high schooler to a foreign med school

Pre-Med & Medical School Pre-Med Topics
41

<p>Hey i am an 19 year old student in my second semester of Med School in Germany.</p>

<p>I went to an all American Highschool, and got a regular High-School education. My family is from Germany, due to my dads job we lived in the US for several years (6).</p>

<p>If you want to ask anything go ahead and email me...</p>

<p><a href="mailto:ralphschwiebert@hotmail.com">ralphschwiebert@hotmail.com</a></p>

<p>...because i can't promise ill remember to look back into this thread :D.</p>

<p>Ultimatly my advice would be to stay in the US if you want to keep living and practicing in the US later on. Don't worry so much about MCAT and USML and whatnot. </p>

<p>If you study, you will do well - its that simple. You aren't just a number, there is always a way.</p>

42

<p>a random question..
can a foreign med school student come to US to take USMLE step 3, when the person has not even taken steps 1 and 2?</p>

43

<p>Doesn't appear so: <a href="http://www.usmle.org/applicationmaterials/default.htm%5B/url%5D"&gt;http://www.usmle.org/applicationmaterials/default.htm&lt;/a&gt;&lt;/p>

<p>Says for step 3 you have to have passed the first two steps.</p>

<p>But I think that not all states require step 3 as part of the licensing process.</p>

<p>It appears that US citizens who studied in foreign medical schools are eligible for step 3 ONLY if they did their undergraduate work at a US institution. But they have to do a year of the "Fifth Pathway" program. <a href="http://www.usmle.org/bulletin/2006/eligibility.htm%5B/url%5D"&gt;http://www.usmle.org/bulletin/2006/eligibility.htm&lt;/a&gt;&lt;/p>

44

<p>Undergrad meaning medical school, not your bachelor's work, I assume? (The ambiguity in that term always confuses me.)</p>

45

<p>no, undergrad = bachelors</p>

<p>As I've seen most things, the breakdown typically continues as the following:</p>

<p>medical education = med school</p>

<p>post grad year = graduate medical education =residency and fellowships</p>

46

<p>Huh. That strikes me as kind of a strange requirement. But when BRM's right, he's right.</p>

47

<p>this board seems a bit pessimistic for overseas people. I am pakistani-american and the general pakistani community around where i live is like 70-85 percent doctor and very high professions. I am not kidding with u they are in prestigious fields such as cardiologists, neurologists, dermatologists, etc. Of course, naturally these people worked really hard back home, but saying that good professions are cut off for overseas people is absurd. Have you gone to your hospital and talked to the india-pak doctors there? usually they are in quite a prestigious field. So obviously it is anything but impossible.</p>

48

<p>Mak, obviously nobody is arguing that people FROM Pakistan can't get into good professions.</p>

<p>The question is, do people FROM the US who go overseas for medical school still have all their options open? The answer is no.</p>

49

<p>I think that the recent trends have done a lot to make it more difficult for these IMG's to come to the US in recent years - particularly the Step 2 Clinical Skills portion of the USMLE's that was introduced in 2004. </p>

<p>But the trends from The Match show there is a definite skew against IMG's for residency programs. The data below is from the 2002 Match as published in The Ultimate Guide to Choosing a Medical Specialty by Brian Freeman MD</p>

<p>US seniors = students applying from one of the 125 allopathic medical schools in the United States</p>

<p>Also keep in mind this is pre Step 2 CS requirement. That may have altered these trends some b/c no residency program wants to use people who are at risk for not passing boards.</p>

<p>Finally, the calculations may be slightly off due to rounding errors (my calculations and those from the book) Anything in parenthesis besides the US senior component of applicants is a calculation I performed.</p>

<p>Anesthesiology:</p>

<p>1169 positions
1588 applicants (992 were US seniors - remaining were "independent" applicants with no breakdown of IMG or DO candidates) "applicants mean they ranked at least one program in this specialty, but doesn't announce where this specialty was ranked - could have been 10th or lower
95.2% of positions filled during initial match (1112)
Sucessfully matched applicants: 81.8% US Seniors (910 students), 13.1% IMG students (146 students) 4% Osteopathic Grads (DO)</p>

<p>Dermatology:
545 applicants (347 US Seniors)
275 positions
100% of all positions filled in initial Match
Successful Applicants 91.9% US seniors (253) 4% IMG (11) 4% DO (11)</p>

<p>Emergency Medicine:
1564 applicants (992 US seniors)
1211 positions
98% of all positions filled on Initial Match (1187 filled)
Successful applicants 87.5% US Seniors (1039) 4.5% IMG (53) 7.5% DO (89) </p>

<p>Family Practice:
3761 applicants (1533 US seniors)
2962 positions
79.1% of positions filled on initial Match (2343 positions)
Successful Applicants: 59.7% US Seniors (1399), 25.4% IMG (595) 11.1% DO (260)</p>

<p>General Surgery
2250 applicants (1350 US seniors)
2019 positions (1039 Categorical and 980 prelim)
94.4% of all positions filled in Initial Match (1906 spots)
Successful applicants: 79.7% US Seniors (1519), 12.6% IMG (240), 3% DO (57)</p>

<p>Internal Medicine:
9551 applications (5146 US seniors)
6297 positions (4622 categorical and 1675 prelim)
94.3% filled on initial match (5938)
Successful applicants: 62.3% US Seniors (3700), 29.4% IMG (1746), 5.6% DO (333)
% of US seniors unmatched who only ranked Internal Medicine positions: 1.6%</p>

<p>Neurology:
638 applicants (324 US seniors)
541 positions
90% of positions filled on initial Match (487)
Successful applicants 64.3% US Seniors (313), 28.7% IMG (140), 6.5% DO (32)</p>

<p>Neurosurgery: Not very good data here, part of the SF Match...
227 applicants
143 positions
93.7% of positions matched (134)
15% of US seniors who only applied to Neurosurgery positions left unmatched
Average USMLE step I scores were 230 - we've already discussed the issues IMG's have with just passing Step 1</p>

<p>OB/GYN
1389 applicants (920 US Seniors)
1138 positions
93.8% fill rate on Initial match (1067)
Sucessful applicants 79.6% US seniors (850), 12.1% IMG (129), 5.3% DO (57)</p>

<p>Ophthamology: More SF Match Data
671 applicants (I calculate 492 US Seniors, though it wasn't given like the other specialties)
440 positions
99.5% positions filled on initial Match (438)
Sucessful applicants: 87.7% US Seniors (384) 7.9% IMG (35), no DO grads.
22% of US seniors who only ranked Ophthalmology were left unmatched.</p>

<p>Orthopedic Surgery
842 applicants (670 US Seniors)
570 positions
99.3% postions filled on initial Match (566)
Successful applicants: 93.6% US seniors (530), 1.4% IMG (8), .2% DO (1)
14.9% US senior unmatched rate applying only to Ortho</p>

<p>ENT/Head/Neck: more SF match data
390 applicants
250 positions
98.8% initial match fill rate
15% of US seniors applying only to ENT left unmatched
Average Step 1 score of matched applicants: 233</p>

<p>Pathology:
639 applicants (214 US Seniors)
398 positions
83.7% fill rate on initial Match (333)
Sucessful applicants: 62.7% US seniors (209), 29.7% IMG (99), 4% DO (13)</p>

<p>Pediatrics:
2821 applicants (1769 US Seniors)
2209 positions
90.2% of positions filled on initial match (1993)
Successful applicants: 78.4% US Seniors (1563), 14.4% IMG (287), 4.5% DO (90)</p>

<p>Physical Medicine and Rehabilitation
467 Applicants (201 US Seniors)
323 Positions
89.5% initial match rate (289)
Successful applicants: 67.8% US seniors (196), 20.3% IMG (59), 3.1% DO (9)</p>

<p>Plastic Surgery:
157 Applicants (134 US Seniors)
77 Positions
100% of all positions filled on initial match
Successful applicants: 93.5% US seniors (72), 1.3% IMG (1), 1.3% DO (1)</p>

<p>Psychiatry:
1588 applicants (652 US seniors)
984 positions
94.5% of positions filled on initial match (930)
Successful applicants: 58.9% US seniors (548), 27.7% IMG (258), 5.3% DO (49)</p>

<p>Radiation Oncology:
188 applicants (140 US seniors)
97 positions
97.9% filled on initial match (95)
Sucessful applicants: 89.6% US Seniors (85), 7.2% IMG (7), 3.2 % DO (3)</p>

<p>Radiology:
1380 applicants (938 US Seniors)
920 positions
97.9% fill rate after initial match (900)
Successful applicants: 86.4% US Seniors (778), 4.8% IMG (43), 2.4% DO (22)</p>

<p>Urology: Does it's own match
336 applicants
233 positions
100% fill rate by initial match
Successful applicants: 80% US seniors (186), 20% IMG (47).
20% of US seniors applying only to Urology left unmatched.</p>

50

<p>Okay, that was a long post to type. </p>

<p>A couple of things:
Besides any rounding errors, any initial match numbers that don't match up to the %ages of the successful applicants are due to physicians already in training who change their mind on the field they are in and decide to reapply to the match. May also be due to applicants who took a transitional PGY-1 year and had to reapply to the match.</p>

<p>The numbers, even in 2002, speak for themselves. Yes, as an International medical Graduate (IMG) you can get into some of the competive fields. But, their is a significant advantage to being a US Senior going through the match. Even in fields that have a lot of IMG's, like pathology and Internal Med, the placement rate of US seniors is much, much higher than those of the IMG's. And like I said, this is 2002, before the intro of the Step 2 CS part of the USMLE, which must be passed in order to take USMLE Step 3. I imagine that the CS requirement has further enhanced the difficulty for IMG's who are not native English speakers.</p>

<p>For example, lets look at path:
**Pathology:*
639 applicants (214 US Seniors)
398 positions
83.7% fill rate on initial Match (333)
Sucessful applicants: 62.7% US seniors (209), 29.7% IMG (99), 4% DO (13)*
US seniors made up only 214/639 applicants - or 33.5% of applicants, yet were almost double that % of successful matchs at 62.7%</p>

<p>For Medicine - which is where you go for cardiology, oncology, or GI:</p>

<p>**Internal Medicine:*
9551 applications (5146 US seniors)
6297 positions (4622 categorical and 1675 prelim)
94.3% filled on initial match (5938)
Successful applicants: 62.3% US Seniors (3700), 29.4% IMG (1746), 5.6% DO (333)
% of US seniors unmatched who only ranked Internal Medicine positions: 1.6%*</p>

<p>US seniors were 53.9% of all applicants, and yet ended filling 62.3% of the slots. What's important to recognize here though is that Medicine is often listed as a "safety" of sorts for people who either are unsure of what they want to go into, or intelligent enough to add if they are applying to very competitive specialties. Because as I mentioned, being an "applicant" for a specialty only means you ranked at least one program on the rank list for the match, with no indiciation of where that was ranked. I put the unmatched rate there to demonstrate that if you really want to IM as a US senior, you are very likely to match somewhere.</p>

<p>The fact remains that going to a International medical school is not a good idea if you want to practice in the US.</p>

51

<p>Internal Medicine:
9551 applications (5146 US seniors)
6297 positions (4622 categorical and 1675 prelim)
94.3% filled on initial match (5938)
Successful applicants: 62.3% US Seniors (3700), 29.4% IMG (1746), 5.6% DO (333)
% of US seniors unmatched who only ranked Internal Medicine positions: 1.6%</p>

<p>^ im personally looking into internal medicine and IMG's dont look to bad in here. </p>

<p>You showed us how many US seniors applied out of the applicants but not how many of the rest are DO's and IMG's, so how do we know that a large chunk of the rejects arent DO's. It could be so that a lot of DO's applied and didnt get in and they are making the IMG's look bad. Yes, i understand that the U.S seniors have the best chances, but perhaps the IMG's arent as bad as the statics you've posted so far have shown. Thanks btw for the info.</p>

52

<p>I don't have a break down for DO's, but there are only 19 Osteopathic schools. The largest entering classes for anyone of these schools appears to be about 250 students, the smallest about 100. I'll be generous and assume the average is 200 (which it certainly appears not to be) <a href="http://www.aacom.org/colleges/enrollment.asp%5B/url%5D"&gt;http://www.aacom.org/colleges/enrollment.asp&lt;/a> , then there are only 3800 graduating DO's. </p>

<p>About a third of them are likely to go into a traditional Osteopathic residency (<a href="http://www.aacom.org/data/studentreport/website/index.html%5B/url%5D"&gt;http://www.aacom.org/data/studentreport/website/index.html&lt;/a> - look on page 41). I'll even use that 31.8% from 01-02 seniors to match up with data set above as best I can.</p>

<p>3800 - .318*3800 = 2591.</p>

<p>Now I totalled an absolute minimum of 1071, without any data from ENT, Neurosurgery, or Urology. Perhaps we can assume those are 0. That leaves us with 1520 students left...of my overstated number of DO grads.</p>

<p>How many total independent applicants are there total? With just data from the NRMP, there were a total of 11994 applications to various match programs.</p>

<p>Now it is important to realize that you can put multiple specialty types on your rank order list, which thereby counts you twice or three times or however many times you ranked different specialties. But there is obviously a finite number of programs you can garner interviews from, and for each different specialty, you need new letters of rec and new essays explaining why you are the perfect candidate for ortho and not derm. So the most that anyone person is likely to rank multiple specialties is probably 3, due to the extra effort, the variation between the specialties and so on. And even the most indecisive people probably have it narrowed down to two really good ideas, seeing how this is going to be one's career, and doctors don't exactly have the flexibility to just change from one field to another. But the point is that there is some inflation of the true number of applicants when it is caluculated by total appearences in more than one specialty.</p>

<p>Finally the last component of the independent applicants besides DO and IMG students, are the MD's who started down one residency and decide to go through the match again...I have no idea how prevalent these people are, but I imagine the stress of going through the match again is likely a strong deterrent - the having to start over, etc. But I know that it does happen - look at Carter on ER, he started out in surgery and moved to ED. If I had to guess, my generous offer would be 1000 people nationwide, which I think would be rather high.</p>

<p>Even then with nearly 12000 independent applicants (as determined by the rank order lists), minus 1000 PostGrad MD's, and minus the 2500 DO applicants (and lets assume they ALL applied to 2 different specialties), IMG's still make up 50% of those independent applications, with 6000.</p>

<p>And yet there were only 3904 IMG's who successfully matched on the initial match. Less than 2/3 of my extremely generous understatement of the number of IMG applicants. </p>

<p>Given all that, I feel pretty safe in assuming that less than 1/2 of all IMG's that go through the match actually end up with a residency position. And of the most competitive residencies (Derm, Ortho, and Ophthalmology, Plastics) there were only 55 - FIFTY FIVE - out of 1362 positions were filled by IMG's. </p>

<p>It not just that I'm saying US M4's have the best chances, but that the chances they have, the advantage they have, is astronomical. And this is with old data that doesn't include the effect of Step 2 CS. It is w/o a doubt becoming far more difficult for IMG's to come to the US. Those docs that you speak of had a much easier time getting into this country (and I'm not even going to talk about the issues with visas and students that resulted from 9/11).</p>

53

<p>Hit me with a bottom line, BRM:</p>

<p>If you're a US grad, what are your odds of being matched? What about for IMGs?</p>

54

<p>I just wanted to express my opinion about the MCATS here. I am going to be a college freshman at Georgetown University who turned down the BS/MD program @ VCU/MCV. To me, it's really absurd how many are just trying to get out of taking the MCAT because they are afraid of how bad they think they'll do. I mean come on, you won't take this test for another 3 years most likely and your undergraduate experience will definitely make you more prepared for it. You will learn throughout college how to handle its rigors, how to study the right way, and there are also MCAT test preparation classes you could take to help you! For the person who mentioned before that undergrad is a waste, I think you are the biggest moron. Sure you want to become a doctor, but all you will know is how to find the disease and treat it. How will you build your communication and writing skills, become more knowledgable and well-rounded about everything else in the world? An undergraduate experience is necessary to build maturity, explore, and then see if you indeed still have the passion for medicine. So take the MCAT and see how you do. After all, you won't let your score become so low if you have the motivation to stick with your dreams. If you're so pessimistic, then leave the profession. Medicine doesn't need inapt people like you who feel the need to take the easy route to gain the title "doctor". Leave it for others who are willing to take on the challange since they are the ones who will make it in the field.</p>

<p>Just my 2 cents.</p>

55

<p>
[quote]
Bigredmed:Breakdown of Match Stats</p>

<hr>

<p>I was finally looking around the NRMP website and found these stats about how the different applicants to the match fare:</p>

<p><a href="http://www.nrmp.org/2006advdata.pdf%5B/url%5D"&gt;http://www.nrmp.org/2006advdata.pdf&lt;/a&gt;&lt;/p>

<p>Key stat for 2006: </p>

<p>US Seniors matched for PGY-1: 93.7%
Osteopaths matched for PGY-1:67.9%
US Foreign grads matched for PGY-1: 50.4%
Non US Foreign grads matched for PGY-1: 48.9%</p>

<p>US seniors and Osteopaths are also likely at a big advantage for finding unfilled positions during "the scramble" simply b/c their schools and deans are going to be helping them find unfilled positions.

[/quote]
</p>

<p>(10char) (10char)</p>

56

<p>Maybe now people will realize that I wasn't being pessimistic towards IMG's. It's absolutely astounding the difference being from a US school makes.</p>