Research Before Applying to Residency Programs

Let’s face it, if you are an IMG you will have challenges and it you should recognize that there will be tremendous amount of obstacles before you land on a residency spot.  The biggest obstacle will be where to get a residency. What I noticed is that some students will apply blindly to numerous residency programs without researching. You should always research to see if your school is approved in the state and you should also research to see if the residency program will accept you. Most states don’t DISAPPROVE Caribbean medical schools and they have the APPROVED list of schools.  If your school is not in the DISAPPROVED list then it’s good; however, some residency programs will only accept students from schools in the state’s approved list.

According to the IU Health Ball Memorial Hospital Family Medicine Residency Program web site:

Before applying, please visit the Indiana Licensing Board’s web site to determine if your school is approved for licensure in Indiana. If your school is not on the “approved” list, we will not be able to consider your application.

According to the Indian Licensing Board, Ross, Saba, SGU, and AUC are the only foreign schools which are approved. And all other schools which are not in the disapproved list are taken in a case by case manner. Some schools in Indiana will not consider students if they are not in the approved list. So, students from SJSM, MUA, Xavier, AUA, AGU and other schools, don’t bother applying in Indiana. Don’t waste your money in applying for programs in states that your school is not approved in.

Another issue you need to consider is when will you get your medical license. Residents usually sit for USMLE Step 3 after the intern year of residency and get their license. However certain criteria have been changed and now some states require residents to complete their entire residency in order for the state to issue their medical license if their school is not from the approved list.

According to the Georgia Medical Board:

Graduates attending schools not listed in the Medical Schools Recognized by the Medical Board of California must complete three (3) years of post graduate training in a program accredited by the ACGME.

Basically post graduate training is residency and you have to finish your residency in order to get your license.

According to the Alaska Medical Board web site, it doesn’t have much restrictions except just passing your boards and be a legal US resident.  The following is from the board’s medical statues & regulations:

Sec. 08.64.225. Foreign medical graduates.
(a) Applicants who are graduates of medical colleges not accredited by the Association of American Medical Colleges and the Council on Medical Education of the American
Medical Association shall
  (1) meet the requirements of AS 08.64.200(a)(3) and (4) and 08.64.255;
  (2) have successfully completed
     (A) three years of postgraduate training as evidenced by a certificate of completion of the first year of
postgraduate training from the facility where the applicant completed the first year of internship or residency and a certificate of successful completion of two additional years of postgraduate training at a recognized hospital; or
     (B) other requirements establishing proof of competency and professional qualifications as the board considers necessary to ensure the continued protection of the public adopted at the discretion of the board by regulation; and
  (3) have passed examinations as specified by the board in regulations.
(b) Requirements establishing proof of competency under (a)(2)(B) of this section may include
  (1) current licensure in another state and an active medical practice in that state for at least three years; or
  (2) current board certification in a practice specialty by the American Board of Medical Specialties.
(c) In this section, “recognized hospital” means a hospital that has been approved for internship or residency training by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada.

Be smart and research before applying for residencies so you will save your self time and money and increase your chances of getting a residency.

Challenges in Applying for Residencies for Caribbean Medical Students

The following was an email from a blog reader.  I think the reply I gave should answer questions for some prospective students.

I just wanted to know if you could tell me the challenges applying for residency that come with being a caribbean student. I know the obvious issues but what can you do to get around it besides having a good score?

Hello,

Unless you graduate from the offshore schools of Ross University, St. George University, or American University of the Caribbean, you may run into a good amount of obstacles to gain residency. Most Caribbean medical schools are not approved in all 50 states. My school Saint James School of Medicine, is about to reach 15 years in which the school will apply to big states like Texas and Florida for licensing. Usually it’s a case-by-case basis for license approval in those states. Luckily my school has not been disapproved in any states. A good number of states follow the California approval list and so some Caribbean medical schools may not be approved.

Another issue is if you are Canadian then some program will not accept you unless you are also a US citizen or a US green card holder. Some residency programs will not sponsor visas for foreign grads, that’s where US citizens who went to offshore schools have the advantage.

At the end of the day, the Step 1 and Step 2 CK scores matter. Some programs look at your Step 1 score and some programs look at your Step 2 CK score, and others may look at both. So it’s a good idea to score high in both tests with Step 2 CK score being higher than Step 1 score.

Another issue could be your letters of recommendation. Some schools have good rotation posts in which students get good LORs but others may not so it depends on the school and what rotation spots they have.

Also, with more American medical schools being built and more American medical grads are applying to primary care, IMGs will have high competition since residency spots have not increased significantly. Therefore, it’s better to go to a US med school, the second option would be to attend the top three Caribbean medical schools which I listed: Ross, AUC, and SGU.

Family Medicine Rotation Review

I completed my six weeks Family Medicine core rotation at JPH and also on offsite locations.  The rotation is basically concentrated in clinical setting and also in geriatrics. I honestly did not enjoy it because I did not like working in the nursing home. I did clinic hours in the hospital but then I had to drive to over 15 nursing homes and take care of patients there. 
The rotation basically dealt with typing up history and physical notes on Practice Fusion software. I had to type it up and then the doctor would do his checkup and retype his own notes. I didn’t see the reason I had to type it unless it was for my learning experience because the student’s notes are never accepted.
I hated working in the nursing homes in Chicago because I felt bad for the patients there. Majority of the nursing home patients look depressed because their families dump them there and rarely visit them. Only a few of the residents are jolly because their families come often and take them on outings. One of the nursing homes was right across the street of a graveyard; that is so cruel, it’s like telling the nursing home residents where they will go next. Also, in some of the nursing homes the nurses have a serious attitude issue with the students so, be aware of that and be extra polite to them.
I got an A grade out of it because it was easy in my opinion but I did not enjoy it because of seeing the condition of the senior patients was disappointing.