bbb
IM Program Coordinator
Topics: 32
Posts: 4,681
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My program director and I were talking about prematches and he was wondering why an applicant - and an obviously stellar candidate - would accept a position outside of the match.
I know about the security of actually having a position, etc. But what about the wondering if you had gone to the match if you would have landed in a program that had everything you wanted, even fellowship, research, etc. That perfect place.
Why don't applicants want to go through the match?
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bbb - trying to combine common sense and humour into realistic answers, but not going to guess on anyone's chances of getting into a position....off until July 14th exploring the caves of NYC
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| dharjma
Forum Senior
Topics: 11
Posts: 182
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prospective doctors are risk aversive people to begin with. many are partly attracted to the profession as it has some sort of job security..
couple that with the fact that IMG's tend to undersell themselves a lot. this is because sometimes they over-estimate how tough it is and forget how hard it is for a program to find a stellar candidate in every aspect!
so youre left with someone who 1. rather not take the risk of not matching at all and 2. who doesnt think he is in high demand. it would be really hard for an IMG to accept the fact he did not match. every year, about 50% of img's dont. that would mean something liike USD 10 000 down the drain and one year without a stable job and a dream completely shattered. so when viewed from that point, they dont mind sacrificing a tiny portion of their dream to 'get a foot into the picture'
for american candidates on the other hand 98% match successfully, usually within their top 4 choices. so really their match record is something worth betting on! on and i think american students are not allowed to prematch if theyre still in med-school anyway (i might be wrong)
this is what i, as a future img, think. hope i made sense!
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| gita_b
Forum Senior
Topics: 7
Posts: 46
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I could not agree more with Dharjma.
I haev been offered three prematches in three community programs. I might match into a University somewhere...but as of this year, no Universities haev come calling. I dont have another year to waste to reapply with better creds. The only programs that have come calling are those that do not fill through the match....
Do I think I am underselling myself? Absolutely. Do I have a better alternative? No.
Not a perfect situation, but then its not a perfect world.
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| mmoghbelli
Forum Elite
Topics: 18
Posts: 180
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Totally agree with you guys, although I do think I am a comparatively good candidate, I am waiting for January to see what prematches are offered to me ( 4 so far) and I will be taking one of them for sure. Ive seen people matching in lower places than they were offered prematches, and I dont have a year of my life to waste dreaming what would have or could have happened if I went to Harvard, when there are places with less of a name, and therefore less air in there heads, who readily accept us. Its a game Ive basically got sick of, because I see the US grads get special treatment wherever they go. They get grants for there school tuition, and special treatment in general. Ive seen US grads from the best residency programs in Baylor, Hopkins and the such, and it is my belief that these applicants are not as high quality physicians as FMG's, at least not in medicine. Maybe in ENT and derm and ortho theyre top notch, but I find this to be a new form of segregation.....and I am determined to find the least pain in getting through this process, and prematch is the way to do it BBB.
Edited by mmoghbelli on 12/13/05 - 11:32 AM
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| wombat
Forum Guru
Topics: 22
Posts: 304
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I have been to 3 interviews so far, got 3 prematch offers but didn't take any. There is this dream place I want to go to but the price is to work with them on the floor for a while (sort of test drive I guess). Will I do that? Of course yes. Because that's the only way for me to ever get into a good program like that. So my current plan is to go through match, although I understand this means a lot risk. We will see...
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| njccmd2002
Forum Elite
Topics: 35
Posts: 168
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Im Hungry. I can eat bread and water right now. Or i can hope for my neighbor to throw out the garbage, and hope to find half eaten steak and burnt rice.
Its about satisfying a necessity. Its not a fair game. The reason to many roadblocks are being set up, its because IMGs are not welcomed.
Lets see most requirements.
- 3 US LORs = Mmmmh I wonder if my family physican counts, hell be the only one to sponsor me.
- 6 mos minimum Clinical Exp. = Mmmh I think i have 20k saved to adventure myself in an externship.
- Freshly graduated = Mmmh I think i can be able to afford my testing, i dont have to work my way through testing.
Im not trying to be a brat about it, but sometimes these requirements are just set to filter out IMGs, but we overcome these requirements, there will alwasy be something to put in front of us.
Would i take a prematch, YESS, in a heartbeat..... Why? I have to pay bills, and live. There is no time to dream, unfortunately. But then again, it is not we the ones that loose. Its the programs.
A lot of IMG are bright minds. ( not me) but i try. I can do more with less. whereas others rely too much on technology.
well , i am still waiting for my prematch to come....
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| drmamu
Forum Elite
Topics: 43
Posts: 188
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Hai guys,
I agree with you totally. The main reason that many hospitals dont take many of the smart imgs is that they dont know them properly. They dont know the schools where you have studied. They dont trust the lors from outside state. They dont respect the experience you have from outside. What I feel is that I should join a reasonably good place in a prematch. Once you prove your competency, any hospital will give you opportunities for learning, research and good electives. But try to avoid a hospital that may keep you very busy because in that case u may not get enough time for designing a study or impress any big shot. In the medicine is all about whom you know rather than what you know. If you have a chance of getting in a big shot university program, it is always worth taking the rsik. But such ones dont usually call fmg. The ones who get them are really exceptional. I dont have much idea about such people. For eg. GW has rejected almost all its fmg applicants. I have not heard anyone receive a call from there. So my advice is to take where you get it and start working your way up. So those who are really smart will get what they want at the end of three years. For eg: a person who has multiple publications in international journal, gfold medals and research awards will continue to do the same wherever you go. Anotther thing is to see how you were before you came. Were you always the best among your fellows in your school, high school and medical school and your foreign residency. If yes, you will continue to be the best in US no matter whereever you go. This is my beleif. But I have not yet acted upon it, that is - I have not taken my decision on my prematch offer.
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| bbb
IM Program Coordinator
Topics: 32
Posts: 4,681
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But most hospitals know IMG's - their IM residencys have 40%-60% IMGs - it's not an unknown entity. Even some of the university programs (I am talking about IMG friendly programs - not the ones that haven't seen the light).
But these answers will give my PD a little more insight into where you are all coming from.
Good luck all!
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bbb - trying to combine common sense and humour into realistic answers, but not going to guess on anyone's chances of getting into a position....off until July 14th exploring the caves of NYC
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| mmoghbelli
Forum Elite
Topics: 18
Posts: 180
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Thanks BBB...but let me give you an example of a fairly good university program with very few FMG's...Vanderbilt, or Baylor, UTSW, Emory, Wash U, or...They generally have 10% FMG's in there program, and these are some of the top places the best FMGs look for ( PS not me). Places that US grads look for and are reaaly intrested in like Duke, Mass General, Brighams, Chapel Hills, UCLA, Hopkins, and the such have no FMGs in them. Therefore I believe FMGs will take there chances in the match with the possibility of going into these places otherwise theyll go for the prematch. Ive met every reqiurment anyone has asked for on there websites, scorewise, visa status im a citizen, 1 year US clinical experience, 4 US LOR's, research, native english speaker, but still half my applications have already been rejected, whereas I see my brother, a PhD student in engineering, apply to 2 Universities and get acceptance at both and decide where he wants to go. Why the difference in Medicine??? I really dont know, but it has really begun to effect me in a way that I hate seeing these things, and look for programs who dont bias on these merits, although even at these programs, the worst US applicant will get ranked higher than me, but these are the facts of life, of which I have no power on changing, therefore again, the easy way out is prematch. Also if anyone hasnt noticed, at interviews the programs sell theyre program to US grads, and really try to entice them ( BRIBE) into coming into the program, whereas a FMG has to hope for being able to sell himself or herself at an interview, and wish there will be a buyer out there. So the role switching is also very annoying, and I have seen it numerous places.
Edited by mmoghbelli on 12/14/05 - 09:50 AM
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| trishue
Forum Elite
Topics: 24
Posts: 156
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Hi BBB, how are you? I have not been able to log in and post these past few days because I am currently busy with my H1b docs.
I don't know with other IMGs, but I accepted a prematch offer because 1. I have family near that state 2. I have a friend currently a PGY1 there (THe PD and the attendings obviously know who they will be working with when they know someone from your medical school... so maybe that's a factor why they offered me) 3. the other programs I have interviewed in are of equal caliber and strength with the program that I've accepted...
Others have different reasons, but I know what I am capable of, and I also know what I am sacrificing, and for me, this hospital is my top choice... hehe... take care and GOD bless to all joining the MATCH!
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| kigot
Forum Newbie
Topics: 5
Posts: 11
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folks, I also accepted a prematch in a comm. hospital although I had 3 interviews from univ. programs too, but I thought 3 is not enough for securing a spot, this hospital was my fourth option in my list but I didnt wanted to take risks and I like tha location of that hospital. Im not coward, no no, but I feel that I just played it safe this way...Frankly I feel I deserve better than that, but again as an IMGs the ball rolls against our favor. I ranked 300 out of 100'000 applicants inorder to get to the medical school that I come from. Honestly Im not sure if all AMGs here would have been able to get accpeted into a medical school in my country considering the rough conditions that Ive been through. Ive seen some US doctors who are JUST average in where Idid some rotations in the southeast... anyways this is just to restate what other folks said in this thread, we all have to play the game here and I really dont blame PDs for ranking the weakest AMGs over us. its the way it is folks..... BEST TO ALLLLLLL
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| drkill
Forum Elite
Topics: 15
Posts: 189
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hi all!
well i dont think its unjust to say amg's arent smart.and one cant blame hospitals for picking them over us.after all it is their native country,their education is upto the standard for american schools and they have been in the system.that said, it is also unfair to close doors to img's at all.some of the places like hopkins etc r not easy for amgs to get in either.they compete amongst themselves too.imgs with exceptional credentials shd be given a chance to compete too,rather than just not chosen cuz of img status.we do have to realise that very few imgs have major research experince,publications,uptodate with technology n work systems in tyheir med schools unlike in american schools.ofcourse there r "exceptional imgs" like mmoghbelli but these r few.so just bcuz amgs have lower usmle scores we cant say they r less smart.their emphasis is not so much on the score as ours is and they dont usually study for months like we do.they just dont try that hard at it cuz its not needed for them.i am not defending amgs in any way,i am an img myself n in the race like all of u....but this is my pt of view.instead of being bitter n feel like we r being treated unfair, y dont we look at the situation as a challenge? and be glad that we have opportunity to make it big in this country on our own and be optimistic abt the future n have faith in our abilities.be proud of ureself guys we have come so far n may we all do with our lives the best we can!
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| Petal
Forum Senior
Topics: 9
Posts: 74
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Here's my 2 cents:
I accepted a pre-match because the program was my first choice. It was exactly what I wanted. What contributed to my decision was that I was short on budjet, and attending all other intervews would have cost me a lot. But I agree that if the program is not one's first choice, then match is the best option.
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| drmamu
Forum Elite
Topics: 43
Posts: 188
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I feel that the more an img compares himself to a local grad, more he will feel frustrated. Try to accept the fact. Local grad are favoured, its their native country, they have spent hundreds of thousands of dollars as medical school fees and at least 3 to 4 years of pregrads extra when compared to any img. We are not expected to equlaise to them just because we speak English, have a green card or have a 99 score on usmle. I am not trying to offend any imgs. I am also an img. But I am thankful to what ever the country is offering. At the same time I am also ready to accept that many of the prestigeous institution are not for us, or at least me. But I beleive once I get into a program(where I can survive for three year without muh problem), I will be able to show where I stand among the American grads(better or worse as case may be). Once that is evident, I will get what I really deserve. But even in fellowship opportunities, The same discrimination to fmgs exist, though a bit less. Thats again the truth of life. we will be happier if we accept it rather than thinking and complaining more about it. There is probably nothing we can do to change rather than trying hard.
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| doc_droc_apurva
Moderator
Topics: 38
Posts: 1,705
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my 0.02
human iq is the same geographically. if ur amongst the top 10% of ur country - u will be amongst the top 10% anywhere. its not that whos better - i believe we re the same. amgs vs imgs - doesnt make sense. the guy from harvard could whip any imgs ass just like the guy from aiims wud whip any amgs. all amgs arent superb just as all imgs arent hippocrates reincarnated.. theres the good, bad and the apurvas amongsts all of us
previously there was a trend of the ppl who couldnt get into residencies back home in india to leave shores by the various routes available to them and get into us residencies. that time has past but the impression the pds have of slightly less bright imgs sticks.
the current imgs are a new breed. not boasting but i know of lots of ppl in this forum who would have got into decent residencies back home with the same efforts they have put in for usmle.
think about it - i know ppl with mid 80s who got into good places a few yrs back into good programs. now with mid 80s u wud be hard pressed to have few decent iviews. not the mle scores are the deciders of intelligence. its just that theyre being treated as that.. previously the 99 limit was set at 240. now its upto 243 and the mean is upto 217 from 213. maybe each succeeding generation is gettin smarter ala darwin... does it mean the guy with 80s is a dunce and the guy with 99 is fantastic. i wud take an mrcp or md with 80s anyday to treat my loved ones over a 99/99/99 fresh grad.
the era of the mass imgs is over. and after a few yrs when the pds realise the class of good imgs that are standing for this match - doors will begin to open.
what you can do? work hard and leave good footprints for ppl following you.. i will be most probably reapplyin next yr - so kindly dont piss off ur pd
apurva
just my 0.02 - no offence to ppl - i seem to ruffle feathers everywhere i go - i am a natural
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| alenka
Forum Elite
Topics: 22
Posts: 330
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hi guys,
i just wanted to contribute my 2 pennies.
i agree that the match is not a fair game,but think about it:
if you were an american graduate,who have always dreamt of becoming a doctor,who worked his butt off in school to get good grades....you might say-so what?i had to work my butt off too etc.
but-there's a big difference-we don't have 150-250 K in debts like they do,is that fair?what if YOU had a 200 K debt?wouldn't you feel it unfair if the IMG who has no or minimal debt- with the same score got a position and you didn't?
i thought about it and i think-we have to struggle UNTIL we get a position finally.but they have to struggle a lot longer trying to pay off all they owe.so maybe overall it's not all that bad for us......
good luck to everybody.
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| chivasregal
Forum Elite
Topics: 10
Posts: 285
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Hmmmm..could't remain silent after reading everybody's opinion..the question abt y IMG's accept prematch when they could go for match...its a very personal decision i would say...like all fingers of the hand r not alike, so everybody is different having different opinions...i would say its mostly the insecurity of going UnMatched what prompts IMG's to accept pre match..some of us have spent thousands of $$$ for applying to programs..some have been doing it for couple of years...some don't have decent jobs..we all have to live , feed our families, pay our bills like every AMG does too...but AMG's get lot of medical related jobs even while they r in undergrad college[ thats from one of AMG's i talked to]..n some have already paid off their undergrad tuition fee..whereas IMG's cant find any medical related jobs so some of us end up working at Fleet Farm, Sears, Walmart..i dont say its bad to work at these places since I worked as a Truck unloader at one of these places for a while coz there's no other job i could find...some of us have Visa issues..people with Visa issues want to b safe n secure so they can start their Visa processing on time....everybody has a dream to fulfill n thats y they r in US...if i had stayed back in my home country I would have been doing Orthopedics coz thats wat i love but since being an IMG its almost impossible to think of getting Orthopedics..but my story is not relevant here....I would't say AMG's r less qualified or IMG's r more qualified....i have seen very intelligent AMG's as well as Dumb IMG's who shouldt deserve a chance in residency even though they had double 99's...well talking abt AMG's paying off loans for education..hmmm...well we cant do anything about it coz in our country our med schooling was govt. funded n thats y we have entrance exams where only the topmost students get through..education is costly in US..so the US govt. should do something abt it..i have heard that Michigan state might start giving free med school education to US grads..but do u think that would make that program consider IMG's coz then AMG's dont have to pay Loans...all said n done...Prematch gives one sense of security..meaning no more interviews to attend...saving money..knowing one will b able to pay off bills which one accumulated over period of time....programs want fresh grads..but they dont realise that not every IMG comes from rich affluent families...n some of us have to work to save money to pay for USMLE exams..coz we all dream to b physicians in US..n thats does't mean we should stop ourselves from thinking abt having better lives........i dont know i might have gone offtrack here but one thing abt USCE i dont understand y do programs want that..i think its their polite way of saying sorry IMG's not welcome here coz they think we dont know how the system in US works,,hmmm,,we all passed CS exam n i agree it doest truly reflect the exact US hospital system...but most of IMG's worked back home n were excellent physicians...are patients any different in USA than in say,, cambodia,pakistan,india,london..i dont think so..n i'll never understand this USCE bias...coz programs know that coz of HIPAA its difficult for IMG's to get USCE but still they dont ask those people who have USCE that how they got it without violating HIPAA???
AMG's do score 99..its a misconception that they dont..i met one AMG going for ophthal interviews n he told me that step 1 cut off to apply for ophthal was 235..so tht tells everything...but its not like that AMG's who score less on step 1 dont get ophthal interviews but then they have to do better on step 2...but everyone says that AMG's take abt a week to take USMLE exams ..thats true..but their med school inservice exams/ board exams r all based on USMLE format..their schools prepare them from first year abt these exams....n IMG's have to score high to prove themselves to get interviews so they prepare longer for these exams....n not to forget some IMG's study medicine in their native language n then learn english n study medicine in english n take USMLE exams n on top of it score 99 on these exams..but still their efforts r not recognised..
USMLE scores r one of the biggest deciding criteria by PD's abt who would get interview calls..coz i read in some book that PD's can evaluate AMG's on lot of diff. basis..like..med. school..transcripts,,AOA status n stuff..but every country's transcripts r different so they rely on USMLE scores[ which might not truly reflect the potential of a person].........talking abt PD's knowing abt AMG's med. schools n stuff but IMG med. schools r listed by WHO..is't it..so that means WHO knows abt our med. schools thats y we have been allowed to take USMLE exams,,..so wats this thing abt " we dont know abt IMG's med. school"..i agree there r bad n good people everywhere....i hope i answered BBB's query n lot of other people's questions...well thats my opinion..hope everyone gets what they dream for..good luck
Edited by chivasregal on 12/16/05 - 06:51 AM
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| bbb
IM Program Coordinator
Topics: 32
Posts: 4,681
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Thanks everyone - this gives me lots of information to give to my program director when I meet with him next. I appreciate your honesty and valuable feedback. I've told him concerns that I have heard (from IMGs) over the years, but this is coming directly from you all which will carry a little more weight.
Having lived overseas and understanding the work visa situation (first hand), I am able to put myself in your shoes (to a tiny degree).
Thanks again for your help.
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bbb - trying to combine common sense and humour into realistic answers, but not going to guess on anyone's chances of getting into a position....off until July 14th exploring the caves of NYC
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| gita_b
Forum Senior
Topics: 7
Posts: 46
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Another issue....many IMG friendly programs fill the majority of their seats by prematch...which leaves candidiates going in for the match at a disadvantage...because the places that an IMG is likely to get into, release a smaller number of seats for the match, thus increasing the likelihood of going unmatched....Am I making any sense at all?
If there was no system of prematches at all and everybody had to go through the match, then it might be more fair....
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| johnavin
Forum Senior
Topics: 7
Posts: 45
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Dear BBB,
I like a prematch because you will know exactly where you are going. It would be your decision to join and not going because the program matched you. I have this fear of being match with the last program on my list.
Being an FMG, its difficult but not impossible to get into a uni program but a strong community program that offers prematch is just as good for me. Since uni programs do not offer prematch the second choice is the best choice.
The match do favour AMGs. Eventhough I am an FMG I think AMGs should be ranked first since the residencies are made for them. There is a greater chance for an FMG not being matched than a AMGs hence, I do not gamble when I have an offer from a good community program.
In the end it works both ways. Its an honor to receive a prematch offer because you know the program wants you, not because you were the last person on their rank order list. You will be happier too because you know the program wants you.
I hope that I have answered you question well, BBB.
I would like to take this opportunity to thank you for helping us out with our questions.
With Warm Regards,
John
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| bbb
IM Program Coordinator
Topics: 32
Posts: 4,681
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Thanks John.
I would like to say that the match favors all candidates over the programs. It will give a candidate a first choice over a residency program.
Either way, it's always an adventure and thanks for taking the time to answer my question.
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bbb - trying to combine common sense and humour into realistic answers, but not going to guess on anyone's chances of getting into a position....off until July 14th exploring the caves of NYC
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| Petal
Forum Senior
Topics: 9
Posts: 74
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Thank you BBB for your passionate support. God bless you.
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| MD2003
Forum Newbie
Topics: 0
Posts: 1
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I think what's funny about this is that someone outside of these process have no idea the difficulties involved in becoming a doctor. One thing I can truly say is that this has been a very humbling experience. May god bless all of you!
So coming down to it why does someone accept a prematch? I think the question should be why wouldn't someone accept it if offered. Not accepting it is very risky and not one many can afford to take. You have to look at the facts when making a sound decision.
- Over 4,000 participants of the match go unmatched each year.
- These same 4,000 try to better their credentials and reapply the following year.
- There are more than 12,000 AMGs graduating each year, and 8,000 plus IMGs + 4,000 from previous year all applying for a little over 20,000 positions. (Keep in mind that my number are very conservative, there are more IMGs than that.) And keeping in mind that over 98% of AMGs will match, this means that the 4,000 people who do not match are all IMGs, can you really afford to be one amongst those 4K?
- Then take into account that the number of positions offered in the match continue to get smaller. The facts are that programs know that going into the match is risky for them also. They don't want to end up with below average people. They much rather offer a prematch to their top five IMGs and fill those five seats and then rank all their AMGs in the match for the remaining 5 seats.
If I was to do some rough math I would end up with about 60% chance of an IMG matching if they went into the match. (Again I think I being very conservative I think its actually around 57%.) Not very reassuring is it?
So the question then becomes can you really afford not to take the pre-match? Working with those figures you really have to have a lot of confidence, credentials, and risk taking personality to be brave enough to go into the match.
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| Agrada
Forum Junior
Topics: 9
Posts: 47
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No one blame doctors for their negativity, and their sociopath attitude...they suffered like jewish people..
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| brokenhearted
Forum Senior
Topics: 5
Posts: 68
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Hey bbb,
Can you plz tell me what are the chances to get residency if you score in 70's in steps 1st attempt,pass step 2cs,no visa rewuired....do 1month observership & some research work......what are the chances to get residency in this condition within chicago area....?....ur help will be appreciated.
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