IMGM2. What am I up against?

[tcruzikiss]

Hey fellow healthcare humans, I'm seeking guidance.

New to SDN (well, new to an account), and looking for feedback on what I am REALLY up against during M3/M4. Here are current stats:

Finishing up M2 at one of the "big 4". Let's just say it's a decent school for the Caribbean, but I have had to teach myself most everything. (Thankfully Pathoma, Sketchy, Rx, and Uworld are on the internet...)
Decent grades, usually top 30-40% of the class.
Yes, attrition is terrible, but when you leave island it's usually the "strongest survive" mentality. We take an NBME exam (COMP if anyone has heard that term) that you must pass before taking Step 1. I read that was an important factor.
I tutor and TA (I'm not a lazy dingus).
Socially competent, clinical and interview skills proficient. (I can speak well and I'm not awkward)
Recent practice NBME had me barely passing Step 1 right now, aiming at March 2017 for official test date (I finish M2 in December)
I'd ideally (really, ideally) like to do Peds EM or EM, but I realize IM is most realistic given research...

TL;DR: I'm a socially normal, decently intelligent, M2 that is freaking out about what extra things I need to do be make myself on a pretty platter during M3 rotations in order to get a residency. Please help.

*Please, don't give me **** for being a IMG, I know that I have a lot against me, and I don't need a reminder.

Thanks in advance for any and all constructive advice!!!!

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[general987]

I'm sure you saw already, but the new 2016 charting outcome statistics are out. I think really that, as well as which institutions have a high ratio of IMG (Freida on AMA website should help with that - it is a residency search tool. It gives the percentage of DO, IMG, and allopathic students in a program). I think those combined will give you the best advice. Best of luck!

 

[DetectiveAlonzo]

There are more than enough spots in IM to go around. Chill. Location may suck, but you will match with an above average USMLE score.

Then again, any place in the US is probably better than the third world conditions of the islands you guys are coming from.

 

[sliceofbread136]

Do decently on step 1 and you may very well be rewarded with an IM residency spot in the middle of nowhere. Good luck!

 

[Snoopy2006]

1) Score as high as possible on Step 1. At least 230, but aim for 240.

2) Study Charting the Outcomes from previous years carefully

3) Don't be picky or foolish when you choose a specialty. Apply to specialties that take a relatively high number of Caribbean grads.

4) Apply broadly. Don't target favorable geographical locations (coasts, big cities). Look for smaller or more rural programs that have taken Carib grads (esp students from your school) in the past.

 

[W19]

It's insane that a US IMG needs 230+ to get an IM spot in the middle of nowhere... Why do some people put themselves in such precarious situation when they know the system is unfair to them? I know there is a lot 240+ step 1 in SDN, but it's not that easy to get 240+ on that beast.

 

[PL198]

There are more than enough spots in IM to go around. Chill. Location may suck, but you will match with an above average USMLE score.

Then again, any place in the US is probably better than the third world conditions of the islands you guys are coming from.

are you confusing the caribbean with the middle east?

 

[Lexdiamondz]

There are more than enough spots in IM to go around. Chill. Location may suck, but you will match with an above average USMLE score.

Then again, any place in the US is probably better than the third world conditions of the islands you guys are coming from.

You mean islands like Grenada and St Maarten where the roads are paved and everyone has running water, electricity, A/C and there's an abundance of American-style fast food?

Let's try not to be a jackass.

 

[DetectiveAlonzo]

You mean islands like Grenada and St Maarten where the roads are paved and everyone has running water, electricity, A/C and there's an abundance of American-style fast food?

Let's try not to be a jackass.

Direct quote from a friend of mine who went there a few years back.

"Dude.. water constantly runs out and turns brown. Occasionally get slightly electrocuted in my shower at time so I'm am super scared to even take a long shower anymore. Groceries cost 3 times as much back home. If I try to get fast food, especially Subway, they are out of bread and half of their damn veggies. Sometimes when it rain's super hard, there will be a slight flooding of the muddy ass roads. Oh.. not to mention the warning that was sent out that there were some escapees from the prison/jail on the island".

Yeah...

thank GOD I didn't end up following his steps and going to such a ****ty place to pursue my medical education. You don't have time to worry about dumb **** that Carib students do. That place is STILL an island....

do not let the touristy parts fool you.

 

[DetectiveAlonzo]

Please let's not turn this into a Carib bashing thing. Plenty of IMGs still match and will end up doing IM/ FM / Psych (maybe not anymore as it starts to get competitive) and Peds.

Not in a location of your choice though.

Onto your regular scheduled programming folks...

 

[Rekt]

Why is everyone dancing around the facts? This is what you're up against.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-IMGs-2016.pdf

If you make it to graduation, you chances of matching overall are about 50%. Unfortunately, 3rd and 4th year is known for its subjectivity of grading. Do your best on your shelf exams. Get great LORs in your specialty. Your best best bet is applying smartly. Even if you improve your step and land a 250+, it doesn't mean you can apply to MGH. Over the past couple years, the IMGs I've seen that match, are applying to >100 programs. I don't recommend the EM path. It's not that friendly for IMGs, even assuming you're a USIMG, plus it's still increasing in competitiveness from both MD and DO front. Stick with IM, FP, or Peds.

 

[DetectiveAlonzo]

Why is everyone dancing around the facts? This is what you're up against.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-IMGs-2016.pdf

If you make it to graduation, you chances of matching overall are about 50%. Unfortunately, 3rd and 4th year is known for its subjectivity of grading. Do your best on your shelf exams. Get great LORs in your specialty. Your best best bet is applying smartly. Even if you improve your step and land a 250+, it doesn't mean you can apply to MGH. Over the past couple years, the IMGs I've seen that match, are applying to >100 programs. I don't recommend the EM path. It's not that friendly for IMGs, even assuming you're a USIMG, plus it's still increasing in competitiveness from both MD and DO front. Stick with IM, FP, or Peds.

Because people tend to easily get butthurt over the internet and everytime one of these threads pops up and you speak the truth, it turns into a dick waving contest with Argus coming in here throwing around his numbers and stats and bunch of other people get called in and yeah.

It becomes a **** show.

But you right. You's muhfuhkkin right!

 

[Lexdiamondz]

Direct quote from a friend of mine who went there a few years back.

"Dude.. water constantly runs out and turns brown. Occasionally get slightly electrocuted in my shower at time so I'm am super scared to even take a long shower anymore. Groceries cost 3 times as much back home. If I try to get fast food, especially Subway, they are out of bread and half of their damn veggies. Sometimes when it rain's super hard, there will be a slight flooding of the muddy ass roads. Oh.. not to mention the warning that was sent out that there were some escapees from the prison/jail on the island".

Yeah...

thank GOD I didn't end up following his steps and going to such a ****ty place to pursue my medical education. You don't have time to worry about dumb **** that Carib students do. That place is STILL an island....

do not let the touristy parts fool you.

Lmao do you hear yourself?

"There's slight flooding when it rains super hard" - pretty sure that happens everywhere

"Water constantly runs out and turns brown" - Cali's currently rationing water and my tap in NYC runs brown all the time, despite my building having been built in the 1980s

"groceries cost 3x as much as back home" - makes sense if you're buying American produce that needs to be imported.

The place isn't ****ty so much as your wasteful lifestyle is ****ty. Welcome to the rest of the world where people don't take hour-long showers because resources are actually finite.

 

[deleted480308]

Lmao do you hear yourself?

"There's slight flooding when it rains super hard" - pretty sure that happens everywhere

"Water constantly runs out and turns brown" - Cali's currently rationing water and my tap in NYC runs brown all the time, despite my building having been built in the 1980s

"groceries cost 3x as much as back home" - makes sense if you're buying American produce that needs to be imported.

The place isn't ****ty so much as your wasteful lifestyle is ****ty. Welcome to the rest of the world where people don't take hour-long showers because resources are actually finite.

Anywhere I can't take a reliably hot and clean 1hr shower after getting safe sushi next to a local organic coffew shop is third world ok? That's just science.

 

[DetectiveAlonzo]

Lmao do you hear yourself?

"There's slight flooding when it rains super hard" - pretty sure that happens everywhere

"Water constantly runs out and turns brown" - Cali's currently rationing water and my tap in NYC runs brown all the time, despite my building having been built in the 1980s

"groceries cost 3x as much as back home" - makes sense if you're buying American produce that needs to be imported.

The place isn't ****ty so much as your wasteful lifestyle is ****ty. Welcome to the rest of the world where people don't take hour-long showers because resources are actually finite.

oh.. my bad.

Looks like I struck a nerve with you but you gotta chillax bro.

I'm just glad I don't have to worry about that **** like you Carib folks do.

Med school is stressful enough, but man.. some of my buddies that have come back from Carib are definitely crushed mentally and spiritually.

I would probably bet that the amount of PTSD in Carib students is higher than their US counterparts.

 

[Sardinia]

@DetectiveAlonzo @sb247 Be easy on him, if he's living in New York then chances are he's also living on an island in the middle of nowhere.

 

[Lexdiamondz]

oh.. my bad.

Looks like I struck a nerve with you but you gotta chillax bro.

I'm just glad I don't have to worry about that **** like you Carib folks do.

Med school is stressful enough, but man.. some of my buddies that have come back from Carib are definitely crushed mentally and spiritually.

I would probably bet that the amount of PTSD in Carib students is higher than their US counterparts.

I'm originally from one of "those islands" and the Medical students are notorious for being rude, entitled prima donnas. Comments such as those don't help improve the perception of Caribbean Medical students or the perception of Americans in general.

 

[tcruzikiss]

Can we get back on topic? Looking for third year input on rotations/succeeding, not speculation on where or how I've been living for the last 18months.

 

[Rekt]

Can we get back on topic? Looking for third year input on rotations/succeeding, not speculation on where or how I've been living for the last 18months.

What are you expecting that people tell you? There's no magic pill that suddenly gives you honors in all your rotations and causes ivory tower LORs to rain down upon you. Your immediate and only focus right now needs to be your step 1. March is awhile away, but if you're "barely" passing, then you have a lot of work to do.

 

[Donald Juan]

Can we get back on topic? Looking for third year input on rotations/succeeding, not speculation on where or how I've been living for the last 18months.

Don't be a weirdo, take feedback constructively, know your patients, be eager to help out, eager to learn, eager to see new patients, excited to learn new things.

As above, focus on step 1. Way more important right now. It's fine to be barely passing this far out...I was the same. It still means you have a lot of work to do.

 

[DetectiveAlonzo]

Can we get back on topic? Looking for third year input on rotations/succeeding, not speculation on where or how I've been living for the last 18months.

You need to worry about STEP 1 first.

Get an EXCELLENT score, you'll most likely get IM, FM, or Peds.

I personally know somebody with a 260+ score from one of the big 4 programs. Had to apply to 100+ programs and started an at IM program on the east coast.

PDs know y'all get A LOT of time to prepare for your STEP. MONTHs even. That and the IMG status push your guys app to the bottom.

That's what this whole "fifth" semester crap is for anyway. A whole semester to take a Kaplan review score and study for the STEP exam while US students get maybe 5-6 weeks MAX.

Therefore... you cannot be picky about location. You need to do well and apply everywhere.

I'm originally from one of "those islands" and the Medical students are notorious for being rude, entitled prima donnas. Comments such as those don't help improve the perception of Caribbean Medical students or the perception of Americans in general.

Yeah.. I figured how you lashed out about it. No need to get upset about it my friend. You made it off the island.. you're good.

 

[tcruzikiss]

What are you expecting that people tell you? There's no magic pill that suddenly gives you honors in all your rotations and causes ivory tower LORs to rain down upon you. Your immediate and only focus right now needs to be your step 1. March is awhile away, but if you're "barely" passing, then you have a lot of work to do.

For the record, I'm barely passing having not completed three system modules yet. I'm averaging 70% on uworld (timed, not tutor mode, all sections, on subjects I've covered this far). So me barely passing step 1 on practice is pretty okay for right now. I'm not asking for a magic button, but merely "think about research in area, look at these volunteer opportunities, etc.".

But thank you for the reminder that I have a lot of work to do for Step, super helpful.

 

[DetectiveAlonzo]

For the record, I'm barely passing having not completed three system modules yet. I'm averaging 70% on uworld (timed, not tutor mode, all sections, on subjects I've covered this far). So me barely passing step 1 on practice is pretty okay for right now. I'm not asking for a magic button, but merely "think about research in area, look at these volunteer opportunities, etc.".

But thank you for the reminder that I have a lot of work to do for Step, super helpful.

You're gonna do fine dude. Seriously. Chill. There are plenty of IMGs out there. Country is in a shortage of docs, especially in primary care. It will take what it can get.

 

[tcruzikiss]

You need to worry about STEP 1 first.

Get an EXCELLENT score, you'll most likely get IM, FM, or Peds.

I personally know somebody with a 260+ score from one of the big 4 programs. Had to apply to 100+ programs and started an at IM program on the east coast.

PDs know y'all get A LOT of time to prepare for your STEP. MONTHs even. That and the IMG status push your guys app to the bottom.

That's what this whole "fifth" semester crap is for anyway. A whole semester to take a Kaplan review score and study for the STEP exam while US students get maybe 5-6 weeks MAX.

Therefore... you cannot be picky about location. You need to do well and apply everywhere.



Yeah.. I figured how you lashed out about it. No need to get upset about it my friend. You made it off the island.. you're good.

No 5th semester here. We take a COMP after four semesters, and have an 8 week window to take step. We don't get a "special course" or whatever. If someone isn't in the top 30% of the class they have to take a 6 week test prep class prior to STEP. I personally have been studying during modules and started uworld early. It's been changing a lot in the last few years for Carib kids.

 

[DetectiveAlonzo]

No 5th semester here. We take a COMP after four semesters, and have an 8 week window to take step. We don't get a "special course" or whatever. If someone isn't in the top 30% of the class they have to take a 6 week test prep class prior to STEP. I personally have been studying during modules and started uworld early. It's been changing a lot in the last few years for Carib kids.

You still get 2 months.

That's a LONG time for one exam.

 

[Donald Juan]

For the record, I'm barely passing having not completed three system modules yet. I'm averaging 70% on uworld (timed, not tutor mode, all sections, on subjects I've covered this far). So me barely passing step 1 on practice is pretty okay for right now. I'm not asking for a magic button, but merely "think about research in area, look at these volunteer opportunities, etc.".

But thank you for the reminder that I have a lot of work to do for Step, super helpful.

Look, I know we're on an anonymous forum, so you might be a bit bolder than you would be in real life....but this is an example of not taking feedback constructively, which will work against you on wards.

 

[IslandStyle808]

You still get 2 months.

That's a LONG time for one exam.

My previous home state MD school gives 8 weeks. Its within the edge of normal.

 

[the argus]

It's insane that a US IMG needs 230+ to get an IM spot in the middle of nowhere... Why do some people put themselves in such precarious situation when they know the system is unfair to them? I know there is a lot 240+ step 1 in SDN, but it's not that easy to get 240+ on that beast.

It's insane, and also completely untrue. From the brand new charting outcomes, the mean step 1 score for matched US-IMGs is 228. That means half of matched applicants, which happens to be ~500 this past year, had step 1 scores less than 228.

 

[the argus]

Why is everyone dancing around the facts? This is what you're up against.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-IMGs-2016.pdf

If you make it to graduation, you chances of matching overall are about 50%. Unfortunately, 3rd and 4th year is known for its subjectivity of grading. Do your best on your shelf exams. Get great LORs in your specialty. Your best best bet is applying smartly. Even if you improve your step and land a 250+, it doesn't mean you can apply to MGH. Over the past couple years, the IMGs I've seen that match, are applying to >100 programs. I don't recommend the EM path. It's not that friendly for IMGs, even assuming you're a USIMG, plus it's still increasing in competitiveness from both MD and DO front. Stick with IM, FP, or Peds.

This is not true and a misrepresentation of what the data in that report actually represents. That data does not separate recent grads/first time applicants from repeat applicants.

There is without a doubt a certain percentage of Caribbean grads (likely ~10%) that are poor applicants and can not ever match. These people build up, continue to apply every year, and significantly skew the IMG match rate. It is exemplified by the previous IMG charting outcomes document that clearly shows the mean time since graduation for the unmatched cohort to be 5.7 years, whereas the mean time since graduation for matched US-IMGs was 1.7 years.

The most recent Charting Outcomes document you cite doesn't take into account first-time applicants and re-applicants, and doesn't give years since graduation. Not separating first-time applicants and re-applicants heavily oversamples the yearly unmatched cohort, which completely skews the overall match rate.

 

[the argus]

To the OP, as some others have said, there's no magic bullet to getting a residency position out of the Caribbean. Get the best grades you can during the basic sciences, do the best you can on Step 1 (and don't listen to people saying you need an astronomical score, or those peddling scare stories about people with 260 who barely matched), work hard and be engaged during your clinical rotations, and get the best LORs you can from people with impressive titles. Basically all the same things that US grads do.

And honestly, spending time on SDN creating threads is not helping you either. Delete your account and spend the time you've been wasting on this website on studying. I'm one of the few people commenting on this thread that was actually in your shoes, and I can tell you one thing I certainly didn't do during medical school, and that's waste time posting on this website.

 

[Psai]

It's insane, and also completely untrue. From the brand new charting outcomes, the mean step 1 score for matched US-IMGs is 228. That means half of matched applicants, which happens to be ~500 this past year, had step 1 scores less than 228.

No it doesn't. For someone who obsesses over statistics, you sure don't know the difference between a mean and a median.

 

[Goro]

This is why I have him on "ignore"

No it doesn't. For someone who obsesses over statistics, you sure don't know the difference between a mean and a median.

 

[DetectiveAlonzo]

My previous home state MD school gives 8 weeks. Its within the edge of normal.

Who said anything about US MD programs? We know they are at the top of everything in terms of their school set up and curriculum. They actually teach to the USMLE and most of their curriculums are tailored for the STEP 1 anyway.

Which is why it always better to get into a US MD program solely for the best shot at raping the STEP exam.

 

[the argus]

No it doesn't. For someone who obsesses over statistics, you sure don't know the difference between a mean and a median.

Your right, you got me. These things usually are close to following a normal distribution, but what I said is not technically correct.

Doesn't change the fact that 427/793 (54%) of the matched US-IMGs in IM with a recorded step 1 score had a score <230.

This is why I have him on "ignore"

No, he has me on ignore because I ask him to back up his ridiculous and afactual nonsense with evidence, which he obviously can't do because it's all made up. Not because I occasionally made assumptions about the statistical distribution of data sets.

 

[IslandStyle808]

Who said anything about US MD programs? We know they are at the top of everything in terms of their school set up and curriculum. They actually teach to the USMLE and most of their curriculums are tailored for the STEP 1 anyway.

Which is why it always better to get into a US MD program solely for the best shot at raping the STEP exam.

Your point was that the 8 week time frame was something you would only see for caribbean school, which is not true. There are definitely US MD schools that give 8 weeks. If this were >12 weeks, you would have a point (can't think of one US school that gives this much self study time).


While it is important to deter people from the caribbean, but we should do this as factually as possible.

 

[Rekt]

Your point was that the 8 week time frame was something you would only see for caribbean school, which is not true. There are definitely US MD schools that give 8 weeks. If this were >12 weeks, you would have a point (can't think of one US school that gives this much self study time).


While it is important to deter people from the caribbean, but we should do this as factually as possible.

He said he's aiming for March. If his M2 ends in Dec and he takes it in March, it's not like he can start rotations early? Thus, he'd just push it back. It's pretty well know that Carib kids get massive amounts of dedicated time.

 

[W19]

Your point was that the 8 week time frame was something you would only see for caribbean school, which is not true. There are definitely US MD schools that give 8 weeks. If this were >12 weeks, you would have a point (can't think of one US school that gives this much self study time).


While it is important to deter people from the caribbean, but we should do this as factually as possible.

True... We had 9 weeks, and some who took their OSCE early had almost 10 weeks.

 

[DetectiveAlonzo]

Your point was that the 8 week time frame was something you would only see for caribbean school, which is not true. There are definitely US MD schools that give 8 weeks. If this were >12 weeks, you would have a point (can't think of one US school that gives this much self study time).


While it is important to deter people from the caribbean, but we should do this as factually as possible.

nah man.

 

[IslandStyle808]

He said he's aiming for March. If his M2 ends in Dec and he takes it in March, it's not like he can start rotations early? Thus, he'd just push it back. It's pretty well know that Carib kids get massive amounts of dedicated time.

Not arguing that point, which is totally true. Just saying 8 weeks is not seen only in caribbean schools.

 

[bannie22]

2016 average Step 1 for matching applicants is now Mid 230s. I would say an IMG needs to probably do 15-20 points above to be on the same playing field.