Americans Who Go To Foriegn Med Schools

[Farbar]

I am just curious. I have worked with some of these grads and I have a mixed opinion. Some are great and some not. It doesn't seem to be any different from American grad's. Are American FMG's who go to the Carribean, Ireland, Australia, etc... as capable as all of us? And, what can we learn from those who trained elswhere?

---

Members don't see this ad.

 

[Pir8DeacDoc]

Your experience pretty much mirrors mine. I've met some that were great and some that were worthless.


Honestly, I see some of them as folks that just bloomed later in their academic career or didn't manage to do so hot on the MCAT. I have a lot more respect if they just discuss why they went that route and don't make up ridiculious stories about it.

I.e. "I got accepted to a ton of american schools but I just wanted to hang out in the Caribbean for a few years." Right, sure thing.


I prefer "dude, I sucked it up early on in college, hard to recover from that."
Good for you for sticking with your goal of being an MD and making it happen.

 

[GoodMonkey]

i've met many a US grad who suck hard core as a physician and who i wouldn't trust as a physician taking care of me or my family/friends.

what can we learn? well, going to a "good" medical school does not always a competent doctor make, just as going to a "bad" one doesn't guarantee incompetence.

 

[gasnewby]

i've worked with 2 grads from ireland. excellent docs

n=2

 

[filter07]

Work ethic is all that matters. There is nobody who makes it to medical school who is intellectually unable to comprehend material.

 

[Top Gun]

I am just curious. I have worked with some of these grads and I have a mixed opinion. Some are great and some not. It doesn't seem to be any different from American grad's. Are American FMG's who go to the Carribean, Ireland, Australia, etc... as capable as all of us? And, what can we learn from those who trained elswhere?

You are correct in your assessment that IMG's are as capable as US grads. There are some who are great at what they do, and there are others whom I wouldn't even trust to treat horses, let alone human beings. Same thing with US grads. There are good and bad docs from every med school throughout the world.

 

[c5a]

i'm a US citizen who went foreign, and i just finished my M.D.

not to be high and mighty, but i'm mostly annoyed with the laziness and incompetence that surrounds me. US med school students have a right to feel prejudiced against us, because a lot of what they think is correct. i've worked especially hard to be level with my US med school student counterparts, or even above them in knowledge.

so the ones that make it okay are late bloomers, that's all. we had some life circumstances that prevented us from doing optimally in undergrad.

usually the system (USMLE) will weed out the good and the bad IMGs.

 

[Faebinder]

i'm a US citizen who went foreign, and i just finished my M.D.

not to be high and mighty, but i'm mostly annoyed with the laziness and incompetence that surrounds me. US med school students have a right to feel prejudiced against us, because a lot of what they think is correct. i've worked especially hard to be level with my US med school student counterparts, or even above them in knowledge.

so the ones that make it okay are late bloomers, that's all. we had some life circumstances that prevented us from doing optimally in undergrad.

usually the system (USMLE) will weed out the good and the bad IMGs.

So....

When you pose infront of a mirror... do you put your right side forward or your left side?

 

[tkim]

i'm a US citizen who went foreign, and i just finished my M.D.

not to be high and mighty, but i'm mostly annoyed with the laziness and incompetence that surrounds me. US med school students have a right to feel prejudiced against us, because a lot of what they think is correct. i've worked especially hard to be level with my US med school student counterparts, or even above them in knowledge.

so the ones that make it okay are late bloomers, that's all. we had some life circumstances that prevented us from doing optimally in undergrad.

usually the system (USMLE) will weed out the good and the bad IMGs.

i got a 88/218 on step 1, but a 79/193 on step 2. my wife just had our first baby 2 months before, and then 3 weeks before my exam got appendicitis. my baby duty time obviously affected my score, as my wife wasn't able to do very much. do i mention it or not in an updated PS?

(1 IV so far, 2 rejects).

Um.

 

[gasnewby]

what the hell is your avatar- is that from silence of the lambs?

 

[tkim]

what the hell is your avatar- is that from silence of the lambs?

That's the soap dispenser near one of the OR scrub sinks.

 

[Pir8DeacDoc]

Don't go around posting facts and expect people to take kindly to it. We all much preferred when we thought the poster above had busted his arse to rock medical school.


You aren't high and mighty because you shouldn't be.

 

[howelljolly]

US citizens with an International degree have such a hard time getting residencies, and end up having to deliver pizzas for a living. And then they go and recruit non-US-IMGs to work in underserved areas.
Carib students do their 3rd and 4th years in underserved areas, and then cant get residency. Unfair.

http://abcnews.go.com/Health/wireStory?id=3402138

 

[Winged Scapula]

I would venture that most US citizens, even those educated abroad, do NOT have a hard time getting a residency.

At least all other things being equal, like USMLE scores, USCE and the competitiveness of the field to which they apply. The vast majority of US IMGs will match into a residency program; those that do not are an anomaly.

 

[howelljolly]

I would venture that most US citizens, even those educated abroad, do NOT have a hard time getting a residency.

At least all other things being equal, like USMLE scores, USCE and the competitiveness of the field to which they apply. The vast majority of US IMGs will match into a residency program; those that do not are an anomaly.

I sure hope you're right, cause thats gonna be me in March 09.

 

[Faebinder]

I would venture that most US citizens, even those educated abroad, do NOT have a hard time getting a residency.

At least all other things being equal, like USMLE scores, USCE and the competitiveness of the field to which they apply. The vast majority of US IMGs will match into a residency program; those that do not are an anomaly.

Actually Kim, it's a 50-50 shot... as you can see on Table 2 here. 1,347 active applicants is a lot of unmatched people. Heck 2 years ago, you were better off not being a US citizen if you are a foreign graduate.

 

[howelljolly]

Yep, there are similar charts in First Aid for Step1, and 2.

I wonder if the other 50% of American IMGs successfully pre-match or scramble.

I know of one American IMG that delivers pizza for a living. He wouldnt apply for anything other than EM, and he never got in.

 

[howelljolly]

Each year, they make it harder on the US IMGs.

All USCE must be done under the supervision of an ACGME certified Residency program. If you transfer to another foreign school after passing Step1, youre in trouble. If you transfer during your clinical years, youre sunk. You must have CE from the country where you went to med school. You must have an ECFMG certificate in hand... (US-IMGs generally apply during their final MS year, therefore dont have one).

It seems that any way you cut it... the US medical system would rather have an international physician, than an american IMG.

Maybe because they would rather have a physician that was a good student and went to a good med school, in another country, than have a physician who was a bad student, went to a bad med school, and then became a good student.

I dunno

 

[Faebinder]

Each year, they make it harder on the US IMGs.

All USCE must be done under the supervision of an ACGME certified Residency program. If you transfer to another foreign school after passing Step1, youre in trouble. If you transfer during your clinical years, youre sunk. You must have CE from the country where you went to med school. You must have an ECFMG certificate in hand... (US-IMGs generally apply during their final MS year, therefore dont have one).

It seems that any way you cut it... the US medical system would rather have an international physician, than an american IMG.

Maybe because they would rather have a physician that was a good student and went to a good med school, in another country, than have a physician who was a bad student, went to a bad med school, and then became a good student.

I dunno

Nah, it really is all about scores. They mildly care US vs non-US citizen (if they cant sponser a visa, which is only a small percentage, then they certainly will care). But they would rather get a 99/99/99 from XXXX over a US citizen with 80/80/80 and that's the bottom line. The US clinical experience requirement is their way of saying, IMGs/FMGs don't bother here unless you got the 99/99/99.

 

[Top Gun]

Yep, there are similar charts in First Aid for Step1, and 2.

I wonder if the other 50% of American IMGs successfully pre-match or scramble.

I know of one American IMG that delivers pizza for a living. He wouldnt apply for anything other than EM, and he never got in.

Does this guy who delivers pizzas plan to try again? If so, he should try for EM if he still wants it, but also apply to something less competitive, like IM or family medicine as a backup.

 

[howelljolly]

Does this guy who delivers pizzas plan to try again? If so, he should try for EM if he still wants it, but also apply to something less competitive, like IM or family medicine as a backup.

Odd, isn't it?
I dont actually know. The person I know of him thru has lost touch with him. The guy worked as an ER Tech both before and after med school. After working in the ER for a few years s/p MD, he decided he couldnt stand the mind numbing scut work and abuse as a tech any longer. So he quit, and started delivering pizza, living in blissful ignorance.

Must be tough.

I've worked with a few people that were (honestly) "MDs in [their] country"
FP in Phillipines (he was working during his USMLE prep), A Radiologist from the MiddleEast working as a nurses aid, and a neuropsychiatrist from South America..... werent even attempting the USMLE.

I talked to an IMG cardiologist who employs a medical assistant who was a cardiologist back in their (same) home country.

I also found out that the guy that served me my coffee every night before work was a pharmacist for South America somewhere. He asked me if I knew how he could get his license in the US... about a week before I left the job for med school.

 

[Winged Scapula]

Actually Kim, it's a 50-50 shot... as you can see on Table 2 here. 1,347 active applicants is a lot of unmatched people. Heck 2 years ago, you were better off not being a US citizen if you are a foreign graduate.

My response above was in reply to howell jolly who implies that "Caribbean students who spend their 3rd and 4th years in the US" don't match.

Obviously the table shows an approximate 50% match rate for US IMGs.

However, it doesn't tell the whole story because this is simply group data and doesn't explain all the variability in applicants and match rates.
The NRMP data doesn't include people who pre-match which is an option for anyone educated outside of the US. It also doesn't differentiate between US FMGs who are applying a 2nd, 3rd, or more times (and would presumably be less attractive to a program), nor does it give us any idea where these students are from.

I would venture that a student at one of the "Big 3" applying for a first time match in a relatively non-competitive field, with good USMLE scores, LORs, and USCE, has a better than 50% match rate. I think the match rate is brought down significantly by people coming from schools no one has heard of, with poor scores, no letters, no USCE and perhaps attempting the match multiple times.

I'll admit this is purely anecdotal...but if you look at match rates for the "Big 3" independently of the NRMP data, you will see much higher figures than 50%.

That said, there is no doubt that things are tightening up since I matched. More and more programs are requiring students to have ECFMG certification BEFORE applying, to have passed Step 3, to have a Green Card or US citizenship and fewer places are offering clinical rotations to non-ACGME students.

I don't know where I fall on the side of the argument: should a program prefer a US citizen over a foreign national with superior credentials. I'll admit to being pretty wishy-washy on the subject and understanding both sides of the debate.

At any rate, I wouldn't take the NRMP data at face value...I still think that most US citizens who have good scores, etc. will be able to match. We can all tell a story of a "friend" who is now delivering pizzas rather than practicing medicine, but I'd truly bet that if we knew the whole story (which is rare, even for friends) that there is a good reason why that person didn't match. In almost all cases on SDN, when someone posts such a story, there is a clear reason (which may take awhile to come to light) why they didn't match.

The same goes for these foreign physicians who come to the US and are working in gas stations, restaurants, etc. Many of them don't have the first idea about how to get into the US medical system, and only half-heartedly try, assuming that their experience will take precedence in the application evaluation. I don't blame programs for not wanting someone who graduated from medical school 20 years ago and hasn't worked in a medical capacity in some years. Many programs won't look at applications from people more than 5 years out in practice and that's true for US grads as well. Its hard to teach an old dog new tricks.

 

[Faebinder]

Warning... don't read further if you do not feel like reading some whining, brutal reality, the darkside of the moon and other fun stuff.

And before you go further, I happen to like Kimmie so it's not an lash out.

However, it doesn't tell the whole story because this is simply group data and doesn't explain all the variability in applicants and match rates.
The NRMP data doesn't include people who pre-match which is an option for anyone educated outside of the US. It also doesn't differentiate between US FMGs who are applying a 2nd, 3rd, or more times (and would presumably be less attractive to a program), nor does it give us any idea where these students are from.

Okay lets put some brutal honesty. Prematch is not common. Infact, it's less and less common for carribbean students. Plus they balance out those who have to reapply again. So for every person who prematches there is probably a person who has to reapply again.

US FMGs are still US citizens who went elsewhere, whether they went to Poland or to SGU or AUC or whatever... still a US citizen that used US loans to go to medical school and come back. I even hear of people going to med school in Europe and doing their clinicals in the US. Met some around during my interviews. And lets be more honest. A person can be one of those trying a 2nd or 3rd time for one reason or another. Are we to believe that carribbean schools have a match rate of 60%? How about 68% like the DOs trying the nrmp match? 68% still sucks with 1 out of 3 not matching.

I would venture that a student at one of the "Big 3" applying for a first time match in a relatively non-competitive field, with good USMLE scores, LORs, and USCE, has a better than 50% match rate. I think the match rate is brought down significantly by people coming from schools no one has heard of, with poor scores, no letters, no USCE and perhaps attempting the match multiple times.

Define good USMLE scores? 85? I bet you non-US FMGs with 80s and good LoRs dont have that difficult of a time applying to non competitive fields. And just how many people do you want to score in the 80s? Half? Okay, well we know half match and half dont according to nrmp. Bad School + Poor Score + no USCE + no letters? Just how many of those do you think are out there? You are combining too many factors. APD confirmed what the dean of two med schools told me already and two other high faculty: Scores + School + Class rank = interviews. Scores + Interview scores + Influence = ranking. The rest is just BS that might influence interview scores. Citizenship only helps when they have to have a visa.. otherwise J-1 is easy. USCE only helps bypass some requirements.

I'll admit this is purely anecdotal...but if you look at match rates for the "Big 3" independently of the NRMP data, you will see much higher figures than 50%.

That said, there is no doubt that things are tightening up since I matched. More and more programs are requiring students to have ECFMG certification BEFORE applying, to have passed Step 3, to have a Green Card or US citizenship and fewer places are offering clinical rotations to non-ACGME students.

I don't know where I fall on the side of the argument: should a program prefer a US citizen over a foreign national with superior credentials. I'll admit to being pretty wishy-washy on the subject and understanding both sides of the debate.

Indeed, I got several messages from some programs last year that they wont even consider the application without step 3. My first hand experience was from pathology and psychiatry actually... so if anyone is going for those.. start doing step 3. Should they prefer a citizen over a non-citizen. Mmm.. Are they qualified? As per ECFMG yes. Hmm.. non-US FMG doesn't have a $250k loan chasing him for the rest of his life.. you tell me. If the 75 in USMLE is not qualified then by all means.. raise it up. (Oh ya, we'll start seeing more AMGs failing it as well.. maybe we dont really wanna do that eh? Not that it matters considering their dean can easily open up an intern spot for them (witnessed first hand thank you very much

)). And why shouldn't they... I'd do the same. It's just the carribs dont have such protection.

At any rate, I wouldn't take the NRMP data at face value...I still think that most US citizens who have good scores, etc. will be able to match. We can all tell a story of a "friend" who is now delivering pizzas rather than practicing medicine, but I'd truly bet that if we knew the whole story (which is rare, even for friends) that there is a good reason why that person didn't match. In almost all cases on SDN, when someone posts such a story, there is a clear reason (which may take awhile to come to light) why they didn't match.

The same goes for these foreign physicians who come to the US and are working in gas stations, restaurants, etc. Many of them don't have the first idea about how to get into the US medical system, and only half-heartedly try, assuming that their experience will take precedence in the application evaluation. I don't blame programs for not wanting someone who graduated from medical school 20 years ago and hasn't worked in a medical capacity in some years. Many programs won't look at applications from people more than 5 years out in practice and that's true for US grads as well. Its hard to teach an old dog new tricks.

Kim, it's not rare. You are in the hospital working and don't meet these people. Every year there is nearly 1.5k US citizens that dont match + the DOs + the fifth pathway. They pile up and not everyone can afford to retry every year and no not everyone graduated 20 years ago, maybe you are thinking of the ones that are not US citizens. I agree that there are ones who are US citizens who graduated 20 years ago. Generally those folks do well on the USMLE cause they have been working in medicine for a long time that the scenarios they put in the steps have been experienced in the past. Once they apply to the right places that take dont care how long ago you graduated as long as you got a high score, then they are in.

Bah, end of rant, but in all honesty, I think people ignore nrmp statistics way too much and keep wanting to look at a prettier picture which is wrong.

And now I must end my post with my favorite smilie... the three headed monkey!

 

[Winged Scapula]

And before you go further, I happen to like Kimmie so it's not an lash out.

You don't have to like me, but its appreciated. But I like you too, so what follows is not a personal attack either.

Okay lets put some brutal honesty. Prematch is not common. Infact, it's less and less common for carribbean students. Plus they balance out those who have to reapply again. So for every person who prematches there is probably a person who has to reapply again.

I don't know how common or uncommon it is but have no reason not to believe you if you say it is rare.

US FMGs are still US citizens who went elsewhere, whether they went to Poland or to SGU or AUC or whatever... still a US citizen that used US loans to go to medical school and come back. I even hear of people going to med school in Europe and doing their clinicals in the US. Met some around during my interviews.

Sure...no argument there.

And lets be more honest. A person can be one of those trying a 2nd or 3rd time for one reason or another. Are we to believe that carribbean schools have a match rate of 60%? How about 68% like the DOs trying the nrmp match? 68% still sucks with 1 out of 3 not matching.

It sucks, but its better than 1 out of 2 not matching. I don't know what the match rate of the Caribbean schools are, but I'd venture they are probably higher than 60%. SGU was boasting a match rate (for those that make it to 4th year) better than that of the US schools (99%)? That doesn't mean that students are matching into their Top choice, but they are matching. And I'd be willing to bet that the rates are high for the other two schools as well.

Define good USMLE scores? 85? I bet you non-US FMGs with 80s and good LoRs dont have that difficult of a time applying to non competitive fields. And just how many people do you want to score in the 80s? Half? Okay, well we know half match and half dont according to nrmp. Bad School + Poor Score + no USCE + no letters? Just how many of those do you think are out there? You are combining too many factors.

But those people ARE out there (bad school, poor score, no USCE, no US letters). AND there are people out there with one or more of those factors that are trying to match. Your second line says it: scores in the 80s and good LORs don't have a difficult time when applying to non-competitive fields.

I don't know what a "good" score is either, because that depends on the individual program, but are you saying that people with "good" scores, USCE, good LORs, recent graduation and from a well recognized foreign school are only matching at 50%? Because if that's the case then people need to know that.

APD confirmed what the dean of two med schools told me already and two other high faculty: Scores + School + Class rank = interviews. Scores + Interview scores + Influence = ranking. The rest is just BS that might influence interview scores. Citizenship only helps when they have to have a visa.. otherwise J-1 is easy. USCE only helps bypass some requirements.

Obviously, those things are preferred (scores, school ranking and class rank). BUT in the case of IMGs/FMGs, school ranking and class rank mean NOTHING, so its almost all dependent on scores. The influence of USCE, LORs, school recognition play a role, albeit a small one. My point in including those factors is that some programs won't even consider your application without USCE. I only have to look at SDN (admittedly a select population) to see that there ARE people applying without USCE. These people aren't astute enough to realize that programs might not consider them without such and are possibly very likely not to match. Same goes for people applying from programs which are not recognized in certain states. Yet, grads of the "Big 3" will tell you that they often have more success at programs in which they rotated...that tells me that the "evil you know" is sometimes a valid consideration when evaluating applicants.

Indeed, I got several messages from some programs last year that they wont even consider the application without step 3. My first hand experience was from pathology and psychiatry actually... so if anyone is going for those.. start doing step 3.

As I noted, that IS starting to become standard for many places, something that has changed since I matched. So how many people are not as astute as you and actually read what programs require, understand it and follow through? There are some incredibly ignorant people out there applying for the US match. People who have no idea of what is required and pay no attention to the information offered, even when it comes to the programs themselves. Now I always caution people to not take stuff at face value (ie, "we don't take FMGs") without doing some extra work. But some people, even when they do and are faced with the reasons why something won't work, continue to forge ahead, misguided by smiley faces and "you can do it" creedos. I think there are more of those people in the match than you might realize.

Should they prefer a citizen over a non-citizen. Mmm.. Are they qualified? As per ECFMG yes. Hmm.. non-US FMG doesn't have a $250k loan chasing him for the rest of his life.. you tell me. If the 75 in USMLE is not qualified then by all means.. raise it up. (Oh ya, we'll start seeing more AMGs failing it as well.. maybe we dont really wanna do that eh? Not that it matters considering their dean can easily open up an intern spot for them (witnessed first hand thank you very much

)). And why shouldn't they... I'd do the same. It's just the carribs dont have such protection.

As I noted in my earlier message, I haven't decided whether or not programs should prefer a US citizen over others, although most countries in the world do it that way. BUt you have raised a serious point - the issue of loaning people vast amounts of money and then preventing them from getting a job to pay that loan off. However, are we saying that the reason these people are not matching is beyond their control? Are we implying that just because you CAN get a loan to go to school somewhere means you should?

Kim, it's not rare. You are in the hospital working and don't meet these people. Every year there is nearly 1.5k US citizens that dont match + the DOs + the fifth pathway.

I don't doubt that there are large numbers of people who don't match. Are you implying that these people who don't match are really, really, really qualified and should have matched? My whole point is that, yes...I do not doubt the NRMP statistics. They are real, and a lot of people don't match. But without the breakdown by USMLE scores, country of origin, USCE, Step 3, (all the stuff we agreed was important to getting an interview and matching) I don't know how that data helps the average candidate. Just as it doesn't help anyone to tell them that they WILL match, it doesn't help anyone to tell them they probably WON'T match based on NRMP stats. I'd be willing to bet that the US IMG with a "good" USMLE score, USCE, Step 3 passed and some good LORs has a better than 50-50 chance of matching. I don't know what the number is, but since the NRMP data includes these people as well as those without all that, its gotta pull the match statistics down.

They pile up and not everyone can afford to retry every year and no not everyone graduated 20 years ago, maybe you are thinking of the ones that are not US citizens. I agree that there are ones who are US citizens who graduated 20 years ago. Generally those folks do well on the USMLE cause they have been working in medicine for a long time that the scenarios they put in the steps have been experienced in the past. Once they apply to the right places that take dont care how long ago you graduated as long as you got a high score, then they are in.

I'm not sure that's the case (who cares how long ago you graduated). If you graduated more than 5 years ago and have been working in the field, then your chances are probably better than the person who graduated more than 5years ago and has been working in a restaurant. BUT I have personally seen programs state that they do not take applications from anyone who has graduated more than 5 years prior or already done another residency elsewhere. So it IS a factor at some places.

Bah, end of rant, but in all honesty, I think people ignore nrmp statistics way too much and keep wanting to look at a prettier picture which is wrong.

True. People need to be aware of the statistics but they also need to be aware of what is not shown by them.

I'm no everyone will match cheerleader either, but if SGU posts a match rate of 99% for US citizens and PR, I need to know - are they lying, or are the other schools and other applicants just that much worse (to end up with a 50% match rate)?

 

[Faebinder]

I'm no everyone will match cheerleader either, but if SGU posts a match rate of 99% for US citizens and PR, I need to know - are they lying, or are the other schools and other applicants just that much worse (to end up with a 50% match rate)?

I am pretty sure they are lying. 99% of 310 people is 3.1 people not matching. That's way bulls**t and we all know it and we just let them say it anyway. Maybe it was 99% like 10 years ago. And I am sure they are not counting second and third tries.

 

[howelljolly]

I am pretty sure they are lying. 99% of 310 people is 3.1 people not matching. That's way bulls**t and we all know it and we just let them say it anyway. Maybe it was 99% like 10 years ago. And I am sure they are not counting second and third tries.

Yeah its fun to lie with statistics. My school inflates their Step1 pass rate by reporting what % of individuals pass, not what % of attempts are passed. So theoretically, a near 50% pass rate can look like a near 100% pass rate.

 

[Blade28]

Remember the old adage:

If it sounds too good to be true...

 

[Top Gun]

I am pretty sure they are lying. 99% of 310 people is 3.1 people not matching. That's way bulls**t and we all know it and we just let them say it anyway. Maybe it was 99% like 10 years ago. And I am sure they are not counting second and third tries.

I'm not sure SGU is necessarily lying. That percentage most likely only counts the students who actually made it through 4th year, without being held back a semester, dropping out, or being dismissed. At SGU, there are a lot of students who drop half their courses, and retake only the courses they dropped the following semester. So those students end up graduating off-cycle. So I kind of doubt that they're counted among the students who match. Now, students who actually drop out or are dismissed from SGU tend to be pretty rare. So that number would be negligible when counting the students who match. I would say the same thing probably holds true for other Caribbean schools, like Ross, AUC, or Saba. In fact, I've heard that at least some of these schools, half the class drops out or is dismissed by the end of first semester. And there are more who drop out after subsequent semesters. So when a Caribbean school gives you something like a match rate of 99%, keep in mind that number only counts students who actually graduated when they were originally supposed to.

 

[Faebinder]

I'm not sure SGU is necessarily lying. That percentage most likely only counts the students who actually made it through 4th year, without being held back a semester, dropping out, or being dismissed. At SGU, there are a lot of students who drop half their courses, and retake only the courses they dropped the following semester. So those students end up graduating off-cycle. So I kind of doubt that they're counted among the students who match. Now, students who actually drop out or are dismissed from SGU tend to be pretty rare. So that number would be negligible when counting the students who match. I would say the same thing probably holds true for other Caribbean schools, like Ross, AUC, or Saba. In fact, I've heard that at least some of these schools, half the class drops out or is dismissed by the end of first semester. And there are more who drop out after subsequent semesters. So when a Caribbean school gives you something like a match rate of 99%, keep in mind that number only counts students who actually graduated when they were originally supposed to.

Nope, I am not counting those dismissed. I am pretty sure 99% is wrong for those who officially graduate.

 

[Top Gun]

Nope, I am not counting those dismissed. I am pretty sure 99% is wrong for those who officially graduate.

And you're not counting the ones who graduated off-cycle? Like I said, there are a lot of students who decel, and end up graduating a semester or two later than they were originally supposed to. If you're not, it is possible that SGU inflated their match statistics. How much the statistics were inflated, we may never know.

Incidentally, did you graduate from the Caribbean as well? Just curious.

 

[Winged Scapula]

I don't know whether SGU is lying about their stats but its a pretty good bet that ALL schools engage in some sort of statistical chicanery, even the US schools.

Its likely that the USMLE pass rate is for *all attempts* but just first timers, and match rates posted are probably for first timers, and might include pre-match contracts, etc. which would inflate numbers.

 

[ElZeekio]

This is a very interesting thread. Just for the record, there are *some* North Americans attending schools outside of the US, because they want to experience other countries, save some money, and get an excellent education. I'm not sure how many, but counting myself I know there's at least one. I have a good enough MCAT/GPA/etc to get into a US med school, perhaps not Harvard or John Hopkins. I did apply last year, but was late in the cycle, took the August MCAT, living over in the UK, and got waitlisted. I couldn't hang on any longer with things up in the air and gave up on it come May. Anyhow, I got into one of the top med schools in the UK, which is just as difficult and competitive as any US school, and I hope that coming from this institution will help me get a good residency if/when I return to the US. I've lived over here long enough that I get resident tuition, so I'm saving a small fortune (though my undergrad loans still need to be paid off). I came here for a complexity of reasons, not simply because I couldn't hack it in the US. I've talked to a few other people in the fora who were well-qualified for US med school but have personal reasons for wanting to study in the UK (I can't speak for Poland, Eire, or the Caribbean). Yes, it will make it a bit more difficult to get a US residency, but it just means we IMGs have to work harder to prove ourselves worthy. It kind of sucks being all lumped in together. Most students in the EU begrudge having to pay anything to attend school, so when US students come over begging to pay $25k in tuition every year, the schools fall all over themselves to design a program for them. Does this compromise the quality of education and academic rigors? Perhaps. I guess that's where I'm really lucky. My program isn't designed for US med students, but EU/UK med students and geared toward making clinical doctors rather than turning a profit.

That said, I think there must be a significant number of people who did go to foreign $chools b/c they were underperformers academically (but, this will be further supported by weak LORs, USMLE scores, and grades in med school). Are these the people who will have a difficult time matching, if at all? I certainly hope so, for my own sake. Perhaps they have excellent clinical skills and bedside manner, but wouldn't this make them better qualified to work in some other role within the healthcare team?

 

[Jatpot]

There are good students and bad students at all med schools.

I think you'll find that the UK/Aus trained students have solid clinical skills and can certainly answer the questions when pimped but usually do it from first principles instead of rote memorization.

I can't speak about other training schemes, having trained in Australia. I don't really think all foreign schools are equal, but I'm confident in my training and the extra work I did to adapt to the system in the states put me on at least equal footing w/US students on my aways.

 

[SamusLives]

I've met some outstanding IMGs, just plain brilliant. If you're like that, then getting a residency won't be a problem. If you're average or less, you get spots after AMGs.

 

[DarthNeurology]

I think that some U.S. students go to foreign schools because they have had good grades and knew they would be able to do well in medical school wherever they go, but for the luck of the draw were unable to enter a U.S. medical school. I have rotated with U.S. MD students, U.S. DO students as well as IMGs such as myself, . . . I have seen the U.S. DO's do some pretty lazy things, like showing up late repitively and just basically partying on the weekend. I think U.S. medical students, some of them at least, have a little bit of an attitude in that although I am the senior medical student (Steps 2-3 96-99) they were a little uncertain about listening what I had to say about medical topic x, for example if I was talking about ABGs to a group of US med students who recorded O2 sats everyday on their vitals but had no idea what an ABG was or what the O2 sat meant, they would sort of look at me and then not say much and just stare into space. U.S. attendings who graduated from U.S. med schools like to pimp and torture their students, . . . but I have found that foreign trained physicians who went outside the US but then came to US to do residency are some of the nicest attendings to work with, maybe because they have been humbled by the whole process. Pretty much though when I showed what I knew on the wards the senior residents and attendings would really warm up to me, . . . first year and second year residents took a while to catch on/admit that I was working harder than most on the rotation, and had a very good fund of knowledge, . . . I have seen a lot of foreign residents who I would be scared to have as a doctor, mostly because they had poor language skills (but obviously passed Step 2 CS) they missed things in front of patients with me in the clinic, just basically couldn't take as detailed a history and often misunderstood what a patient was saying to them and had a large amount of trouble translating clinical terms into everyday language. I had to tell several patients what the foreign resident wanted done, they couldn't understand. I have seen a lot of foreign residents who were really sloopy in clinical work, in terms of just caring about the patient and making sure their clinical care was up to snuff, while worrying about getting a visa. I don't know how foreign residents can be expected to stay current in the medical literature with really bad language skills, i.e. if they can barely read english? On the other hand, I have seen some foreign attendings who spoke English good to very well, and were excellent attendings in every sense of the word like many U.S. attendings, so not all foreign doctors are equivalent, just like U.S. med students.

 

[DOCTORSAIB]

Fixed that for you.

They're called "paragraphs". Look into it.

He said it all in one breath man.

Leave him alone.

 

[kirurg]

My non-blinded, non-randomized study (from the POV of a 4th year student):

Best resident = US-born IMG student
Worst resident = from India
Close runner-up for worst resident = from Spain

The foreign grads seemed to have an enormous chip on their shoulder. I've heard many comments like "American medical students don't know how to take a history." To which I replied "Maybe it's because we have CT-scanners here." (I know, that was wrong). I've also been told by IMGs that American medical students are lazy, American medical students do not read, American medical students are spoiled, ..... The filipino residents were not like this though, they were all (n=3) pretty fun and great teachers.

Maybe the US-born IMGs had to work harder to get a US residency and they are more grateful for it. Who knows, I only worked with one, but he was very respected by the attendings, well-liked by the patients, a fun person, and an excellent teacher.

 

[BlondeDocteur]

Work ethic is all that matters. There is nobody who makes it to medical school who is intellectually unable to comprehend material.

OMG, how I wish this were true!! The average Caribbean med student (not all, but the average) went to a mediocre state college, graduated with a 3.0 - 3.4 GPA, got somewhere in the low to mid 20s on the MCAT, and was accepted by the money-making for-profit Caribbean medical schools for that purpose. If they squeak through (and less than half who matriculate do, with little help from their school, and with little stimulation from their classmates), they rotate in urban medical centers with desperately underserved patient populations, 100% FMG residency staffs and absolutely dispassionate clerkship directors who just need warm bodies and who are happy to pass them. For God's sake, read their boards on SDN. They can barely express themselves or write in English, their native tongue.

Contrast this with the average medical grad from India, who studied hard from the womb in order to pass the national exams to win a seat in a medical college, who studied hard in that medical college, and who wants to migrate to the US to have a better life, earn more than a pittance, and have the opportunity to pursue further training/research that's unavailable in India.

You might say that the USMLEs would separate the sheep from the goats. Well, I'd argue that anyone could pass that test given 6 months to study and multiple attempts.

Like an above poster said, the Caribbean schools are a great Plan B for the kids who didn't realize they wanted to be doctors until too late, who screwed around early in college but who later cleaned up their act, studied hard, passed the boards with decent scores and who will be excellent residents. I was all prepared to look favorably on Caribbean grads, having gone to State U for undergrad myself and dismissing the negative attitudes towards them as mere snobbery. But I was absolutely gobsmacked by their ignorance, incompetence and apathy. They knew far, far less about medicine than my 3rd year classmates, and they didn't care. They routinely made dangerous errors from oversight and ignorance. And it didn't bother them one bit.

If I see a resident who graduated from Aga Khan in Pakistan or Tokyo University or the Royal Free in London, I'd take them in a heartbeat over anyone with a native American drawl and a SGU/Ross/Saba/whatever diploma.

 

[kirurg]

I'm torn about what to think about (non-US born) FMGs practicing in the states.

I've heard the argument that by taking residents from the 3rd world, the US is depleting those countries of proper health care. Those countries invest their dollars/rupies/pesos to train physicians and we use their investment to serve our needs (not enough primary care docs here). Also, I also understand that people want to earn as much as possible, provide better lives for their families, etc, etc, but how can a truly altruistic person leave their home when they know the poverty and need for their service they are leaving behind? If they don't care for their own paisanos, will they really care about our families who see them?

Again, I can see both sides and wonder what others think...

 

[Faebinder]

This entire thread is garbage. I've seen brilliant and crappy US allopathic / osteopathic / US IMGs / FMGs. Personality is not everything and neither is intelligence or communication.

Your n = 3 or n = 10 is garbage. Worse, it's a view done by you as a resident or a student and therefore incomplete. For all you know, the person might be doing enough/more/less and you dont really know cause you aren't their program director.

Finally, your perspective will change as you go up the ranks. (Which reminds me of the joke about the chief resident of surgery that was so obsessed with lab values that he would check them at his fifth year despite having interns and juniors under him.. sometimes it's impossible to change something in a person even when they know what they are doing is something that everyone agrees is not important). What mattered to you as a third year med student is different than when you are an intern and is different than when you are a chief and changes yet again when you are an attending.

 

[McLaren]

I am in this situation. It is depressing, but I will work the extra 1000 miles. Even working unpaid. It is a matter of making most of my time with an excellent training, rather than a guaranteed bad training somewhere else.

 

[debuub]

If I see a resident who graduated from Aga Khan in Pakistan or Tokyo University or the Royal Free in London, I'd take them in a heartbeat over anyone with a native American drawl and a SGU/Ross/Saba/whatever diploma.

Guess what?
Folks at the University of Rochester were probably as blinkered as you are when they selected this fellow.
He was a star in their estimation yet he managed to butcher countless patients in two states before having his license permanently revoked in New York and Oregon.
He then shuffled off to Australia where he is currently charged with murdering 67 patients and the tally is still rising.

He has flown the coop and is now back in the states.
May you and he be fortunate enough to cross paths as patient and doctor.

http://64.233.167.104/search?q=cache73FCJMx0zwJ:news.bbc.co.uk/2/hi/asia-pa...&cd=4&gl=us

http://blog.oregonlive.com/oregonianextra/2008/03/_australia_ready_to_charge.html

http://www.msnbc.msn.com/id/7991906/

 

[cabruen]

Guess what?
Folks at the University of Rochester were probably as blinkered as you are when they selected this fellow.
He was a star in their estimation yet he managed to butcher countless patients in two states before having his license permanently revoked in New York and Oregon.
He then shuffled off to Australia where he is currently charged with murdering 67 patients and the tally is still rising.

He has flown the coop and is now back in the states.
May you and he be fortunate enough to cross paths as patient and doctor.

http://64.233.167.104/search?q=cache73FCJMx0zwJ:news.bbc.co.uk/2/hi/asia-pa...&cd=4&gl=us

http://blog.oregonlive.com/oregonianextra/2008/03/_australia_ready_to_charge.html

http://www.msnbc.msn.com/id/7991906/

Wow!! I just finished reading those articles, and it is amazing what this guys history has been. He was a program director for goodness sake!

 

[AlternateSome1]

The real question is why the University of Buffalo picked him up to finish a residency after he was kicked out of the University of Rochester.

Guess what?
Folks at the University of Rochester were probably as blinkered as you are when they selected this fellow.
He was a star in their estimation yet he managed to butcher countless patients in two states before having his license permanently revoked in New York and Oregon.
He then shuffled off to Australia where he is currently charged with murdering 67 patients and the tally is still rising.

He has flown the coop and is now back in the states.
May you and he be fortunate enough to cross paths as patient and doctor.

http://64.233.167.104/search?q=cache73FCJMx0zwJ:news.bbc.co.uk/2/hi/asia-pa...&cd=4&gl=us

http://blog.oregonlive.com/oregonianextra/2008/03/_australia_ready_to_charge.html

http://www.msnbc.msn.com/id/7991906/

 

[Doowai]

Guess what?
Folks at the University of Rochester were probably as blinkered as you are when they selected this fellow.
He was a star in their estimation yet he managed to butcher countless patients in two states before having his license permanently revoked in New York and Oregon.
He then shuffled off to Australia where he is currently charged with murdering 67 patients and the tally is still rising.

He has flown the coop and is now back in the states.
May you and he be fortunate enough to cross paths as patient and doctor.

http://64.233.167.104/search?q=cache73FCJMx0zwJ:news.bbc.co.uk/2/hi/asia-pa...&cd=4&gl=us

http://blog.oregonlive.com/oregonianextra/2008/03/_australia_ready_to_charge.html

http://www.msnbc.msn.com/id/7991906/

I think most people on this board would consider such anecdotal evidence with a grain of salt. Examples of such occur everywhere, UK, USA etc with UK trained, USA trained etc.

http://www.independent.co.uk/life-s...overed-up-for-incompetent-surgeon-517387.html


http://www.buzzflash.com/articles/analysis/214 graduated from Duke university


http://www.news.com.au/heraldsun/story/0,21985,23496702-2862,00.html


Such anecdotal evidence does not really demonstrate anything about any particular race of MD, or country of training

 

[TriathleticGirl]

I am just curious. I have worked with some of these grads and I have a mixed opinion. Some are great and some not. It doesn't seem to be any different from American grad's. Are American FMG's who go to the Carribean, Ireland, Australia, etc... as capable as all of us? And, what can we learn from those who trained elswhere?

In my limited experience, I think I've met incompetant physicians who were both US trained, and trained abroad. I think it depends on the residency you're speaking of. At my local teaching hospital, I've met a few St. Georges grads who are now in gen. surgery or ortho residencies that are fantastic! But I am sure they are not representative of the entire population of carribean grads, they must have kicked major *** on the boards, and really worked their butts off to get those residencies.

I've also met really incompetant, socially retarted MD's who went to med school at my associated teaching hospital.. I think it just depends.

 

[Captopril]

I'm a final year student in Pakistan, but I was born and raised in America. I will agree with the assessment that my breed of med student usually bloomed late in college. Unfortunately, American undergrad is very unforgiving when it comes to medical school admission prospects, so I shipped out to my parent's homeland. I knew the Caribbean option was still on the table with my undergrad grades, but I just couldn't justify it in my mind. It was more money for essentially a worse education. At least in Pakistan I was paying for what I was going to get. Fortunately, the training here has been a pleasant surprise.

I recently did away rotations in America at one of the top 3 institutes, and found that I was able to keep up with my American counterparts. I don't mean to say that I was setting benchmarks for scholastic efficiency, but I knew what everyone was talking about and was able to throw in a word or two that didn't make me sound completely stupid. Good enough for me, especially at a bargain basement price!

 

[buckley]

i think one of the main strengths of us medicine is that it is a melting pot, in terms of the patient load and pathology as well as the backgrounds of medical practitioners. that is why us training is respected in so many areas in the world, okay, maybe you won't get the license, but the respect is definitely there.

just as in any profession, if you judge people solely by where they studied, you'd definitely miss out on some great ones and fumble over some who'dve thought's...

 

[mrantarctica]

As a foreigner, I can say with confidence that the perception of "US medicine" down here (NZ/Australia) is not one of respect, but more one of reservation. This is partly due to the "big fish, small pond - we're the best, everyone else is inferior" mentality and partly due to the "bad press" that we receive about the US medical system and what a lottery it appears to be for outsiders.

Certainly, the impression overseas is that US medicine favors unnecessary investigation, treatment, and over-medicalization of patients compared to some other western centers. Perhaps this is due to the legal environment that surrounds the practice of medicine there. It's also becoming increasingly apparent that while a LOT of research comes out of the US - a lot of contains what is very poor statistical methodology/quality, and there is more conflict of interest than meets the eye (i.e. authors publishing the efficacy of a drug just HAPPEN to be sponsored by some pharamaceutical company. hmm)

Some of the bad press is also from doctors from the US that migrate here (often shoddy for some reason or other), and do such an awful job that everyone assumes all American doctors, and American medical training must be terrible. However, I suspect this is probably more a reflection that the people that migrate are not particularly talented rather than a faulty medical system.

Things are done differently everywhere now. I've found that foreign grads seem to rely a lot more on tests, and scans than clinical examination. While we are certainly not backward down here in Aus/NZ - and have plenty of our own CT scanners, MRI's and PETs - we seem to place a lot more emphasis on clinical skills in terms of decision making. Obviously these differences between regions can make foreigners seem 'useless' or 'less knowledgeable', but theyre just simply used to practicing a different type of medicine - and may be good doctors back in their own systems.

Having spent a some time working in an extremely busy Indian hospital (1500 inpatient beds, 3000 outpatients a day. Our team's medicine clinic had 300 outpatients a day. In cardiothoracic theater we operated 30 cases a week, not to mention seeing patients in clinic, and admissions for the rest of the time) - I think the case load theory is valid, but only to a degree. But at no point did I feel that my equivalents in indian training were any more knowledgeable, any more skilled practically, and any more competent. Then again, there are plenty of my colleagues right here who I think that about too!

While there is some truth in your point about case load - I think it is an overvalued idea. Sure if you look at nationwide statistics - the US sees a LOT of patients, and a LOT of pathology, but in any one teaching hospital - the size of the population served may not be all that different from some other hospitals around the world. So, overall, in medical training - you may not see that many MORE interesting cases.

Certainly - the case volume theory also means that staff, and virtually always, students are busier - and have less time to actually go through things and teach thoroughly, and learn things properly. They spend more time doing the 'jobs', and less time learning.

In medicine, nothing beats actually have done something 20 or 30 times (or more), but it's also important to learn a really good technique from the beginning, and practise with supervision slowly, and once you master the technique - go and repeat again and again.

So, there is also some value in things being a little slower too.