Critique my roadmap to a competitive residency as an IMG

[demiurg]

Hey everyone, long time lurker first time poster here!

I am a medical student from Turkey and I want to continue with my medical education in the US, including residency and fellowships.

The system here is 6 years - 3 years preclinical, 2 years clinical and 1 year internship. I'm in my second year. I have created a roadmap for obtaining my residency spot. My main interests are neurosurgery, psychiatry, heme&onc (either normal or pediatric) and ob/gyn. I know that these range from extremely competitive options to very easy ones, but I don't care about competitiveness, I care about what interests me. And for that I want to be as competitive as possible. Here's my roadmap

Year 1: Past. Did a nuclear medicine internship for a month in Croatia. Not much besides that.

Year 2: Did a crapton of research. Will be published in at least 6 studies (mixed topics: 2 microbiology, 1 ID, 1 endocrinology, 1 neurosurgery, 1 rheumatology). A moderately competitive GPA (just above 3.5). I will be doing genetics research internship at a top tier medical university in the US this summer (possibly get a publication there as well). I will try to make as many connections as possible in the topics I'm interested in and try to work overtime and volunteer for extra stuff.

Year 3: Continue with an intense research schedule, maintain my GPA, do another year of research in the US, probably in the topic I'm interested in doing my residency in. Possibly study for Step 1 and take it this year.

Year 4: This is a very difficult year, probably the most (IM, surgery and paediatrics clerkships). Take step 2 CK this year. Continue with research if possible. Possibly lay summer off.

Year 5: A rather easy year. Clerkships are much more minor (ENT, neurosurgery, psychiatry, ID, cards [cards is separate from IM here], ophto, derma etc.). Take step 1 if I didn't take it in year 3. Seems like a good opportunity for lots of research. Do a month of US electives if possible, in the field of my focus. Must lay summer off for scheduling reasons.

Year 6: Should be a very easy year since I won't be studying for the local residency exam. Do a US elective. Pump out research, focusing on getting published with a first name. Take step 3 during summer.

PGY-1 (and possible PGY-2): Due to our graduation timeline, I must take a gap year between the match and year 6. This year I will apply for and work at a laboratory focusing on the residency of choice.

Throughout my school, I will try to obtain LORs from both influential local doctors and from the doctors I've studied with abroad. I'm almost sure I will take CK in year 4, but I'm not entirely certain whether to take step 1 in year 3 or 5. Year 5 seems a bit more reasonable though.

Considering this roadmap, assuming I choose to focus on neurosurgery (for reference purposes), would you consider this a sound plan? I know that maybe 5 IMG's match into neurosurgery each year. What would you consider my odds of becoming one of those outliers with this roadmap?

Thanks a ton!

Edit: I have a 10 year visa that's nearing it's end. I used to live in the US as a child and have an expired Green Card and a still valid SSN. AFAIK, getting a green card or any kind of visa if you had a green card before is a lot easier compared to if you had not.

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[Mad Jack]

Score extremely high on the USMLE and do as many rotations as you can in the US. Those neurosurgery matches usually are from people that graduated from highly regarded international schools (though last year one of them was a Carib graduate). So it isn't impossible, but it is highly unlikely unless you're coming from a school with serious international name recognition. Other fields (ortho etc) are much more likely if you're being realistic, even if they are still a long shot.

 

[doc05]

neurosurgery is highly unlikely. but good luck.

 

[WedgeDawg]

Looking at the most recent match data for 2016:

8 non-US IMG matches into neurosurgery. From 2012-2016, anywhere from 7-18 "foreign trained" (including US IMG) matched into Neurosurgery.

Looking at Charting Outcomes in the Match 2014 and that year, 17 independent applicants (including DO applicants, USMD non-seniors, and international applicants) matched into ACGME neurosurgery. 7 of these were IMG (US citizen or non-US citizen, it doesn't differentiate). 63 did not. Both matched and unmatched applicants had a total of ~13.5 research output products (posters, abstracts, papers, etc).

Of those 17, 3 of them ranked only 1 program, which implies that they likely had some sort of agreement with the PD where they were guaranteed to match (though, interestingly, 19 non-matched applicants also only ranked one program, so I'm not entirely sure what that means). In fact more than half of unmatched applicants only ranked 1 or 2 programs, so I'm not 100% sure how to interpret that - it's possible that these applicants only received one or two interviews. 9 matched applicants ranked 3-7 programs and the rest (5) ranked 10-13 programs.

Nearly half of unmatched independent applicants ranked more than 1 type of program (i.e. another specialty than neurosurgery). In contrast, 2/3s of successful applicants only applied to neurosurgery. The mean step scores are 240/251 for matched and 230/230 for unmatched applicants. However, getting a 260 step 1 still puts you at only about a 30% chance of matching.

What this means is that the chance of matching neurosurgery is going to be very very very low. If you look at some recent non-US IMG matches into neurosurgery, you'll see their resumes are absolutely outstanding.

If you still want to try for neurosurgery, you should think about what it will mean to not match (the most likely scenario no matter how strong your application is) and you'll need to have a very solid backup plan.

 

[Law2Doc]

You likely won't get neurosurgery. Double down on one of the less competitive paths if you want to make this happen.