Thread: Let Me Project What Will Happen...(5th Pathway vs a 5th Year)

In regards to what will happen since 5th Pathway is gone...

I have been in practice for awhile so here is my opinion...based on what I know of the TSBME in Texas and their past history...


The TSBME, at this time made up of all US docs, will say...only the Titulo is acceptable. They have done this before. Texas rejected 5th Pathway students but had the law on the books. A lot of states did not accept 5th Pathway at all.

The Texas Board at the time let you sit for the state licensing exam with 5th Pathway BUT Titulo grads had to do 3 years of residency. I think it is the same now, just that 5th Pathway is gone. I took the FLEX in a state that did not require this.

Check with your state but if they tell you an internship is necessary as the minimum for the USMLE Part 3 exam, then you will have to get a Titulo to get into the US to do one.

Summation (IMPORTANT !):...some Mexican schools give the Titulo out at graduation after 4 years. I know two Monterrey grads that told me their schools, one private and one public, in Monterrey do not require Internado or Social Service and that the Titulo was given at graduation. Another student out of Juarez told me his school didn't require anything to get the Titulo either. They didn't have access to 5th Pathway and didn't need it.
**The UAG should have done the same thing decades ago.

Trying to set up a Mexican '5th Year' is not 5th Pathway.

Originally Posted by Big Medicine

In regards to what will happen since 5th Pathway is gone...

I have been in practice for awhile so here is my opinion...based on what I know of the TSBME in Texas and their past history...


The TSBME, at this time made up of all US docs, will say...only the Titulo is acceptable. They have done this before. Texas rejected 5th Pathway students but had the law on the books. A lot of states did not accept 5th Pathway at all.

The Texas Board at the time let you sit for the state licensing exam with 5th Pathway BUT Titulo grads had to do 3 years of residency. I think it is the same now, just that 5th Pathway is gone. I took the FLEX in a state that did not require this.

Check with your state but if they tell you an internship is necessary as the minimum for the USMLE Part 3 exam, then you will have to get a Titulo to get into the US to do one.

Summation (IMPORTANT !):...some Mexican schools give the Titulo out at graduation after 4 years. I know two Monterrey grads that told me their schools, one private and one public, in Monterrey do not require Internado or Social Service and that the Titulo was given at graduation. Another student out of Juarez told me his school didn't require anything to get the Titulo either. They didn't have access to 5th Pathway and didn't need it.
**The UAG should have done the same thing decades ago.

Trying to set up a Mexican '5th Year' is not 5th Pathway. You will be giving your money (40 thousand) to some hospitals to be an EXTERN then have to sit for the Professional Exam anyway or have to do the year in Mexico...another total loss. 5th Pathway was a US run and accepted program not one run by UAG. Any state can say...so you did a 5th year...big deal you do not qualify for Part 3 of the USMLE in our state BUT they cannot do that if you have the Titulo (see below).

I know what you are thinking.... wow we can get the Titulo and use USMLE 1 & 2 in lieu of the Professional Exam. BUT if UNAM takes 2 years (the average time to process your papers) to get a Titulo together, you lose residency and a chance to go to Part 3 of the USMLE.

Ok, in the words of Popeye "I've had all I can stands, I can't stands no more!" Sorry Big Medicine (I will refrain from calling you BM hope you understand) but I finally had to speak. I know my voice won't count for much, but I do hope it is heard. Here is the situation as I see it: I appreciate you speaking up for what you believe to be a just cause, and speaking out against the "evil" that is (again, in your opinion) the institution of UAG...but things are VERY different from what you knew, and it is honestly starting to show your ignorance about many, many things. To begin with, please stop talking about taking the FLEX, the ECFMG, or the Nacional/Professional Exam (not all from this post, I know...but basically summing up all the other posts too). None of those tests apply and some don't exist. I know you are well aware that there is no more FLEX...that went out years ago. There is no more ECFMG exam either. In one post I believe you mention taking the "NBME"...I am sure most (if not all) of us are thinking of the PRACTICE tests we take/took for the USMLE. As for the Nacional (Professional Exam) you keep mentioning that we will have to take it. This is not true. The new program, as you yourself mentioned, allows the international program grads to go to NY (or stay in Guad) for the internado, during which Step 1 (already passed if you are going to NY) and Step 2 and Step 2CS are passed. This provides the full Titulo. You know this and mention it. I also know that you know that this is NOT the license to practice in MX...for that we WOULD have to take the professional exam. So, with all those "know you know I know you know" stuff...why keep bringing it up? I don't think anyone, though, really wants to practice in MX, which is why we are in the international program. That titulo (and the 3 seperate USMLE) are more than enough to apply for our residencies through ECFMG. You warn us about the UNAM and the delay...you also say "if" alot about it all. By your own admittance, it has been YEARS since you have been back. You really have no way of knowing how much has changed then. Just as an example...I doubt many here really know what you are talking about when you talk about Tesistan. We have ICB and HAL...outside of our PMC rotations, many have no clue what or where Tesistan even is.

Now, I know I am going to be poo-pood and what not, but I am not just totting the UAG horn and pulling happy thoughts out of my butt. I have friends and acquaintances who are finishing up the first "Non-5th Pathway" year in NY (and several who has started)....no problems or complaints yet with any residency applications, titulo application (process is already started for those that passed Step 2), etc. The only problems have come from those who can't pass the tests (and a technical problem in CA that is being addressed). The USMLE fail rate is really the student's fault, not the school's, in my opinion. The full discussion of that is a ragind debate, I am sure, so we won't get into that here.

Now, in regards to this particular message of yours, you do realize that 5th Pathway was WELL accepted in TX? I don't know exactly when this started (since you say it was not), but if you like I can provide you multiple references of people who have successfully completed a variety of residencies in several different TX hospitals (surgery, IM, pathology, pediatrics, etc. in Houston, Dallas, San Antonio, etc.) I can't speak for the past that YOU know, but I can speak for the past few years that I DO know, and they have been positive for many UAG grads.

Now, in regards to the other schools in MX not requiring Internado/Servicio...well, I don't know what to say other than I have conflicting information. I have a very dear friend who is from Monterrey, and having worked for the government (he is a dentist, and worked with the DIF as well as the IMSS) he has assured me that no school in Monterrey would ever allow the internado and/or Servicio social to be disregarded for any students wanting their Titulo and license in Mexico. I also have spoken with the Minister of Health of the state of Coahuila, and he has told me the same...you CANNOT practice medicine in Mexico without that Servicio Social. As for them providing only Titulos, without the license....my question is simply are these schools accepted on the same level as UAG? Five different (all very well respected, a few nationally recognized in their field) directors of departments in different hospitals have personally assured me that UAG grads would be on the short list of foreign medical graduates they would accept in their personal programs. high praise for the program, I would think, that it is recognized as one of a few "acceptable" programs in their eyes. This doesn't even speak to the various other grads that are working (would you like names?) around the country in positions of leadership within their hospitals/institutions.

I know you have gone through terrible trials both in Guad and here. You mention some of these. I do appreciate the trailblazing you have done with the program, and am sorry that you had to go through so much. The thing is, TIMES HAVE SERIOUSLY CHANGED. The International program has very little if anything at ALL to do with any of the "latino" program. We never interact. The professors that teach both (only at HAL...not at ICB) even recognize (well, most...there are always the few difficult ones) that our program is better behaved, more mature, and generally are appreciated as better students. Will there be "anti-gringo" sentiment? Sure...that happens here in the US though too! Racism exists no matter where you go, and to all people....sad fact but true. I know, though, that anti-american sentiment is not a huge factor in general through our rotations any more. The few butt-heads that do have very anti-gringo feelings that I worked with were willing to change, as soon as I showed them I wasn't the lazy student they were used to seeing. A little work goes a long way!

I won't bore you with any more. I feel better. I got it off my chest. I jsut ask that you lay off the negativity. I know you feel you are trying to help, but the truth is you are spouting some very harsh criticism based on very outdated ideas and experiences. I can't speak for everyone on here, but in general I think the sentiment is the same: we all know things aren't ideal, but you know what? We are doing our best to achieve something we have dreamt about and wanted....and we are getting there. It is possible, it is getting done, and it is not as bad as you are making it sound.

Reepicheep that's an excellently written post! I was about to write something similar but I don't think I could have said it any better. Plus, it sounds like you've spoken to people to see what the situation presently is. Thanks for that.

However, taken as a time capsule, some of the things Big Medicine has said are interesting and food for thought.

I just finished reading the long posts written by BM. I have very conflicting thoughts about it. A lot of the information is outdated and not applicable nowadays. The internado and social service year is a universal step to become fully license in Mexico and EVERYBODY and EVEY SCHOOL has to follow it; it is a law that has been enforced for many, many years without exception. But, since we ARE NOT going to practice in Mexico, it is not applicable to the international program. Since its implementation, NOBODY has done a year of social service. This is not only experienced by mexico but all of latinoamerican countries. Even the national program students at the UAG have to do it. Big time universities like the tech of monterrey, UAG and UNAM, being a public school, have to comply with the requirement. Many things will never change but many have changed since the old days at the UAG. I just hope to never talked bad about the school that gave me the opportunity to become a doctor. Culture shock is a biacht and I can believe someone can carry the sentiment for so long. I cant refute some of the information which seems to be a common denominator as well nowadays. I would recommend do a little bit more research about current conditions instead of predicting useless information based on a 30+ year old experience. It is just not wise and intelligent of your part; I would think you would know better at your current age and position in society. Dont get me wrong, I like your experiences and I bet they were harsh and difficult to deal with but predicting the future based on outdated information is just mere moronic. Good luck and come back when you have current information or keep posting old experiences which are great for entertainment. You are not helping much here except for your valuable experiences while here but misinforming current and prospective students. Congrats on becoming a doctor and I am sure that if you were able to complete the program, we will as well.

I never said the school has not reformed.

BUT UNAM issues the Titulo and you should see it before you believe it is going to happen.

You have not said that a Titulo was yet issued to anyone in the new program...I will believe it when I see it come out of UNAM without the Professional Exam.

As for the Internado...heck that is what you are paying 40 thousand for...a joke.

As for the Social Service...I said they should have knocked that down long ago.

If a state accepts Part 1 & 2 for residency great ! (see below)


As for Texas having 5th Pathway grads from Texas programs, that is simply untrue. I knew many many Texans that fought this out with the state and not one medical school would open it up.

I think you need to check your facts there.

If not check with the school. (U.A.G.)

OH, and by the way I just got off the phone with the TSBME you know the one in Austin.

You have to COMPLETE 3 years of residency, as I stated in a previous post or no license as part of your application AND the USMLE parts 1,2, and 3 must be passed in 3 attempts (certain exceptions apply) as I also stated in a previous post. SO ...YOU.... ARE.... WRONG !

They ALSO stated, If you do not apply within 10 years here you have to do another residency, take the SPEX examination, and/or do a fellowship or be board certified.

They have a website...go over and cry on it.

You cannot eveeeeeen take Part 3 for a license in Texas without finishing 3 years of a program....meaning if it is 5 years as surgery...you got 3 years before they will give you a license regardless. SO, if you are in a 3 year residency that REQUIRES you pass Part 3 to get out, better know where to go cause you are not taking it in Texas...as I previously STATED.

Additionally, I was told by the licensing department that they personally had NEVER seen a 5th Pathway document issued by any school in Texas EVER.

For edification... I want somone to prove they did 5th Pathway in Texas. That would mean the schools relented. Please prove me wrong. But you can't.

As for the Titulo, the licensing department said they see cedulas now not Titulos. They have no idea why, but they take those or the Titulo.

As for my friends, they said they got their Titulos at graduation in Monterrey, BOTH of them. Yes, they both got residencies in a very well known and respected medical school in Texas and graduated AND got a license in Texas after residency. No Professional Exam. Isn't that what you are trying to do here ?

So the Old Man is SPOT ON !

You can dream on all you want but if a residency has a requirement of 3 parts of the USMLE before you are accepted, you will not be eligible to get Part 3 in Texas.

When I took the FLEX Texas had this rule as well.

I took it in a state where only an internship was required. Why ? Because ny residency director wanted it passed before graduation.

Awesome post Reepicheep. It could not be said better.

I really do hope the school and UNAM honor their committments to you.

But in the meantime you guys are hilarious and paranoid. I understand. I was there... AND in worse circumstances than you.

BUT, as a caveat, don't be surprised if the UAG, UNAM or both keep you there 6 years or tie you up in a paperwork snafu with UNAM over the Titulo.

Since I am degreed with the Titulo if I can help your cause with Mexico City and UNAM or UAG, let me know. Just post a lead with my name on it.

Oh, and the school is called Tesistan. Leano probably changed it to his name when he built the hospital. But the town of Tesistan is still there and that was the name of the school at that time. We heard the hospital would be built but not in our time there.

Originally Posted by Big Medicine

I really do hope the school and UNAM honor their committments to you.

But in the meantime you guys are hilarious and paranoid. I understand. I was there... AND in worse circumstances than you.

BUT, as a caveat, don't be surprised if the UAG, UNAM or both keep you there 6 years or tie you up in a paperwork snafu with UNAM over the Titulo.

Since I am degreed with the Titulo if I can help your cause with Mexico City and UNAM or UAG, let me know. Just post a lead with my name on it.

Oh, and the school is called Tesistan. Leano probably changed it to his name when he built the hospital. But the town of Tesistan is still there and that was the name of the school at that time. We heard the hospital would be built but not in our time there.

what does UNAM has to do with anything here? UNAM is a major public university located in Mexico City. UAG or any other private or public medical school respond only to the department of education of the republic of Mexico. UNAM doesnt verify documents or issues diplomas from other universities. Can you explain why you keep mentioning UNAM as an important party in our path? This is one of the things that are so confusing about your posts. UNAM is an independent school that has no ties with the UAG or any other school in Mexico.

Listen putin UNAM is the PARENT school to the UAG. (Universidad Nacional Autonoma de Mexico)

Go ask the UAG. *************************. The Titulo comes from UNAM. You will see. It has EVERYTHING to do with the UAG. I should know, I picked the Titulo up in Mexico City at the main campus.

The UAG has NEVER issued a Titulo in its entire history. The Professional Exam is given by UNAM on the UAG campus, not by the UAG.

**************************

*************************

Originally Posted by Big Medicine

Listen putin UNAM is the PARENT school to the UAG. (Universidad Nacional Autonoma de Mexico)

LOL....you are funny. Please show me a link that validates your comment. I have NEVER heard such a thing I have family members graduated form the UAG and I have never seen any UNAM seal on the diploma or anything like that. the last person that graduated from the UAG pick up the diploma from CU; she didnt have to go to Mexico City. You are a funny person and I would love to see if you can prove me wrong. PLease post a link stating the "obvious" and I will believe you and make a statue of you in la Minerva. Thanks and I will be waiting and please dont say " I dont have to do anything", back your responses with facts otherwise your words are just "estiercol". Hopefully you learned that much spanish in mexico.