Hi, everyone! I'd like to ask you a question. If I'm an IMG, graduated fromThailand and I get the score 99 both step 1 and 2. Can I get into the USA general surgeon program? Thank for every advice.
score 99?
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Even if you get 76 from second trial
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No one is going to be able to tell you what your chances are. General Surgery has become increasingly competitive. For the last two years, the number of available spots post-match has decreased dramatically and the number of US grads going unmatched increased. Your USMLE scores are good (BTW, US programs use the 3 digit score, not the 2 digit) but not the only factor in getting a US residency.
To increase your chances...
1) you should have graduated from medical school within the last couple of years,
2) US clinical experience - if you have already graduated you can only get observerships (which are practically worthless IMHO) or research
3) letters of rec from US faculty
4) and anything else that makes you special and makes US faculty believe they should take you over a well qualified US med school grad
Dear Dr.Cox
Thanks for your advice.I'm still in the last month of medical school. I'd like to have a clinical experience in US medical center but I don't even know how to start,please recommend me.
I looked in few threads about elective program. Anyone please tells me that if I pass both step 1 and 2, is the TOFEL still a requriement?
Sorry about this question, what is IMHO?
Thanks for everyone
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If you are in your last MONTH of medical school you are not going to be able to arrange US clinical electives unless your medical school keeps you on student status. It can take months to arrange the electives.
There are several threads in this forum about how to arrange them, where you might be accepted, etc. so I suggest you start with a search. I'm not sure if the TOEFL is still required or whether that is assess during the CK examination.
Details about coming to the US for residency and what it required can be found at http://www.ecfmg.org
IMHO = in my humble opinion
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Remember, you must still be a student in order to do an elective in the US. You may not do one after you graduate. Some programs require that you have taken and passed USMLE Step 1. All programs will require that you have medical indemnity insurance. These can take some time.
One place you could enquire is the Cleveland Clinic - they are quite accommodating, provide housing. They do require that you have your USMLE scores and are in final year, but I believe you already have those.
It takes time to process applications, so I'd do it ASAP. You will have to get things signed by your school's registrar, etc. And when you're on elective, your goal is basically to impress your attendings enough that they will write you a good letter of recommendation.
Thanks a lot for your kindness.
I'm still in the last year of medical school. I have three months left, not a month that I mentioned before. Luckily, I took a look in the google for the information about medical program and I found this community. It helps me so much. Hope this keep on helping people like me.
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Ahhh...the million dollar question!
I happen to think its a combination of both - all specialties go through an ebb and flow in applications (usually every 5-7 years) and I do think there are some who are foolish enough to decide to do surgery who wouldn't have previously because of the new work hour restrictions. Obviously they assumed restriction = enforcement.
If everyone had to do a fellowship to do general surgery, the reps wouldn't be dying to find someone. The problem is not everyone HAS to do a fellowship, everyone DOES a fellowship. There are so many ads and jobs for bread and butter general surgery out there that you could have your choice of jobs if that is what you want.
BUT people don't want those jobs. They don't want to take call with a high chance of having to come in, the reimbursements aren't what they used to be (but if you didn't work in the glory days, it won't be any different than it used to be) and they don't like seeing cases given to specialists. If you are realistic and don't expect a $600K/year salary and market yourself in an area without a lot of specialists, then you will do fine. IMHO, making $200-$300K with the potential for more is not too shabby.
So why are there more and more applicants to general surgery? Well, for one as we noted above, its the natural cycle and two, those that think they can handle the hours now are more likely to apply. But other reasons include the fact that general surgery is the gateway to specialties - so we may still have a dearth of general surgeons years from now as people continue to do fellowships. I hardly think anyone has to, although laparoscopic or vascular skills in addition to general surgery seem to be in high demand (in my cursory view of the ads and phone calls I get). Women are applying in higher numbers as well and I think you still get a lot of IMGs and others who have heard surgery is an easy match (outdated information), so try and apply for the field. I'm not sure that the latter two have any real effect on the field.
Bottom line is that there are tons of jobs out there, with decent reimbursement and good call schedules for those that want them.
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One might remind them that there is little to no enforcement of these rules and that they may be suprised to find themselves working more than 80 hrs on a regular basis and not going home early post call. I hope they LOVE surgery, otherwise its difficult to put up with the rigor and the BS for 5+ years.
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Thanks a lot for your kindness.
I'm still in the last year of medical school. I have three months left, not a month that I mentioned before. Luckily, I took a look in the google for the information about medical program and I found this community. It helps me so much. Hope this keep on helping people like me.
Still, if you only have 3 months left, you haven't a lot of time. Academia, even in the US, is notoriously slow. It can take 3 months just for them to review your application.
There are lots of schools that take FMGs for electives - you can either do a search in this forum (there are lots of threads about it), or simply contact schools you are interested in, or look at their web sites. You must do it NOW, if you wish to be eligible to do one before you graduate.
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applying for electives at places that have previously accepted Imgs and are generally considered uncompetetive among Amg's wont be a bad idea
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i wouldn't say that. IMGs frequently do electives in quite competitive places. You just have to apply early so that spots don't fill up before you apply.
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i did not mean that a foreign student can not do a elective at a big name program . doing a elective at a place where one would want to match is a regular thing among amgs(the audition rotation) , so i thought this might apply to imgs as well
I'm an IMG hoping to apply for the 2008 match.
I have almost finished medical school and probably wont be able to apply for an elective, however i would like to know if it is possible for me to apply for an externship position. Also, how would this count as US clinical experience?
I have almost finished medical school and probably wont be able to apply for an elective, however i would like to know if it is possible for me to apply for an externship position. Also, how would this count as US clinical experience?
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To obtain clinical experience, you either must be still enrolled in school or be a physician with ECFMG certification. The stumbling block is malpractice insurance - if you are still a student, your medical school or sometimes, the hospital providing the elective, should provide it for you. Once you have graduated, the premiums are much higher (because your responsibility is much higher).
Externships do not really exist in the form in which you can get clinical experience once you have graduated. They tend to be relegated to research or observerships, neither of which offer the opportunity for your supervisor to assess your clinical skills.
You have the option of asking your school to keep you on student status while you complete some US electives, to do research or an observership.
BTW, I noted that you asked essentially this same question in another thread - it is not necessary, and is, in fact, a violation of the SDN Terms of Service Agreement.
Thanks for the information Kimberli. I apologise for posting the two messages on different threads i didn't realise they were asking more or less the same question.
If getting US clinical experience is so difficult for IMGs how do some programs (eg. MGH, BWH) expect foreign students to have one year of USCE before they can apply?I'm sure it's impossible for anyone to be able to get one year's worth of electives. How do IMGs who do match at these programs get around it?
Also, if I do apply for a clinical elective, do I have to do so through my medical school and what documents does my medical school have to provide on my behalf.
I would really appreciate any replies to this..
Thanks
If getting US clinical experience is so difficult for IMGs how do some programs (eg. MGH, BWH) expect foreign students to have one year of USCE before they can apply?I'm sure it's impossible for anyone to be able to get one year's worth of electives. How do IMGs who do match at these programs get around it?
Also, if I do apply for a clinical elective, do I have to do so through my medical school and what documents does my medical school have to provide on my behalf.
I would really appreciate any replies to this..
Thanks
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Not all programs expect US clinical experience before applying. Especially if you are a foreign student (they would expect FMGs who are US citizens to have more experience). Because of difficulties with US clinical experience, they may expect you to do a period of observership before you start the program, but that's specific to the program and specialty.
The IMGs who do not have much trouble comparatively in getting US electives either go to a school which provides its students with malpractice insurance, or have specific relationships/exchanges set up with a particular US hospital. Most IMGs do not take a whole year's worth of electives (although some may through skipping various things at their home school). The only schools in which IMGs do years of US clinical rotations are the Caribbean schools.
In most cases, your application for an elective has to be done through your medical school because you have to have your application form signed by your school. Technically, electives are performed at teaching hospitals, and teaching hospitals are always associated with universities/medical schools. Documentation is specific to the program you're applying for - usually the application form itself, proof of insurance, immunization records, transcripts, and possibly other forms which they will specify.
The IMGs who do not have much trouble comparatively in getting US electives either go to a school which provides its students with malpractice insurance, or have specific relationships/exchanges set up with a particular US hospital. Most IMGs do not take a whole year's worth of electives (although some may through skipping various things at their home school). The only schools in which IMGs do years of US clinical rotations are the Caribbean schools.
In most cases, your application for an elective has to be done through your medical school because you have to have your application form signed by your school. Technically, electives are performed at teaching hospitals, and teaching hospitals are always associated with universities/medical schools. Documentation is specific to the program you're applying for - usually the application form itself, proof of insurance, immunization records, transcripts, and possibly other forms which they will specify.
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No problem. Just wanted you to be aware.
Just to reiterate what leorl wrote above.
1) getting US clinical experience is not necessarily difficult, you just have to know the procedure and get all your work done
2) be aware that there are two different terms: IMG typically refers to the US citizen training abroad (ie, in Caribbean schools) whereas FMG typically refers to foreign nationals training abroad - either in their home country or elsewhere
3) MGH and BWH are pretty prestigious hospitals and may have different regulations than others regarding US clinical experience
4) not all hospitals require you to have ANY clinical experience in the US, although it would certainly be welcomed
5) unless you are training in a Caribbean or other school which send you to the US to complete your 3rd and 4th (final) years of medical school, you cannot have a year of US clinical experience. As leorl noted, IMGs (again, American citizens training abroad) who attend such schools can easily complete this requirement. Those who attend schools in the UK, Australia, and elsewhere cannot. And most FMGs cannot either.
6) a program can make any rule it wants; just because Mass gen and Brigham want you to have a year of US clinical experience, doesn't mean that this is anywhere near a requirements of most other programs. But they can and will set requirements - IMHO, sometimes these are a means to keep out FMGs.
As noted above, they either get around it by attending a school which sends them to the US for the entire 3rd and 4th clinical years or in truth, a stellar application from someone without the required US clinical experience may be given a waiver. That is, not all rules are hard and fast. I expect most IMGs who match at such places do so because they have attended a school which places them in the US for 2 or more years.
Each school/hospital will have its own requirements for applying for clinical electives. Typically your school has to provide proof that you have satisfactorily completed the Core rotations of Internal medicine, Surgery, Ob/Gyn, Peds and Psych as well as any prequisite courses the US program wants you to have.
Some may require that you have a passing score on USMLE Step 1.
Most will also require that your medical school provide proof of malpractice insurance which is good in North America and that you provide evidence of health insurance which will cover you in the US.
Details can be obtained from the specific programs to which you are applying.
