IMG Advice for Onc/Haem/Research

[Blankdots]

I am currently doing a combined medical/research degree in a reputable university overseas, somewhat analogous to the MTSP.
I'm pretty early on in my degree, but would love to plan ahead so I don't get caught out. So if anyone could give some advice it would help a lot. Also please forgive my ignorance if I say something that's not quite right.

The plan is to do my residency or a fellowship in the US - depending on which is easier to get into. However, the only way I would see it being worthwhile is if I can match with a top 5 Onc program; i.e. Brighams, Mass gen, JH, Mayo, MD anderson. Although really my preferences are probably 1. Mayo 2. JH (if this changes anything).

I want to know what the chances are, with a MD/PHD + publications (3-5 in mid tier journals) + USMLE scores at least 1SD above mean (245+). This is as an IMG.

Would these chances be boosted by doing a clinical/research elective in one of the above hospitals? If so which (clinical vs research) is more important (I suspect clinical)?

Another important question is, would it be easier to match for fellowship or residency?

Lastly, more to do with the far future and research. I would like to do 80/20 at some point; are there programs out there that let you do this early on? (obviously you need to still be clinically trained, so i'd assume not until pgy3?)

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[gutonc]

With very few exceptions, if you want to do a clinical fellowship at one of these top places, you will need to do residency in the US as well. You would be well served by looking into the ABIM Research Pathway which most of these places will support.

You will also need some USCE...at least 3 months, preferably 6-12 months. The downside is that those places you mention probably won't be as open to you doing rotations there as some other places. But no reason not to try.

 

[Blankdots]

With very few exceptions, if you want to do a clinical fellowship at one of these top places, you will need to do residency in the US as well. You would be well served by looking into the ABIM Research Pathway which most of these places will support.

You will also need some USCE...at least 3 months, preferably 6-12 months. The downside is that those places you mention probably won't be as open to you doing rotations there as some other places. But no reason not to try.

Thanks for the advice, so i'm assuming without US clinical experience, it would be impossible to match with one of these resident programs.

The problem is that mayo only allows you to do 1 4 week rotation and jh will not even accept non US medical students.

How should I get clinical experience? Is this something that should be done during medical school? If done after, how does this work? will I need to match with a program thats not as good then try again?

Lastly, even if i do 6-12 months UCSE what would be my chances of matching one of those hospitals? If the chance is low, then I will probably not plan so much for it especially in terms of electives.

 

[gutonc]

Thanks for the advice, so i'm assuming without US clinical experience, it would be impossible to match with one of these resident programs.

The problem is that mayo only allows you to do 1 4 week rotation and jh will not even accept non US medical students.

How should I get clinical experience? Is this something that should be done during medical school? If done after, how does this work? will I need to match with a program thats not as good then try again?

Lastly, even if i do 6-12 months UCSE what would be my chances of matching one of those hospitals? If the chance is low, then I will probably not plan so much for it especially in terms of electives.

Without USCE, matching into a top program will be an uphill climb for an IMG. You absolutely should do this during med school. Rotations done after graduation (observerships) are considered meaningless by most programs.

I can't tell you your chances of matching a top IM program and then moving into a top fellowship program. You either need to roll the dice and see what happens or just stay where you are and go on with your life. I also think you need to reassess the practical difference between the "Top X" programs and the "middle tier" in terms of training and preparation for an academic career. I think you're putting a lot of emphasis on names (some of which are the wrong names frankly) without really understanding what that means.

 

[Blankdots]

Without USCE, matching into a top program will be an uphill climb for an IMG. You absolutely should do this during med school. Rotations done after graduation (observerships) are considered meaningless by most programs.

I can't tell you your chances of matching a top IM program and then moving into a top fellowship program. You either need to roll the dice and see what happens or just stay where you are and go on with your life. I also think you need to reassess the practical difference between the "Top X" programs and the "middle tier" in terms of training and preparation for an academic career. I think you're putting a lot of emphasis on names (some of which are the wrong names frankly) without really understanding what that means.

Yeah thanks for the advice. I guess its very hard to make a good decision when there's not many people at home to talk to. So I really appreciate your frank response.

While I do love research (more than clinical) - the balance in the US is probably not feasible as a resident. I want to have a focus on clinical early on to get trained, but I really don't want to stay out of the research loop for that long. But I think you can't win everything.

I am chasing brand names because I don't plan to stay in the US in the long term. Its more a matter of getting some really good experience and coming back home with a good CV. And back home, brand names do count for a lot. I mean ultimately, for me its about coming back home and being able to start my own lab and get easier funding.

I think you are right in saying to roll the dice and see what happens.

What other residency programs (i.e. hospitals) do you suggest (specifically for IMG)? and why? Also if for a research fellowship - which universities/hospitals would you suggest are the best for cancer research?

 

[gutonc]

Yeah thanks for the advice. I guess its very hard to make a good decision when there's not many people at home to talk to. So I really appreciate your frank response.

While I do love research (more than clinical) - the balance in the US is probably not feasible as a resident. I want to have a focus on clinical early on to get trained, but I really don't want to stay out of the research loop for that long. But I think you can't win everything.

I am chasing brand names because I don't plan to stay in the US in the long term. Its more a matter of getting some really good experience and coming back home with a good CV. And back home, brand names do count for a lot. I mean ultimately, for me its about coming back home and being able to start my own lab and get easier funding.

I think you are right in saying to roll the dice and see what happens.

What other residency programs (i.e. hospitals) do you suggest (specifically for IMG)? and why? Also if for a research fellowship - which universities/hospitals would you suggest are the best for cancer research?

Before I answer any of your questions, I need to know if you've looked into the research pathway. Because that's where the money is for somebody like you. It's what I did. 6 years total (for IM and Onc), 3 FT clinical (2 IM, 1 Onc) and 3 FT research (with weekly clinic and occasional weekend call...like 4 times a year). It is not going to get any better than this.

 

[Blankdots]

Yeah I had a look at the link you provided. Personal remuneration isn't nearly as important to me as getting good research funding.

How would your clinical training be affected by only 3 FT years? If you decided a few years after finishing to go back to clinical would this be a problem?

Other questions I have are - you're doing it now - how are you planning your research? Ideally I would want to do some research during the 'FT clinical' - because I really dislike the idea of going from research to null space and then back. I would like to keep some of my skills somewhat fresh.

Lastly it says - ideally it will lead to a 'graduate degree' at the end of 3 years research (if you haven't acquired one already). If you do have one already - what are the implications, if any?

The program looks good - but If i can get a haem/onc certification faster, I may simply do that - because I can always go back home and do research. For the research pathway to be worthwhile, It would have to be at a good research university/hospital (Need advice on this in particular). It has to be an experience which I wouldn't be able to get back home to make it worthwhile.