Need advice please - Career Question

[Relentless1]

Hi everyone,

After much googling and reading posts in these forums, I'm hoping to get some sound advice on my situation here as I've seen many helpful souls respond to others...

I am a Caribbean med school graduate (2011) - (not one of the "top 5") - am ECFMG certified, still have Step 3 remaining, excellent LORs, but have not been able to secure a residency...mainly because I have multiple attempts on Step 1 and 2 CK with, literally, just-passing scores. I am passionate about Psychiatry and FM, but am open to TY or anything at this point, really. I have gone on to get my MHA and MPH recently. I have seen that an MD without a license really means nothing and has no value. I desperately still want to be a practicing physician - but don't know what I can do to get there.

What is done is done (exams), and I can't change my performance, but what can I do now to at least get one interview in the Match?

Has anyone heard about an internship year in Puerto Rico which provides a license that can be used in the US - is this true?

I am based in FL - does anyone know of any unique opportunities here? I heard of the 'House Physician' position, however, that also seems to require licensure?

Any other career paths or ideas for me with my MD, MHA, MPH but no license?

I would really appreciate your time and any guidance you could provide!!! Many thanks in advance.

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[AdmiralChz]

This is a tough one. There are a couple major issues here that would be difficult to overcome alone but all together it's a poor outlook sort of situation.

The biggest issue is years since graduation (sometimes referred to as YOG) - you graduated in 2011, for next cycle it would have been 8 years since you graduated and 2 entire classes of students would have entered and graduated.

You mention you've gotten a MHA and MPH, but these are non-clinical degrees. Have you been doing anything clinical recently? It's been 7 years since graduation for you - residencies will have to assume you'll almost certainly start from nothing.

Multiple failures on USMLEs is a problem as well - you are at risk for failing your specialty board exams, which reflects poorly on residency programs.

Finally, school matters. Unfortunately, and you seem to know this, there are literally dozens of dubious medical schools in the Caribbean. If you didn't go to the top 3 (Ross, St. George and maybe AUC) it's going to be exceedingly difficult to break into US residencies and the other issues put you behind the ball even more.

If you haven't gotten ANY interviews over the past few cycles the chances of trying again and matching is essentially zero. You can look into the associate physician program in Missouri (often cited on this website) but it's going to be hard to convince a physician to sponsor you with so much length since your medical school graduation.

To summarize: 8 YOG, multiple step failures, no clinical work, dubious school.

Unfortunately, this is probably a tough love situation. Your clinical career is probably just not going to happen, you could definitely use your degrees in MHA or MPH to break into healthcare policy and/or administration where your MD may (more likely not though) make a positive impact. You could also look into consulting roles with pharmaceutical companies or other healthcare management agencies. But realistically, I don't see any way for you to bolster your application enough to even possibly land a residency. I also think it would be insulting for you to go back and try to get into PA school for an alternative way into medicine, do you really want to spend that much more money?

I feel for you, I really do, but this is yet another unfortunate example of why so many of us recommend against jumping to the Caribbean for medical school.

 

[rokshana]

I feel for you, I really do, but this is yet another unfortunate example of why so many of us recommend against jumping to the Caribbean for medical school.

Really? i know you are pretty anti caribbean, but that is the least of his red flags...

 

[AdmiralChz]

Really? i know you are pretty anti caribbean, but that is the least of his red flags...

I'm not really "anti" Caribbean at all - I've worked alongside many solid grads and my program has had several chief residents from medical schools there. I certainly don't mean to sound like that, but this story isn't unique for US IMGs in the Caribbean. I agree with you the biggest red flag is more likely the YOG.

That being said I suspect a lot of the issues started there - the typical story is a very marginal / unsuitable US applicant didn't get into any US MD/DO schools so they went Caribbean, but even the typical (STG, Ross, AUC) schools said no so the last resort is the lesser-known places. These schools do a very poor job of explaining the reality facing their graduates unless they have excellent clinical acumen combined with excellent scores. Unfortunately the lacking academic performance clearly continued into medical school, and now it's been 7 years since graduation. Would this person have matched if graduating from a US MD/DO school with the same stats? I can't answer that, but it is definitely a better scenario.

As MD and DO schools continue to expand enrollment, FMGs and US IMGs are going to continue to feel the squeeze since the residency spots aren't increasing to the same degree. So to be successful you'll need to have even better stats and there's less room for error than before.

I also shouldn't have been so harsh about attending Caribbean schools as a generic statement - one just needs to be thoughtful and honest with themselves about the path going forward, and not just blindly go to any school. With the right set of circumstances, young doctors can thrive in that environment. But not everyone does, and that's more of what I was trying to say.

 

[doc05]

You're not going to get a training spot. Best to cut your losses and move on. Look into nonclinical roles with pharma, consulting, etc.

 

[Apollyon]

"Top 5"? I went to St George, and I can't name the "top 5".

 

[Raryn]

"Top 5"? I went to St George, and I can't name the "top 5".

I can think of a top 3 (SGU, Ross, AUC) or a top 4 (add Saba), but I can't think of a 5th. And OP says he went to one outside of those 5.

 

[Apollyon]

I can think of a top 3 (SGU, Ross, AUC) or a top 4 (add Saba), but I can't think of a 5th. And OP says he went to one outside of those 5.

Yeah, I knew those 4. I think someone is REALLY reaching. Hell, I remember when AUC WASN'T one of the "big three" - it was only SGU and Ross, and the rest were throwaways.

 

[NotAProgDirector]

To add to the OP's woes, he/she is probably outside the USMLE window for step 3.

So, as mentioned, you're simply not going to get a spot no matter what you do. If you pursue another degree, your career will be based upon that degree, not your MD. Whether it's a sound financial plan to spend more on a new degree depends upon your financial situation and risk tolerance.

There are internships in PR. You would need to be fluent in Spanish. They technically "count" as training, but quality can be poor. PR remains in trouble from the last hurricane.