Thread: medical residency

The match scene is changing in a significant way over the coming few years. (If you haven´t yet, then definitely read up on the AAMC, their efforts to create a 1-to-1 ratio of US grads to US residency positions by 2016, etc.).

Hell, there are no guarantees anyway, for FM or any other specialty. Lots of IMGs don´t match, and that can be the case even if they pass everything on the first attempt.

IMHO, within about 5 years or so IMGs will have to have pretty impeccable credentials across the board to get any match at all in the US. Maybe a little longer than that, but not much.

(Did you really head off to the Carib without doing any research into this particular topic?)

i did do research. but most people say that the 2 years of clinical experience before applying to residency and also getting good board scores will make it so that you should be able to get at least family medicine. i find it really hard to believe that America will shut down all IMG's including their own citizens, like me, from Caribbean schools that score just as good as AMG's. America trying to make it a 1 to 1 ratio just for its own graduates and not allow any others is very hard to believe. Also with Ocare going into law aren't there supposed to more residency positions that are created? also there are so many students that go to caribbean medical that had spectacular GPA's in high school and got into guaranteed medical programs in the US but because of money they go the caribbean route. with so many people choosing this route can they really limit it this much

It may be hard for you to believe, but feel free to check with the AAMC on that. I am not pulling it out of my rear end. That 1-to-1 ratio is their publicly stated goal by 2016. (I personally think it will take longer than that, but that is just my opinion.) There was an article in JAMA about it, as well. Do you think that the AAMC does not pay attention to things like O-Care and other considerations?

Look, getting two years of USCE definitely helps your cause, there is no question. Having a US passport (and USCE and US LORs and first time passes on the USMLE Steps) will go a long way toward getting a match. But nothing is guaranteed. Just because you are a US citizen -- as am I -- doesn´t mean that they owe us anything once we step foot outside the US for foreign medical education... great Step scores or not.

And hey, if you really think that O-Care is going to solve all of these problems and lead the way into an era of physician prosperity, then I would encourage some more reading. It does some good stuff... and it definitely does some bad stuff.

I hope you get matched, I really do. Make sure that you are not allowing yourself to be content with low-range scores, though, because the day may well come that it´s simply not good enough. Play it safe. Kick butt.

Yea absolutely I know nothing is guaranteed for sure. The only thing is I don't want to stay in a program where even if I get great grades and do really good on the USMLE Step 1 I'm still not going to end up with even Family Medicine. I'd rather just cut my losses right now. Thanks for the advice. Also are you currently in a residency program, or somewhere else in your medicine career?

I studied in E-Europe and recently accepted a residency position in Switzerland. However, I did not ever expect to get a gig in Switzerland, so I spent my entire time in medical school focused on the process of coming back to the US for residency.

On the good side of your situation, you are at one of the few programs with 50 state approval, so you have more options than many others. If you complete your program with great grades and Step scores, you make good contacts throughout clinicals, and you apply broadly and intelligently to the match, you will probably have a very good shot at matching. The problem is that a lot of people do not do that. They either struggle academically, or have middling-to-poor Steps, or (most glaringly!) do not apply broadly or intelligently to the match... and then they end up in a crappy situation.

Again, nothing is guaranteed, but all you can do is your absolute best and make sure that you keep good track of the situations surrounding the match as you proceed. I wish you well... it can be done, but you will need to be very dedicated. That is nothing new, of course, but it is about to become even more important in the coming years.

I say, cut your losses...your attitude is not going to propel you to the top of your class or push you to strive to get the highest step scores possible....and there is no guarantee even now that you do everything right that you will get a spot....if you need that guarentee then you came to the wrong place.

And if you were stupid enough...yes stupid enough to have actually CHOSEN to go to a Caribbean school instead of a US med school because of MONEY...then you get what you deserve...

you don't know anything about my academic ability or my attitude towards succeeding in medical school. also i never said that i expected any sort of guarantee of a residency when accepting a spot in the caribbean. and for you to say that me or anyone else is stupid enough to choose the caribbean just cause of money shows how ignorant you are. when i posted on this forum all i was wanting was an opinion about how residencies will be in the future, because without a residency a M.D. degree is pretty much useless. i don't need some random person to try and give me a lecture on here. you got views on someone's attitude keep that to yourself.

to devildoc8404: if you get an md degree from the caribbean but end up not matching to a residency in the US, do you know if it possible to do a residency in another country and start practicing over there? and if it is possible, would you have to have some sort of citizenship or anything like that for that country. also are there other career paths for people that have a caribbean md but don't match?

That totally depends on the school and the country, and it can be one of the drawbacks (in my opinion) of a Carib degree. Some countries are not in a hurry to accept Carib degrees, others will accept specific Carib degrees, and there are probably a few countries out there someplace that will accept just about any medical degree. (Whether or not you would want to work there is another question entirely!)

Every bit as important is functional fluency in the language of that foreign country, and there are not a whole bunch of English-speaking countries around that are options.

The difficulty comes because of a few factors. The citizenship requirements for medical practice are also completely dependent on the country and can vary wildly. For example, look at the UK, another English-speaking nation. Even if your medical degree is fully accepted by the British GMC (and I honestly do not know if AUA is, you would have to check on that), you have a near-zero percent chance of getting residency training and work there as a physician unless you are a UK or EU citizen.

I did not have a particular hankering to work there, myself, but I had some nice chats with the British medical recruiters at some medical job fairs, and they all told me that as an American I did not have a chance in hell. (Actually, I think that three of them used almost that exact same term, it was pretty funny.) The irony, of course, was that I speak English pretty damned well, and the group of Middle Eastern guys who were talking with one of them right before me all had absolutely terrible English skills except for one, who was translating... but because they had married Romanian girls and now had EU ties, they were going to be able to apply for FY1 and FY2 positions in the UK. Go figure. Wales, Scotland, and Northern Ireland are the same, because they are part of the UK.

Canada, probably the closest example to home, is even harder on IMGs than the US is, so it is not exactly a likely scenario.

Republic of Ireland might be an option, if(f) they accept an AUA degree. You would have to check with the IMC. Ireland was a much more likely landing spot for non-EU IMGs before about a year ago, when they cut funding across the board. Now it is something of a long shot, even if they will accept the AUA diploma.

Malta is out, they also require EU citizenship.

New Zealand is a very attractive option IF you can get a couple of years of clinical experience (but the question remains... where?) and IF they will accept an AUA degree. Australia is having trouble getting enough internship seats for their own medical grads, let alone IMGs, so I rather doubt that is a likely landing point at the moment.

Other career paths? Pharma. Research. Teaching. I frankly have not busied myself with that much because I want a clinical career with some research mixed in.

I would recommend looking at all of your options, and putting together as many as you can for the completion of your degree. That way you will hopefully match, but if you do not then you are not stuck with nothing to do. I wish you success.