Which Countries do most IMGs in US come from ?

A 2006 American Medical Association Discussion paper on IMGs called the "International Medical Graduates in the U.S. Workforce" did a pretty good study on the IMG distributions and other workforce data.


Here are some interesting facts that the paper presents :

1. As of 2006, IMGs came from 127 Countries !

2. IMGs constituted 185,234 physicians out of a total of 794,893 in USA

3. 44% IMGs worked in the Area of Primary Care

4. And here are the Top-10 Countries that most IMGs came from =

i. India : 24%
ii. Phillipines : 10.6%
iii. Mexico : 6.7%
iv. Pakistan: 5.7%
v. Dominican Republic: 3.8%
vi. Russia: 2.9%
vii. Grenada: 2.8%
ix. Egypt: 2.6%
x. South Korea: 2.5%


Interestingly Iran makes about 2.3% of the IMG population (12th on the Top-20 IMG countries list) despite Iran being a restricted area for taking the USMLEs or applying for exam visas. I had a reader ask me how could an Iranian IMG go about USMLEs and Residencies - I have yet to work on finding that out. I would appreciate any comments on that issue.

Another interesting thing is that while the Billion-plus populated India makes the most IMGs, its Billion-plus populated neighbor, China, ranks 11th. Pathology has a pretty good Chinese IMG population, but overall their volumes have stayed low on the clinical side.

With a big physician shortage projected in the United States, IMGs will continue to play a big role in America health care arena.


Data Source: International Medical Graduates in the U.S.


You also might wanna check out this interactive map-based plot showing countries that IMGs typically come from, comparing patterns over year and also includes the top-10 medical schools supplying IMGs in USA


Workforce: April 2006 AMA Discussion Paper [pdf]





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How much does a Green Card / Citizenship help for A Residency?

Curious to know how a Green card looks ? Click here :-)

Well...This post is for IMGs who do not need visa sponsorship for their residencies, to see how much your green-card / citizenship status can help you to land a residency spot.


1. In a pool of IMG applications with similar competency, Program Directors always have a preference for IMGs that DO NOT need a visa. Why ? Sponsoring a visa has its hassles for residency programs and takes time to get processed. A H1b even costs the program some $$$ per resident. H1b is even more of a hassle than a J1, since J1 is 'sponsored' by the ECFMG, while the H1b needs to be sponsored by the specific residency program. Often, a residency program must comply to the University system that it is a part of, which itself may have limits and policies to go through before a visa can be sponsored. Indeed, some programs even have strict rulings from the parent university on the number of visas they are allowed to give out each year. Do note that a green card / citizenship status for a low scores compared to visa-needing IMGs with excellent scores and highly competitive profiles is no longer too attractive to residency programs that do not mind sponsoring visas- thanks to a huge deluge of the latter. Read more about the IMG flood here.
(Some resident friends tell me that after applications have been screened, at some residency programs, the print outs of the applications are arranged in three stacks: AMGs, IMGs that do not need visas and IMGs that need Visas. Best candidates from each stack are then finalized for interviews in the same order -- don't know how much verity that has, but certainly sounds feasible...)

2. A more important advantage for GC / Citizenship holders is that there are many more residency programs that they can apply to, as compared to visa-seeking IMGs, since they are in a position to apply to programs that both sponsor & do not sponsor visas. Therefore, especially if scores are on the lower side, its a logical idea to spread your risks by making sure you apply to a good number of IMG-friendly programs that DO NOT sponsor visas - such as the Palmetto Health Internal Medicine Residency Program (Columbia, South Carolina) or the Southern Illinois University Internal Medicine Residency Program

3. Residencies that need a Prelim / Transitional year residency as a requisite (Such as PMR, Radiology, etc.) are more accessible to GC / Citizenship holders since most often, programs do not sponsor visas for a single year program.


And Sure enough in a survey study published in the Journal of American Medical Association, Following was the break up of the most common immigration / status for IMGs:

• Permanent Residents: 24.4%
• J1 Visa IMGs: 13.9%
• H1b Visa IMGs: 13.6%
• Native US Citizens: 15.5 %
• Naturalized US Citizens: 10.1%
• F1 (OPT visa): 0.4 %
• Others : you calculate...Jeez...enough spoon feeding ;-)
  

IMG-Friendly Residency Programs with Visa Sponsorship Information is being compiled at IMGfriendly.blogspot.com.

Its never too late to begin compiling your list, researching programs and contact programs near your residency to show interest in applying and then asking for observerships...is it? :-)

Specifying Desired Visa on ERAS Application: H1b ? J1 ? Or Both ?

It's been an awfully long time since my last post on Tips4Match Blog and it's time to rekindle the flame here.

Well...like I probably have written elsewhere on one of my too-many blogs [seriously, am losing count! ] - having excessive choices make our life miserable, coz' each choice has it's own 'opportunity cost' - that is, the price you pay for missing out on the benefits of other choices when you finally make a choice. Unless, you could simply select all and still be right ;-)


When you be fill out the Common Application Form(CAF) while applying for residencies through ERAS, visa-needing IMGs are required to specify their visa preferences: H1b or J1 or Both

Here are some thoughts on why I feel you should select both:

1. Given the increasing competition, wisdom suggests that its best to keep your application less restrictive so that it flows through the initial screening sieves that residency program directors use for incoming applications. An old medical school friend visited me as she was interviewing for fellowships - she mentioned that the biggest regret she had was restricting her visa choices to 'H1b visa only' when she had applied, coz' that seriously brought down the number of programs that called her for interviews.



2. Being open to both visa types is especially advisable for IMGs applying for the primary care specialties where J1-waiver job opportunities are good: Family Practice, Internal Medicine, Pediatrics, Psychiatry Obstetrics-Gynecology and General Surgery. This does not mean other specialties will not have J1-waiver jobs, only lesser and may need early searching, but then the number of IMGs getting in those specialties are fewer too.

Recently on a AMA News article concerning J1-Waiver physician supply, Texas Dept. of Health Primary Care Office reported that a total of about 896 physicians received J1-waiver jobs in 2005 and considering that the Conrad 30 program alone allows 30 J1-waiver jobs in each of the 50 US states, we got a lot of unused potential J1-waiver positions. Of course, it's not that mathematically easy to land a waiver job, but not impossible if you use the right strategies (shall put that up later).

[ To refresh your memory - Read about the types of agencies that sponsor J1-waiver jobs for IMGs]


3. There is a palpable positive change in the outlook of IMGs towards taking up J1-visa Residencies :

a. Some very good residency programs offer J1 visas only
b. Fellowship options are certainly more and better on J1 than H1b
c. And yeah - its better to have a residency than to go down trying exclusively for that H1b - he he..a retarded way of putting the same is : A J1 residency in Hand is worth 2 H1bs residencies in the bush ;-)

4. At times, programs that say they prefer J1 visas may in fact grant you an H1b visa on non-invasive, patient persuasion. In fact, I know a guy who convinced his program to change their J1 offer to a H1b visa offer AFTER the match.

[Read about how to negotiate for the H1b visa with Residency Programs]


So for what candidates is it worth it to mention only H1b as the desired visa type ? For those who plan to take up non-clinical H1b jobs in the US after residency - in areas like management, informatics, pharma companies. etc. And why would such IMGs do a residency in the first place ? Coz' having an MD in some non-clinical fields gives a great edge.



Speaking of too many choices, maybe Barry Schwartz's book "The Paradox of Choice: Why More is Less" is right on target :-)





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Clinical / Medical Research: Advantages for IMGs

Earlier on "Does Clinical Research Improve Residency Chances", I had dealt with the factors that WILL help - This post is about the overall advantages that research can confer on the IMGs


1. University programs and even University-Affiliated residency programs love research and publications on the resumes of incoming candidates- Of course you gotta also have the scores and other credentials in addition, but in many University programs, its possible for low scores to get in with excellent research credentials. Community programs may not care much about them - they would rather look at scores, US clinical experience, US LORs, and freshness from medical school

2. A friend who got into a cardiology fellowship told me how he had to take a "research break" for a year after completing his Internal Medicine Residency, in order to qualify for good cardiology fellowship programs. He wished he had devoted time to research while he had time before applying for his internal medicine residency. His opinion = a candidate with fellowship aspirations will need to do research sometime - better to do it BEFORE residency while you still have the patience and inclination, gets kinda tough once you are used to the working life as a resident.



3. Often the researching MD faculty at University Residency programs are very influential since they get a good amount of Grant money to the University. Doing good work for them makes them good 'contacts' for you for residency programs in the same institution and their strong word can potentially be a big trump card for you to get in. Either ways, even for other programs their Letter of Recommendation will matter a lot a too.

4. Two visa-related advantages for the International Medical Graduates:

a. If you manage to land a H1b Research job, the advantage is that residency Programs are more willing for a H1b visa transfer than to sponsor a new H1b Visa for candidates- coz' the transfer is faster and a bigger surety that the IMG will be able to start residency on time. The disadvantage though is that you can hold an H1b for 6 years at a stretch and the research job may 'eat up' your H1b tenure, which could rather be used for residency+ fellowship. Increasingly though, IMGs are beginning to take up H1b physician jobs after H1b residencies, get a Labor Certification, get a green card and THEN apply for fellowships.

b. Having publications in magazines of repute and International Circulation makes it possible for a lawyer to help you apply for your green card on the faster EB1 track reserved for Aliens with Extraordinary ability, which DOES NOT need Labor certification, unlike the regular EB3 track. A friend tells me more than three first-author publications will make it easier for a candidate to apply through the Eb1 Track, but I am not entirely sure. Read about the EB1 track on the US Immigration Website Here.



When I was a kid and was still able to run the athletic race-tracks, I enjoyed the 800-meter multi-lap run better than the frenzied 50-meter dash. The former gave me the joy of strategy part - starting out slow and then running past the "initially-overzealous-but-now-tired" guys with a smug smile..he he....So, for a fresh, well-informed and pre-planner IMG with Residency & Fellowship aspirations in University programs, indulging in publication generating research might be a long-term but an extremely powerful route with excellent benefits. The ideal route, then would look like this:

Medical School (with US Clinical Electives done in the Last Year) --> Complete USMLE Step 1, Step 2 CK, Step 2 CS With Good Scores --> Voluntary /Paid Research Position at a US University with Observerships / Externships now and then in the same University for a Year or Two -> Apply for Residencies within 3 to 5 Years of Graduating from Medical School Graduation --> Enjoy the Benefits :-)


I shall soon put up a post on going about the clinical research track for residency, as time permits...of which I wish I had like 48 hours a day ;-). Hmmm...For Starters, you might wanna check out the individual websites for research job openings in this list of Top-50 American Universities for Medical Research.




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Do IMGs need to take the TOEFL for Residency ?

No ! They Don't :-)

Since the June of 2004 - the TOEFL [Test Of English as a Foreign Language] is no longer needed for IMGs entering Residency Programs. This is because, June 2004 was the month when the old ' ECFMG CSA format' was replaced by the new 'USMLE Step 2 CS'. The Step 2 CS grading format includes the SEP [Spoken English Proficiency] component besides the CIS and the ICE Components. [If these terms are making you scratch your head - Read about ICE, SEP and CIS components of CS here before you lose it completely ]

Hmmmm...This is one area where I must applaud the USMLE-NBME-ECFMG axis ! Specifically, this is what the ECFMG site says on this issue:

"From June 2004, the TOEFL exam will no longer be a requirement for ECFMG Certification. Additionally, when Step 2 CS is implemented, applicants who have passed an English test will no longer be required to revalidate expired English test dates in order to enter GME"

But note that TOEFL will still be required for Admission in Masters / PhD programs in the USA. Thus TOEFL is needed for IMGs planning the GRE route to Residency. IMGs cannot use their Step 2 CS passing scores as a TOEFL-waiver for graduate programs.


Having said that - For those with a decent grammatical command over spoken English, studying for TOEFL will not take more than a week - for others, maybe its a good idea to take 3-4 weeks and do a lot of self-assessing tests (will not be boring, coz' it's such a fun and low-tension exam !).


Hmmmm...contemplating a bit ....It is interesting to note that scores for while TOEFL scores are valid only for 2 years, GRE scores are valid only for 5 years while USMLE Scores are valid for 7 years - what does that tell us ? To me it sounds like the authorities believe our knowledge of English becomes untrustworthy after 2 years, that of logical reasoning cannot be trusted after 5 years while Medical knowledge can be trusted for like 7 long years without a residency. When I think about it, I go like - I am more likely to have good English and reasoning skills persistent for like ALL my life, while the USMLE test stuff seems unbelievable volatile...lol - or well, maybe that's just me.




- Official Guide to the New TOEFL IBT

PATHOLOGY RESIDENCY & IMGs

Make no mistake, it's not all that easy as other branches for IMGs.

- It's often labelled as a "lifestyle" field, with good academic feel, free weekends, excellent pays and with minimum job stress with almost no emergencies (the only calls are frozen section diagnoses and some autopsies and most program allow residents to be "on call" from their home ! - which, well, makes it competitive

- Add to it the fact that residency positions are much less in number ! Some programs even have just a single position per year, while average is 3 to 4 per program. There maybe about 30 pathology residency programs offering H1b visas, the rest do J1 ..and waiver jobs in Pathology are tougher than compared to waiver jobs in family medicine and internal medicine. (Waiver jobs are generally more in primary care, mental health and dental health - Read more about J1-Waiver Sponsors and Specialties Here)

- Good scores, recommendation letters from US Pathologists, a PhD in related fields or Post-Graduate degrees in Pathology from home-countries are generally preferred. To get a more clear picture, have a look at the Point-system criteria that University of Iowa uses to screen applicants for their pathology residency, Click Here. Research does seem important to many programs - as Long Island Jewish Medical Center Pathology puts it on their Requirements : "Favorable consideration is also given to clinical/research experience, publications in peer-reviewed journals, previous residency training and local references."



Pathology is fast going the same way as Dermatology (near impossible for IMGs) in maybe 5 years.... for it's attractiveness to American medical Graduates as a "cool & paying branch". The other day I met this IMG Neurology resident who seriously contemplated switching into Pathology and I did meet some American surgery residents who switched to pathology! But then, let's not forget, that you gotta really like Pathology to do it. On the flip side, pathologists at times have to deal with being labeled as 'not real doctors' and are confined to labs without much patient contact. But again, they are also known as "Doctor's consultants" and as far as I think after speaking to several Pathology Residents and faculty, it is a very satisfying and fulfilling career.



If you are thinking about a residency in Pathology, Step 1 Scores matter more than Step 2 CK scores for obvious reasons.

One more thing, if you can get thru step 3 before your interview, that's another bonus, since a lot of pathology residents flunk Step 3 exams ! Not surprising, since most of them are not too clinically inclined. Just remember that the residencies are usually 4 years and can extend to 5 years in some places.


Fellowship Options after Pathology Residency ?

Plenty ! Here are the main ones :

- Blood Banking/Transfusion Medicine
- Chemical Pathology
- Cytopathology
- Forensic Pathology
- Hematology
- Immunopathology
- Laboratory Informatics / Information Systems
- Medical Microbiology
- Neuropathology
- Pediatric Pathology
- Selective Pathology

How is the job scene in Pathology in USA?

Good ! Excellent Salaries and nice lifestyles. You probably would not get as many job offers as an Internal Medicine Resident or Family Medicine resident or other clinical branches would get, but certainly get a job :-) Less number of job offers also means you have lesser choices in where you wanna be located in the US.


Until the year 2005 Combined Anatomic and Clinical Pathology has been a 5-year residency program, but since 2006, the combined program is now 4 years ! So now, if you think about the job market - the employers which paid you for 5 years of training will be reluctant to pay the same for a 4-year training. Hence the new trend in Pathology is that atleast one fellowship is needed to give yourself that "5-year training label".

It is recommended that you take up combined training rather than just Anatomical or Clinical pathology, since that makes you very marketable for jobs.




Also Read : Pathologist Salaries in USA



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EVER CONSIDERED PMR RESIDENCY ?

Whats PMR ? Stands for Physical Medicine & Rehabilitation ! And what are you called after you finish this residency ? A Physiatrist ...So What's a Physiatrist ? A physiatrist (fizz ee at' trist) is a physician specializing in physical medicine and rehabilitation. Physiatrists treat a wide range of problems from sore shoulders to spinal cord injuries.

Whoaaa ! Am I trying to confuse you here ? No --- Just showing you some light and go beyond thinking of the most common IMG Choices of IM, FP, Peds, Psych and Obg-Gyn. No a physiatrist does not make you a physical / occupational therapist - its very very clinical , academic and respectable with exciting fellowship options ranging such as musculoskeletal rehabilitation, pediatrics, traumatic brain injury, spinal cord injury, and sports medicine. I have an IMG friend who secured a fellowship in Spinal Pain Intervention at a prestigious university program. Pays are good too with the 50th Percentile base salaries in Houson, TX (as an example) hitting about 193,000 $ per annum - Compare this with that of Internal Medicine in the same area which rounds up to 154,000 $ per annum.

The only problem , however, as my pal tells me, might be the fact that most programs need IMG/FMG candidates to complete a year of intenrship / prelim year or transitional year and then move on to the full-fledged residency program.( For example, go through the FAQs section for IMGs on the Spaulding Rehabilitation PMR Residency Programs - which by the way sponsor H1b Visas too). But, visas are usually NOT sponsored for the Prelim year - which means you need to be self-sponsored on the Visa front for this one ! Second, PMR is bound to get tough in the coming years as this branch is one with good money and good smooth lifestyle ....so get thinking...

Read more about MD Salary Figures in USA Here.

And Click here to know more about PMR!

DERMATOLOGY & IMGs

Beauty is only skin deep and unfortunately, so are the chances for an IMG to get into a Dermatology residency program. But then again, like we spoke in Radiology, it may be possible to eventually land a residency in Dermatology after "getting into the system" through a residency in Internal Medicine , Family Practice, etc.


Lotsa things contribute to making Dermatology very very tough :

1. American graduates love the field for the great life-style and the good incomes

2. Unlike the number of seats for specialties like Internal Medicine and Family Practice (Indeed - many programs could build one or more football teams with their Internal Medicine residents ;-)), the number of positions for Dermatology remain very low - like 2 to 5 and rarely more.

3. Thirdly, the American Board of Dermatology requires all residents to have a postgraduate year of medical training, in a specialty approved by the Board of Dermatology (internal medicine, general surgery, family practice, obstetrics & gynecology, pediatrics or emergency medicine) prior to beginning the dermatology training - which basically calls for a prelim / transitional year or even leaving another residency half-way ....Hmmm

4. Life-style Professions are fairly closely guarded, meaning you get an entry mostly through contacts and recommendation letters from other skin docs....


Dermatology in US has got more exciting with the advent of new technologies and with "Teledermatology" where patients far away from the clinic are diagnosed over high-resolution video cams.

Harvard Medical School does have a "International Training Program" in Dermatology meant to train FMGs - to find out more and contact them, Click Here.

Also , University of South Florida accepts 4th Year Medical School IMGs for Dermatology Electives - Click Here for application process



Also Read:

Read about Dermatologist Salaries Here

Locate some IMG friendly Dermatology Program Here

INTERNAL MEDICINE & IMGs

What exactly is Internal Medicine ?

An Internist is a physician who completes a residency in Internal Medicine. A good way of describing an Internist is a doctor trained in managing hospital inpatients. It is akin to doing a Post-Graduate(PG) course in "General Medicine" in countries like India.

According to the Association of American Medical Colleges an Internist is : "A personal physician who provides long-term comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of of cancer, infections, and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems"

If a Family Practitioner is likened to a General Practitioner in other countries like UK, India etc. - then an Internist can be likened to a hospital general practitioner !

Why does it remain the top favorite amongst IMGs ?

The lure of Internal medicine lies in the impressive list of specializations that one can pursue in the form of Fellowships in the following fields AFTER a residency in Internal Medicine:

• Allergy and Immunology
• Cardiovascular Disease
• Critical Care Medicine
• Endocrinology, Diabetes & Metabolism
• Gastroenterology
• Geriatric Medicine
• Hematology
• Hematology & Oncology
• Hosptalist (Upcoming Hot Fellowship Option)
  
• Infectious Disease
• Interventional Cardiology
• Nephrology
• Oncology
• Pulmonary Disease
• Pulmonary Disease and Critical Care Medicine
• Rheumatology
• Sports Medicine

If you dont do a fellowship, you may work as an Internist - also called as a Hospitalist when exclusively working in hospital settings. A person I heard of notched an earning of 186,000/- as a hospitalist + Moonlighting in Philly after his IM residency.

This reminds me...I was talking to an American generalist physician who was in charge of recruting docs to fill up their Hospitalist position (Hospitalist is an internist or pediatrician or a family medicine physician who devotes more than 25% work time to inpatients - and some even devote 100%). He told me that a lot of IMGs certified as Internists were competing for the position, but he was kinda wary of hiring IMGs because : "as a general rule - IMGs never wanna stay as Generalists, they ALWAYS think of specialization" - meaning he was concerned that they will NOT stick to the job long enough but move on as soon as they secure a Fellowship.

At the same time he understood why that was the trend- he said he knew that IMGs spent a lot of money and hardwork to get here and wish to keep trying to get the best of what they have invested...

Another big, undeniable reason why Internal Medicine remains an IMG favorite is that other high-paying specialties like Anesthesia, Surgery, Radiology, Dermatology, etc. remain favorites of American Medical Graduates and aren't available for IMGs anyways :-) Which means a HUGE number of Internal Medicine programs would go unfilled, had it not been for IMGs !

GENERAL SURGERY : POSSIBLE FOR IMGs/FMGs ?

Definitely tough - but a residency in general surgery ain't impossible. A friend of mine recently got a residency position at the Methodist Hospital System in Houston on a J1 Visa and I shall be putting up advice from him pretty soon.

G. surgery has become kinda easier for IMGs over the past 2-3 years due to a reduced interest by AMGs. who are rather drawn increasingly to Anesthesiology , Radiology, Orthopedics...which bring in good pays pretty early in the profession.

On other hand, it still remains tougher than IM or FP or Ob-Gyn, and it usually is a 1-year "preliminary" position that is granted initially without any guarantees from the program about a position later - which means match participation is needed again for categorical positions. Most categorical programs need incoming residents to have completed either a preliminary year or externships / sub-internship. A good place for Surgery Aspirants to consider is the Surgery Subinternship program offered at the University of Washington at Seattle. The program offers 4-6 visiting student sub-internship positions to IMGs each year. Click here to know more about the program and apply.

However, ground work is needed - observerships count a lot ! surgical research too counts. Fellowship options after General Surgery ? These include cardiothoracic surgery (one of the highest paid specialties in USA!) , vascular surgery, surgical oncology, plastic surgery, etc.


Here are some places that are known to have offered General Surgery Observerships in the past:

St. Luke's Hospital of Bethlehem (PA)
Thomas Jefferson University
University of Buffalo
University of Iowa
University of Michigan
University of Nebraska Medical Center
University of Pittsburgh
University of Tennessee
University of Vermont
University of Wisconsin
Vanderbilt University


According to this 1998 Paper, International medical graduates account for 10% of the academic surgical faculty in the United States


And this is what Sameer Khalid, MD from Khyber Medical College, Peshawar has to say on my Orkut Residency Community :


"Surgery is not as tough to get in as it was previously - both scores in mid or early 90s would just be sufficient for an average community based prelim position in surgery. But it would be a prelim position.. Having said that, your chances of getting a second year position diretly would be very slim until and unless your are very very brilliant. And I know of people, amazing brains , great lors, getting into prelim and just cannot somehow get a 2nd or a 3rd year seat..
If you are really really dedicated about surgery, then forget about how long it takes.. the best method would be to get a research position in some top notch university like harvard ( i know ppl who have got in there ), get the research on an H1 visa, work for 2 to 3 years, get a green card, and then apply for a catagorical position in surgery, that is how your future would be safe.. and you would eventually become a surgeon..

Prelim , I repeat once again, is very risky, and I know of a lot of people who have been forced to leave it after an year or 2. As for orthopedics, well it is very close to impossible to get in, but then where theres a will...the only IMGs from pakistan I know who have gotten into ortho, have done the same thing.. as i mentioned above i.e. get an ortho research, paid on an H1 visa, work hard for a few years and then apply to Ortho. People from Aga Khan Med school have made it through this way ..and i repeat orthopedic surgery and general surgery are different specialties.. and residencies !! good luck, hope it helps .."

There are points that some would differ on, like getting a second year position once you have a prelim year feather on your hat may not be tougher. A person I know accepted surgery on a J1 visa and had information that J1-waiver jobs are not at all impossible for surgery either. Accept contradicting information on this blog as options - and see the best of what's possible in your circumstances...

g/l


Also read: General Surgery Salaries in USA





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RADIOLOGY RESIDENCY & IMGS

Everyone and Everybody talks about how tough Radiology is for IMGs (even for AMGs). It sure is, but for those passionate about radiology, it would be wrong to give up the dream altogether. And before you read ahead, I must stress on the two big credentials needed are Very high USMLE scores (preferable 99s) and Research publications in Radiology. The average three-digit scores of candidates matching into Diagnostic Radiology in 2007 were around 230 to 235 in both USMLE Step 1 & Step 2 CK.

Direct residency positions are sure tough for IMGs, making IMGs try indirect routes. I got to speak to a IMG Radiology faculty doc at a University hospital and he told me about his journey and what people these days do to get in. It surely takes more time, but is worth it if that's where your passion lies. He himself did a residency in Internal Medicine first and during those rotations made good contacts in the Radiology Dept. , volunteered to research and off-day observations and got into the program AFTER completing his IM residency.

The other way, which may be easier, is first doing a Radiology residency in your own home country and then applying to Radiology fellowships in USA - Read my post on Direct Fellowships without Residency - not saying Radiology residency is easy in your own countries - Radiology is pretty much a highly sought specialty after all over the world, but a radiology residency back home may be a better way to spend time rather than trying, trying and trying for US residency positions.

The competition sure is tough - even a lot of AMGs with high scores end up doing prelims and transitional years and hope to get into a Radiology program the following year. Do check out USMLEtoMD.com/imgfriendly for updated information on IMG-accepting Radiology Programs. However, remember that even if they do accept IMG applications, American Graduates are always given the first preference. And of course the IMGs with Green cards / Citizenships have an advantage...


Take home message: Don't compromise on your scores, apply to Radiology residency programs, but also apply to Internal Medicine, Internal Medicine-Peds and 1-year Preliminary Medicine spots. In case Radiology does not happen, don't lose heart - take up the backup residency, work your towards your goal slowly and strategically through exposure, experience and contacts :-) You got a better chance that way than not taking up any residency at all and wasting a year. And my advice for any tough residency specialty - always have a plan B in your home country for a Radiology residency - coz that way, the option of direct fellowships stays open too.


Also See : ERAS Application Statistics by Specialty

Q. What are the Fellowship Options After Radiology ?

A.

• Abdominal Radiology
• Cardiothoracic Radiology
• Endovascular Surgical Neuroradiology
• Musculoskeletal Radiology
• Neuroradiology
• Nuclear Radiology
• Pediatric Radiology
• Vascular and Interventional Radiology

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