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Thread: Absolute must read for anyone considering ross or any img route

  1. #1
    SpursDoc is offline Member 666 points
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    Absolute must read for anyone considering ross or any img route

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    This JAMA article sums up what I and numerous others have been preaching to those considering Ross or any other international route.

    Some Highlights: (Source: AMA, December 5, 2012—Vol 308, No. 21)

    "A forecasted physician short- age has led to expansion of enrollment in existing US medi- cal schools and establishment of new ones (both allopathic and osteopathic), with 19 230 first-year students enrolled in 2011; the number of students graduating from US medi- cal schools is therefore increasing quickly (projected to reach 26 709 enrolled per year by 2016-2017, a 37% increase rela- tive to 2002-2003).4 However, the number of training posi- tions in US residency programs has not similarly expanded and, indeed, may contract as a consequence of decreases in graduate medical education funding. In 2011 there were 26 386 postgraduate year 1 positions in Accreditation Coun- cil for Graduate Medical Education–accredited programs (growth rate from 2001-2010, 0.883% per year)"

    "The expected changes in the number of available train- ing positions in the United States may be of particular con- cern to the burgeoning number of US citizens who attend medical school abroad (increased from 769 in 1992 to 2772 in 2006, more than 50% of whom are in Caribbean medical schools).8 These students may now find reentry into the United States to be especially difficult, particularly since they will be competing with a markedly increasing number of graduating medical students not only in the United States but also worldwide; there are currently more than 2300 medi- cal schools in the world, and nearly 800 of them have opened since the mid-1990s."

    "The rapidly increasing number of medical school gradu- ates coupled with a constrained graduate medical educa- tion system is likely to have a substantial effect on the num- ber of IMG recruits to US programs. These trends threaten to reduce the diversity of the physician community and could meaningfully affect primary care delivery in the United States and even health care quality abroad.10 Despite the proven value of IMGs to the US health care system, coming to America is likely to prove increasingly challenging for fu- ture IMGs."
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    Last edited by SpursDoc; 12-05-2012 at 11:55 PM.
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    wksun88 is offline Junior Member 513 points
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    Thank you for the share! Read it and it has now solidified my decision to not go to Ross or any other Carib school for that matter (They sent me an email today requesting my overdue seat deposit)

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    kodefishero is offline Junior Member 510 points
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    Does anyone think something is going to be done about this anytime soon? I mean, what is a graduate from a US medical school, saddled with 150,000+ dollars of debt going to do if he can't get a residency?

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    The problem will definitely not be for US medical school grads... they will almost always be able to find a spot someplace. The problems will be for the IMG/FMG set. As the article states, "coming to America is likely to prove increasingly challenging."

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    Great article/post SpursDoc

    As has been discussed w/ all the recent changes (like DO MD combining residencies), it certainly stacks the deck against us, but as I've said before w/o a "climate" change, the PCP residency structure won't change drastically. At least for a few years from now.

    Off the top of my head, of 10 USMG's I know, who will be matching when I do, NONE of them are looking at PCP residencies. And I mean, have thought of, yet don't consider it, so it's not ignorance. The article points out that a majority of IMG's PGY1 PCP spots.

    But I don't want to relay that it's nothing to think about. Because even tho, I don't think the PCP residencies most of us choose are going to be outrageously out of reach, the "climate" between us USIMG's is going to get far worse!! We aren't necessarily trying to elbow out USMG's from spots we want in PCP residencies, but we definitely are competing against each other a lot more!!!

    That said, I am personally a lot more anxious matching. And I'm top 15% of my class. I have a better than average Step 1 score. The C average students w/ the sub 200 Step 1 score ABSOLUTELY should be worried.

    This post is re: PCP residencies. I couldn't imagine shooting for a specialty in the 2015 + beyond Match!!!
    **Board-Certified Internist**

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    MedGirl77 is offline Newbie 510 points
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    This article makes me very worried about starting at Ross. Ross was the only school I applied to because of my low MCAT (though I have a high gpa). I got accepted into merp. I paid my seat deposit but now I am hesitant to go. If people are having trouble getting into residency programs now, I can only imagine how it will be in 4 yrs.
    How difficult is it to get into OB/GYN being from a Caribbean school? Also do you think PCP will be out of reach in 4 yrs for IMG?
    Last edited by MedGirl77; 12-06-2012 at 03:00 PM.

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    There is absolutely no way to tell. Regardless, articles like this one, as well as the recently stated goal of AAMC to have a 1-to-1 ratio of USMD grads and PGY1 positions by 2016 (even if they don't achieve it -- and that is a tall order) certainly turn it into a pretty nerve-racking proposition.

    If you are bound and determined to work in the US, then USMD or USDO programs are the way to go. If you are willing to consider other areas of the world for practice, then that expands things a bit, but that also means a lot of due diligence for Carib and other foreign medical students with regard to where their credentials will be accepted.

    Funny, less than a year ago people on VMD were saying that talking about this issue was a Chicken Little-type exercise -- "Quit even remotely suggesting that the sky is falling, IMG/FMGs have always matched, that will never change," etc. Somehow, I think that getting the word from JAMA suddenly offers the issue a bit more credibility. I believe that IMG/FMGs will still match, but it is not going to be easy, and the numbers will have to shift dramatically. Currently, USMD grads apply to non PC specialties because they know that they can get them. If that starts to shut down, and they are shunted into PC residencies (which is a damn sight better than not matching), then something's got to give.
    Last edited by devildoc8404; 12-06-2012 at 03:28 PM.
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    rokshana is offline Member Guru 11644 points
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    Quote Originally Posted by devildoc8404 View Post
    Currently, USMD grads apply to non PC specialties because they know that they can get them. If that starts to shut down, and they are shunted into PC residencies (which is a damn sight better than not matching), then something's got to give.
    EXactly...

    right now there are places that are I/FMG friendly (or dominant) and are not places that AMGs traditionally apply (or at least dont rank), but who is to say that as US senior # increase and residency spots dont (or at least certainly not at the rate that AMG numbers are increasing), they WILL become places that US seniors start to consider, or at least have to consider and rank. Once these programs start getting applicant that are viable candidates, well they will shift fast enough to accepting and ranking those US seniors...and someone has to be pushed out of the way...
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    Well the only thing USIMG's like me or anyone reading this can do is hope that PD's place value on things like Sub-I's and LOR's. My nightmare scenario is going into the match, having completed some sub-I's at places I would absolutely love to match at, and IV for Match...only to get ranked lower than some AMG (w/ similar stats) who tossed a random "hail mary" at my spot, and he/she get it because of the almighty AMG v. USIMG prejudice.

    2014 Match is basically out of reach for me, so I'll be in that 2015 Match w/ the new US med school grads in the pool w/ me. The docs I know, esp the one's who are/have been PD's, tell me they still value LOR's and sub-I's.
    **Board-Certified Internist**

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    laricb is offline Member 542 points
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    Quote Originally Posted by devildoc8404 View Post
    The problem will definitely not be for US medical school grads... they will almost always be able to find a spot someplace. The problems will be for the IMG/FMG set. As the article states, "coming to America is likely to prove increasingly challenging."
    No they will have issues also. They don't want to be in FM OR IM. I still believe many of those spots will go to AMERICAN foreign medical students.

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