Training for surgery in USA for foreign student

[Arwin Smithy]

Hi. I have live in Ireland all my life and I am going into an undergraduate medical degree in trinity university in Ireland. It lasts 5 years and I have just completed my leaving cert which is the equivalent of a high school diploma. I want to leave Ireland after I finish and pursue further training in the states to eventually become a surgeon. What do I need to do to get training in the USA as a foreign student and eventually be qualified to practice surgery there? I imagine its competitive but are your test scores the most important thing or should I be doing a lot to pad my c.v./ resume over the next five years. Any advice is appreciated thanks. Also if you have gone down a similar path I would love to know about you experience.

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[bashwell]

Hi. I have live in Ireland all my life and I am going into an undergraduate medical degree in trinity university in Ireland. It lasts 5 years and I have just completed my leaving cert which is the equivalent of a high school diploma. I want to leave Ireland after I finish and pursue further training in the states to eventually become a surgeon. What do I need to do to get training in the USA as a foreign student and eventually be qualified to practice surgery there? I imagine its competitive but are your test scores the most important thing or should I be doing a lot to pad my c.v./ resume over the next five years. Any advice is appreciated thanks. Also if you have gone down a similar path I would love to know about you experience.

1) I'm assuming you want general surgery, not a surgical subspecialty, because you didn't specify. Surgical subspecialties (e.g., plastic surgery, neurosurgery, orthopaedics, ENT, ophtho, urology, vascular) are more competitive for IMGs than general surgery. According to NRMP's Results and Data: 2017 Main Residency Match, US Seniors (US MDs) filled 78.5% of all general surgical (categorical) positions, 80% of all vascular surgery positions, 83.9& of all neurosurgery positions, 91.5% of all ENT positions, 91.9% of all orthopedic positions, 93.1% of all plastic surgery positions. I think ophtho and urology use the SF Match, not NRMP. Also, both DOs and US-IMGs (both of whom have US citizenship or a green card, which is a big advantage) would be competing with IMGs for the remaining positions US Seniors (US MDs) didn't fill. And with the increased number of US medical schools opening, and increased number of US MDs and DOs graduating each year, while residency positions are not proportionately increasing, the percentages of US Seniors matching into each of these will most likely only increase as well. This will increasingly shut out US-IMGs and IMGs.

2) Do well in med school. Top your class if at all possible.

3) Score very well on the USMLE Step 1 and Step 2CK. The higher the better. Aim for a minimum of 250+ on each. According to NRMP's Charting Outcomes for the IMG (2016), the mean USMLE score for IMGs who matched to general surgery for Step 1 was 242 and Step 2CK was 245. That number will likely be higher in 5 years.

4) Research. Posters, abstracts, papers, etc. Publish as much surgery related research as you can.

5) Get plenty of US clinical experience. As much as possible. For example, US-IMGs from the Caribbean will have 2 years of US clinical experience, but your med school probably won't allow you to do so many months of electives. Aim for 1 year if at all possible.

6) Get strong letters of reference (LORs) from American attending surgeons on faculty. Aim for the chief of surgery, program director, associate program director, assistant program director, and other faculty who would be in a position to help you match into a surgical residency.

7) If possible, be in a position where you don't need to be sponsored for a visa, because many programs will not sponsor a visa, which effectively shuts you out of applying to these programs. If possible, get US citizenship.

Good luck!

Edit: This is from NRMP's Charting Outcomes for the IMG (2016) for general surgery:

 

[Arwin Smithy]

Do you enter a residency immediately after graduating from your medical degree for general as well as subspecialty surgery?
As in you can enter a residency either way but a subspecialty residency is just a lot harder to get into for IMG's?

 

[LyMed]

If you match, yes, it's right after graduation.

 

[sinombre]

Do you enter a residency immediately after graduating from your medical degree for general as well as subspecialty surgery?
As in you can enter a residency either way but a subspecialty residency is just a lot harder to get into for IMG's?

Some of them, yes. Others are fellowships (further training) you complete after residency. And other subspecialties you can get to via either route.

Examples of subspecialties you have to do a residency in: urology, ophthalmology, ENT, ortho
Examples of subspecialties with fellowships completed after a general surgery residency: transplant surgery, surgical oncology, cardiothoracic surgery, plastic surgery, vascular surgery
Examples of subspecialties available by either an 'integrated' residency (where you complete a residency in that subspecialty and not general surgery) or a fellowship which you complete after a general surgery residency: plastic surgery, vascular surgery, cardiothoracic surgery

Some of the general surgery subspecialties are changing from a fellowship model to an integrated residency model. A good example is plastics, where there are fewer and fewer fellowship positions every year. There will always be plenty of general surgery subspecialty options via fellowship, but the landscape is changing and will likely look different in 10 years.

You aren't guaranteed a residency program by the way, it's a separate competitive application process, similar to getting in to med school. General surgery is moderately competitive whereas the subspecialty residencies are very competitive. This is exaggerated for IMGs. To get a ball park idea, look at the IMG general surgery interview thread in the surgery forum from last year. It is possible for IMGs to match into surgical specialties, but they pretty much have to be cream of the crop and/or have solid connections.

 

[bashwell]

Do you enter a residency immediately after graduating from your medical degree for general as well as subspecialty surgery?
As in you can enter a residency either way but a subspecialty residency is just a lot harder to get into for IMG's?

In the US, yes, once you finish med school, you immediately enter into a residency for a specialty (unless you failed to match or are taking time off for some reason). This includes general surgery and all the surgical subspecialties. It's not like the UK (not sure about Ireland but I assume it's similar to the UK) where you do two years in the Foundation Programme, work on your CV, sit entrance exams for the Royal College of Surgeons, hoping to become a surgical registrar. Rather, you go directly and immediately from medical school to residency in general surgery, orthopaedics, ENT, ophtho, urology, etc. There are a couple of exceptions (e.g., you can also do a plastic surgery fellowship and a vascular fellowship after general surgery), but I'm just speaking in general.

Also, general surgery is probably the "easiest" of the surgical specialties and subspecialties for an IMG to enter. As I noted in my previous reply, 78.5% of the general surgery positions are filled by US MDs. For comparison, the easiest overall specialty for IMGs to enter is probably pathology where US MDs filled 35.9% of the positions. So 78.5% is "low" only relative to other surgical specialties and subspecialties, but it's still quite difficult for an IMG. But as I also mentioned in my earlier reply, this 78.5% figure is likely to go up in the future. Probably past 80%, 85% even. So it's getting more difficult each year, and who knows what it will look like in 5 years when you're applying.

 

[Arwin Smithy]

OK thanks that's all great info. I noticed your a resident in Australia. Is the process to become a surgeon there similar to the united states? I don't really mind moving to any country(I know a lot of places are really competitive) as long as the training is good and I can get universally recognised qualifications.

 

[bashwell]

OK thanks that's all great info. I noticed your a resident in Australia. Is the process to become a surgeon there similar to the united states? I don't really mind moving to any country(I know a lot of places are really competitive) as long as the training is good and I can get universally recognised qualifications.

I'm American and Australian (dual citizenships/passports), spent some time in the US, but I'm a resident in Australia now. In future I may try to move back to the States, but I'm not entirely sure. I do love Australia. It's a beautiful country with fantastic people. But I have family in USA too.

The Australian healthcare system is a mix between public and private. Of course, there are problems with Australia's healthcare system like any other healthcare system in the world, but my understanding is it's currently much more stable than USA and UK. There are heaps of British and Irish physicians in Australia (and New Zealand). I have several friends and many more acquaintances who are from UK and Ireland. I often meet new British and Irish physicians as well. From what they tell me (granted, they may be biased), the NHS is doing very poorly, such as with the doctors strikes, heaps of junior physicians leaving and so on. Unfortunately they tell me things are quite bleak for the NHS.

Most of the physicians I know have come over to Australia after completing their intern year in UK. I'm not entirely sure how it works for them, but I assume Australia is much easier for a physician from UK or Ireland to enter than America because the medical training and healthcare systems are much more similar within the Commonwealth. That said I do know the Australian government is attempting to limit entry in future because it means there will be less spots for local Australians whilst at the same time more medical schools graduating more medical students have opened in Australia over the last several years. So I'm not entirely sure what the situation will be in 5 years' time when you finish.

I believe the process to become a surgeon in Australia is quite similar to UK. I'm in Sydney. After medical school, we do two years similar to the Foundation Programme (PGY1-2). PGY3 or thereabouts we attempt to apply to become a registrar. Surgery is extremely competitive, but the training is excellent in most hospitals in Sydney, Melbourne and other capital cities in Australia. Candidates try to improve their CV such as by taking various courses (the EMST/ATLS course is a must), publishing research, attending conferences and networking, doing a masters degree, sometimes even a PhD, doing unaccredited years. We sit entrance exams to the college, but I believe we are only allowed to apply 3x to the college and that's it. If one fails to become a surgical registrar after 3 attempts, then they can no longer apply, I think.

In general priority for jobs is given to Australian permanent residents and citizens, so perhaps this is a similar issue to USA and needing visa sponsorship. But overall it's probably not as difficult entering Australia (vs USA) for you if you're coming from Ireland, I would think.

I should say most the junior physicians from UK and Ireland that I know in Australia are in less competitive specialties than surgery (e.g., GP, emergency medicine, ICU). There are some surgeons from UK and Ireland, but to my knowledge I think most or perhaps all of them are already consultants in UK or Ireland. I think they must've come to Australia not as junior physicians, but after already completing their training and passing their exams.

 

[Domperidone]

Bashwell, where exactly are you in your training in Australia?

The royal college of surgery's first requirement is that you be an Australian citizen or permanent resident. it is not merely a preference.
Selection | Royal Australasian College of Surgeons.

Full details on selection criteria is here: Selection Requirements and SET Application | Royal Australasian College of Surgeons. It's based on a points system.
Or for general surgery, even more detail down to what should be in your CV, is here:
https://www.generalsurgeons.com.au/media/files/Education and Training/Selection/GDE 2016-11-15 Final.pdf

The anatomy exam is a minimum requirement too. the course in order to take it is optional, but highly recommended. a whopping 20k (but tax deductible).

But yes, very generally, getting into RACS is similar to Ireland.

nowadays most have to do a couple of surgical oriented resident or house officer years, followed by unaccredited registrar years (also hard to get - based on networks and connections). Before you finally be competitive enough to apply. Many are PGY5-6 at least before they get into general surgery as a registrar officially. It is perhaps more competitive and highly prized to get into than in the US. If you're feeling inpatient or in a rush, Australia is not for you.

Sure, the Australian government is limiting spots. It's very easy, they just have to limit how many junior doctors get PR or make it more challenging to do so. They've already done that by the way.

You can come to Australia, but expect to rotate a number of years as house officer before you can even make it to the point of application for registrar training. It's a war of attrition.

 

[bashwell]

Bashwell, where exactly are you in your training in Australia?

The royal college of surgery's first requirement is that you be an Australian citizen or permanent resident. it is not merely a preference.
Selection | Royal Australasian College of Surgeons.

Full details on selection criteria is here: Selection Requirements and SET Application | Royal Australasian College of Surgeons. It's based on a points system.
Or for general surgery, even more detail down to what should be in your CV, is here:
https://www.generalsurgeons.com.au/media/files/Education and Training/Selection/GDE 2016-11-15 Final.pdf

The anatomy exam is a minimum requirement too. the course in order to take it is optional, but highly recommended. a whopping 20k (but tax deductible).

But yes, very generally, getting into RACS is similar to Ireland.

nowadays most have to do a couple of surgical oriented resident or house officer years, followed by unaccredited registrar years (also hard to get - based on networks and connections). Before you finally be competitive enough to apply. Many are PGY5-6 at least before they get into general surgery as a registrar officially. It is perhaps more competitive and highly prized to get into than in the US. If you're feeling inpatient or in a rush, Australia is not for you.

Sure, the Australian government is limiting spots. It's very easy, they just have to limit how many junior doctors get PR or make it more challenging to do so. They've already done that by the way.

You can come to Australia, but expect to rotate a number of years as house officer before you can even make it to the point of application for registrar training. It's a war of attrition.

Helpful additional info. I agree. However it sounds like you're casting some doubt over what I've said? If so, I don't think what I've said is inconsistent with what you've said. I think they both fit or work together. Did what I say or my choice of words make it seem like surgery in Australia is easy? Not my intention if so. I did also say it was "extremely competitive" in Australia and that most or all the British surgeons in Australia I know of or can think of were, I am fairly certain, already consultants before they came to Australia. As well, I too mentioned people (including Australians) having to do unaccredited years, postgrad degrees (even PhDs) etc before getting on. And I noted that most the British and Irish IMGs I know and know of are in far less competitive specialties (I mentioned GP, EM, ICU).

Granted, I've never been interested in surgery so never looked into it personally in any great detail. I'm definitely more on the "medical" side. I'm not sure how to compare directly between the competitiveness of applying to surgery in Australia vs USA as an IMG, but regardless as I've said both are extremely competitive for an IMG.

Although as I also said, I would think it's probably "easier" for an IMG from Ireland to come to Australia than the States. I'm not referring to becoming a surgical registrar, but a junior doctor (intern/resident jobs) in Australia vs a surgical resident in America (both aren't directly comparable, as I said above, it'd probably be better to compare attempting to become a surgical resident in the US vs surgical registrar in Australia, but even these aren't perfectly directly comparable). Anyway, as I said, I assume it's "easier" to become a junior physician in Australia relatively speaking, not absolutely speaking since it's still quite difficult, because Ireland and Australia seem more similar in medical training and healthcare systems to one another than either to the States so presumably there's some greater degree of shared knowledge and experience. Anecdotally, I've also met a number of British and Irish junior physicians here in Sydney and they tell me much the same. At the least they didn't have to bother with sitting the very difficult USMLEs and trying to gain the kind of hands on USCE and LORs that IMGs to US residencies have to do. For them, the biggest issues seemed to be visa related. I'm a citizen so never had to worry, but to my knowledge an IMG would be near the very bottom when applying for intern or RMO jobs based on each state's priority list, but not necessarily shut out completely, unless circumstances have changed.

But again, I think we're both in agreement, not disagreement, in what we've said in general.

 

[Domperidone]

It's more that I'm curious.
you tend to more precise (pointing out official info published on NRMP or ERAS etc. etc) when it comes to discussing American requirements (even though you've neither done rotations nor worked in the US) but with Australian ones you're choosing to go by assumption or anecdotal information. you can do that, it's the internet.

But it's also not really the full picture. It's also misleading if you're saying, priority goes to PR or citizens - but actually not just priority it's official selection (or 'exclusion') criteria. I'm not trying to cast doubt, but I'm going to call you out on things if you're not being fully accurate with people who are seeking advice. It's a life that your words may affect - to what extent who knows. I get that it's not yours, lucky you, you're a citizen etc etc. At least try to be precise out of respect to OP or other posters who may take your advice to heart (i.e. where in your posts have you mentioned RACS? - I'd have nothing add if you had). Maybe it doesn't affect you personally as you're not interested in Surgery anyway. (are you now going to assume that I'm somehow a surgical trainee or am interested in it? I mean, how do you know I'm not a trainee on some other program? It's that I choose to use official info and be as precise and accurate as I possibly can)

Again, yes, BPT is far easier to get into, but that exam at BPT3 is extraordinarily hard. Do you actually know the requirements? Have you actually looked or tried applying? (again, I can link all the official info and anecdotal info if that is what OP was seeking, but they're not, so I'm going to stop here on BPT).

invariably when people ask about surgical training in Australia, they want to know how to get into a training program, not endlessly rotate as a house officer.

Where are you in training? are you an intern? still in med school?

 

[bashwell]

It's more that I'm curious.
you tend to more precise (pointing out official info published on NRMP or ERAS etc. etc) when it comes to discussing American requirements (even though you've neither done rotations nor worked in the US) but with Australian ones you're choosing to go by assumption or anecdotal information. you can do that, it's the internet.

But it's also not really the full picture. It's also misleading if you're saying, priority goes to PR or citizens - but actually not just priority it's official selection (or 'exclusion') criteria. I'm not trying to cast doubt, but I'm going to call you out on things if you're not being fully accurate with people who are seeking advice. It's a life that your words may affect - to what extent who knows. I get that it's not yours, lucky you, you're a citizen etc etc. At least try to be precise out of respect to OP or other posters who may take your advice to heart (i.e. where in your posts have you mentioned RACS? - I'd have nothing add if you had). Maybe it doesn't affect you personally as you're not interested in Surgery anyway. (are you now going to assume that I'm somehow a surgical trainee or am interested in it? I mean, how do you know I'm not a trainee on some other program? It's that I choose to use official info and be as precise and accurate as I possibly can)

Again, yes, BPT is far easier to get into, but that exam at BPT3 is extraordinarily hard. Do you actually know the requirements? Have you actually looked or tried applying? (again, I can link all the official info and anecdotal info if that is what OP was seeking, but they're not, so I'm going to stop here on BPT).

invariably when people ask about surgical training in Australia, they want to know how to get into a training program, not endlessly rotate as a house officer.

Where are you in training? are you an intern? still in med school?

1) Here I thought I was being quite polite and civil with you. But what you've said to me is insulting to me (in a passive-aggressive way). It's hardly worth responding to. You're trying to find a problem where there isn't one. You're trying to make me out to be a dodgy person when I'm just trying to help. For example, you say things like, "At least try to be precise out of respect to OP or other posters . . . " As if I wasn't trying to be "respectful"? Really? Is that where you want to take this? Personal attacks now? But even if it's true I'm "imprecise" or (unintentionally) "misleading" in your view, then maybe there are other explanations for my alleged imprecision or "misleading" besides I'm not trying to "respect to OP or other posters"?

2) What's with all the **ck waving with where I am in my training? Why don't you tell me where you are in your training? It goes both ways, you know. Are you a med student? Intern/resident? Registrar? Consultant? Tell me now! Yes this was sarcasm, don't really tell me where you are in your training, because I don't actually care, because where someone is in their training isn't the primary issue. It's a secondary issue at most. The primary issue is whether what's been said is accurate or not. Don't get sidetracked by arguments from authority which aren't of primary relevance here. Especially since I took pains to clarify what I know and don't know (e.g., "to my knowledge an IMG would be near the very bottom when applying for intern or RMO jobs based on each state's priority list, but not necessarily shut out completely, unless circumstances have changed").

3) Also, for the sake of argument, let us say it's true one person (like me) gives "imprecise" or even completely mistaken advice. If that happens, then another person (like you) could simply correct it! This is an open forum where anyone with an account can comment after all. Just correct what I've said without turning things into a series of personal attacks, questioning personal backgrounds, motives and other things.

4) And if you want to turn this into a personal attack, hidden motives, arguments from authority etc, then why don't you tell people it's been your agenda for a while now to warn virtually everyone you can about coming to Australia? All the dangers about horrible Australia! Don't come here! Everything is so hard! Etc, etc, etc. But while you're at it, why don't you tell people "out of respect" for them that you're a Canadian who came to Australia for med school as well? Surely your being a Canadian who came to Australia for med school influences your views about Australia too! Personally, I don't care that you have negative opinions about Australia, and I agree with a lot of your negative opinions, but my main point is I don't question your background as a Canadian etc every single time you mention something negative about Australia, its medical education, its healthcare system and other things about Australia (even though it is obviously true a person's background influences their answers in almost any situation). And I don't expect others to question your background every single time either.

5) You can have the last word. It's ridiculous that I'm wasting so much of my time responding to a reply with passive-aggressive personal attacks from you, questioning motives etc.

 

[Domperidone]

Sigh.
If you're that concerned, feel free to add me to your ignore list or report me. Either is fine. I have nothing to lose or gain on a public, anonymous forum.

Again, there's no malice on my part. Only that of concern.
You're very precise about American requirements, but not about Australian ones - I'll say it again, nothing wrong with anecdotal evidence but merely - if you take the trouble to provide links and stat on American things, can you consider applying the same to Australian topics? Then again, if you don't wish to, then don't. take it as a suggestion not an imposition.

However, if you're a student or intern, I question the level of experience you would have on advising someone about postgraduate training above your level - if it is going to be based on anecdotal experience alone. that was my rationale for asking your level of training. nothing inherently wrong either, as you would still know more than an IMG who has never been to Australia. but anyway.

For personal reasons, I'm not going to disclose publicly what my level is. I'll PM you if you're genuinely interested. I'm proud of my accomplishments and have nothing to hide, that said, I don't wish to be doxxed given how stringents the laws are surrounding social media and students/residents/trainees. If you're asking in order to have a go at me because you're angry at my post, I'm probably less keen to share. So, feel free to ask again if you wish - but tell me if you're being earnest and actually interested, or just angry.

Finally, I've always fully disclosed my origins to the degree that I'm comfortable about my background when offering information and advising with regards to approaching Australia. The reason I do so is not for my benefit, but to those I wish to give advice to - students and premed. I've never suggested that I'm Australian. You have a tendency to leave this out - and as we've touch on before, there's nothing wrong with being a domestic Australian giving advice to international students or IMGs. to the contrary, it's wonderful.

However, as you've consistently reminded me time and again, you don't have issues that IMGs or international students have (nothing innately wrong in this - don't get me wrong). But what I'm saying is that to no fault of your own - you end up overlooking the vulnerabilities that students who start at a 'disadvantage' face. relative term, but they start their careers as IMGs to their home countries and 'international students' to Australia. Try to place yourself in their shoes - i.e. if you had to attend say the medical school of oceania in Samoa (where there are Australians - who are and will be IMGs to Australia) and faced being in a priority group behind the entire country.

And I've always, always been clear about my motives. That's never been hidden. If you don't like it, put me on ignore. Traditionally, there's an overwhelming emphasis on the positive sides to the Australian education for an international student, without sufficient information given about the pitfalls. The main aim I'd had to joining SDN is ensuring that students approach going offshore 'armed' with the knowledge that while they will have an opportunity to become doctors, it may not turn out entirely as they had dreamed. They have to be comfortable with the idea of working rural or being family doctors - as a possibility. Nothing wrong with these careers - both are highly respected, and high in demand. but a good chunk of students will not have aspired to be either of these things. Should they wish to return home, they have to be comfortable with being more than self-sufficient and independent in their preparations - there's no way to rely on an off shore school to do this for them.

While I've succeeded in my path and have no regrets, it's not to say I haven't seen failures and heart break of classmates and close friends. It breaks my heart still. I can't undo someone's past for them. For some, potentially they shouldn't have embarked on their journeys, but what can you really say to them after the fact? I'd also spent a good chunk of time working as a student rep had to face a lot of the disillusionment in much of the student population. It's not to say all of them to be sure, but it's not like student council receives endless praise from students for the medical education system they're a part of.

If I'm harsh, it's because I do question the moral or ethics to which medical education has become a business. there's no personal gains for me to being on SDN. it's anonymous. I succeeded in what I had intended when I attended an Australian school. More than I had ever thought possible. So, there's no vendetta I have for the Australian system. But it doesn't erase the concerns I have for the thousands of premeds and current students of all backgrounds - North American, Malaysian, Sri Lankan, Singaporean etc. what futures will they have? what will prepare them for that? It's getting harder not easier. If I didn't care what becomes of them, I wouldn't be here. Actually, would be a waste of my time, given all the things I should be doing.

If I come across as sounding extremely harsh. My apologies, it wasn't ever the intent. My tone will go up and down according to how many hours I've worked. If I come off 7 nights in a row, 16 hrs each, i'm not exactly going to come off as sounding joyous. It's not excuse, and maintaining composure on the internet is something I'm still learning.

 

[bashwell]

Sigh.
If you're that concerned, feel free to add me to your ignore list or report me. Either is fine. I have nothing to lose or gain on a public, anonymous forum.

Again, there's no malice on my part. Only that of concern.
You're very precise about American requirements, but not about Australian ones - I'll say it again, nothing wrong with anecdotal evidence but merely - if you take the trouble to provide links and stat on American things, can you consider applying the same to Australian topics? Then again, if you don't wish to, then don't. take it a suggestion not imposition.

However, if you're a student or intern, I question the level of experience you would have on advising someone about postgraduate training about your level - if it is going to be based on anecdotal experience alone. that was my rationale for asking your level of training.

For personal things, I'm not going to disclose publicly. I'll PM you if you're genuinely interested. I'm proud of my accomplishments and have nothing to hide, that said, I don't wish to be doxxed given how stringents the laws are surrounding social media and students/residents/trainees. If you're asking in order to have a go at me because you're angry at my post, I'm probably less keen to share. So, feel free to ask again if you wish - but tell me if you're earnest and actually interested, or just angry.

Finally, I've always fully disclosed my origins to the degree that I'm comfortable about my background when offering information and advising with regards to approaching Australia. The reason I do so is not for my benefit, but to those I wish to give advice to - students and premed. I've never suggested that I'm Australian. You have a tendency to leave this out - and as we've touch on before, there's nothing wrong with being a domestic Australian giving advice to international students or IMGs. to the contrary, it's wonderful.

However, as you've consistently reminded me time and again, you don't have issues that IMGs or international students have (nothing innately wrong in this - don't get me wrong). But what I'm saying is that to no fault of your own - you end up overlooking the vulnerability that students who start at a 'disadvantage' face. relative term, but they start their careers as IMGs to their home countries and 'international students' to Australia. Try to place yourself in their shoes - i.e. if you had to attend say the medical school of oceania (where there are Australians - who are and will be IMGs to Australia) and faced being in a priority group behind the entire country.

And I've always, always been clear about my motives. That's never been hidden. If you don't like it, put me on ignore. Traditionally, there's an overwhelming emphasis on the positive sides to the Australian education for an international student, without sufficient information given about the pitfalls. The main aim I'd had to joining SDN is ensuring that students approach going offshore 'armed' with the knowledge that while they will have an opportunity to become doctors, it may not turn out entirely as they had dreamed. They have to be comfortable with the idea of working rural or being family doctors. Nothing wrong with these careers - both are highly respected, and high in demand. but a good chunk of students will not have aspired to be either of these things.

While I've succeeded in my path and have no regrets, it's not to say I haven't seen failures and heart break of classmates and close friends. It breaks my heart still. I can't undo someone's past for them. For some, potentially they shouldn't have embarked on their journeys, but what can you really say? I'd also spent a good chunk of time working as a student rep had to face a lot of the disillusionment in much of the student population. It's not to say all to be sure, but it's not like student council receives endless praise from students for the medical education system they're a part of.

If I'm harsh, it's because I do question the moral or ethics to which medical education has become a business.

If I come across as sounding extremely harsh. My apologies, it wasn't ever the intent. My tone will go up and down according to how many hours I've worked. If I come off 7 nights in a row, 16 hrs each, i'm not exactly going to come off as sounding joyous. It's not excuse, and maintaining composure on the internet is something I'm still learning.

1) This was a more pleasant reply, and I happily and gratefully accept your apologies. No ill will on my part either. We all work long hours and I'm sure it's happened to me as well. We've all been there.

2) Sure, please PM me any personal information you'd like to share in private rather than public.

3) I say this honestly and respectfully but I didn't expect to have to provide supporting links for nearly every statement I make. What I write on SDN isn't an RCT published in an academic journal. It's an unusually high standard and most people posting on SDN would likely fall short if that's the standard you're applying to everyone. In point of fact, I say this respectfully, but you haven't provided links to nearly every statement you've said here either, only some of the statements you've made (same with me). However I don't think that's as big of a problem as it sounds like you think it is. That's because, even at worst, most of what you and I have said, anyone can simply Google or research on their own if they are in serious doubt. We aren't here to spoon-feed everyone everything (and I doubt we would be able to spoon-feed everyone even if we wanted). Regardless I believe that's a piece of the puzzle you're likely missing -- most people reading these forums are pre-medical students, medical students, physicians-in-training or physicians, all of whom are intelligent and clever enough to "fact check" what's been said if they are in doubt, but respectfully again, you act as if people reading this are going to take every single word we say as "gospel truth" and bet their lives on everything we said. I don't think that's the case and I trust most people reading this are intelligent enough to know not to base life-changing decisions solely on what other people on the internet say. Of course, I agree we ought to try our best to provide accurate information, and I believe that's what I've done, but no-one is perfect in everything. And again that's my point -- if any of us have fallen short, or not provided resources when we should have, then others like you can simply correct what's been said, provide links or other resources if you think that's relevant or necessary, then move on without getting personal about things. That's all I wanted to say really. Cheers and all the best.

 

[Domperidone]

1) This was a more pleasant reply, and I happily and gratefully accept your apologies. No ill will on my part either. We all work long hours and I'm sure it's happened to me as well. We've all been there.

2) Sure, please PM me any personal information you'd like to share in private rather than public.

3) I say this honestly and respectfully but I didn't expect to have to provide supporting links for nearly every statement I make. What I write on SDN isn't an RCT published in an academic journal. It's an unusually high standard and most people posting on SDN would likely fall short if that's the standard you're applying to everyone. In point of fact, I say this respectfully, but you haven't provided links to nearly every statement you've said here either, only some of the statements you've made (same with me). However I don't think that's as big of a problem as it sounds like you think it is. That's because, even at worst, most of what you and I have said, anyone can simply Google or research on their own if they are in serious doubt. We aren't here to spoon-feed everyone everything (and I doubt we would be able to spoon-feed everyone even if we wanted). Regardless I believe that's a piece of the puzzle you're likely missing -- most people reading these forums are pre-medical students, medical students, physicians-in-training or physicians, all of whom are intelligent and clever enough to "fact check" what's been said if they are in doubt, but respectfully again, you act as if people reading this are going to take every single word we say as "gospel truth" and bet their lives on everything we said. I don't think that's the case and I trust most people reading this are intelligent enough to know not to base life-changing decisions solely on what other people on the internet say. Of course, I agree we ought to try our best to provide accurate information, and I believe that's what I've done, but no-one is perfect in everything. And again that's my point -- if any of us have fallen short, or not provided resources when we should have, then others like you can simply correct what's been said, provide links or other resources if you think that's relevant or necessary, then move on without getting personal about things. That's all I wanted to say really. Cheers and all the best.

Cheers.
If I come down hard, just remember it's from a place of worry and concern. It's not personal, not towards you. I don't worry about domestic Australians, not to the extent i worry for the vulnerability of premeds from offshore.

It is clouded by experience, not necessarily personal. It's again, hard and frustrating to watch (mostly) young 20 somethings pour their lives and 300k+ into something that may not turn out the way they wanted it to.

There's a degree of naivete and tunnel vision when it comes to dreams. If I act as though it could be taken as gospel, it's because that's literally what I've known pre-med students to have done that arrive in Australia as medical students. Part of the onus of joining SDN (as a grad, I would never have done this as a student - greater fear of repercussions) is because I'd grown tired of medical students saying why hadn't anyone told them of X, or Y or Z. Why wasn't this information on forums they'd gleaned before heading over. they took at face value what anecdotal things randoms online, randoms in life (one random grad working in wyoming doesn't count as spectacular resource taken alone), or what their school said or whatever recruitment agency said, without considering the source. It's ironic considering most off shore premeds have undergraduate degrees. i'm not the first to make that observation. It's equally depressing to me that the schools and their recruitment agencies don't want to take any responsibility. It's always left to someone else, the medical student organizations, the alumni. (Obviously, these opinions are my own)

Frankly, many premeds want the dream, they don't want to research it further. Not when it's so easy. they want it now. I'd consider it lucky, when there are even premeds reading forums before they go to the carribbean, Australia, Ireland, etc. Worse, is that some believe that if they ask their local governments, medical schools, doctors or hospitals if it's a good idea to go offshore, if it's a negative take, they discredit the advice as a stigma. prejudice. others, will never even make that effort. It's easier to just take the acceptance, and not face what may be hard to bear emotionally.

 

[bashwell]

Cheers.
If I come down hard, just remember it's from a place of worry and concern. It's not personal, not towards you. I don't worry about domestic Australians, not to the extent i worry for the vulnerability of premeds from offshore.

It is clouded by experience, not necessarily personal. It's again, hard and frustrating to watch (mostly) young 20 somethings pour their lives and 300k+ into something that may not turn out the way they wanted it to.

There's a degree of naivete and tunnel vision when it comes to dreams. If I act as though it could be taken as gospel, it's because that's literally what I've known pre-med students to have done that arrive in Australia as medical students. Part of the onus of joining SDN (as a grad, I would never have done this as a student - greater fear of repercussions) is because I'd grown tired of medical students saying why hadn't anyone told them of X, or Y or Z. Why wasn't this information on forums they'd gleaned before heading over. they took at face value what anecdotal things randoms online, randoms in life (one random grad working in wyoming doesn't count as spectacular resource taken alone), or what their school said or whatever recruitment agency said, without considering the source. It's ironic considering most off shore premeds have undergraduate degrees. i'm not the first to make that observation. It's equally depressing to me that the schools and their recruitment agencies don't want to take any responsibility. It's always left to someone else, the medical student organizations, the alumni. (Obviously, these opinions are my own)

Frankly, many premeds want the dream, they don't want to research it further. Not when it's so easy. they want it now. I'd consider it lucky, when there are even premeds reading forums before they go to the carribbean, Australia, Ireland, etc. Worse, is that some believe that if they ask their local governments, medical schools, doctors or hospitals if it's a good idea to go offshore, if it's a negative take, they discredit the advice as a stigma. prejudice. others, will never even make that effort. It's easier to just take the acceptance, and not face what may be hard to bear emotionally.

Fair enough, agree with you here Domperidone. And i want the same for others as well and I appreciate you contributing your knowledge and experiences here as well. At the end of the day, I think our goals are very much the same, as we both want to help provide accurate and helpful information to others. All the best to you, Domperidone.