Question and Answer session - 1

Q1. 6 April 2014 18:15 User asks Thank you. 1-where does each program state its minimum requirements? 2-What do you mean by " it will filters in many a programs" ? 3-I was planning to go for radiology but after getting that score I decided to go for Internal medicine? Do you think it's a right decision? Thank you for your help. 

A1. Hi, Thanks for writing in, each program usually states their minimum requirements online on the residency information page. For example, check the Duke University emergency medicine application page. When I said, it “filters in”, I meant many programs will set their minimum to something like 220 in which case if you are able it, you will be in. Radiology is still pretty competitive. If your final goal is to be a radiologist then I would still consider that as a parallel option. 

Q2. Alex F. Lazo Vásquez, 8 April 2014 09:37 writes Hey. I have been reading your blog. Very interesting topics and thanks for everything. Concerning this topic (program rank order list and implications for applicant ), I was actually thinking that if there are more applicants, then it would be more difficult to match? Because you have more competition? But I do not have a good grip on this whole NRMP thing like you, so I might not be getting it. On the other hand, we are 2014 now, and I have heard that Radiology has become VERY difficult, especially for IMGs. Very competitive, and even more coveted than general surgery. 

 A2. Hi, Alex. You have a good question and are correct that if there are more applicants then it would be difficult to match but the point of the article was to compare the pool of applicants that are ranked versus those that are not ranked at all. Thus if the number of applicants in the ranked pool grows then each of those applicants in the pool has at least a chance (compared to the pool of non-ranked folks whose chance of matching is zero). Thus even if there is increased competition that is still better than being eliminated from the game early on. You are correct radiology has become difficult for all applicants and especially so for the IMGs. However, the above still applies, as long as you are on the program ROL somewhere, there is a chance. For example, you are on spot number 8 on a program ROL and there are 5 positions. All the 7 candidates above you that the program ranked chose not to go there, then despite being not in the top 5 you will still match. Thus the article says that if the pool of ranked applicants widens, then all those applicants automatically increase the probability of matching to > 0 compared to non-ranked where probability of matching = 0. Hope this helps. Good luck

Q3. Arifa patel writes on Physician Assistant program: A better alternative to MHA or MPH? (8 April 2014 14:36.) Hi thanks a lot, I have one more problem, most of the pa programs require anatomy, physio and biochem to be completed at a regional institute not accepting tge courses we took in med school. Are there any program s that accept foreign courses.

A3. Hello Arifa, I did check to see briefly, if there are PA courses that will accept foreign transcripts. Unfortunately, it seems like the requirement for training at US institutions is fairly uniform. There may be some exceptions since at the CASPA site  "If you attended a foreign school or earned your degree outside of the United States, CASPA does not require any documentation, but most PA programs DO. The majority of PA programs require that you have your foreign coursework submitted to an evaluation service for a course-by-course U.S. equivalency report.  This report should then be sent to CASPA directly from the evaluation service. Contact the foreign transcript evaluation service as early as possible. The services may take several weeks to process your foreign transcript once it is received." The best would be contact the schools in person or via e-mail and ask them to clarify the requirement. Hope this helps. Thanks

Q4. chhhhkpuk8 write on Fellowships without residency training  (April 2014 19:09). Hi! I just wanted to ask whether after completing such a fellowship, would one be eligible to write the board exams? (specifically for orthopedics, as ABOS doesn't mention any such thing on their website). Because as far as I have heard, board certification is pretty much necessary to get the patients to trust a doctor. Thanks!

A4. There are 3 types of fellowships that one can pursue.
1. ACGME accredited fellowships
2.Non-accredited clinical fellowships.
3.Non-accredited research fellowships.

ACGME accredited fellowships lead up to exam and board certification. These almost always require graduating from a residency training program in US. The Non-accredited clinical fellowships are common in highly special niche areas of medicine (movement disorders, neuro-immunology or even areas in cardiology) and can be applied to by either those applicants who have finished training in US residency programs or those that are ECFMG certified and are able to secure a training medical license. Some institutions will sponsor a J1 visa for the duration of the training. For example check out Gastrointestinal and Liver Pathology Fellowship  at University of Florida.
3.Non-accredited research fellowships. This is purely research and there is no clinical interaction with patients in any form.
So to answer your question you would know prior to applying/finishing such fellowship if such position was accredited or not. Hope this helps.

Q5. Gloria9 writes in response to Influence Of A Gap In Medical Education - Cv On Residency Application (April 2014 14:31)

Hi Droidor, How do I mention volunteer work in the CV? Do I have to submit some certificate/proof? I have been active with some university groups in the US who does voluntary works. Will those count? I don't know if they'll give me any certificates or something..Thanks in advance.

Hello Gloria, usually volunteerism by itself has limited influence on your CV unless it is 1) significant 2) directly involved medical aid (e.g. relief work during cholera epidemic in Haiti 2010-13 etc). Mention your volunteer work as per example,

OTHER WORK EXPERIENCE
Volunteer: 10 hours a week of nursing care under supervision for terminally ill geriatric adults at xyz nursing home.

Usually, there are no certificates for volunteer work and rarely you need to submit proof. The information provided is considered in good faith so not good to lie about it. having volunteer work on CV offers 2 advantages,
1) topic for discussion where the program director/faculty can engage with your in a nice conversation to know you better as a person
2) Show that you were pro-active and did not sit around accumulating gaps in your CV. Hope this helps, thanks.

Q6. Dr.Seema Thakur writes on Influence Of A Gap In Medical Education - Cv On Residency Application (15 January 2014 02:05). Am an IMG from India, currently preparing for step 1..How much gap is considered acceptable? trying for observership but unable to get. Can volunteer jobs be used to fulfill these gaps??

Hi Dr. Seema. usually a gap of 6 months may considered okay anything longer than 2 years would certainly raise questions regarding what you were doing for that period of time. Volunteer jobs may be used to fulfill some gap but if you keep rolling from one volunteer job to next then it may lose its appeal in big scheme of things. If you anticipate that you are going to have a tough time matching from low scores  or attempts etc then graduate school may buy you time better than volunteering. Good luck!

Q7. Rock Champ writes on PhD as an Alternative for International Medical Graduates (10 April 2014 23:14). 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?

Hello Rockchamp, Great choice that you want to apply to graduate program in neurosciences. The fact that you have some research experience is good in my opinion. Since you are interested in neuroscience, you have to ask yourself the question "what was it that attracted you to this field" once you find the answer - write down a very well articulated piece on your motivations to be a neuro scientist. This will be your personal statement. Seek out counsel of faculty or scientist in this field who you can share your ideas with. Ask about the state of science, funding and progress in their field (i.e show interest in what they do), they may even be okay writing a letter of recommendation for you. Then focus on GRE and TOEFL and score well. Poor scores will get you nowhere especially neuroscience which tends to be a little competitive.  Finally, once you have done all above - apply to all institutions that of interest to you and then wait for things to unfold (for the best). hope this helps. 

Q8. Utsav Shrestha writes on Step 1 score and Chances of interview  (11 April 2014 05:14). Hi, I am an IMG and recently completed STEP 1, and got a score of 245, I was really expecting more than that but what can I say. I'm interested in residency programs in psychiatry. I plan to give STEP 2 CK in the next few months. Just wanted to ask how my score was in comparison to the usual IMGs being matched for psychaitry and how much should I really get in my CK to keep the ball rolling and get into a competitive residency program. Thanks !!!

Hello Utsav, some calculations done using the charting outcomes data from NRMP indicate that the tipping point (i.e. the step 1 score above which more applicants matched versus unmatched) for IMGs was between 231 and 240 for psychiatry. So you are good in that regard. Compare to the similar tipping point for US IMG which was between 211 and 220. So you seem to be in the safe zone good luck!