<p>Are you a US citizen? Do you plan on coming back to the US to practice (even if you aren't a US citizen), or more importantly for residency?</p>
<p>If you are a US citizen, who plans on returning to the states for residency and/or practice, be advised that going abroad for you medical education will severely limit your opportunities upon return to the US. It's not a matter that you can't succeed in coming back, just that the odds are stacked against you.</p>
<p>Passage rate of USMLE Step I on the first try by US 2nd year students is ~93%, while around 60% for International Medical Graduates (IMG's). Considering that these board scores are one of the key criteria by which residency programs judge applicants, it logically follows that if you are at decreased liklihood of passing Step I, it's also much less likely that you will achieve an exceptional score. For residencies in Derm, Ophthamalogy, Radiology, Orthopedics, and Neuro, board scores must be significantly above average to have a shot at these residencies. </p>
<p>Further, IMG's do not fare very well during the Match process which puts med school grads into residency programs via Rank Order lists. Fewer than 1/2 of IMG's actually find residency positions during the first round of the match, whereas >90% of US seniors are put into a residency program through the Match. US seniors are also at a much greater advantage during "the Scramble" - the period after students are informed they were not matched, but before revealing, b/c they have the benefit of the deans and program directors at their medical school helping them in finding a position. </p>
<p>Further, even if you do well on Steps I and II CK, and pass II CS (Clinical skills exam in which you are tested on how you interact with patients - difficult for some IMG's), there are many residency programs, spread throughout many specialties (even the very prestigious ones), that simply will not consider IMG's who are originally from the US. </p>
<p>These are very important considerations. Again, I'm not saying that you can't come back just that the cards are not in your favor.</p>
<p>Now if you plan on going to these countries, staying there for your training and practincing there, then a foreign medical education is certainly something to consider. It's just important to be aware of the barriers simply put up by the medical establishment that can impede your career if don't plan on living in India or Pakistan.</p>
<p>And finally, b/c I know you're going to say it...yes there are many doctors from India, Pakistan or Europe in this country now who are in very prestigious specialties and earning amazing salaries and so on. However, they most assuredly were able to come to this country under different circumstances, before the USMLE's, before the Clinical Skills exam, before alterations in the visa and work permit process. These are the things that you have to deal with, and should not be taken lightly as they can and will affect your future.</p>
<p>My questions to you include, why do you want to go abroad for your education? Is there a reason why you must be done so quickly? Are you prepared for scenarios in which you cannot return to the US for training? The first questions I asked at the top are also important ones too.</p>