Tuesday, 3 April 2012

PhD as an Alternative for International Medical Graduates

In the first part of the article, I spoke about masters as an option for foreign medical graduates either before or as an alternative to getting a residency. You can read that article here, Masters programs as alternative for IMGs. As discussed before, getting a residency is getting tougher every year. The 45-50% match rate for international or foreign medical graduates is going to decrease. This is due to an increasing number of foreign medical graduates applying each year. For the unmatched applicants alternatives are an important question. Here in, I discuss graduate school as an alternative for international medical graduates with special emphasis on PhD track as an option.

The two main reasons discussed earlier as to why IMGs are attracted to graduate school programs are still the same -

• As a temporizing measure
• As a permanent solution.

As a temporizing measure, PhD program is not a good idea. Firstly, if you do drop out of your program and choose to jump ship, this will forever be a point of contention on your CV. It may appear that you do not have the conviction to finish the task and affect your chances later on in life. There is a middle option for those who do not wish to continue with PhD. At least finish your course work, appear for qualifiers and graduate with a masters in the subject (your graduate committee permitting).
 

In what subjects can foreign medical graduates can do a doctoral study.
The following lists the possible areas of study; this list is not entirely comprehensive as there may be universities that offer more specialized or unique programs that are not offered elsewhere
Bear in mind that even though you could apply to any program of study, it will be beneficial for your resume and chances for residency later if you apply to specific programs. The table  below shows the ideal programs and subject to apply for with specific residencies in mind. 

Fig 1. Relationship between research areas and medical specialties

Application to graduate schools
In US, persons of various backgrounds apply to graduate school, medical graduates included. In addition, you can chose to study any field for your PhD but remember to keep the choices that are relevant to your education as a physician. The list above is a good one to follow for medical graduates.

Application to graduate schools is on an individual basis and you will have to fill in online applications to the university programs of your choosing. You can choose your graduate schools and narrow down the list that suits your needs, gradschools and princeton review offer excellent resources. Many programs have deadlines in September through December and early applications are encouraged. There are specific requirement of each program including minimum cut off scores for GRE and TOEFL. Some institutions may waive the requirement for TOEFL if you have passed the step 2 CS but this is an extremely rare occurrence. You will also need a statement of purpose (like a residency personal statement, but geared towards research – graduate school). Programs also require 3 to 4 letters of reference for admission process. An independent agency verification and conversion of your transcript (medical, junior college degree) to a GPA system may be required in some cases.

Graduate school modus operandi
If accepted to graduate school, approximately first 2 years involve taking courses and classes to prepare you for doctoral study. Most programs especially those involved in science research will also allow rotation in different labs and with different mentors to help choosing the desired project. These rotations usually are 3-4 month blocks with about 2-4 faculty members. At the end of the rotations, you chose a mentor, join the lab, and start work on topic of your research. Work on research topic usually goes on for 3-5 years depending on the faculty, motivation of the graduate student and facilities available. In the second, third or fourth year you will have to a comprehensive examination which is a mock dissertation. Defending your thesis work is the biggest presentation you will have and will lead to a culmination in completion of your PhD work. Thesis defense or final oral exams are theoretically open to all including all the faculty members of the department, related departments and committee members. Any person in the audience can challenge or ask questions regarding the work and defending your ideas, concept or reasoning leads to a successful ‘thesis defense’.

At the end of a successful completion of doctoral program, you are awarded a doctoral degree (PhD) in the major that your research topic falls under. This is certainly a long road to get to residency and has some advantages and disadvantages

Advantages
  • You can study for your USMLE exams and prepare well
  • Expense can be borne easily as you are paid a stipend or fellowship during your PhD research work
  • You can make contacts and enhance your professional network
  • You can collaborate with physician faculty and thus get into more clinically oriented research on the side.
  • Getting US letters of recommendation is a breeze.
  • You can find opportunities to obtain US clinical experience/ observerships since you are working with in a university system. It is almost unheard of that a graduate student who request shadowing with a university physician is refused without genuine reasons.
  • Even if you do not match – there is another option open for you (teaching, academia, industry or scientist are all pathways that are wonderful alternatives to residency-fellowship-physician pathway)
Disadvantages
  • Time consuming process, there is a wait period of 4-5 years till you can be ready to apply
  • You are automatically and old graduate by the time you apply for a residency position
  • Again – because of the gap – policies may change over the years and foreign grads may have tougher time getting a residency.

Hopefully, this article provides some information regarding the PhD track as an alternative for those medical graduates who are looking for other options. Also read up about physician assistant as an alternative for those seeking alternate options.

186 comments:

  1. Thanks for raising this topic. I just want to do phd in neurosciences or genetics or bioinformatics.
    i am a medical graduate[2012] from india.
    can you please suggest some links where i can apply.
    tushain@gmail.com

    ReplyDelete
    Replies
    1. Hi Tushar, Do you have any preference for the location where you want to pursue graduate studies? Gradshools.com is a good place to start, you can also check out princetonreview site (link above) for some details. Once you narrow down the list of places that fit your criteria, go to the program website for more details and dont feel shy in writing to the program secretary. They will be able to fill you in on the details of the application process.

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  2. Hey, this is an important piece of information, thanks alot for posting it,by the way what do you think of ms/PhD in translational research...how good it is.

    thanks again

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    Replies
    1. translational research is a big thing these days and is growing as much popularly as basic science research. There are also growing funding opportunities for such a branch. While there are not many dedicated institutions that offer courses and study in translational research, there are may CTS centers (Clinical and translational science) all over US (mayo clinic, cleveland clinic, UTMB etc) which can provide your the opportunity for this type of graduate study.

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  3. I have decided to start a phd in nutrition this fall as a longer route to get into residency. I am already an old IMG but I feel I need the phd to be more competitive. Thanks a lot for the information. From your advice I gather that its important to get clinically relevant publications, build contacts and get an observership or 2 or 3 during the phd. I already have my steps. I am thinking a preventive medicine residency may be the way to go for me but I still need 1 year of clinical experience.

    ReplyDelete
    Replies
    1. Sometimes having a back up is just as important as having a primary plan. You are correct in planning for a long term basis because if for some reason the chance of getting a residency does not pan through, you will still be able to seek a fulfilling and gainful career in research. You did surmise correctly, be very involved in your work and plan of publishing from day one, collaborate with other labs, lab members and other PIs (if you can) to get your name on as many publications as possible. show that you are productive. definitely do an obsie while doing your PhD but i would recommend doing it within a year of applying for residency. no point in doing it too early and then apply after 4 years etc.

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    2. Thanks for your insight. I was wondering if you know of IMGs that have successfully traveled this farther route to residency.

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    3. Hi Long Shark. My story is the long route version with a PhD and then residency. I also know of 2 physician residents who did their PhDs and then applied to a residency program.

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    4. Hi I am old grad 2005 did with all exams also thinking to follow this long route if I will not match this year .is this is useful for me

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    5. Hello Dr. Mahwish, I cannot comment on the usefulness of this route but can only share my personal experience. Each persons situation may be different and the same opportunity may present but consequences may be different. The question you need to ask your self is - are you committed to like of a research scholar? if yes, then this will be a very exciting and rewarding choice to make. If you are doing this to piggyback onto something else, then it may not may not work out for you.

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    6. *life of a research scholar (not like - typo)

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    7. Hello. I am an old grad (2006). Finished all the steps but did not match. My interest is in psychiatry. So I was thinking to do PhD in psychology. But I never heard of any IMG doing PhD in psychology. Do you have any advice/suggestions? Thanks.

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  4. Hey,DROIDOR U r an awesome person.Giving valuable info.
    Can you please tell us about Microbiology Immunology ,PhDs,which one has better job prospects .
    which is best if someone is trying for pathology residency.
    Also please enlighten us about the future of Bio informatics.
    Thanks

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    Replies
    1. And also, I want to know if the programs waive GRE if we are ECFMG certified

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    2. microbiology-immunology PhD are very popular options for medical graduates. This allows them to get into a field that is medically relevant and can be immediately clinically applicable especially sections like pathogenesis of disease, immune regulation, therapeutics of various diseases. There are graduate programs which offer training in pathobiology and molecular medicine which may have some relevance to path applicants. Other options include graduate studies in Anatomy, cell biology, neurobiology or developmental biology. There are plenty of options, find something that you like and go with it.

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    3. @ Vamsi: Many programs have individual requirements. Most do not waive the option for GRE in lieu of ECFMG certification because they are measurements of different areas of training. GRE has physics, mathematics, English (TOEFL) components which are not well examined in USMLE exams (which deal with human disease condition). After you select the area of choice, narrow down the list of grad schools and then inquire with the graduate office about the requirement for GRE.

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  5. respected sir
    i am currently in 1st year of md pharmacology and am interesrted in doing phd medical pharmacology in either new york or california. kindly guide me how to go abt the process. wt r the minimum scores am looking at and when shud i strt preparing and write the gre and toefl? i ll be completing my md in india in 2015.

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    1. i would recommend doing online research to narrow down the list of schools in NY or California using Princeton review or grad-schools website. All graduate programs require a GRE and TOEFL. some may waive requirement of TOEFL if you are ECFMG certified, this is a rare occurrence but you should certainly inquire. First semesters for PhD or masters courses begin in August after commencement. You should apply by the program deadlines (each dept has their own but usually sept-to-Jan are common.

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    2. thank u sir for this advice..will surely follow through

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    3. Hello Droidor,
      Thank you for the info.
      I am a 2011 foreign medical graduate, will be applying this year for the match cycle.
      Is it very competitive to get into Phd programs since this will be my back up next year?

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    4. Hi Priyanka, Good luck for the application. Graduate programs including PhD program are not as competitive to get into but specific grad schools (harvard, mayo, UCSF, ivy league institutions are very difficult to get into). The biggest issues a foreign doctor faces when he applies to graduate school is the programs know that you are doing this as a backup, so it is up to you to convince them that you will see this through to the end.

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  6. Hello Droidor,
    iam a practicing gynaecologist graduated in 2005.very soon i will be moving to US as my GC is processed..what would u advise me? what r my chances of getting in phd?i hav not done any steps

    ReplyDelete
    Replies
    1. you chances to get into a graduate program depend heavily on your GRE and TOEFL scores and little bit on exposure to research. IF you dont have research experience even then it is not a issue but make sure you show interest and dedication to pursuing graduate study.

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  7. Hello,
    Do graduate programs require general GRE or GRE subject tests also?
    I'm IMG. I've won GC this year. But I'm not sure that I want to be a practicing physician. Of course, I don't want to lose my years of education.That's why I think graduate studies may be an option for me. I can't decide.

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    Replies
    1. subject GRE is not required unless specified by the programs. Graduate school would be a good option to get into. Your training as a physician would help you as well think with more clinical application than someone trained in basic sciences

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  8. Hello,
    Thank you for the very helpful article. I am interested in doing PhD too. However, I may do it after residency. I am aiming for Cardiology and want to boost my credential to be competitive.
    1) Do you think it is a good idea? To be away from clinical practice for 5-6 year. Just worry to will be disadvantage when I come back to clinical field.
    2) I am also concerned about visa things. I am holding J-1 visa. Will it be a problem if I change visa to F1 or another type of J-1 (J-1 research) and change it back to J-1 clinical? Do I need to go back to my home country because of 2-yr HRR?
    Thank you so much.

    ReplyDelete
    Replies
    1. I dont think that doing a PhD after residency is a good idea. you will out out of touch with clinical medicine and then you will have issues being hired as a clinician. If you want to do cardiology, the plan would be to get into a medicine residency and then start working on posters, cases, connections, presentations and research in cardiology from day 1. being away from clinical training for 5-6 years after residency will be a tough sell when you plan to get back into fellowship or job.as far as I know if you have have the J1 clinical exchange visitor visa, there is no way around the 2 year rule unless you obtain a waiver. I would recommend consulting visa forums that regard. Good luck!

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  9. hey Droidor u have given here very useful piece of info i wanted to knw if any of usmle step scores matter here in phd programs.and i wanna know grad schools which are img friendly so that we can apply there.and can please give information about the best time period to apply here.i am an indian but did my graduation from russia..also gave step 1 but got low scores..i am a graduate of 2012.

    ReplyDelete
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    1. not really, graduate school programs are interested in GRE and TOEFL scores. you can get more information of gradschools.com or princeton review site. best time to apply is between July to November. some schools even have deadlines as late as dec and jan, so contact the programs.

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  10. hello,

    is there anyway to stay clinically acquainted ,while one pursues PhD in USA?
    at least for part of the 5years it generally takes to complete PhD.

    Regards .

    ReplyDelete
    Replies
    1. yes, if you are doing PhD at a graduate school which has a medical school or a hospital on campus, you can seek out faculty to do rotations with. you will have more chance of being allowed to do so in your senior years than when you are just starting

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    2. thanks for the information .i get ur point about getting more chances as a senior.
      also is there any pre-requisite like USMLE score or ECFMG certificate, they will look for when i seek such a rotation.?
      on what basis can i ask for such a rotation ?i mean not every other PhD student would b asking for a clinical rotation!arent there any rules which wont allow me to do it ?

      Regards.

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  11. hi dear sir
    i am Ali from Iran.i graduate 2005.because of some problems i couldnt continue my education and i worked as MD.i have some articles in pubmed.i am very interested in continuing residency program in us.i want to know what is the best way for me?it is not better i start phd program and after that apply for residency?
    thanks alot for your articles
    best regards

    ReplyDelete
    Replies
    1. Ali, it depends on strongly you want to pursue postgraduate medical education in US. If you opt to do PhD then you will have to wait another 5 years till you apply for residency. you will be 12-13 year out from your graduation and that can affect the number of places and the interviews you will receive. Ultimately, it is your decision to pursue or forgo the idea of residency. read about all the factors here and on other sites to make a well informed decision.

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  12. thanks for your reply
    if i start for residency program now i will have any chance because i have about 10 years gap of course i worked in these years as physician
    thanks
    best regards

    ReplyDelete
    Replies
    1. being graduated more than 7 years out does make a difference but some of the disadvantage can be mitigated if you have been busy in clinical practice. Thus having a old YOG with continuous clinical experience in between is much better than old YOG with none.

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  13. thank very much for very valuable guides.this site helped me very much.best regards

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  14. Droidor,I wish you a very happy new year,
    I finished my USMLE steps, certified by ECFMG and I am doing MS in clinical and tranalational research now,( starting classes in this spring)
    I want to know what is the future --in terms of jobs in industry or academic areas with this background. As the residencies r getting very competetive each year I am just looking for opportunities to survive decently in USA.
    Thanks
    Dr.Krishna

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    1. Hi Dr. Krishna, MS in translational research is a new field and it remains to be seen how useful it is going to be. But I can definitely say that it is better than some other masters programs. you may be better off than not doing anything however to increase the chances of jobs in industry or academia - doctoral training (PhD) is better option. from http://pediatrics.iu.edu/pediatric-education/ms-in-translational-science/ M.S. degree in Translational Science addresses this critical need by providing a cross-disciplinary training mechanism for researchers that can produce a translational scientist with an understanding of human disease at both a basic and clinical level. Your MBBS training will put you in a unique position in industry and academia as well

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    2. Hi Vamsi. I am interested in doing MS in clinical and translational research. I need you help in admission. My email address is combinedstudy4@gmail.com. Could you please leave a mail on my email address so that I can contact you.

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  15. Hi Droidor, Happy New Year.
    I graduated in 2007. Iam done with step 1. Iam interested in nonclinical side. 1.My plans are doing MS in Pharmacokinetics and entering into pharma industries.
    2. Doing MS in pathology and applying for pathology residency.Please tell me the chances of getting residency.
    I have worked in india for sometime. I dont have clinical experience in usa. I am volunteering in American cancer society for breast cancer awareness and preparing for step 2. I have a green card.

    Which one is better like getting into pharma industry or trying for pathology residency. Iam in confusion. Please advice me.
    Thank you.

    ReplyDelete
    Replies
    1. pathology residencies are tough to get into so if you are serious about it you need to work on your application and get superb scores on your steps in addition to path specific work in US. The other option of pharmacokinetics is also a good one and may be less stressful. There are many grad schools which offer courses Masters and doctoral level options in pharmacology related subjects. Having a green card will make things easier for you to get related work experience in US. based on your performance and application, one will be able to say which is better but read above to get a feel of where you stand

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  16. Dear Sir, I have gone through your article.It is very much informative.
    I am an international student,doing my graduation in medicine.I will be highly grateful to you if you let me know that what are the job options there if i do Ph.D in one of the above said subjects and do not take the USMLE examination?

    ReplyDelete
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    1. after your PhD completion you may chose one of 3 things
      1. get back into residency provided you want to do the USMLE and look for residency
      2. Join academic research/education/teaching at university or college
      3. Join industry (chemical, drug development or pharma).

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    2. Thankyou Sir for your reply.

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    3. Sir, after my completion of graduation in my country what are the requirements to join Ph.D program other than GRE/TOEFL?

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    4. for most graduate programs GRE and TOEFL are the only examinaton criteria for application. There may be individual requirements like good grades in school/college and GPA etc (you may need to have your college scores converted to a GPA type grade - this is done by a few agencies in US). the graduate school will help you on this.

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  17. What is the procedure for applying and how much is it going to cost? Also please mention what are th requirements? Can i appy on mbbs basis only?

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    1. you have to pass the GRE and TOEFL exams. have the scores sent to universities and colleges of your choice. apply to program before deadline. The cost is not as much as residency or USMLE track but can become substantial if you apply to many programs. you can apply on basis of MBBS only

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  18. What are the chances for IMG with MD in Medical biochemistry and good score to get into pathology residency ? please enlighten.

    ReplyDelete
    Replies
    1. pathology is getting somewhat competitive. please check the articles for some pathology based data for IMG applicants. MD biochem in itself may be some benefit but again solid scores and strong letters of recommendation with some contacts in US are going to go a long way.

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  19. hi thank you for this very informative website.i m a 2007 img with 80 and 89 on usmle and step 3 green card.tried for the match 3 years no use.did lots of observerships externships now i m looking at other options either pa school .phd .doing an mph or mha.basically the options r now so confusing.i know pa school is tough to get in to .wat r the options for an img with only mph or mha in the job market?i have heard that job options r not great that s y im asking.which do u think would be the best option for a person in my situation.

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    1. As far as i know getting into the job market with only MHA or MPH is tough because there are many entry level applicants for that. if you are productive and enhance your CV and make good connections (yeah even for jobs you will need those). The chances of landing a job depend on a lot of factors luck, connections, timing but in general doctoral candidates fare better than masters candidates. my 2c.

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    2. Mewpusss....you can do MS in clinical research and look for pharma jobs..I heard that they pay well for doctors.Dear Droidor..I welcome your inputs into this.

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  20. Hi! Can a person do a PhD in Biological Engg. after MBBS without a background in engineering?

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    1. you may have difficulty getting into a program in the first place. If you are applying for a PhD program they may have some stipulations or basic courses you require to fulfill before they can accept you. Even if you find a school that will take you, you have to show some inclination towards mathematics, physics or computation. You may find it hard to take the level 3 and level 4 (advanced level graduate) courses when enrolled.

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  21. hey!
    thanks for writing such a helpful article. I just got done with my MBBS and wish to pursue a career in basic science research in US.. particularly biotech or genetics. In this regard, would a Masters or a PhD better for me? What are the salary ranges in both the fields for someone with my background? are there many jobs in these fields and is it true that there are federal cuts in these areas??
    P.S i have not given any steps.

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    1. hello dr. Pulsar, it depends on what your priorities are. the options offered after PhD are better than masters but then again you have to invest that much more time in training (5-8 years versus 2-3 years). The salary ranges differ a lot. If you are in a masters program you will likely NOT be funded by a scholarship or stipend and you will have to bear tuition, housing and living expenses by your self (how ever you can find a job on campus to support your self - but these jobs are also tough to come by). As a PhD student, if the department is well funded (which is more common) you will receive a stipend and your tuition will be paid for. There are always jobs in the healthcare, biotech, pharm industry.

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  22. Hello Droidor,
    Many thanks for your article. I'm an IMG and I will graduate from Med School in 2015. I would like to get into a PhD because I have a genuine interest in research, but I'm afraid I will lose my interest in clinical medicine and that it will be hard for me to get in a residency (also in terms of my own motivation).
    I came across some infos about combined residency and PhD programs, but I didn't managed to find websites structured enough in order to get a clear idea. Do you have some infos about this kind of programs? Are they more competitive than residency programs and really hard to get into if you are an IMG?
    Best wishes,
    Diana

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  23. Hello Dr. Mirela, You bring up a wonderful point. After your comment, I looked into finding out if there are more opportunities for a combined residency and PhD training and sadly there were very few. Seems like this is a very institution specific position and best may be to get in touch with these institutions directly. On SDN I found some places like yale, Upenn and UCLA that offered these. I am of the opinion that because there are so few spots, these will like be very competitive and harder for an IMG to get into. Good luck!

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  24. Hi,
    Thank you for the excellent post, you already confirmed many thoughts I had in mind and further explained others, I am an international medical student graduating soon and planning to pursue IM residency in the US, I am considering the PhD track, but I have good opportunities for PhD in Europe as I worked their on biomoedical research in a year before,the programs duration I applied to are 3-year duration and I am graduating this year and can start right away. I am concerned about being away from clinical medicine for 3 years (at least) especially with the increasing competitiveness for residency matching. Reasons why I am considering PhD are support to residency application and on the long run I want a career in academic medicine as medical scientist which combines Patient care, teaching and research. I would appreciate your opinion as I am hesitant a bit about my decision, I have a 4 months american clinical experience and one month of Canadian clinical experience at prestigious medical centers with excellent recommendation letters, however, I did not do my steps yet but planning to do soon. do you think a PhD would be in favor? and is there a good chance of becoming a university hospital faculty as an international student without being an MD/PhD? my major interest is in the field of hematology/oncology and that's what I will be researching on if I go for PhD. Thanks

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    1. Looking forward to hear your opinion about doing basic science PhD in Europe in a 3-year program at a well ranked research university in Europe, does such a degree still support US residency application?! or is it more of spending unnecessary off-clinic time! I just loved being in Europe (Switzerland) and part of why I want to do this is getting the chance of living there besides my goal of becoming a clinician- scientist.
      Thanks

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    2. Dear Dr. HAK, if you have excellent letters and are just waiting to sit for your exam I suggest you see where you stand after scores are available. If you do very well and have an excellent score profile you should not wait but go ahead an apply. The current scenario is tough as it is, it is thought that if there is no increment in residency spots it will next to impossible for IMGs to be in residency by 2016-2017 (this is a consequence of increases in graduating medical school MDs and increase in DO schools). The other way to look at this is to set aside your ambition of US residency at this time and focus on being a world class researcher. It will be easier to move to us to have an academic career. Getting back into clinical medicine may be difficult but it will be an issue that can be sorted out later.

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    3. Dear Dr. Droidor, Thanks for the reply and the advice,your blog is very enlightening, regarding the shortage in residency spots I have just read this article about an expected gradual increment in residency spots in the coming five years.
      https://www.aamc.org/newsroom/newsreleases/330948/031413.html
      you might like to read it and comment on it and wether it's really gonna be that much harder for IMGs to match in the near future or not.
      for me now, the earliest I can be in residency is 2015, 2 years from now,my dilemma is whether to spend the coming 2 years in internship at my country or as a transitional IM resident until I start residency in the US vs. getting a PhD in 3 years instead of 2 and start residency after. If a Program director is to evaluate my application what would support it or make it more attractive, temporary residency at home vs. PhD in bio-medical sciences? I am worried about being not in clinic for 3 years, besides that, the research environment in Europe from my previous experience is favorable and brings nice opportunities and one can learn a lot about wrtiting articles, writing grants, managing a lab etc.., however I don't want to be drifting away from my chance of getting into a very good residency program just because I love the working environment in Europe. As the decision time is approaching this is becoming a major concern in my mind and I know a decision needs to be done soon.
      Thank you very much, would be nice to hear your thoughts.

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  25. Hey Droidor, your post is very interesting. I was hoping for some input too. I will be 8yrs out of med school this year. I have an MPH from here. I have done a lot of things, taken all the steps, research, observerships, etc. But since I didn't do well in step 1, I didn't get any interviews this year. I applied to IM and psychiatry. I am thinking of going back to medical school here. Do you think that would help? I know I can't take the steps again but if I can get into a good school, would that help at all? My logic at this point is that a good alma mater and a new year of graduation might improve my chances. Hoping to hear from you.

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    1. Dear resident 2013, Getting into medical school afresh is a hard and difficult step for foreign grads. While it may seem an intuitive step there are several things to consider including very high cost and expense of obtaining medical education. MPH in itself never is helpful unless you have formed good connections and networked in the university setting. The greatest impediment to your chances are the poor step 1 scores. It is a big decision to get back into medical school and do not take it without understanding the implications of it. While a good alma mater will improve chances of getting a residency getting into a good medical school is not easy. You have MCATs and a stiff competition from American undergrads competing to get into medical schools.

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  26. Yes that is true. Getting in won't be easy nor will another 4 years of medical school be. I passed step 1 on the third attempt, nothing can fix that. I have networked and even had senior doctors talk to PDs on my behalf. But with no interviews again this season, I know I need to look elsewhere. I think an MBA is also a good option. A lot of MBA programs want doctors, especially those that have MD programs within the university. I realize now that my MPH degree was not that helpful. I wish I had better guidance 8 years ago. This is a good discussion site.

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  27. Hi, Droid .I am a First time visitor to your site. U r doing a Life saving job somewat..keep it up...
    I am an old graduate 2004,India, ve cleared Step 1- 84, Step 2- 78, Step 2 CS all in first Attempt by 2008. But because could not get residency after 2 yrs of Application & few IVS, gave step 3 in Desperation & failed twice by small margin as I had my Stay in US for 6 months,2009 &
    & had to everything from USCE to Step 3 Exam... So after 2010 Match I gave up due to both money & mental exhaustion...I am Pediatrician in My country India... But again My heart never Quit ted...Now again want to revive My plans for US dream...Kindly advice whether I shd attempt Step 3 with a Good Score > 85( Which I can if I try hard) . . or tey GRE & Toefl Way or Some research work any how....Kindly guide me as My whole directions depends on 1 Right Decision

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    1. Since you desperately want to pursue your dream of medical training in US, and your heart has not really quit and , the answer if pretty apparent. it is not bad to apply with out step 3 scores but certainly a problem to apply with a step 3 attempt. now you are left with no choice but to rectify the attempt on your step 3. even then you will be looked at negatively because programs do not like attempts of any sort on the applicants resume. SO try hard score well and try your luck. GRE route is long and just as difficult alternative. that is always an option if everything else fails, but do you really want to give up being a physician and move into a totally different field at this time? think about it.

      Delete
  28. Or whether I should give up for ever

    ReplyDelete
  29. Hello Droidor,

    Its amazing how you have continued to update this blog. I have a bit of a convoluted plan but I will really need your input. I understand that there is no easy decision at this point and that I may end up sacrificing a good thing I have.

    I have an MPH and currently doing a PhD in nutrition in a good school with full funding. I will be completing coursework soon. There is an option of getting a Masters if "something happens". I do not have competitive USMLE scores with attempts on 2 steps (CK and CS). I want to apply for a prelim IM spot or categorical FM. I know these are very hard to get because of my profile and I still need to figure out the logistics for interviewing. My question is: If I match into a prelim IM program, can I risk getting one year off my PhD, with the aim of coming back to continue by giving them a suitable reason/excuse/lie? If I get a cat FM, I plan to get a masters and move to residency. Also after the prelim year, can I try for a PGY2 spot or go to preventive medicine residency (Which I also know is not an easy endeavour?)

    Sorry for the multiple questions but you can guess I am trying to make an informed decision. Thanks

    ReplyDelete
    Replies
    1. first things: do not subvert or lie. Academia is a small world and you will find that it will come back and hurt you really badly if it comes to pass that you have been dishonest with your fellows. you will need to mainatin good relations with your current program as you are going to need their support many years down the line (letters, job, applying for medical board, applying for green card etc..it call comes back). I dont see an advantage of doing a year of prelim Im and coming back to do a PhD because you will likely jeopardize getting a PGY2 spot. programs like to have smooth transitions. PLUS a big no no is break in your residecy even though it is well intentioned, you will be left explaining for the rest of your life why your GME was not continuous, trust me the amount of effort you will need to justify this to a prospective employer or a state medical board is humongous. So at this point be clear to your lab and PI what you plan to do once this happens. Good luck!

      Delete
  30. Hello dr.oidor
    Thank y for these information ... I am graduated in 2011 .. I have bad usmle score 193 in step 2 pass cs both from 1st attempt(but I know now a day it does not matter since I have bad score) .. now I am confusing whether I start preparing for step 1 and do research and USCE and catch 2014 match season or to spent the time on GRE and Toefl to get in to phd program hopefully to get in residency spot after that .. and while I being through the process of phd acceptance process I can finish step1 cuz it takes almost 9months from starting apply in NOV till get enroll in next july if I accepted and still able to catch the 2014 season but with 1 or2 months obdrevership at most .. thank y for your time

    ReplyDelete
    Replies
    1. Hello Dr. Omar, I am confused by your question but will answer it based on what I think you are asking. Yyou will be in a better position to assess your chances once you have the step 1 scores in your hand. i recommend considering the GRE option if your scores are consistently poor. it have a superb performance in step 1 and you are able to justify your poor performance in step 2 you may still receive interview invitations. USCE is always better to have on your CV and more than that the contacts you make from USCE help even more if used appropriately.

      Delete
  31. And also please if y can guide me thankfully how can I enroll to medical school since I am an img graduated ..

    ReplyDelete
    Replies
    1. are you planning to do medical school again in US after being graduate from a medical school in a foreign country?

      Delete
  32. Hi Doctor,

    I am an old IMG ....I was not able to pass USMLE step 1 when i moved to this country as I had to work full time and other circumstances....Should I keep on running after USMLE or change my course a little bit . I was planning to persue my studies further by doing MPH and then PHD ....but can I take admission in PHD directly ...and if yes whats the procedure to do that?

    ReplyDelete
    Replies
    1. you apply to graduate school directly. what is the point of doing a MPH and then a PhD? the doctoral studies are varied and after MPH you may be pigeonholed in to doing your thesis on a limited area of medical expertise. if you directly apply to a PhD program, you have the choice of the field you want to apply to. see the options listed in the article above.

      Delete
  33. Hi Doctor,

    thank you so much for this informative post.I have a question about the pre requisites.Some of the pre requisites for PA,nursing or phd were never taken when I was in medical school such as sociology and anthropology,while others such as anatomy,physiology ,micro I did take but some programs require that these courses must have been completed in the last 5 years.So my question is can I still transfer to a community college to take the pre requisite courses since I need those to apply for a higher degree and strengthen my application for residency in the future.I am in the USA under f1 visa.Do you think a transfer would be possible in my case?

    Best regards

    deb

    ReplyDelete
  34. hello doc.

    can u say what are the chances of getting accepted into a PhD program ,in a reasonably good institute with just MBBS background and no research/lab experience,given that the candidate has good GRE and TOEFL/ILETS score ????

    Regards.

    ReplyDelete
    Replies
    1. pretty good. if you have very good GRE and TOEFL scores, then your MBBS background with no research should not be an issue. Programs are looking for candidates with commitment, drive and ambition to do research. Even if there is a sliver of doubt that you are not going to conclude your training and skip to bail the research ship, they will not take you.

      Delete
    2. firstly, thanks for the reply.
      well , with a MBBS degree and no research to my name , the program would surely think that i m choosing theirs just to get into the system..!

      Any tips on how to convince them that i would see it through??and not leave it halfway for residency..
      and also , having a USMLE STEP 1 on my CV, will be seen as positive or increase their dobut ??!!

      Regards.

      Delete
    3. your statement of purpose which is similar to a PS letter drafter for residency purposes should be able to do that. also make sure you call and contact the grad schools in person so that they have a better idea of who you are and what your goals are

      Delete
  35. Hi, I am a cuban medical doctor, neurologist....I have to do usmle steps exams for my lisence here in USA, but I am interesting too in a PhD noe before to do the exams....what can I do, Please?
    Thanks

    ReplyDelete
    Replies
    1. PHD is a long time long term commitment, if research is something you see yourself doing in the long term then it will be a good path to choose. for now you should focus on USMLE exams if you want to practice medicine. good luck!

      Delete
  36. I am an old IMG from India passed out in 1994 . Then clinical practice till 2010 in India. I came here in 2011 with my husband. I have no intention of writing usmle but want work here. What are my options? I don't mind going to school again. Was thinking of MPH until I read all the above. I have not done any research. What other masters programs can get me a job

    ReplyDelete
    Replies
    1. MPH is not a terrible option. it is a little rough for those who want to get back into medical practice and do MPH to buy time. but if you are not wanting to pursue the medical practice and are thinking of doing non clinical but medical services then it should be no issue. Also do consider health administration and health informatics as they are 2 very solid options for someone like you

      Delete
  37. Hello sir......

    It is a wonderful article that u have written and tackles the residency vs pHD dilemma very well.....kudos !!!!

    I was very much interested in the research field since my school and had evn got admission at Ohio State Univ in Molecular Genetics...but my parents thought doing medicine here in India will serve me well and so I had to forgo that option......though I do not regret it much as being a doctor has its own advantages.....!!!!

    Im a 2012 graduate and started my USMLE prep but due to some unforseen circumstances was not able to give my step 1 or ck till now and you may be knowing that sept 15 deadline for 2014 match is anything but here...:(
    I do not want to waste another year as I have already wasted the previous year doing nothing much......

    My dilemma is that now should i continue my prep for step 1 and sit for 2015 match or can i still give my GRE in 2-3 months(Aug,Sept,Oct) and apply for various pHD prog.as a backup as most have deadline in dec start.....

    If i do get selected at a very gud university.......i wil take it as I love research anyways.....if not....i can go back to preparing for my steps from dec onwards as I will have a full year to give them now.......

    So is it a good plan to give the GRE with 2-3 months prep and apply as I do not have a chance for this year match in USMLE but i can still try for pHD or should I wait for the next year 2 sit in the match of USMLE and then go 2 dis back up option.......wat do you say sir....???

    P.S. I do not consider pHD as a back up per say....i have said it as a back up only coz i chose USMLE over pHD as my choice of prep....so i do not mind going into pHD also from a good university if i can get it this year....

    i know its a very long post....sorry for that, but I have no 1 else to look up to....sorry and thanks in advance for your advice...:)

    ReplyDelete
    Replies
    1. all said an done, between USMLE/residency and GRE/graduate school I recommend doing residency option first simply because of how things may shape for future applicants. Things are getting tougher each year and policies change. It is difficult to speculate how things will be in 4-5 years, I suggest you continue USMLE preparation and see how you do with your residency application. GRE is an option if residency is difficult. research is always an option later on in life should you decide to pursue it.

      Delete
  38. Thanx very much for wonderful article :-)
    Wish u all the best

    Can I ask some questions?

    1- getting phd in any programme will be strong enough to take a surgical residency such as orthopaedic , neurosurgery , plastic?


    2- Do u prefer md/phd programme or MS for IMG?

    3- can we consider PHD , MS and PAs an alternative ways from research , observship and publications ?

    ReplyDelete
    Replies
    1. If you look at some of the data analysis about the programs that rely on research - http://www.mleresidencytips.com/2011/04/how-important-is-research-for-match.html
      This is the concluding para from that article, hopefully, it will answer your questions.
      As an IMG sadly, the programs tend to place less weight on research than on other factors. So unless you are aiming for a career in research (Clinical or otherwise), banking too much on this may backfire. If through your research you will get publications, make yourself known, and develop relationships with people who are in a position to help you secure residency than by all means go for it. The problem with doing research is that you must have something conclusive to show at the end of it. Unless you want to go on for PhD or devote yourself to committed research, there is 'law of diminishing returns' when it comes to IMGs and research. It reaches a ceiling effect after a few good publications. This on the other hand is not true for AMGs, and more they place emphasis on research, the better and better their chances become to match to stellar places.

      Delete
  39. Hello Doctor
    I went through all the discussions here and must say you are doing a great job. I wanted to get some doubts cleared. I have cleared my steps and am ECFMG certified. My step score is bad (I barely passed) and I have a 224 on step 2. Although I am going to apply this year for the match, I am not too sure about my prospects. I still haven't given step 3. If I don't match this year, would you recommend I go for a 1 year MPH degree or try getting into some research somewhere in the US or get into PHd (that will be too long). Also is there any difference between a 1 and 2 year MPH?

    ReplyDelete
    Replies
    1. If you are looking to do MS or MPH solely for a gap filling measure then I recommend that use the timeline that would allow for you to be successful in getting USCE, connections or anything that will help further your application. If it is going to take a year then a year it is, if 2 then two it is. PhD is going to be a long term investement with most return compared to other options.

      Delete
    2. hello droidor,
      you are doing a great work here.

      I am img, with good step 1 and ck scores, awaiting cs results. i recently got into a phd program here in us few wks ago. i want to apply this fall for the match.
      i need USCE, so i intend emailing some attendings in the affiliated medical school for a chance to shadow them, with the hope of getting recommendation letters for the match.

      my question is that if this comes to the knowledge of my phd program, can it affect me.

      Delete
    3. it may affect your personal relationships with the members of your department. If you do not care about how or what they might think of you, then it should not matter. But remember, play it carefully since if the word goes out that you are trying to bail, it may affect initiation/continuation of your project with the PI

      Delete
    4. thanks droidor,

      i will refrain from doing usce with the affiliated teaching hospital. i will consider other sources.
      i dont want a bad reputation with the faculty or PI, since the PhD is my plan B.

      Delete
    5. Hi crafted222
      Can you please share your email ID? I need your guidance regarding the PhD path. Please!!!

      Delete
  40. hi droidor..thank you for starting such an informative post:)
    I have just joined MD microbiology in India. I want to get into research in USA.Should I go for a phD course post MD, here in India and then apply for a job there or should I apply for PhD in US directly. Do I have to write GRE for that? What do you suggest sir

    ReplyDelete
    Replies
    1. you will need to pass GRE and TOEFL to be eligible for graduate schools in US. Ideally the sooner you get in to the US education system the easier it becomes to get a job afterwards. That being said, it may still be possible to get into research in US after MD microbiology in India.

      Delete
  41. Hello Droidor,

    First of very kind of you to take out time to reply everyone.Doing a very wise job.

    Finished my MBBS in 2010 Feb from mumbai,same time took step 1.Was not a very wise decision to get rid of the exam soon but i had my reasons.Got 79 percentile in the first go.Later started working full time as it was a necessity at that time.All clear now n planning to get back on MLE front.have hands on clinical experience of almost 3 yrs now.Don't want to waste any more time and move forward in a flawless way.Was planning to find a program that would buy me some time in the US to pass the rest of the steps plus give me an edge over others.

    I read all the previous posts and analyzed that PhD is the only worthy program to make up for my step 1 bad score.Is there anything else for me?will also work my life out to get a good score in ck and clear everything in the first go.

    What do you think about it?will this work out?

    Thanks a million.

    ReplyDelete
    Replies
    1. 79 on step 1 is tough score to apply with. PhD is a big commitment in time and effort. If that is what you think are your best chances, then by all means go for it. IF you are going to do PhD to buy time and pass rest of steps, then PhD may not be an ideal option, there are others - MS, MHA , MPH etc. If you want to have a solid back up plan and work on laying strong foundation then I recommend thinking about PhD in a pathway that you have an interest in, finishing it and then in parallel work on your steps and then decide what you want to do.

      Delete
    2. Hello.

      Thanks for the previous replies.

      As per the other articles here,MPH is no longer an alternate way to get residency which leaves me with only one choice - PhD.Presently PhD is the only option looking decent and very promising to compensate for my low step 1 score.What do you think?

      Is it really worth going for MPH these days?

      Thanks a ton for your time.

      Delete
  42. Practicing in the US has always been my motto.if i score well in the rest plus earn an additional masters either PhD. or PA,do you think i still stand chances finding residency in the US?

    ReplyDelete
    Replies
    1. it is possible, but at this time there are too many blanks left to fill to get a better gauge of how you will do.

      Delete
  43. I missed out my score.it was 194.

    ReplyDelete
    Replies
    1. OK thanks, see replies above. Good luck!

      Delete
  44. HiDroidor,

    I am an IMG. I am specialist anaesthetist. My interest is in critical care.

    I am also australian medical council graduate. Currently I am aorking as intensivist in india. I have 5 years experience in anaes and critical care.

    I want to gain an experience in critical care or anaes in usa.(Fellowship/PhD)

    Could you advise me if PhD in which university I can gain entry to gain experience in critical care/ anae/research in critical care/anaes?

    Which pathway should be chosen by me?

    ReplyDelete
    Replies
    1. Hello Dr. Singh, it will be very hard to come by clinical programs offering PhD in anesthesia research. This means you will be devoted to doing non-clinical work in a graduate program at a university. If you are okay doing that then, by all means it is possible. Some potential areas of interest for you in this case would be anesthetic drug discovery, pharmacology, pain physiology, receptor chemistry etc. Then again the possibility of being a clinician while you are getting PhD will be very remote. There are anesthesia fellowships pain medicine, critical care, obstetric anesthesia, CT anesthesia etc which may be also options for you but this will have to be negotiated with individual programs.

      Delete
  45. how to get a PhD in bioengineering when you have no background in Engineering at all?

    ReplyDelete
    Replies
    1. you may have to lay some ground work before you may be eligible for the admission to a masters or PhD program. IEEE Engineering in Medicine and Biology Society (EMBS) this may offer some clues. some institutions allow for a direct PhD entry for those who do not have MS in engg or biomed engg. Hope this helps. Good luck!

      Delete
  46. Hello Droidor,

    Just a friendly reminder that I am still waiting for your reply and suggestions.

    Others too feel free to post comments or suggestions in reply to my post.

    ReplyDelete
    Replies
    1. HI Dr. Sumit, Thanks for the reminder. I do this as a hobby and is not my full time commitment. I do try and help as much as I can, when I can and usually reply to all comments in batches.

      Delete
  47. Hello again.

    Thanks for the previous replies.

    As per the other articles here,MPH is no longer an alternate way to get residency which leaves me with only one choice - PhD.Presently PhD is the only option looking decent and very promising to compensate for my low step 1 score.What do you think?

    Is it really worth going for MPH these days?

    Thanks a ton for your time.

    ReplyDelete
    Replies
    1. MPH in itself has little to offer in the way of improving your residency application. What it does offer is a chance to make connections, get established in the US educations system - get US LORS, observerships etc. With that in mind, weigh your pros and cons and then decide what you want to do.

      Delete
  48. Dear Droidor.

    Its now 5 years since I graduated. I have a 85 and 86 on step 1 and 2 respectively and passed CS on my 2nd attempt. Naturally not a very promising profile. Got 2 interviews last year but did't match. will apply this year too but I am not keeping my hopes high.
    I have 2 questions if you would be kind to answer them ..

    1) Does one has to pay tuition fee in the first 2 years of PhD ??

    2) By the time it will be done it will be around 12 to 13 years since my graduation (MBBS) . would there be some hope of getting a residency after that long ??

    You are doing a wonderful work sir, taking time out only to help people. I thank you.

    ReplyDelete
    Replies
    1. If you are accepted to a graduate school then you will get stipend for your PhD (which is like a salary - but you are not an employee). you tuition may also be waived. Many good school with decent funding are able to do this, so it is important to check the standing and funding of program before you apply. 12+ years is too remote in the past to be eligible for residency but then there are impossible cases of very old grads who still get in. So it hard to say, each case is unique but on a whole - the chances are not very good.

      Delete
  49. Dear Droidor.

    Got in touch with a few more docs working as hospitalist in US hospitals.Also gave me the same advise as you.
    They said to go for PhD only if ready for a commitment and later ready to settle for something else other than residency.
    If residency is the only goal then go for MPH or MHA.
    Thanks for everything.

    ReplyDelete
    Replies
    1. Glad to know that you are getting similar feedback from other physicians. Good luck!

      Delete
    2. Thanks for the wishes and good luck to you too..

      Delete
  50. Thanks sir. This is just very informative. You are really helping people. My best wishes for you...........

    ReplyDelete
    Replies
    1. Thank you for the good wishes. Good luck!

      Delete
  51. I am an IMG with 3 yrs clinical experience in my country. Planning to follow this PhD path into Orthopaedics residency in the US. Need your advice on the PhD programs that i can apply for. Thks

    ReplyDelete
    Replies
    1. Orthopedics residencies are extremely competitive. I personally do not know or heard of any IMG getting in ortho residency especially by the PhD path. Surgical specialties like ortho are tough even for american graduates. Good luck!

      Delete
  52. thanks sir.The information provided by you is of immense help .Its great to see that there are still people in world who have desire to help others without any selfishness or personal benefits.I am planning to work in pharma industry in India and later on going for phd in pharma in us.I graduated in june 2013 ( cleared every mbbs semester in single attempt) from India but have only average of 60% marks in mbbs.Can I still get into good phd programmes with gre&toefl.

    ReplyDelete
    Replies
    1. Yes, I think it is very much possible. Admissions to graduate programs rely significantly on the standardized test scores. So your goal would be to excel in GRE and TOEFL and aim for really high scores. If you do well in these exams, your MBBS scores may not be an impediment. You might also want to highlight in your Statement of purpose (SOP) your education in pharmacology and pharmaceutics in your 2nd year MBBS and the experience in pharma industry. good luck!

      Delete
  53. Thank you for your advise. I am an IMG with more than 10 year out of medical school. This is my seecond time applying for FM residency and no interviews. I am preparing to take step 3 but at the same time i am loosing hope about getting to residency since it is becoming very difficult. I have also MPH graduated May/2013. I am thinking about joining PHD or fellowship. I need your help to guide me regarding the possible options.
    Thank you.

    ReplyDelete
    Replies
    1. Hello Dr. Fevere, the best recourse in this situation is be content and confident in the decision you make. If you are through with your tryst with USMLE and residency journey, then you can start planning you career in other areas that are medically related. If you want to pursue PhD, have you though which field you want to pursue doctoral studies? what will you do after PhD - academics? research? industry? pharma? what is your aptitude? you will have to spend at least a decent amount of time answering these questions and seeing you are an appropriate fit. If not, the last thing you want is 5 years down the line you find yourself in a frustrating situation where life is not enjoyable. Work on GRE and TOEFLs, look you grad school and programs and take a good amount of time to know your strengths and weaknesses and see what career choices would be your best fit

      Delete
  54. dear sir,
    thanks a lot for so valuable information...i completed mbbs in 2008 and did residency in general surgery in india in 2011..currently i am senior resident in surgery....having this journey of mine in clinical field, can i still be able to get Phd in microbiology or pharmacology ?? will this is journey of mine be advantageous or disadvantageous for me for this particular field? i was thinking about it for last 2 years but everytbody suggesting me against it..i dont want to continue in clinical field .. may i be considered for phd applications after taking gre and toefl...? please answer.. it is very important for me to clearly understand pros and cons of doing it before i make my mind firmly..
    thanks in advance...

    ReplyDelete
    Replies
    1. Yes it may be possible. you need
      1) strong justification to switch career to research track
      2) Excellent GRE and TOEFL scores.

      you might want to add to your personal statement that you have already finished residency in home country so you are not interested in pursuing residency in US. This will be looked up favorably, since may physicians who apply for PhD track drop midway to pursue residency in US. You made a pretty decisive statement: "I dont want to continue in clinical field" which tells me you are to some extent decided. Thats good. Pursuing non clinical medical related fields definitely get an edge up if you have a doctoral degree.

      Delete
  55. Sir i am fmg completed my medicine with 2 years work experience ... Planning to do MPH EPIDEMIOLOGY .... Not intrested in clinicals.... After seeing your tips above i have queries .... Can i apply for phd will it increase my chance in job aspect.... Or do i need to complete my mph and go to phd

    ReplyDelete
  56. Hello Droidor-
    First of all thank-you for all the information and suggestions you have provided through your blog. Your work is very much appreciated especially for the IMGs who are looking into different options beside residency. I am an img graduated 5 years back and unable to get into residency . Now I want to pursue PhD in Pathology permanently. My interest is only pathology and its sub-specialties. Is there anyone here who is looking into PhD pathology. I tried to find a forum for discussions about PhD, but count't find one. DrOidor are you a PhD graduate? Can you mention what was your specialty and how was your experience. The other thing I am worried about PhD is whether there are good jobs after 5 years of studies? I am not talking about high pay but a moderate pay and be able to feed our family. I see most of the work that a PhD patho does can be easily done my MD pathologist, so i don't see jobs opportunities in hospitals . Jobs can be in some research or drug industry. Any suggestions are appreciated thanks. Good Luck to everyone.
    Ray

    ReplyDelete
    Replies
    1. Hello Ray,
      There are graduate school options in pathology and are usually graduate programs in anatomic or clinical pathology or pathobiology. It is relatively rare for someone to be interested in graduate pathology school and that may be a reason why there is paucity of online discussion. This does not mean it does not exist, perhaps you can pose the question in one of the may forums. Jobs after PhD are available, there are always situations which need highly skilled personnel both in academia and in industry. As a PhD patho your job profile may not overlap strictly with MD pathology but what it entails may not be what you might be interested in. As an example please take a look at the graduating students of http://www.bumc.bu.edu/busm-pathology/graduate-program/ and see where they are going for jobs.

      Delete
  57. Hello Droider,
    I am an international medical graduate from 1996.Do i stand any chance in any residency program in USA.I am residing in USA .
    thanks,
    Khan

    ReplyDelete
    Replies
    1. Depends on a lot of factors including your USMLE scores and what you have been doing since you graduated. Good luck

      Delete
  58. I have done my MD and doing my PhD in Europe. If I come to USA do I get a waiver for passing exams for obtaining a licence to practice and teach.

    ReplyDelete
    Replies
    1. @sharat: You will have to complete usmle steps, get ecfmg certified and get into residency. After that you can practice as an MD. For teaching I think you can get teaching opportunities.

      Delete
    2. Every one who has obtained a medical degree out side of the US medical schools needs to be ECFMG certified. To practice as MD you have to be hold a state medical license (temp or permanent) for which you have to satisfy certain criteria including passing USMLE exams. There is no waiver for obtaining license to practice a full practicing physician (as far as I know)

      Delete
  59. Thank you for your very informative article. Is it possible that one can still get into residency after 12 years of graduating from medical school ?
    Thanks for sharing.

    ReplyDelete
    Replies
    1. depends of a lots of factors, some being USMLE scores, the people you know, what have you been doing in the last 12 years etc...

      Delete
  60. Hi Droidor,

    My wife an MBBS graduate from India. She's in US on H4 visa. She gave her USMLE Step 1 examination, but the score was not good. Now, considering the competition and the number of years for residency, she plans to choose for non-clinical options in USA. She doesn't want to take up USMLE step examinations. Please let me know the masters options (not PhD) available for MBBS graduates in USA in non-clinical departments. Also, it shall be great if you can share the list of universities that are good in such non-clinical depertments. Please share the list of non-clinical departments which have good job opportunities in USA.

    ReplyDelete
  61. I am an mbbs graduate from India....I graduated last year..I wna pursue either ms in non clinical fields or phd in us...i am in h4 visa right now planning to take up gre and tofel in a couple of months...I would like to know the merits and demerits of both the options...I would also like to know which one has better job opportunities and decent pay...waiting for ur valuable suggestion so tat I can proceed further

    ReplyDelete
    Replies
    1. Your question is very broad and has been dealt with in some effect on this site and also on other sources. In any case, job prospects after doctoral training may be better especially for a physician. Is your final goal pursuing residency in US or you are just looking to change to a non clinical field?

      Delete
  62. This comment has been removed by a blog administrator.

    ReplyDelete
  63. I am looking to change to non clinical field .......I would like to know what branches of masters-pharmacology,microbiology,biotech.....etc has good job offers....thanks for your kind response.....I will b happy if u further throw light on the specific fields which will earn an immediate job .....also I request you to provide me with other links pertaining to ths.....

    ReplyDelete
    Replies
    1. it is had to predict job offers a few years down the line. Chances of getting an immediate job are better if you have a doctoral degree but having masters may also work. Microbiology, immmunology, biochemistry, genetics, may offer chances to hop on over to industry sponsored line of work. However, just having masters may place you at considerably lower pay scale and limited choice of work profile. Depending on your legal status visitor, student, perm resident etc it may affect your job prospects.

      Delete
    2. can suggest more as m a md microbiology and m looking to imigrate in us

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  64. Thank u Sir for ur valuable suggestion...............I would like to know whether clearing all the steps of usmle is a must even after getting phd...?I f i wna apply for residency after phd what are the pre requisites?should i clear all the steps and start from scratch again or is there a simpler way?..kindly reply

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    1. USMLE steps are not a must for PhD - for graduate school must to complete 2 things 1. GRE and 2. TOEFL
      After PhD pre-requistes to residency are the same - must finish all steps and get ECFMG certified. The scores are valid for 7 years. if you can finish you PhD in that time frame you may not need to begin from scratch but if it does otherwise then you will have to take the exams again. From USMLE FAQ "Most medical licensing authorities require completion of USMLE Steps 1, 2, and 3 within a seven-year period, which begins when you pass your first Step"

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  65. Hello Droidor-
    I am a 4th year MBBS student in India and would like to pursue pathology in the future, preferably do lab work and teach.
    I would like to get into pathology residency. But since getting into pathology residency can be difficult for an IMG I wanted to explore other options. I am confused between 3 options
    1) Try to crack the entrance in India and do MD pathology
    2) Is Phd in the US a good idea for me considering the fact that I don't have any research experience and have no specific idea about my area of interest in pathology? How do I convince the program if I don't have any clear cut idea about what I would like to do research on? Will LORs from my clinical tutors or my pathology professors be acceptable?
    3) What is your opinion on doing MS in Pathologists' assistant program in the US?
    Any advice is welcome. Thanks.

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    Replies
    1. My impression is that you do not want to see/diagnose patients and are okay with laboratory work and teaching. If you do MD pathology in India, you could find a fulfilling job at home and continue with the line of work.
      2. Prior research experience is not a usual prerequisite for many graduate schools in US. You need to have good scores in GRE and TOEFL and work on your personal statement as to why you want to do research. you should explore some broad areas - genetics, virology, physiology, microbiology, pathobiology, immunology, infectious disease, neuroscience etc which you find attractive and present your case why you find them so. I used LORs from dept heads not from clinical faculty but from basic sciences faculty (microbiology, physiology and biochemistry) when I applied to grad school. for point 3, will you be satisfied doing low cerebral repetitive grunt work? (processing laboratory and pathological specimens, not involved in analysis or diagnosis), if yes, then its okay but being trained as a physician you may find it less stimulating. Also, pay grade compared to a pathologist would be very small.

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  66. any suitable jobs for doctors in usa without steps?

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    Replies
    1. not as practicing physician. There will be other opportunities (pharma, health informatics etc) but not in the capacity as a doctor.

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  67. Hello doridor
    I have a question about tuition of phd program.I have searced some university and their tuition are so expensive for phd.is there any way to get a loan or scholar!?

    ReplyDelete
    Replies
    1. Before applying, check to see if the graduate program offers 2 things (Most of them do)
      1. Tuition waiver
      2. Stipend

      e.g https://www.drexelmed.edu/Home/AcademicPrograms/BiomedicalGraduateStudies/FinancialAid.aspx see the first 3 bullet point.

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  68. hello sir,
    U have done a great job answering almost all my queries......I would like to know the opportunities for ms pharmacology....I am interested in ths field but not sure if it can get me an immediate job with a decent pay.....also since i am in h4 visa i am not able to get a medical assistant job temporarily to bear my tution fees....wat can b done about tat?pls give me suggestions regarding ths visa issue.....and the scope for masters in pharmacology..also i want to know whether campus placements are there for such non clinical fields similar to masters in I.T or computers......


    Thanks
    Preethi chandrasekaran..

    ReplyDelete
    Replies
    1. unfortunately visa restrictions regarding work outside of scope of visa allocation are strict and should not be broken. You can get better opportunities and/or legally be able to obtain work experience under student visa or related H visa. MS pharmacology opportunities are there but may not be as great as if you have doctoral studies in the same subject. If you are accepted to a graduate school, there are non-study related campus opportunities like working in computer lab or library or being a research assistant (RA) which can help some.

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  69. hi.
    iam almost a medical graduate waiting for my final MBBS exam result to come in. iam very much interested in surgery pref gen surgery as my future speciality. i have heard its very very hard for an IMG to get into any surgical field in the states. no i havn't done any electives in the US or any LORs as for that matter. so should i go for steps and apply for surgery or do you think i should take the phd route and then after phd apply for surgical residency when i have made connections, done observer-ships and attained LORs. i would immensely appreciate your input. thanks in advance :)

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    Replies
    1. It is true that surgical specialties are highly sought after by the American medical school graduates. I do not personally think that there is any merit in doing PhD only get residency in surgery. You do PhD if you want to do research which could be bench-lab work or clinical research. #1 concern for you should be getting very high scores on your USMLE and then decide if, surgical residency is still worth considering. You may want to work on getting some surgical experience/letters from surgeons on the side while you are prepping for your USMLEs

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  70. Hello I am Otolaryngologist and Facial Plastic Surgeon with 15 years of experience from Colombia. I receive my visa : alien for extraordinary ability EB1a. I am in a process to receive my green card. Is necessary to me, take USMLE to job, or how I can get a medical license in some state in USA?? which is a process? Thanks

    ReplyDelete
    Replies
    1. Congratulations Daniel on your Green card. This certainly opens up a host of possibilities as far as employment is concerned. However, as far as I know, state medical boards which oversee the medical licensure require foreign trained physicians to be ECFMG certified. For that you have to pass USMLEs May I direct you to http://www.fsmb.org/usmle_eliinitial.html which will be helpful for answering your questions

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  71. Hi Droidor.. I am an old IMG(2002) living here in the US with my wife who is in IM residency. I have failed Step 1 in my first attempt and now I am on the process of studying for the 1st step again. I am having difficulties since I work for a UK company doing work for them around the globe. I am planning to quit my job and concentrate on the steps. However, it dawned on me that I wanted research and the academe more than I want a medical practice. I believe that I can pass the steps with a good score now that I have consulted a lot of guys about test-taking but my problem will be matching maybe because I am an old graduate already. I am considering taking a PhD just in case I don't get matched. My wife plans to work as a hospitalist next year and if things don't turn out good for me, I was hoping to get a PhD on Micro-Immuno though I know it will be a tough program but once I get in, I do not plan of getting into matching in the sides. I believed you have discussed this( someone opting to take MD again here in the US) before but what are your thoughts about the Medicine-research(MD-PhD) program? Thanks in advance and more power to you!

    ReplyDelete
    Replies
    1. MD PHD programs is for those college graduates who want to do medical school (MD), spend few years doing research training (PhD) and then return to finish medical school. You may or may not be eligible to do medical school again depending on your previous course work, in any case please see https://www.aamc.org/students/applying/requirements/ .
      Also do you want to/ are you prepared to spend another 5-7 years in medical school then 3-5 years of residency (+2-3 years of fellowship, if you want to do something specific) if clinical practice is going to be a part of you occupation (as physician scientist - i expect that you will have 40 to 25% time allocated to clinical duties - rest research. a ratio which changes as your become more established as a scientist ie less and less clinical time). If academia and research are your new goals, then you may be better grounded and ahead time wise by doing a fantastic PhD at a good school so that you are ahead of the independent scientist curve

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    2. Hi again Droidor. Your reply makes a lot of sense and I appreciate it so much. Do you have any idea if it is quite tough to get into a PhD program on Micro-Immuno or even Genetics? Thanks again for taking time answering our queries. Cheers!

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    3. its not a cake walk but it is not super tough either. Focus on your GRE scores and then tier your applications to programs according to that.

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  72. hi droidor..you are doing an awsome job..may God bless you..i am a 2011 graduate with distinctions and gold medal in biochemistry and pathology..i want to go for phd in infectious disease immunology...im not very interested in doing residency..i want to ask how is life in phd..like how hard it is..working hours..how many hours will i have to study ..i am a mother of two babies who need alot of attention..that is the reason i didnt go for residency option..is phd family friendly??..currently im doing my msc in infectious disease from UK..n plan on doing phd in USA..and when im done with this i plan on getting a job in academic field...

    ReplyDelete
    Replies
    1. Hello Dr. Sekal, I am glad you have made up your mind and not hedging your options as that can may it difficult. Since you are committed to pursuing a research career. Let me answer your questions, with a research perspective.
      Life as a PhD grad student is varied. It can be as tough as you want it to make it or you can just skim on the surface and graduate with some thesis. However, the hard work you put in is directly proportional to your out put as research scientist and thus enhances your post graduate chances of a cush job. You have to be ambitious and be wiling to make some sacrifices up front. Life as a grad student can actually be very rewarding. You will get to meet great friends (since you are with then for 3-5 years) and you will develop a higher order of critical thinking. PhD can be family friendly, but while you are in grad school supporting a family can be a little tough. You may not have the luxuries but you can definitely get a nice place and support your family on a stipend. I know of many grad students who were married and had kids during their PhD. So in conclusion, it can be a very rewarding experience personally and professionally.

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    2. thankyou so much for your valuable input

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  73. and can you please tell how is life in academic field..what are working hours ..is it family friendly...i know it is not as rewarding as a physician but my main aim is to get an easy going job as my main job is to take good care of my family but i dont want to waste my medical education too...i really want to get into academic field ...il be very very thankful for ur feedback...

    ReplyDelete
    Replies
    1. Life in academic field can be pretty ordinary as far as comparison to other regular jobs go. Depending on whether you have a job in the industry or in academic university you will have mostly fixed hours. Unless you plan to be an independent researcher with NIH/independent grants, you will have time for your family as well.

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  74. Thanks a lot sir.....I understood clearly that doing a phd is always a better option....I am going to write toefl on april 5th and planning to take gre soon....unfortunately almost all universities closed the applications for phd and deadline is already over for fall 2014....I heard spring admissions are very less ...I want your valuable opinion on this...Are there any chances of getting into a phd program during spring?If so what is the list of universities offering spring admissions?Do I have to wait for next fall ...I mean fall 2015.....If there are chances of getting spring admissions kindly let me know the list ...I am very anxious because i dont wna waste 6 months ...Kindly reply

    ReplyDelete
    Replies
    1. generally most school start their academic admission in Fall, thats when most positions open up, most grad schools recruit students. IF there is a particular school you are interested in, ask the department chair if you can start in spring. If they are keen on having you, they can make the exception and thus you save 6 months.

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  75. I'm an ECFMG certified IMG. Can I start a PhD in pharmacology and toxicology without a Masters in Pharmacology and toxicology first?

    ReplyDelete
    Replies
    1. yes, you can start your graduate school and there is no prerequisite for a masters prior to a doctors. If you are in a PhD track program, the first 2-3 years are considered as your masters training, you will appear for a PhD qualifier exam which if you pass can only then you proceed with doctoral training.

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  76. I am a ECFMG certified IMG and a graduate of year 2009. I have research experience only in gastroenterology and have published 2 papers in it too. I have no Neurology/Neuroscience/Neurosurgery research or clinical experience. However I attended a neuroscience course about 6 months back. I am interested in Neuroscience and research in neurotrauma and neuroregeneration. My experience doesn't show relevant experience and neither are my LORs from neuro-people. Is that a real problem? How do I go about it?

    ReplyDelete
    Replies
    1. I want to get into a PhD program in Neuroscience.

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    2. Hi! Thanks for writing. I have answered your question (Q7) with few other questions here http://www.mleresidencytips.com/2014/05/question-and-answer-session-1.html

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  77. Hi Sir,
    Thank you so much for your great advises. I would appreciate if I can have your professional opinion about my situation. My step 1 is 224, CK 213, but the problem is that I passed the CS in my third attempt. I am a carib grad and a U.S. citizen. Do you think I have more chance in Path or Psych? If doing master like immunology or biochem for Path or Neuroscience for Psych would increase my chances? Thank you

    ReplyDelete
    Replies
    1. Hi Sohio, Thanks for writing. I have answered your question Q1 with a few other questions at http://www.mleresidencytips.com/2014/05/question-and-answer-session-2.html

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  78. Hello

    I am a foreign medical graduate 2002 and I have master degree 2007 and doctorate degree in Geriatric medicine and Gerontology 2012. Currently I am a teaching staff in University and a consultant of Internal medicine and Geriatrics in my country. I am planning to relocate to U.S and till USMLE exams and these procedure are done what are advices and suggestion you can provide for my situation? thank you very much for your wonderful cooperation.

    ReplyDelete
    Replies
    1. Hello Dr. Fathi,
      My recommendation would be to concentrate of USMLE scores first. You likely would not have an issue as far as 'gap' in education is concerned since you have been involved in some form of continuous medial exposure. Also best to apply to family medicine or internal medicine since you will have opportunity to apply for geriatric fellowships. In fact, you may be a very strong candidate for a geri fellowship once you are through with your residency. Another alternative may be to look into direct geriatric fellowships. those however may come with limited options.

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  79. Hello Droider,
    I have completed my GRE and Toefl and I am planning to apply for phd in microbiology.I would like to know the impact of college ranking in application process.I would like to know whether I will be able to get a good job only if I complete graduation in the top graduate schools.In applying for the phd program what factors I should consider?Is the ranking of the college important?I request you to give your suggestions.

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  80. Hello Droider,
    I am an MD from Iran (1993) worked in clinical job for 4 years and then moved to UK in 1997 and received my PhD in Immune-Gene therapy (antibody engineering) in cancer from Manchester Uni/UK (2006). I came back to clinic in 2008 and repeated my internship. Then I got into psychiatry in 2011 to apply my Gene therapy knowledge in anti-addiction proteins and anti alzheimer Gene therapy. I am half way through to become a consultant (sub specialist) psychiatrist. However I found it next to impossible to work as physician scientist in the UK. Besides, due to some reasons I need to move to USA. I can translate genetic knowledge into clinical needs in tissue engineering, vaccine development and transplantation. I am a UK citizenl and a Canadian permanent resident. I will be grateful if I have your advice about whether there is any scope I can enter into pathology or Obs&gyn or other residency programms in the US?
    Regards
    Dr Huskhosr

    ReplyDelete

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