The Caribbean Residency Question

[howelljolly]

See this info is flawed, If only over half were US applicants then who are the other applicants? These sources seem to only get the info from the "MATCH" only and not from other sources, it seems to dig further the reality comes out that the programs do acquire residents from other sources then the Match. If not then the statement would say "over 90%", "most" or "All"("Even the most competitive specialties admitted well over half of their US applicants.")

the "other applicants" who are getting into these competetive residencies are American medical graduates who are NOT "US Seniors". Id est, they are grads of American schools who have already done internship or residency somewhere else, and are applying for a competitive residency via the Match. E.g, Someone who has completed a Surgical residency and is now going for Plastic Surgery... Im also pretty sure that the "other applicants" include DO grads.

---

Members don't see this ad.

 

[oldpro]

the "other applicants" who are getting into these competetive residencies are American medical graduates who are NOT "US Seniors". Id est, they are grads of American schools who have already done internship or residency somewhere else, and are applying for a competitive residency via the Match. E.g, Someone who has completed a Surgical residency and is now going for Plastic Surgery... Im also pretty sure that the "other applicants" include DO grads.

Really? Only FMG's can go outside the MATCH. That is what I was talking about not years later like you are talking about? DO not know why you would post that? Also I know of plenty of FMG's that get into competitive residencies after completing one in something like IM, I have done clinicals already with one such Doc and know of some.

But hey US grads have to have something to kick in the Caribbean students face huh? Neither one of us have stats on this, its all anecdotal.

 

[NotAProgDirector]

I'm afraid you are both misinterpreting the quote:

Even the most competitive specialties admitted well over half of their US applicants

This means that the most competitive specialties admitted more than 50% of the US seniors who applied. It does not tell you that some large number of non-US seniors got in.

For example (completely made up numbers):

There are 100 Derm spots.
150 US Seniors apply to Derm
150 IMG's apply to Derm.
90 US Seniors get Derm and 10 IMG's get Derm.

90/150 = 60% -- "Dermatology admitted well over half of their US applicants"

However, in this example, 90/100 = 90% of Derm matches are US Seniors.

 

[oldpro]

I'm afraid you are both misinterpreting the quote:



This means that the most competitive specialties admitted more than 50% of the US seniors who applied. It does not tell you that some large number of non-US seniors got in.

For example (completely made up numbers):

There are 100 Derm spots.
150 US Seniors apply to Derm
150 IMG's apply to Derm.
90 US Seniors get Derm and 10 IMG's get Derm.

90/150 = 60% -- "Dermatology admitted well over half of their US applicants"

However, in this example, 90/100 = 90% of Derm matches are US Seniors.

Yes I understand, I was just pointing out that it is not clear that 100% are US graduates, But the term "Over Half" it does not mean 90% either it could mean 55%, 60%, 70% too. This statement alone is open for huge arguments.

 

[howelljolly]

Really? Only FMG's can go outside the MATCH. That is what I was talking about not years later like you are talking about? DO not know why you would post that? Also I know of plenty of FMG's that get into competitive residencies after completing one in something like IM, I have done clinicals already with one such Doc and know of some.

But hey US grads have to have something to kick in the Caribbean students face huh? Neither one of us have stats on this, its all anecdotal.

Chill out. Why would I kick Caribbean sand in a Caribbean student's face? Im a Caribbean student myself.

My post was saying that the stats saying that (Im making up a number here) '90% of Plastics residency spots are taken by "US" seniors' is misleading. It doesnt mean that the other 10% is taken by IMGs. The other 10% can very well be taken by US graduates who are NOT US seniors...AKA Independent applicants

What do you think happens to American grads who complete a Transitional or Prelim Year? They go into the pool of the "independent applicants"

You cant assume that the Independent Applicant group in the NRMP Annual Match Outcomes report consists of only IMGs.

Probably, the closest estimation of the fate of Caribbean graduates may be found in any statistic which label the group as "US Citizen IMG", or something of similar.

 

[oldpro]

Chill out. Why would I kick Caribbean sand in a Caribbean student's face? Im a Caribbean student myself.

My post was saying that the stats saying that (Im making up a number here) '90% of Plastics residency spots are taken by "US" seniors' is misleading. It doesnt mean that the other 10% is taken by IMGs. The other 10% can very well be taken by US graduates who are NOT US seniors...AKA Independent applicants

What do you think happens to American grads who complete a Transitional or Prelim Year? They go into the pool of the "independent applicants"

You cant assume that the Independent Applicant group in the NRMP Annual Match Outcomes report consists of only IMGs.

Probably, the closest estimation of the fate of Caribbean graduates may be found in any statistic which label the group as "US Citizen IMG", or something of similar.

The whole point of my post was that some may be IMG's and you cannot assume that its not so we agree but have different Ideas of what those numbers are. At this time we cannot prove it either way.

 

[MDPWR]

Man, this thread has some hostile environment.

 

[tkim]

Really? Only FMG's can go outside the MATCH.

No. DO's and graduated USMD's can sign outside the match as well.

 

[oldpro]

No. DO's and graduated USMD's can sign outside the match as well.

I love the misinformation to win! No they cannot, the rule with the Match is the programs CANNOT accept US grads outside of the match during a match season. If a program does hire a US grad outside the match it must be at a time that the match is not happing, not the season. If they Violate the rule the program looses the Match.

FMG/IMG Grads can go outside the match at any time and it is not a Violation.

Few US grads go outside the Match, No US Grads Matching PGY 1 ( which is what we are talking about and you know this) go out side the match.

But go on trying to "Win one"

 

[NotAProgDirector]

I love the misinformation to win! No they cannot, the rule with the Match is the programs CANNOT accept US grads outside of the match during a match season. If a program does hire a US grad outside the match it must be at a time that the match is not happing, not the season. If they Violate the rule the program looses the Match.

FMG/IMG Grads can go outside the match at any time and it is not a Violation.

Few US grads go outside the Match, No US Grads Matching PGY 1 ( which is what we are talking about and you know this) go out side the match.

But go on trying to "Win one"

Sorry OldPro. This time it turns out you are incorrect.

Fourth year medical students in allopathic programs must go through the match.

DO students, and allopathic students who have previously graduated are free to sign contracts outside the match.

So, if an allopathic student graduates from medical school and then afterwards wants to do a PGY-1 year (Perhaps due to a pregnancy, or if they match into a PGY-1 but then are looking for a PGY-1 in another field), they can sign outside the match.

 

[tkim]

I love the misinformation to win! No they cannot, the rule with the Match is the programs CANNOT accept US grads outside of the match during a match season. If a program does hire a US grad outside the match it must be at a time that the match is not happing, not the season. If they Violate the rule the program looses the Match.

FMG/IMG Grads can go outside the match at any time and it is not a Violation.

Few US grads go outside the Match, No US Grads Matching PGY 1 ( which is what we are talking about and you know this) go out side the match.

But go on trying to "Win one"

The only misinformation in this thread is yours.

http://www.nrmp.org/res_match/policies/map_main.html#indep_apps

2.2.2 Independent Applicants

The term "independent applicant" refers to an applicant who is either:

(a) A physician who is a graduate of an LCME-accredited medical school;

(b) A student enrolled in, or a graduate of, a medical school accredited by the Committee on Accreditation of Canadian Medical Schools;

(c) A student enrolled in, or a graduate of, a school accredited by the American Osteopathic Association;

(d) A student enrolled in, or a graduate of, a school not accredited by the LCME, the Committee on Accreditation of Canadian Medical Schools, or the American Osteopathic Association; or

(e) A student enrolled in, or a graduate of, a Fifth Pathway program.


http://www.nrmp.org/res_match/policies/map_main.html#apps_withdraw_byapps

2.4 Withdrawals

2.4.1 Withdrawal by the Applicant

Independent applicants may withdraw from the Matching Program, but only if the NRMP receives their withdrawal request prior to the rank order list certification deadline through the Match Site Withdrawal screen for the Matching Program. Applicants who have accepted a residency position through any other national matching service or by agreement outside the Matching Program shall not rank a concurrent year residency position. If an applicant ranks a concurrent year position, he/she will be in breach of this Agreement and may be subject to the penalties described in Section 7.0.

---

1) Independant applicants can sign outside the Match *while* participating *in* the Match, so long as they withdraw from the Match before the deadline for certifying their Rank Order List.

2) Independant applicants *include* DOs and graduate USMDs.

I just went through last year's match and participated in both the DO and MD matches, though I withdrew from the DO match and continued with the MD match as an independant candidate. So, I'm pretty familiar with the rules of both matches *and* the specifics of being an independant candidate for the MD match.

Fact-check before you dismiss someone's post. You would think as a conscientious med student, you would know by now that false data is worse than no data, or how to recognize when your personal bias is interfering with your critical thinking skills.

 

[howelljolly]

Chill out. Why would I kick Caribbean sand in a Caribbean student's face? Im a Caribbean student myself.

My post was saying that the stats saying that (Im making up a number here) '90% of Plastics residency spots are taken by "US" seniors' is misleading. It doesnt mean that the other 10% is taken by IMGs. The other 10% can very well be taken by US graduates who are NOT US seniors...AKA Independent applicants

What do you think happens to American grads who complete a Transitional or Prelim Year? They go into the pool of the "independent applicants"

You cant assume that the Independent Applicant group in the NRMP Annual Match Outcomes report consists of only IMGs.

Probably, the closest estimation of the fate of Caribbean graduates may be found in any statistic which label the group as "US Citizen IMG", or something of similar.

I think this is where Im supposed to say "I told you so".

OldPro. After hearing that you are an older student, that started working in the medical field when I was in the Cub Scouts. Keep up with your good attitude. You're doing what a lot of people dont have the guts to do.

We really think that our chosen path to career as an MD in the US is much harder than you try to make it out to be. If looking at the bright side keeps you going, then great. But for some of us, looking at the worst case scenario, and working to stay away from it, is what keeps us going. So at the end of it all, I can say "Hey, I anticipated all the land mines, but that last one... well that was a killer."

 

[oldpro]

The only misinformation in this thread is yours.

http://www.nrmp.org/res_match/policies/map_main.html#indep_apps

2.2.2 Independent Applicants

The term "independent applicant" refers to an applicant who is either:

(a) A physician who is a graduate of an LCME-accredited medical school;

(b) A student enrolled in, or a graduate of, a medical school accredited by the Committee on Accreditation of Canadian Medical Schools;

(c) A student enrolled in, or a graduate of, a school accredited by the American Osteopathic Association;

(d) A student enrolled in, or a graduate of, a school not accredited by the LCME, the Committee on Accreditation of Canadian Medical Schools, or the American Osteopathic Association; or

(e) A student enrolled in, or a graduate of, a Fifth Pathway program.


http://www.nrmp.org/res_match/policies/map_main.html#apps_withdraw_byapps

2.4 Withdrawals

2.4.1 Withdrawal by the Applicant

Independent applicants may withdraw from the Matching Program, but only if the NRMP receives their withdrawal request prior to the rank order list certification deadline through the Match Site Withdrawal screen for the Matching Program. Applicants who have accepted a residency position through any other national matching service or by agreement outside the Matching Program shall not rank a concurrent year residency position. If an applicant ranks a concurrent year position, he/she will be in breach of this Agreement and may be subject to the penalties described in Section 7.0.

---

1) Independant applicants can sign outside the Match *while* participating *in* the Match, so long as they withdraw from the Match before the deadline for certifying their Rank Order List.

2) Independant applicants *include* DOs and graduate USMDs.

I just went through last year's match and participated in both the DO and MD matches, though I withdrew from the DO match and continued with the MD match as an independant candidate. So, I'm pretty familiar with the rules of both matches *and* the specifics of being an independant candidate for the MD match.

Fact-check before you dismiss someone's post. You would think as a conscientious med student, you would know by now that false data is worse than no data, or how to recognize when your personal bias is interfering with your critical thinking skills.

All applicants for a position tracked by the NRMP are IN THE MATCH how else do they get tracked? AND I SAID APPLYING FOR PGY 1 right out of school not after they have practiced a year DUH,

there is a history here of one upsmanship

But really it is transparent that you want to say that Caribbean grads do not match at a significant rate outside the match. Sorry you cannot prove that as much as I can't it is not tracked, but based on the many I know from my years (19 of them practicing ) and years in medical school that as far as I know the numbers have been significant, as high as 15 to 20% of Caribbeans matching (outside the match) into PGY 1.

Good try But I do not buy it as many will not.

 

[oldpro]

Sorry OldPro. This time it turns out you are incorrect.

Fourth year medical students in allopathic programs must go through the match.

DO students, and allopathic students who have previously graduated are free to sign contracts outside the match.

So, if an allopathic student graduates from medical school and then afterwards wants to do a PGY-1 year (Perhaps due to a pregnancy, or if they match into a PGY-1 but then are looking for a PGY-1 in another field), they can sign outside the match.

Nope you are wrong........ only LCME students must, Caribbean are FMG's and can get a PGY 1 outside the match this is well known .( I Know you say your a Program Director, great if there are rules that the NRMP program will not allow FMG and IMG grads to be hired outside the match please Direct us to the info from the NRMP where the program will be sanctioned. I guess the program my friend just prematched in is in trouble?)

So I'm willing to concede there may have been a rule change or something but please prove it cause this is confusing with real people starting PGY 1 this July who were not in the match.

 

[NotAProgDirector]

Nope you are wrong........ only LCME students must, Caribbean are FMG's and can get a PGY 1 outside the match this is well known .( I Know you say your a Program Director, great if there are rules that the NRMP program will not allow FMG and IMG grads to be hired outside the match please Direct us to the info from the NRMP where the program will be sanctioned. I guess the program my friend just prematched in is in trouble?)

So I'm willing to concede there may have been a rule change or something but please prove it cause this is confusing with real people starting PGY 1 this July who were not in the match.

I misread your original post. My apologies.

LCME Allos in their fourth year must participate in the match. All others are free to either match or sign outside the match. Whether this is a strength or a weakness is a matter of debate.

 

[oldpro]

I misread your original post. My apologies.

LCME Allos in their fourth year must participate in the match. All others are free to either match or sign outside the match. Whether this is a strength or a weakness is a matter of debate.

Oh no problem, I misread things all the time ( I screw myself up sometimes jumping You've seen it LOL)

Anyway thanks and no its not an advantage because I think the numbers that do Outside the Match for PGY 1 ( first time ) is only between 10 to 20% at best.

So we agree.

 

[tkim]

But really it is transparent that you want to say that Caribbean grads do not match at a significant rate outside the match. Sorry you cannot prove that as much as I can't it is not tracked, but based on the many I know from my years (19 of them practicing ) and years in medical school that as far as I know the numbers have been significant, as high as 15 to 20% of Caribbeans matching (outside the match) into PGY 1.

Good try But I do not buy it as many will not.

I'm really trying to see how you could possibly interpret what I've written to mean what you think it means. I don't see it.

It's pretty simple. You said that IMG/FMG's are the only ones who could sign outside of the match, and I've proven otherwise. There you go.

 

[oldpro]

I'm really trying to see how you could possibly interpret what I've written to mean what you think it means. I don't see it.

It's pretty simple. You said that IMG/FMG's are the only ones who could sign outside of the match, and I've proven otherwise. There you go.

I'm confused?How can you prove outside the match by the NRMP? they do not have access to such information only the ones who participate in the NRMP in some manner? So what have you proven? (Thats my point and debate)

It's pretty simple. You said that IMG/FMG's are the only ones who could sign outside of the match, and I've proven otherwise. There you go.

LCME students graduating cannot go outside the match
Caribbean students (FMG) non LCME graduating can go outside the match

So how did you, what did you prove again?

 

[howelljolly]

LCME students graduating cannot go outside the match
Caribbean students (FMG) non LCME graduating can go outside the match

So how did you, what did you prove again?

50% of American IMGs do not match (as per the NRMP report). We must agree on that much. I dont have proof of this, but I cant imagine that this 50% includes those dropped out of the Match to sign a contract. That 50% would be those that were in the match, from start to finish. The NRMP charts only the work they have done, not what happening nationally.

Maybe a decent percentage of American IMGs will Scramble, but I'm unconvinced that the 50% of American IMGs who "do not Match successfully" includes those that have dropped out of the Match.

I know plenty of Carib trained docs as well (Im sure many current Carib students do). In fact, both of my own doctors are Carib trained. But times are a-changin' and its getting more difficult.

 

[oldpro]

50% of American IMGs do not match (as per the NRMP report). We must agree on that much. I dont have proof of this, but I cant imagine that this 50% includes those dropped out of the Match to sign a contract. That 50% would be those that were in the match, from start to finish. The NRMP charts only the work they have done, not what happening nationally.

Again what seems to be the mental block on this is outside the match

the NRMP does not track who matches into a program outside the NRMP program.........the match.........these people are not registered with the match so the % is higher then 50%( what the NRMP reports, people registered for the match) I can and do argue this point but american medical students want to think they have the only path to MD, I feel its just plain arrogance IMHO.

Maybe a decent percentage of American IMGs will Scramble, but I'm unconvinced that the 50% of American IMGs who "do not Match successfully" includes those that have dropped out of the Match.

again scramble is the NRMP program, the match, not outside the match.........mental block eh?

I know plenty of Carib trained docs as well (Im sure many current Carib students do). In fact, both of my own doctors are Carib trained. But times are a-changin' and its getting more difficult.

So if they did not get residencies then how are they practicing.............common sense, common sense.

 

[tkim]

I'm confused?How can you prove outside the match by the NRMP? they do not have access to such information only the ones who participate in the NRMP in some manner? So what have you proven? (Thats my point and debate)

LCME students graduating cannot go outside the match
Caribbean students (FMG) non LCME graduating can go outside the match

So how did you, what did you prove again?

So, you are talking about IMG's who do not register with the NRMP for the Match and just sign a contract with a residency?

Let's get this straight, because when I talk about 'signing outside of the Match', I'm referring to people who registered with the NRMP to participate in the Match, and sign contracts before the Match takes place. This is what's commonly understood as 'signing outside the Match', which is why two other posters besides myself are pointing out that you are wrong.

If you are refering to IMG's who simply call up residencies and ask for an interview and try to get a contract offered to them, then I have no idea.

Frankly, how could anyone find a residency opening *without* access to the NRMP list? Sounds like a vanishingly small number of people who try to do it that way. Maybe Findaresident. Have no experience with that.

 

[oldpro]

So, you are talking about IMG's who do not register with the NRMP for the Match and just sign a contract with a residency?

Let's get this straight, because when I talk about 'signing outside of the Match', I'm referring to people who registered with the NRMP to participate in the Match, and sign contracts before the Match takes place. This is what's commonly understood as 'signing outside the Match', which is why two other posters besides myself are pointing out that you are wrong.

If you are refering to IMG's who simply call up residencies and ask for an interview and try to get a contract offered to them, then I have no idea.

Frankly, how could anyone find a residency opening *without* access to the NRMP list? Sounds like a vanishingly small number of people who try to do it that way. Maybe Findaresident. Have no experience with that.

Yes Caribbean grads FMG's and IMG's do not have to apply/sign up with NRMP
"The Match" to get a 1st year residency they can interview and sign a contract that upon graduation they start a residency in July, yes this is and has been done by more then a few, Caribbean students have been known to "Brown nose" themselves during a rotation and get these positions.

LCME students cannot do this as far as contract without entering the match.
But they can brown nose and get ranked as 1 by a program.

That is what I'm posting, not because I think its an advantage but that since these are unknown numbers and I personally along with others know of these people successfully getting positions without "The Match" then I believe these numbers to be around 10% maybe more based on what I have seen.

Not really large but enough to make the % of Caribbean grads that get a PGY 1 position higher then the known Match %, but this higher % is a guess and not provable at this time. the 50% the NRMP is a solid number to add these people in is a Guess as to the real numbers so I believe the actual over all % of Caribbean (FMG) grads to get into a PGY 1 to be at least 60% ( that is the real number of 50% plus 10% for the unreported non NRMP matches)

60% is hardly an advantage over the LCME match rate of 99.99% each year
so why argue over such? LCME still beats Caribbean hands down and I agree with that, I just do not agree that Caribbean students are unsuccessful.

 

[tkim]

Yes Caribbean grads FMG's and IMG's do not have to apply/sign up with NRMP

USMD graduates and DO's don't need to sign up with the NRMP to find a residency, either.

http://www.aamc.org/students/findaresident/benefits.htm

About FindAResident

The AAMC's FindAResident service is a great resource for finding unfilled residency and fellowship positions that fall outside of ERAS, the NRMP Match, and Scramble opportunities.

FindAResident is available to:

* Fourth-year medical students
* International medical graduates
* Prior year medical graduates
* Residents
* Fellows

What types of opportunities are in FindAResident?

FindAResident is open to all ACGME-accredited programs. Residency and Fellowship programs that opt to participate with FindAResident post their available training opportunities on our Web site. FindAResident is an ideal resource for finding:

* Post-Match PGY1 and PGY2 positions (including specialties not featured in ERAS)
* Off-cycle positions
* Fellowship positions

---

http://www.amsa.org/tnp/articles/article.cfx?id=186

In fact, Dr. Kenneth Iserson, author of Getting Into A Residency and a professor of emergency medicine at the University of Arizona, says as many as one-fifth of residency openings are filled outside of the NRMP process. And while it is unclear how many of these were filled through specialty matches or without a match program, he says that, for the assertive and well-informed applicant, there are positions available that allow you to steer clear of the NRMP. "I think there are a lot more people out there in the position to do it than actually take advantage of it," he says. "I think most people don't read that part of [the Match rules] and realize, ‘yes, it's legal.'"

Dr. P. Travis Harker was able to take advantage of such an opportunity. Last August, the 2001 graduate of Ohio State University College of Medicine accepted a Dartmouth family practice and preventive medicine residency that begins this July at Concord Hospital in New Hampshire. While many of his classmates were trying to find their perfect residency during their senior year at medical school, Harker chose to wait and spend a year in a research fellowship at the U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion. And while honing his health-policy skills, Harker heard about a couple of openings in Dartmouth's new preventive medicine element of its residency program and decided to give the hospital a call. "It was just an opportunity that came along," he says. "I feel pretty lucky they had a good program and that it was a pretty good fit for me."

The future resident acknowledges there are risks involved with accepting a position before conducting extensive research of and interviewing with programs. In fact, Harker had taken the initial steps to enter the Match when suddenly the Dartmouth opportunity came along, and he took that position instead. He says it was the right decision for him. "It saved me a lot of money, because I didn't have to fly around from place to place looking at something that might not be a good fit for me," he says. "On the other hand, there may be [another residency program] out there that is better…. I won't be able to find out."

 

[oldpro]

Here we go round and round, a Program Director below posts this:

Sorry OldPro. This time it turns out you are incorrect.

Fourth year medical students in allopathic programs must go through the match.

DO students, and allopathic students who have previously graduated are free to sign contracts outside the match.

So, if an allopathic student graduates from medical school and then afterwards wants to do a PGY-1 year (Perhaps due to a pregnancy, or if they match into a PGY-1 but then are looking for a PGY-1 in another field), they can sign outside the match.

Notice in bold the word MUST. and yet Tkim seems to think they know more then the Program director and Me, even though I have made it clear that it is PGY1 that the LCME students must go through the match for, not after prelim year what ever the first round the first time, but like a broken record to be RIGHT we have this:

TKim

USMD graduates and DO's don't need to sign up with the NRMP to find a residency, either.

http://www.aamc.org/students/findaresident/benefits.htm

About FindAResident

The AAMC's FindAResident service is a great resource for finding unfilled residency and fellowship positions that fall outside of ERAS, the NRMP Match, and Scramble opportunities.

FindAResident is available to:

* Fourth-year medical students
* International medical graduates
* Prior year medical graduates
* Residents
* Fellows

What types of opportunities are in FindAResident?

FindAResident is open to all ACGME-accredited programs. Residency and Fellowship programs that opt to participate with FindAResident post their available training opportunities on our Web site. FindAResident is an ideal resource for finding:

* Post-Match PGY1 and PGY2 positions (including specialties not featured in ERAS)
* Off-cycle positions
* Fellowship positions

Uh please lets read this here:

FindAResident is available to:

* Fourth-year medical students
* International medical graduates
* Prior year medical graduates
* Residents
* Fellows

And this:

* Post-Match PGY1 and PGY2 positions (including specialties not featured in ERAS)
* Off-cycle positions
* Fellowship positions


I do not see where it says new, just graduates from an LCME school will be not be participating in the match as is MANDATORY for them to do to get a residency, if 99.99% match then we are talking about 0.01% Tkim!

What numbers are we talking about here? are you trying to say LCME grads do not match in large numbers?

Really? (What a tangled web we weave to put down Caribbean students) I see this as an attempt to tell us that outside the match could not possibly be a lot of Caribbean students because the US grads are taking the Outside the Match spots,

But as I said, that stats are about 99.99% US grads Match so it cannot be true 0.01% is not that many people.


Whats irritating here is that I'm right. I know it, I know the rules.
LCME students, 4th year students Must participate in the NRMP for a Match, and the fact is over 80% get a match during the match and the rest during the scramble, in most years it's 100%, if there are any positions taken after this, it does not have to be during the Match, just the first time. ( if over 98% of the LCME students get a match during the match and or Scramble then there is few if any trying to get a position after this, Common sense)

My point and other Caribbean students is, We know its tougher for us but we do not have to go through the match, it is not mandatory so a program can hire us without the Caribbean student suffering through the match where 50% get a job, we can obtain a job with the NRMP.

TKim this subject is dead and I'm tired of repeating myself.

You may not accept a large number of FMG and IMG grads getting Jobs but they are getting the Residencies you LCME people did not want in many cases, Hospitals no one cared to work at. Because these programs go unfilled, FMG and IMG's fill the need.

Happy Holidays everyone


(I'll stick around keeping the Caribbean forum straight LOL)

 

[howelljolly]

60% is hardly an advantage over the LCME match rate of 99.99% each year
so why argue over such? LCME still beats Caribbean hands down and I agree with that, I just do not agree that Caribbean students are unsuccessful.

Holy Toledo man! This is what exactly all of us are saying. If we thought that Caribbean students were unsuccessful we would not have gone to med school there, would we?

The NRMP reports a 50% Match rate, and some Gunners (or brown-nosers) get positions outside the match, and some lucky few get in on the Scramble. If that brings the total to 60%, thats still bad! 4 out of 10 Caribbiean graduates do not get a residency.

Regardless of if Carib or US grads do, or do not have to go thru the Match; Or if they can brown-nose into a spot, or if a program creates a spot for them... ~60% of us getting into residency is a scary situation.

If you had a 60% chance of coming out of a magical surgery being able to run the Marathon, AND a 40% chance of coding on the table... vs. not having the surgery and having a 100% chance of being able to just continue taking your daily walks.... would you take the surgery?

 

[oldpro]

Holy Toledo man! This is what exactly all of us are saying. If we thought that Caribbean students were unsuccessful we would not have gone to med school there, would we?

The NRMP reports a 50% Match rate, and some Gunners (or brown-nosers) get positions outside the match, and some lucky few get in on the Scramble. If that brings the total to 60%, thats still bad! 4 out of 10 Caribbiean graduates do not get a residency.

Regardless of if Carib or US grads do, or do not have to go thru the Match; Or if they can brown-nose into a spot, or if a program creates a spot for them... ~60% of us getting into residency is a scary situation.

If you had a 60% chance of coming out of a magical surgery being able to run the Marathon, AND a 40% chance of coding on the table... vs. not having the surgery and having a 100% chance of being able to just continue taking your daily walks.... would you take the surgery?

Well 60% is the worse case, I think its higher like 70% bottom line for one reason or another not all the FMG students are ones that programs want to hire, if you are in a Caribbean Medical school look and around at your class mates and I'm sure you will understand.

 

[NotAProgDirector]

Calm down everybody! You're all right in your own way, arguing basically the same points over and over.

LCME 4th year students basically must go through a match, usually the NRMP but also the SF Match and the military match which are separate. Both of those occur before the NRMP, so you can apply to two matches (or three, but that would be very rare), and you get automatically withdrawn from the NRMP should you match in one of the other matches. Same is true with CaRMS, the Canadian match. But I digress.....

LCME 4th year students who decide that they don't want to go through the match (for whatever reason) must take a year off. Once they do that, they are then able to match the following year, or sign outside the match. There isn't much of a competitive advantage to doing so (although I guess it depends what you do with your year off) -- the most competitive fields / programs rarely take people outside the match. I guess LCME 4th years could avoid the match and just get a spot in the scramble, but that would be pretty dumb overall. FindAResident is used by residents looking to shift programs, or by people looking for offcycle spots. LCME 4th years cannot use this service, and many spots are never listed there anyway.

I believe there is some confusion about the NRMP and ERAS. As an IMG, you could apply via ERAS but not register for the NRMP. This would allow you to fly "under the NRMP radar".

How many carib students get US residency spots? (or perhaps the more important question, how many do not?) There is no easy answer to this question. From the NRMP data for last year's match:

Total number of US IMG's = 4255
US IMG's withdrawn = 928
US IMG's not submitting an ROL = 633

Leaving, in the match = 2694
Matched = 1347
Unmatched = 1347

... yielding the oft quoted 50% match rate. However, this almost certainly underestimates the actual residency placement rate for US IMG's:

1. Of the 928 IMG's withdrawing from the match, the most likely reasons are: Signed a contract outside the match or failed the USMLE/not ECFMG certified. We don't know how many of each, and signing a contract outside the match is just as good as getting a spot in the match.

2. The NRMP allows you to register right up to the ROL deadline. Theoretically, IMG's could put off registering for the NRMP (yet register for ERAS) until after their interviews, and only register if not offered a pre-match spot. I'm not sure how often this happens, since the cost of registering for the match is peanuts compared to all the other costs involved.

3. These numbers include the well known / estabished carib schools, the not-so-well known carib schools, and US IMG's training in poland, UK, ireland, etc. It's impossible to break it down by country.

HOWEVER, we can get a rough estimate of what's happening. This is VERY rough, and only addresses ALL IMG's, not Carib students, and only for PGY-1 matches:

The total number of IMG's matching in the 2006 match was 4382 (Source: NRMP results for the 2007 match, Table 9, last line of the table, 2006 data column).

The total number of IMG physicians enrolled in PGY-1 GME positions in December 2006 was 6613 (Source: JAMA 298:1081 (Sep 2007) - The GME Census, Appendix II, Table 5, last line). This table only includes IMG's with no prior GME experience, which is most IMG's applying for residency).

Hence, it appears that 6613 - 4382 = 2231 IMG's obtained PGY-1 spots without matching. Grossly, that's 2/3 matching and 1/3 signing outside the match, which seems consistant with what I'd expect.

For what it's worth, there it is.

Can we stop squabbling now?

 

[oldpro]

Can we stop squabbling now?

But there is a writer's strike on.

 

[LaCasta]

Holy Toledo man! This is what exactly all of us are saying. If we thought that Caribbean students were unsuccessful we would not have gone to med school there, would we?

The NRMP reports a 50% Match rate, and some Gunners (or brown-nosers) get positions outside the match, and some lucky few get in on the Scramble. If that brings the total to 60%, thats still bad! 4 out of 10 Caribbiean graduates do not get a residency.

Regardless of if Carib or US grads do, or do not have to go thru the Match; Or if they can brown-nose into a spot, or if a program creates a spot for them... ~60% of us getting into residency is a scary situation.

If you had a 60% chance of coming out of a magical surgery being able to run the Marathon, AND a 40% chance of coding on the table... vs. not having the surgery and having a 100% chance of being able to just continue taking your daily walks.... would you take the surgery?

Do 60% not match at all ever, or this per 'application cycle' (if thats the correct term, i dont know much about residencies)

 

[oldpro]

Do 60% not match at all ever, or this per 'application cycle' (if thats the correct term, i dont know much about residencies)

Backwards LOL 30 to 40% may not match from the Caribbean. ( I'm still not convinced its this bad but I have no proof ) ANd it's not forever, just the first time.

 

[AngryBaby]

This was some entertaining reading!!!

I love a crazy, repetitive and ornery argument every now and again.

 

[LaCasta]

Backwards LOL 30 to 40% may not match from the Caribbean. ( I'm still not convinced its this bad but I have no proof ) ANd it's not forever, just the first time.

Ok, thanks

The death on the surgery table analogy was pretty dramatic, it made it seem like some people after graduating from medical school would never find a residency.

 

[oldpro]

Ok, thanks

The death on the surgery table analogy was pretty dramatic, it made it seem like some people after graduating from medical school would never find a residency.

Yea LOL I know there are a lot of extreme responses On SDN, in this forum.

You gotta remember a lot of these people are still just young adults, Under 30 so they lack the life experience of some of us. (43 at the moment)

It's not that bad if you work hard and keep focus .

 

[tkim]

Oldpro. Listen. I don't care what percentage of IMG's get a residency via match or outside. That's the point you keep bringing up. I don't care.

My point has been - and it's the only point I've been making, is that graduate USMDs and DO's can get residencies outside of the match. Same as IMG's. That's it. That's the only point I've made.

I'll say it one more time: graduate USMDs and DOs do not have to participate in the match in order to get a residency.

 

[AllIn4Life]

Oldpro. Listen. I don't care what percentage of IMG's get a residency via match or outside. That's the point you keep bringing up. I don't care.

My point has been - and it's the only point I've been making, is that graduate USMDs and DO's can get residencies outside of the match. Same as IMG's. That's it. That's the only point I've made.

I'll say it one more time: graduate USMDs and DOs do not have to participate in the match in order to get a residency.

ok man u made ur point...USMDs and DOs have every single type of advantage over Caribbean grads

 

[oldpro]

OK I understand but a Program director has said otherwise
I also know that students from an LCME school graduating must participate in the match because the programs who hire these LCME grads, US MD and DO grads coming out of Medical school can suffer sanctions if they do this, the reason is simple, if the programs hire these grads outside the match for PGY 1 then they will not have PGY 1 positions for the match. So the NRMP requires that these programs participating in the match to agree not to hire US MD and DO 4th year graduating students until the match.

For some reason you want us to believe that this system does not exist and US MD and DO students can do what ever they want.............wouldn't that be nice.

I'm really not trying to "Fight" but Debate the facts and question them.

As I said if I'm proven wrong then I will Concede but at the moment all you have done is show us its Post match and after prelim year and that is different then participating in the match during the 4th year.

Also the pool of these people is very small.

Now I'm tired and I'm spending tomorrow studying.

Happy Holidays TKim and everyone else.

By the way TKim I'm glad your here, your debates are stimulating.

 

[oldpro]

ok man u made ur point...USMDs and DOs have every single type of advantage over Caribbean grads

LOL yea Caribbean School are a big no no and we suck for going to them.

 

[howelljolly]

Ok, thanks

The death on the surgery table analogy was pretty dramatic, it made it seem like some people after graduating from medical school would never find a residency.

Yep, it is dramatic. And that is the way I see it. I dont know about oldpro, but I completely dropped my previous career to study medicine. I "put all my eggs in one basket", if you want a less dramatic analogy.

And YES there are some people, who after graduating medical school, never find a residency.
There are a number of variables, such as the relative competetiveness of the field that the applicant is trying to match into, the contents CV of the applicant, and unstoppable TIME. The more distant the applicant is from having graduated, the harder it is to get a residency. Each subsequent attempt at getting a residency makes it that much more difficult to ultimately get one.

I dont know if its true or not, but Ive heard that an MD who doesnt get residency can still get a job as a claims analyst for a Health Insurance co. So that might be where they are... making the lives of MDs who land a residency totally miserable.

 

[tkim]

OK I understand but a Program director has said otherwise
I also know that students from an LCME school graduating must participate in the match because the programs who hire these LCME grads, US MD and DO grads coming out of Medical school can suffer sanctions if they do this, the reason is simple, if the programs hire these grads outside the match for PGY 1 then they will not have PGY 1 positions for the match.

This is a difficult sentence to parse. But here goes:

1) 4th year USMD students must participate in the Match in order to get a residency before graduation. If they graduate without matching or scrambling into a residency, then they are then considered independent applicants and can obtain a residency outside of the match.

2) Programs registered with, and who participate in, the Match, can prematch - or 'sign outside of the Match'. It happens all the time.

So the NRMP requires that these programs participating in the match to agree not to hire US MD and DO 4th year graduating students until the match.

4th USMD students, yes. DO students, no. As I've said before, 4th year DO students are considered independent applicants and can sign outside the match - just like IMGs/FMGs, and graduate USMDs.

For some reason you want us to believe that this system does not exist and US MD and DO students can do what ever they want.............wouldn't that be nice.

You really need to stop putting words in my mouth, or trying to misinterpret my statements.

I've clearly explained the NRMP Match system. I've gone through the Match. I know how the Match works.

I was considered an independent candidate during my Match season, and could have signed outside the Match if offered a contract without violating the the rules of the Match so long as I withdrew before the Rank Order List certifying deadline.

If you doubt the ability of DO's to sign outside of the Match, wander over to the Allopathic forum and ask if DO's can sign outside the Match. You'll get an earfull.

I'm really not trying to "Fight" but Debate the facts and question them.

As I said if I'm proven wrong then I will Concede but at the moment all you have done is show us its Post match and after prelim year and that is different then participating in the match during the 4th year.

Also the pool of these people is very small.

I'm looking for a little clarification here. What exactly are you trying to say?

 

[oldpro]

You really need to stop putting words in my mouth, or trying to misinterpret my statements.

Not trying to put words in your mouth, theres a difference between a Graduate registering with the NRMP and getting a Match and never registering with the NRMP and getting a match ( A job) and I think thats where we slipped in this long thread.

FMG's and IMG's do not ever, never, ever register with the NRMP. and still join a residency if hired.

As I understand it US grads must register
If a US graduate registers then how many do not match and have to go independent in a given year? US MD students keep saying they match 100%
NRMP says about 99% in a given year from what I have seen. So why Independent if you match? Sorry it's confusing?

I've clearly explained the NRMP Match system. I've gone through the Match. I know how the Match works.

I understand, but you have confused the issue IMHO
I have been an RN for 17 years but that does not make me an all around expert either.
Now a medical student 3rd year and still not an expert at all medical schools.

So being in the match may not make you an expert at all particulars also?

I was considered an independent candidate during my Match season, and could have signed outside the Match if offered a contract without violating the the rules of the Match so long as I withdrew before the Rank Order List certifying deadline.

May I ask why? You do not have to answer I'm just wondering?

If you doubt the ability of DO's to sign outside of the Match, wander over to the Allopathic forum and ask if DO's can sign outside the Match. You'll get an earfull.

I'll admit I do not know a whole heck of a lot about DO, just the main thing that they practice at the same level as MD and a few other things like OM

I'm looking for a little clarification here. What exactly are you trying to say?

It feels like we fight and I do not mean to, just keep debating the issues with what I understand and at times I feel like you did not understand my point
and maybe getting my loan money 2 weeks late made me OCD since Christmas was on hold this year ( it sucked) .

 

[NotAProgDirector]

FMG's and IMG's do not ever, never, ever register with the NRMP. and still join a residency if hired.

As I understand it US grads must register
If a US graduate registers then how many do not match and have to go independent in a given year? US MD students keep saying they match 100%
NRMP says about 99% in a given year from what I have seen. So why Independent if you match? Sorry it's confusing?

This first statement is not correct. IMG's register for the match all the time, and many actually match into their programs. Just above, I pointed out that 4000+ IMG's matched into a program via the NRMP.

The difference is that 4th year LCME students must stay inside the match.

Independent applicants (IMG's, DO's, and previous US grads) can register for the match but can sign an early contract and withdraw from the match anytime before ROL's are due.

US Grads (i.e. graduated from medical school already) because: 1) they are off cycle (pregnancy, LOA, etc); 2) They matched previously into a residency, and are now interested in switching fields and so enter the match again; 3) They matched only to a prelim program, and are now trying to find a categorical program; 4) They entered the military, and now need to complete a residency; 5) Any number of other reasons. There were 1700+ US Grads in the match last year, compared with 15,000+ US Seniors, so it happens not infrequently

 

[oldpro]

Yes you are right I ment to say FMG's and IMG's can/may/who never register with the match. My Bad!

But I thought TKim was a new Grad the last round of the Match and claims this independent status? So yea I'm confused then???

 

[tkim]

Not trying to put words in your mouth, theres a difference between a Graduate registering with the NRMP and getting a Match and never registering with the NRMP and getting a match ( A job) and I think thats where we slipped in this long thread.

FMG's and IMG's do not ever, never, ever register with the NRMP. and still join a residency if hired.

As I understand it US grads must register
If a US graduate registers then how many do not match and have to go independent in a given year? US MD students keep saying they match 100%
NRMP says about 99% in a given year from what I have seen. So why Independent if you match? Sorry it's confusing?

In an earlier post I mentioned a USMD grad who did not have go through the Match because he wanted to do a year of research before residency:

http://www.amsa.org/tnp/articles/article.cfx?id=186

In fact, Dr. Kenneth Iserson, author of Getting Into A Residency and a professor of emergency medicine at the University of Arizona, says as many as one-fifth of residency openings are filled outside of the NRMP process. And while it is unclear how many of these were filled through specialty matches or without a match program, he says that, for the assertive and well-informed applicant, there are positions available that allow you to steer clear of the NRMP. “I think there are a lot more people out there in the position to do it than actually take advantage of it,” he says. “I think most people don’t read that part of [the Match rules] and realize, ‘yes, it’s legal.’”

Dr. P. Travis Harker was able to take advantage of such an opportunity. Last August, the 2001 graduate of Ohio State University College of Medicine accepted a Dartmouth family practice and preventive medicine residency that begins this July at Concord Hospital in New Hampshire. While many of his classmates were trying to find their perfect residency during their senior year at medical school, Harker chose to wait and spend a year in a research fellowship at the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion. And while honing his health-policy skills, Harker heard about a couple of openings in Dartmouth’s new preventive medicine element of its residency program and decided to give the hospital a call. “It was just an opportunity that came along,” he says. “I feel pretty lucky they had a good program and that it was a pretty good fit for me.”

The future resident acknowledges there are risks involved with accepting a position before conducting extensive research of and interviewing with programs. In fact, Harker had taken the initial steps to enter the Match when suddenly the Dartmouth opportunity came along, and he took that position instead. He says it was the right decision for him. “It saved me a lot of money, because I didn’t have to fly around from place to place looking at something that might not be a good fit for me,” he says. “On the other hand, there may be [another residency program] out there that is better…. I won’t be able to find out.”

May I ask why? You do not have to answer I'm just wondering?

Why I didn't sign outside the Match? Because it's rare to get a prematch offer for EM. I haven't heard of anyone receiving an offer. I wasn't offered any. But if my top choice had offered one, I would have signed and withdrawn from the Match, and it would have perfectly within the rules to do so.

It feels like we fight and I do not mean to, just keep debating the issues with what I understand and at times I feel like you did not understand my point
and maybe getting my loan money 2 weeks late made me OCD since Christmas was on hold this year ( it sucked) .

You tend not to use the terminology that everyone else uses, or use it in the wrong context, which is why people are trying to correct you. You probably understand the IMG side of the Match pretty well, but don't know about the DO side. What I'm telling you is that we are all considered independent applicants by the residencies, and the only ones who *must* use the Match are 4th year USMD students. However, once they graduate, they are considered independent applicants as well.

 

[Leukocyte]

deleted.