from this requirement. When you go to the consulate they will indicate on the J1 visa if you are exempt. If the visa says that the 2 year rule applies then you have to apply for a waiver from the Dept of State. For that you have to show that there is something that ties you back to your home country such as wife, kids, real estate, job etc. Second you have to get a letter of no objection from your embassy which states that they have no objection to your staying in the US. Some countries such as Greece require only that you complete your military draft. Others such as China require that you go back no matter what to help the motherland.
My situation was that I had a J1 visa and was exempt. i married an american citizen and am on my way to permanent residency (which is by far the cheapest ($350), quickest (2-6mos) and surest (immigration number is immediately available) way to go...
If there are any more questions let me know. Most of the info is online at the INS website

Hi Steph,

Thank you for emailing me back. I hate to sound uninformed but what is the difference between a GP (general practicioner) and a doctor in primary care. I am assuming that primary care includes: IM, Peds, and psychiatry. I have researched exactly what each of these primary care subdivisions are, but I thought that a GP was included in this mix. Where does a Family doctor fit in? Is this the same as a GP? I can't seem to find a website that will make these differentiations for me. Why is it that most SGU grads go into primary care? Are GP positions hard to get or something? Which field makes the most money (I only ask this question because I can't find a reliable website that gives doctor wages in the states and I just wan't to make sure that familly care pays a decent wage). I am going to end up with a lot of debt if I go to St. G's and I want to make sure that I'll manage. Thank you for your time and putting up with a beginner in this whole process like me.

Mike

Sorry for my ignorance, but what is a PGY-1, or 2 ? I have applied but don't know all the ins and outs of the process of getting back to the US. All I know is 2 yrs in the caribb, clinicals in the US, residency, fellowship if going into a specialty......Is this wrong and/or what am I missing?

Negean

OK, I'll try to answer one question at a time.

1) GP vs Primary Care. GP (General Practioner) usually means that the physician has not finished residency (ie drop out of residency) and is not board eligible for anything. Since most states will license an USMG after only one year of internship, GP usually refers to those that only complete the internship year and goes into practice. Nowadays, it's harder and harder for a "GP" to find a job because it's very difficult to afford malpractice insurance for those without residency training. And, very few if any hospitals will grant admitting privileges to GP's who do not have board eligiblity.
"Primary care," on the other hand, means someone who has completed a "primary care" residency, and are at least board eligible. Primary care residencies typically refers to Family Practice, general internal medicine (outpatient internist, as oppose to a growing movement of "hospitalist" internists who generally don't consider ourselves "primary care"), pediatrics, and sometimes ob/gyn and psych. Basically, primary care are generally who you consider as your "family/personal doc."

2) Money. As a general rule, procedure-oriented specialties make more money than non-procedure oriented specialties. A board-eligible/certified family practice doctor can expect to bring in anywhere between 120,000 to 150,000 per year depending on location and type of practice and whether or not they do ob/gyn care. A busy gastroenterologist who is a skilled endoscopist or an interventional cardiologist in my area can make upwards of 500,000 per year (with 250 to 300 more of a norm/mean). Hospitalists in my area make between 150,000 to 200,000 depending on practice and procedure billings.

3) When I say "IMG's who cannot find residencies," I mean just that. IMG's who can't find residencies. Many of them are true IMG's who are not US citizens and are educated in their home countries with non-US model of medical education. Many have trouble passing USMLE/CSA's. Many of them use the research time to network with residency programs and study for USMLE/CSA's. As an SGU grad, you won't have to worry about these if you do your part. The most challenging thing for you, as others have point out, is the Visa issue. I don't know much about Canadian situations when it comes to Visa. Talk to folks at Bay Shore who can help you sort out the process.

4) "PGY" stands for "Post Graduate Year." Since some residency programs start after a year of internship, the terms "R1/R2/R3...etc" becomes confusing because an R-1 (first year "R"sident) in, say, Neurology is technically a "PGY-2" because they have done a year of internship and their first year of neurology residency is technically their second year of training after graduation from medical school.

5) Yes, SGU's program is 2 calendar years in the Caribbean. 3rd and 4th year back in the US (or UK if you choose to or unable to enter US due to visa reasons for non-US citizens). You apply to residency like everyone else, and go from there.

6) Yes, most SGU grads go into "primary care" specialties. But so do graduates from most, if not all, US medical schools. This is simply because primary care residencies are the most numerous out there. And, for folks who want to "subspecialize" into one of the medical subspecialties (such as cardio, GI, rheum, pulm... etc) they must go into categorical internal medicine residency first, which is technically considered "primary care."

7) As for prelim's not getting into categorical spots -- it happens. And yes, some prelims do spend a few years as "prelim interns" before getting into categorical spots. This tend to be more common in surgical residencies/specialties. For those who match into Prelim PGY-1 and specialty PGY-2 during the same match, this is not a problem because they are matched/contracted into both at the same time. It's those who only match into (or sign outside of match into) prelim spots who may have this problem.

Hope I covered most of the questions.

P

__________________
Jean Luc Picard
Academic Hospitalist/Assist. Professor of Medicine, Star Fleet Medical, Earth, United Federation of Planets
Borg-Certified... Resistance is Futile.

In Glock, We Trust... Everyone Else... Keep Your Hands Where I Can See Them.

http://www.odmp.org/search.php?searc...=2001&cause=27
http://www.nypdangels.com/wtc.htm
http://www.hampsteadnh.us/police/A%2...ica%20Died.htm
http://longmontpolice.com/MEMORIAM.HTM