Medical Matching neurosurg from the Caribbean

[gutonc]

Hello. I'm posting this thread out of concern for a friend, and I would genuinely appreciate advice/insight regarding her situation.

My friend matriculated to a top 20 US MD program and finished the first 2 years before she withdrew due to personal circumstances. After her school did not let her return and no other stateside programs allowed her to transfer her credits, she ended up matriculating at SGU in the Caribbean. Her goal is to become a pediatric neurosurgeon, and she has remained steadfast in her conviction. She is currently a second year and plans to return to the states for rotations (I think? Although I'm not sure how that works these days, given the pandemic).

I know that there are some (6) US IMGs who matched neurosurgery in 2020, but it seems that any red flag would drop kick an application out of contention, especially for such a competitive field. My concerns are that her previous withdrawal and subsequent matriculation at an offshore school would likely render her app DOA at most, if not all, programs. I've attempted to talk to her about this and perhaps aiming her sights lower to avoid going unmatched, but she's of the "I've made it this far and my classmates didn't because they didn't work as hard" mentality.

Like I said above, I would appreciate any thoughts on this situation. I know that it's likely too late to do anything about her enrollment status, but at this point, is there anything she could do to salvage her application, or is she likely to be one of the many Caribbean graduates who go unmatched?

I would also appreciate if you did not quote this post in your replies. Thank you!

She's not matching in neurosurgery. Period.

Peds? Like Pediatrics? Maybe, if she does well going forward.

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[Goro]

I can't sugar coat this, your friend had better get used to the idea of not matching in Neurosurg. Going IMG is a red flag already, and then dropping out of a US MD school is a MAJOR red flag to PDs.

data below from the Program Director's survey for 2020

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/08/2020-PD-Survey.pdf

	Interview IMG			Rank IMG
	Often	Seldom	Never	Often	Seldom	Never
Radiation Oncology	0	67	33	0	71	29
Dermatology	0	58	42	0	58	42
Orthopaedic Surgery	3	49	49	3	46	51
Otolaryngology	4	76	20	4	64	32
Physical Medicine and Rehabilitation	6	82	12	6	82	12
Neurological Surgery	8	77	15	8	77	15
Interventional Rads	9	73	18	9	73	18
Child Neurology	12	76	12	12	76	12
Internal Medicine/Pediatrics	14	43	43	14	43	43
Obstetrics and Gynecology	16	56	28	16	54	30
Radiology-Diagnostic	22	74	4	26	70	4
Emergency Medicine	23	64	13	23	59	18
Plastic Surgery	25	33	42	25	33	42
Vascular Surgery	29	71	0	43	43	14
ALL Programs	29	54	17	28	52	20
Anesthesiology	32	60	8	32	60	8
Thoracic Surgery	33	25	42	40	20	40
Psychiatry	34	55	11	29	55	16
Neurology	36	60	4	36	60	4
Transitional Year	36	57	7	27	55	18
Surgery	37	49	15	32	45	23
Family Medicine	42	44	14	43	39	18
Internal Medicine	49	40	11	45	43	11
Pediatrics	50	43	8	51	41	8
Pathology	70	30	0	68	32	0

 

[TheBoneDoctah]

Chance of matching into neurosurgery as an IMG is literally as close to zero as you can get. Pediatrics is attainable, but maybe not at the programs that SHE would be wanting/shooting for. When she applied to the Caribbean is the time she threw away any chance at surgical subspecialties.

 

[lord999]

@gutonc @Goro @TheBoneDoctah Thank you all for your honest responses! They were pretty much in line with what I suspected after looking up data from the NRMP, but she seems to have the idea that as long as she wants it it'll come true. I wanted to hear from people who have either been through the process or know it like the back of their hand instead of the spiels they feed her at SGU. I'll try to convince her to apply to other specialties when it comes the time for that, but ultimately it's her future and not mine she's messing up if she decides to only apply neurosurg. Once again, thank you all for your honest feedback. I truly appreciate it.

There's one other problem, the withdrawal from a T20 is derogatory as personal circumstances not allowing reentry are usually considered that way. This sends up major red flags that would have been hard to overcome even with a normal stateside school graduate. Matching into a residency period is going to be difficult with Caribbean, but it will be even more difficult for her.

 

[TheBoneDoctah]

There's one other problem, the withdrawal from a T20 is derogatory as personal circumstances not allowing reentry are usually considered that way. This sends up major red flags that would have been hard to overcome even with a normal stateside school graduate. Matching into a residency period is going to be difficult with Caribbean, but it will be even more difficult for her.

On top of what @lord999 said, if she applies NSG without a backup, she is literally setting herself up to not becoming a physician AT ALL. She won't match NSG, so she needs to have FM/peds/IM in her application as well. If she does not match, that will be ANOTHER red flag and the chances of her matching next year are basically none.

 

[GoSpursGo]

Just agreeing with above. The IMGs who matched are almost certainly highly competitive foreign applicants who have already been practicing in their home country for years, or maybe Canadian applicants. I can't imagine they are Caribbean graduates, let alone someone who withdrew and then matriculated elsewhere.

 

[NotAProgDirector]

Million $ Mistake | Caribbean Medical Schools – dream stealers (wordpress.com)

Tell your friend to read this. Guy went to SGU and was certain that if he did really well he'd get into ortho. He did really well. Spoiler alert, he didn't get into ortho. SOAP'ed into IM. Then wanted Cardiology and did get a spot but was really angry he didn't get a great spot.

Top performers out of SGU can get really great spots. But ortho or NSG? Almost certainly not without connections of some sort.

 

[MusicDOc124]

@lord999 @TheBoneDoctah @GoSpursGo @NotAProgDirector I've read through all your posts, and I agree with all that you've said, especially with the T20 withdrawal being a major red flag. I'll show her this link, but if she doesn't add primary care specialties to her school list then I've done all I could. Thank you to all the contributors in this thread- I appreciate that you took time out of your days to answer this.

A couple of concerns:

Why wouldn't her former school take her back? That itself is a red flag, or at least often related to a different red flag.

Also, she didn't matriculate in the US elsewhere because they wouldn't transfer the credits? You state she's a 2nd year now in the carib... which means maybe 1 year transferred over, or did she start over no differently than not transferring any credits to another US school? I just think it was a bad decision to go to the carib if it was over one year of credit vs staying in the US, and especially if she started over anyway. The other fishy thing here is the lack of ability to transfer any credits. Were there other ref or even yellow flags not being mentioned? B/c I know multiple people including myself who transferred medical schools between 1st/2nd and between 2nd/3rd year.

After completing her 2 years, did she not take her step 1? Usually transferring is easier since all pre-clinical work and USMLE/COMLEX 1 are taken in which its less about "transfer credit" as much as it is assuming everything that needed to be covered was covered, evidenced by Step 1.

 

[AlteredScale]

I would let your friend know the honest truth that the chances are as slim as they can be. It honestly sounds like she is pretty set on it though and has the thought process that "if I believe in it hard enough and put enough effort it will happen" which is a great mindset but not for her situation.

Encourage her to look into pediatric neurology or perhaps another procedure heavy area that focuses on peds that she may be interested in.