Foreign medical education

[missmd03]

US Citizen – from California

I am interested in anyone’s experience with foreign medical school education…preferably those who are familiar with Ross, St. George University and Universidad Autonoma de Gradalajara.

Thank you[]

[yaga0079]

Hi there
I am also interested in applying to those same programs as well. I have heared really good things from people who attended St. George’s. One person is currently doing his residency at Vanderbilt. I think as long as you do well in your classes and on the boards, there shouldnt be a problem getting a good residency.[]

[yokelridesagain]

I would be very cautious in considering an application to an off-shore medical school as a US citizen. Any one individual’s positive experience (i.e. “residency at fill-in-the blank”) should not be construed as a representation of the average. One certainly should not be swayed by the promotional materials put out by the schools themselves: they certainly are not going to bill themselves by saying “Come to our school and be marginally competitive for marginal residency programs”.

Before considering this you should consider:

1. There are several specialties that are so competitive that the average medical graduate from U.S. MD programs will have a difficult time getting in. If you have your heart set on dermatology, orthopedics, ophthalmology, or neurologic surgery you had better find some way or other to get into a US medical school (post-bacc, “special Masters”, etc.)

2. You can probably get a residency with a Caribbean degree–the question is, is it a residency you really want to have. An offshore degree IS a black mark on any residency application; programs take graduates from those schools because they need to do so to fill–there are about 6000 more residency positions than US MD graduates. However, one would be hard pressed to find a program director who really WANTS to do so. At nearly every medical center save a select few (and by this I mean Hopkins, MGH, UCSF, perhaps a few others) there are at least a few lousy programs that have trouble filling because of mismanagement, working conditions, etc. I went to a medical school that is routinely ranked in the “top 20” by US News: we had one department that took Caribbean graduates with some frequency in the “scramble” because they were never able to fill in the match with people they wanted. Reason? It was a bad program. Good centers have bad programs. “One person is doing his residency at Vanderbilt” is all well and good–I would sure inquire as to whether a residency in “blank” at Vanderbilt is a desirable thing.

3. If you do go to one of these schools, make sure there are opportunities for substantial US clinical experience–and you had better perform smashingly on clinicals as well as the boards. You’re going to be in the “foreign medical graduate” pool and believe me, there are a whole lot of people from China and the Indian subcontinent who are going to be bringing 250/99 Step 1/2 scores to the table.

I really don’t mean to rain on anyone’s parade; however I do think you should have a realistic understanding of what’s going to be available for you as a graduate of one of these schools. Most off-shore grads who get US residencies go into primary care fields in community (i.e. non-academic) programs. If what you really want is to be a family med doc or general internist in private practice and you can live with limited choice in where you do residency this is a viable option. On the other hand, if you get into a US program and excel you can be competitive for essentially any residency.

Bottom line: U.S. medical school admission wouldn’t be so brutally competitive if it wasn’t worth it.

[Jens_Blomqvist]

quote:

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Originally posted by yokelridesagain

I would be very cautious in considering an application to an off-shore medical school as a US citizen. Any one individual’s positive experience (i.e. “residency at fill-in-the blank”) should not be construed as a representation of the average. One certainly should not be swayed by the promotional materials put out by the schools themselves: they certainly are not going to bill themselves by saying “Come to our school and be marginally competitive for marginal residency programs”.

Before considering this you should consider:

1. There are several specialties that are so competitive that the average medical graduate from U.S. MD programs will have a difficult time getting in. If you have your heart set on dermatology, orthopedics, ophthalmology, or neurologic surgery you had better find some way or other to get into a US medical school (post-bacc, “special Masters”, etc.)

2. You can probably get a residency with a Caribbean degree–the question is, is it a residency you really want to have. An offshore degree IS a black mark on any residency application; programs take graduates from those schools because they need to do so to fill–there are about 6000 more residency positions than US MD graduates. However, one would be hard pressed to find a program director who really WANTS to do so. At nearly every medical center save a select few (and by this I mean Hopkins, MGH, UCSF, perhaps a few others) there are at least a few lousy programs that have trouble filling because of mismanagement, working conditions, etc. I went to a medical school that is routinely ranked in the “top 20” by US News: we had one department that took Caribbean graduates with some frequency in the “scramble” because they were never able to fill in the match with people they wanted. Reason? It was a bad program. Good centers have bad programs. “One person is doing his residency at Vanderbilt” is all well and good–I would sure inquire as to whether a residency in “blank” at Vanderbilt is a desirable thing.

3. If you do go to one of these schools, make sure there are opportunities for substantial US clinical experience–and you had better perform smashingly on clinicals as well as the boards. You’re going to be in the “foreign medical graduate” pool and believe me, there are a whole lot of people from China and the Indian subcontinent who are going to be bringing 250/99 Step 1/2 scores to the table.

I really don’t mean to rain on anyone’s parade; however I do think you should have a realistic understanding of what’s going to be available for you as a graduate of one of these schools. Most off-shore grads who get US residencies go into primary care fields in community (i.e. non-academic) programs. If what you really want is to be a family med doc or general internist in private practice and you can live with limited choice in where you do residency this is a viable option. On the other hand, if you get into a US program and excel you can be competitive for essentially any residency.

Bottom line: U.S. medical school admission wouldn’t be so brutally competitive if it wasn’t worth it.

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Yokel, Is the abovementioned true of Graduates from Good universities in the United Kingdom? Will a medical graduate from a prestigious university have trouble transfering to the US medical system and completing a residency in the States?

[yokelridesagain]

Jens–

Generally speaking, no, it’s not the same thing.

Simply put, many of these Caribbean programs exist primarily to provide medical degrees to U.S. students who can’t get into U.S. programs. A medical degree from Cambridge or the University of Edinburgh is quite a different matter; the primary role of British medical schools is to produce British physicians. Most people would consider the medical systems in First World nations like the U.K., Australia, France, Italy, Germany, etc. roughly equivalent to a US degree.

There are some downsides to being an FMG…visa problems in the post 9/11 world are becoming a fact of life and some program directors don’t want the hassle. If you’re not a US citizen and are looking to move permanently to the US, getting permanent resident status can be quite difficult…this is more of a post-residency problem.

But in general, a medical graduate from a “prestigious” UK university would be competitive with an American graduate. If you are British or had a reason to be in Britain on a long term basis, PDs would naturally expect that you would have gone to school in your “home” country. There are Americans who get into European med schools, and indeed a small percentage of students from some European programs are Americans who couldn’t get into US med schools. The stigma associated with a Caribbean school, however, isn’t usually attached to European grads. Unfair perhaps, but that’s the situation.

[Jens_Blomqvist]

quote:

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Originally posted by yokelridesagain

Jens–

Generally speaking, no, it’s not the same thing.

There are some downsides to being an FMG…visa problems in the post 9/11 world are becoming a fact of life and some program directors don’t want the hassle. If you’re not a US citizen and are looking to move permanently to the US, getting permanent resident status can be quite difficult…this is more of a post-residency problem.

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Do you think they would actually turn away a European-born, US trained Specialist Physician if such a person were to apply for permanent residency in the States? Don’t they take things like previous nationality, level of education and prior criminal conduct into consideration when deciding such things?

[yokelridesagain]

Simply put, yes.

There are probably better people to ask about this as I’m an American citizen and have no direct personal experience.

However, the basics: most international medical graduates come to the US on J-1 visas. There’s another type of visa (the H1-B, I believe) that is much less restrictive. If you can get a residency program to give you one of these visas then I think you can pretty much stay in the U.S. if it pleases you. I think these have been difficult to come by in after 9-11-2001. In general, ask the program you’re applying to. Many don’t offer them.

With J-1 visas, there’s a requirement that you leave the U.S. to return to your home country for at least two years before obtaining a job in the U.S. There are ways to get this waived, including:

1. Prove that returning to your home country constitutes a present danger to your person (occasionally people from repressive countries do something so politically egregious to their home governments that they have a legitimate asylum claim).

2. Prove that returning to your home country would constitute a severe hardship to your U.S. citizen or permanent resident spouse (i.e., spouse is sole caregiver for incapacitated relative).

3. Prove that being able to stay in the U.S. is “in the national interest”, which only tends to apply if you’re in biomedical research and have “unique” skills.

4. By far the most common, get sponsored by a government agency. This usually entails working in an underserved (i.e. rural or inner city) area for several years, or potentially at the VA (the US hospital system for military veterans).

Many FMGs every year stay in the US by accepting rural jobs, then leave those jobs to work wherever they desire at the end of the contract. You do have to apply for residency in the US (probably involving a consultation with an immigration lawyer), but if you’re not a criminal or a member of al Qaeda that’s generally readily obtainable.

If one is a US citizen or permanent resident and goes to medical school outside the country, none of this applies. If you are a foreign national, however, unfortunately it often isn’t possible to go directly from US residency-fellowship to a desired position.

[Jens_Blomqvist]

quote:

---

Originally posted by yokelridesagain

Simply put, yes.

There are probably better people to ask about this as I’m an American citizen and have no direct personal experience.

However, the basics: most international medical graduates come to the US on J-1 visas. There’s another type of visa (the H1-B, I believe) that is much less restrictive. If you can get a residency program to give you one of these visas then I think you can pretty much stay in the U.S. if it pleases you. I think these have been difficult to come by in after 9-11-2001. In general, ask the program you’re applying to. Many don’t offer them.

With J-1 visas, there’s a requirement that you leave the U.S. to return to your home country for at least two years before obtaining a job in the U.S. There are ways to get this waived, including:

1. Prove that returning to your home country constitutes a present danger to your person (occasionally people from repressive countries do something so politically egregious to their home governments that they have a legitimate asylum claim).

2. Prove that returning to your home country would constitute a severe hardship to your U.S. citizen or permanent resident spouse (i.e., spouse is sole caregiver for incapacitated relative).

3. Prove that being able to stay in the U.S. is “in the national interest”, which only tends to apply if you’re in biomedical research and have “unique” skills.

4. By far the most common, get sponsored by a government agency. This usually entails working in an underserved (i.e. rural or inner city) area for several years, or potentially at the VA (the US hospital system for military veterans).

Many FMGs every year stay in the US by accepting rural jobs, then leave those jobs to work wherever they desire at the end of the contract. You do have to apply for residency in the US (probably involving a consultation with an immigration lawyer), but if you’re not a criminal or a member of al Qaeda that’s generally readily obtainable.

If one is a US citizen or permanent resident and goes to medical school outside the country, none of this applies. If you are a foreign national, however, unfortunately it often isn’t possible to go directly from US residency-fellowship to a desired position.

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