Monday, April 13, 2015

What are the chances of international medical grads matching in surgery?

Anyone considering attending a Caribbean or any foreign medical school should do due diligence. An Internet search is step one. If the school does not list residency match statistics, that could be a red flag. It would not be easy to accomplish, but try to speak with some current students or recent graduates of any schools you are thinking about.

If the school won't give you any names, use caution, and remember, they are not likely to give you the names of dissatisfied students or alumni.

If a school does not require Medical College Admission Test (MCAT) scores, I would advise extreme caution. That suggests they probably take all comers.
Here's a look at some match data from offshore schools. The list of schools is by no means comprehensive as there are about 25 med schools in the Caribbean area. I attempted to find results from the 2015 match for the following schools: Ross, St. George's, American University of the Caribbean, Caribbean Medical University, St. James University, University of Medicine and Health Sciences, and American Global University.

I used the word "placed" because that term is what one of the schools used, and I believe students who obtained positions in the Supplemental Offer and Acceptance Program (SOAP) after the main match are included.

The orthopedic results are shown to give you an idea of the chances to find a surgical position in any surgical specialty other than general.

For all of the schools that published lists, the overwhelming majority of students obtained positions in family medicine and internal medicine.

The number of unmatched students is not stated, but US schools don't publish that information either.

It is not completely hopeless because if you look at the NRMP's Advance Data for the 2015 match, you can see that 243 (20%) of the general surgery positions and 40 (5.7%) of the positions in orthopedics were filled by non-US grads.

Finally, here's a portion of an email I received last week.

I am a US-IMG who recently matched into a categorical surgery residency at a university program. I graduate in a few weeks from a school in the Middle East. I rotated in my 4th year at some really prominent institutions that many foreign grads don't have access to, and I believe this helped tremendously.

I was definitely on the high end for a foreign grad in terms of interviews in my class. I was very lucky. A lot of people told me I would have to look into other things or didn't believe in me, but in the end, I took a risk for something I love.

Unless you want to be an internist or a family doctor, you will have to decide if you want to risk not being the lucky one.


qtipp said...

Thanks for the article Scalpel. I just want to add 3 anecdotes to give some more nuance to the numbers you have provided. Firstly I would add that the numbers you state above are for those who actually are allowed to ENTER the match by the school. The number of students who were accepted is likely to be much higher.

A friend went to SABA because they started to accept US loans. They didn't require an MCAT and he was getting older... so he took the bait. He didn't make it pass the 1st semester. What he described were teachers and staff that did not help students if they were failing, students who were kicked out if they did not pass exams, ridiculous student to cadaver ratios for anatomy and generally poor teaching and facilities. The student take usually 5 years to graduate due to difficulties scheduling 3rd and 4th year electives and those that actually make it to the junior and senior years are a relatively small fraction of those that started. He thankfully was booted out before having spent a lot. He told me he had a lot of company. I wonder how he would have done at a US school that invests in its students because there are consequences to their attrition rates?

A second friend went to another school (name escapes me right now). He has told me how much of a joke the curriculum and didactics were. So much so that he failed step 1 on his first attempt due to lack of preparation from his school. He faces and almost insurmountable task of matching next year, his 5th year of medical school.

There is a semi-famous blog about one student's experience at Ross and failing out of medical school here and another blog of a student who has now failed to match for the 3rd time after going to the caribbean (and having multiple USMLE failures he attributes to personal issues) here.

Some say that the Caribbean is still an option if you go to the "big three", etc. From my perspective and the experiences of friends that have gone to Caribbean medical schools I would advise everyone I meet of not going to the Caribbean at all OR proceed with EXTREME caution. I have read the success stories and I still think it is a foolish enterprise to contemplate going given the odds of failure. Students who believe they could make through the Caribbean route should wait, improve their stats and do everything in their power to go to a US MD or DO program... even if it takes 2 extra years.

In my opinion that eventually getting your MD degree but facing $200,000 - $300,000 in debt that cannot be escaped by bankruptcy without the income to make the payments is too much of a risk. Especially considering how competitive matching already is and will be in the next 4-5 years.

Sorry for the sermon but I can't in good conscience refuse to add these anecdotes for those considering this step. I have worked with some fine residents from ROSS and AUC during medical school who have matched into primary care positions. But I must advise all to proceed with a lot of caution.

Skeptical Scalpel said...

Thanks for commenting. Those are quite some stories. I wish I could talk to some of those unfortunate people. I would love to hear more details. This needs to be heard.

Anonymous said...

Anonymous Europe: What I gathered from the post and the comment is that these medschools in the Caribbean are only a nice way for the people who teach there to reap some profit in a nice enviroment..... Why do not these students come rather to Europe for medical education? I am not sure about the prices in the Caribbean but I guess you come out financially way better if you come over the pond.... Especially if you study in Eastern Europe where prices are way lower and the quality of training is very high.

Anonymous said...

Hi, I'm a Caribbean grad who matched into my desired specialty this year and am happy with my experience. Sure, there were hiccups along the way, and aspects I'd like improved, but in general, I know I received a top-notch medical education and am confident of my skills and knowledge going into residency.

I've been following Scalpel's blog for a few years now and have noticed a distinct negative bias toward the Caribbean, which now that I’m done and have time, I’d like to address. Not all Caribbean schools are created equally. Some institutions are mickey mouse schools, and some are legitimate,proper medical schools. There are differences in the calibre of the students and quality of the curriculums. Simply stated, one can't characterize Caribbean education as a whole. It's misleading.

The only significant difference I see between American schools and Caribbean schools is that for American schools getting in is the hardest part. Whereas for Caribbean schools, getting in is only the beginning of the hard part. It is true that Carib schools will not coddle students, carry students or boost students who don’t do well. Resources to help you learn are plenty though. Good Carib schools have educational counselors with Phd’s in education to teach study skills, mental health counselors and almost all professors have open-door policies. (Being smallish campuses, you run into your professors everywhere--restaurants, bank, gym) Whether a student avails themselves of the resources, is up to the student.

Let it be known that the grading policies are relatively unforgiving and tests are difficult, but fair. If you fail a subject, you will have to repeat the semester or leave. This is in contrast to what I’ve heard from American med school friends, where you could eg. fail Anatomy, have a chat with the dean, a week later retake the exam, and continue like nothing happened.

I knew what was expected of me in the Caribbean--study and learn a lot. So I did, and did fine. Bottom line, if you believe you have the aptitude and work ethic to be a physician (despite what rejections from American med schools imply), good Caribbean schools will give you the opportunity to demonstrate it.

Skeptical Scalpel said...

I'm not sure about US match rates of graduates of Eastern European med schools and would urge anyone thinking of going to one to really do your homework on that.

Caribbean anon, I am not biased against Caribbean schools. I am just reporting data that the NRMP puts out. When I ran surgical residency programs, I had a number of offshore grads. I actually preferred high quality grads of good Caribbean schools to bottom quarter grads of US schools. That philosophy is apparently not popular among PDs today.

I fear that many Caribbean students are disappointed when they find out they have limited choices.

I agree with you that the better Caribbean schools are fine, and there are several that are dreadful.

Anonymous said...

My brother in law went to Saba, matched readily into a respectable university OB/GYN program, and has done well subsequently. But he is exceptionally bright and industrious--perhaps a cut above graduates from most domestic programs, never mind the Caribbs. And still he did experience CONSIDERABLE prejudice--so this is a real factor that potential applicants to Caribbean schools should consider.

Still, I have trouble with not passing boards. I imagine that all Caribbs have adequate board preparation resources: they're called books. One suspects that too many Caribbean students are not properly prepared.

Skeptical Scalpel said...

I hope the Caribbean grad who thinks I am biased reads your comment. It's not me, it's the perceptions and actions of others. I am just the messenger.

I agree that books can certainly help with memorization of facts. However, some things require explanations and elaboration that only a teacher can provide.

Vanit Singh said...

Thank you very much for this blog. It is clear, easy to understand and immensely helpful. I’m sure you’re an incredible source of support for many aspiring medical students, who want to study Abroad.

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