Monday, February 13, 2012
Wednesday, February 8, 2012
FAQ’s (A pooled list of good questions I’ve been asked by medical students):
1. Question:
I understand some are thought o get in but what is your suggestion and what should I do to make this happen?
Any other suggestion you want to give me?
9a. Question:
9c. Question:
I have taken all my USMLE steps and have a few interviews for internal medicine in US. Do i need to apply through the CaRMS match in order to get a J1 visa or just taking the MCCEE would get me the statement of need?
Answer:
For a J1 Visa, you must:
1.Hold a valid ECFMG certificate (which you will receive once you have completed USMLE 1, 2CS, 2CK and graduated).
2. Hold a contract or official offer for a position in an accredited residency program
3. Provide a statement of need (issued by your home country - this serves to confirm your commitment to return to Canada upon completion of training in the US). To obtain one, you can visit the Health Canada website.
You must pass the MCCEE to get one.
2. Question:
What are the commonly asked residency interview questions for which to prepare?
Answer:
See my list here:
3. Question:
Is it really important to have the MCCQE1 as well as the MCCEE?
Do residency programs in your experience prefer students that have also completed the MCCQE1? I had to complete the USMLE's first due to school requirements for graduation, so I was unable to schedule the exam before this upcoming May session. My classmates previously informed me that the USMLE's are considered equivalent to the MCCQE's.
Answer:
They don't consider the QE exams for the match. USMLEs at this time are only equivalent in Ontario for those who entered residency in 2010 and prior. You will have to take your MCCQE's after starting residency.
4. Question:
“I am at [a great Carribbean med school] and about to take the Step 1 USMLE. As soon as I complete the Step 1, I plan to do some shadowing & get some additional accreditations that might enhance my CV. A big concern I have right now is how my USMLE score will affect my chances of matching in Ontario. Did your scores weigh heavily, if at all?”
Answer:
USMLE scores typically do not matter when applying to Canada. You will submit your scores to the CaRMS application site, but they are not typically considered. I do, however, recommend that you study hard for it to keep options open in the US and obtain as many US interviews as possible (for the interview experience and to have more choices for a residency).
The MCCEE is what you will need to take for applying to Canada. This score does matter for IMG's, mainly as a screening/cut-off tool for interview invitations. Once you get the interview, the score no longer matters.
I talk about scheduling the MCCEE in my first blog post. You should take the MCCEE in September 2012, not too long after you take the USMLE step 2 CK. The content is essentially the same. Be sure to study for each USMLE using USMLEWorld online q bank for practice and getting used to the format/timing.
The MCCEE exam is a shorter exam (4 hours) with shorter question stems. To get an idea, do a few sets of questions on "Canada QBank" a couple of weeks before you take the MCCEE.
5. Question:
What is the scope if one apply for residency in a specialty after completing master in that field? For example, if one is interested in doing residency training in pediatrics, what's the scope of getting a residency in peds after completing master in pediatrics? Will it be a boost on Residency application or will it have a negative impact b/c one is out of clinical practice for long time?
Answer:
From my experience, having a Master's degree definitely boosts your application in applying for residency, especially if it is in the same field. It will provide you with reasons and points of discussion for choosing that particular specialty.
Keep in mind that in Canada when applying for your license before commencing residency (i.e. in Ontario through the CPSO, http://www.cpso.on.ca/), you will need to provide information as to any pause taken during medical practice. This should not be an issue however, since your reason would be to complete a Master's degree immediately after completing medical school.
That being said, in certain fields of general practice, i.e. Internal Medicine, Family medicine, pediatrics, a Master's degree is not expected or required, since many in these fields end up working in the community setting after completing residency, not necessarily as academics (but there are certainly many academic careers that can come from completing one of these residencies).
If you have applied in your final year of medical school and have not matched to a residency program, then doing either a master's or a research year is better than taking the year off, but committing yourself to a Master's may require a minimum of two years. You may even be able to do some clinical observerships if you find the time in a place where you'd like to match.
6. Question:
Were there a fair number of individuals in the mid 30's age range at SGU or will I be “geriatric”?
Answer:
We definitely had a mixed crowd. Most in their 20's, but we had several in their 30's and even a few in their 40's and 50's, believe it or not. It really is "never too late". We had some students who had careers in completely unrelated fields, some who went to grad school, and some who worked as Chiropractors, Physician Assistants and nurses before applying. You will not be a "Geriatric".
7a. Question:
I am an SGU student, about to start my third year clinical rotations and am starting off with medicine core as my first rotation. I will be new to the wards and the added pressure of performing well on an important rotation is making me nervous.
Answer:
Medicine is actually a good one to start with. You'll cover the most important (high-yield) areas needed for boards, so you'll be motivated right off the bat and have an early head start on your studying. You will also see the general approach in clinical scenarios you will apply to other rotations (i.e. you'll be able to look at the big picture when you're on Surgery and be a lot more thorough). Don't worry; they don't expect you to know everything. They know you are just starting your clinicals!
7b. Question:
I was wondering if I could please ask for your advice on how to prepare for these rotations, what to keep in mind during medicine and if there is anything important that I should be doing during clinicals?
Answer:
You will be studying along the way. The SGU affiliated hospitals typically have great didactic lectures scheduled for the students. These are all important topics for boards. Pay attention during those and it helps to study the topic beforehand if you know the schedule in advance. Don't over-study...enjoy your clinical experience and enjoy your time in the US! You will likely review again before the end-of-rotation exams.
In terms of textbooks, please check out this page I made on my blog
click the link on the left for "Wards". Those are the books I bought.
These will obviously depend on your rotations (i.e. you may not need the Neurosurgery text!).
Did you read my blog on "How to study for the Boards and Wards"?
This described how I studied during my rotations.
8. Question:
I have completed all of my USMLE with scores from 86-99, and MCCEE and MCCQE1 with scores in the 95+ percentile.
What programs you think I stand a good chance in? Neurology and Internal Medicine is my preference but I am open to other good specialties like Radiology, OB GYN, etc. I understand some are thought o get in but what is your suggestion and what should I do to make this happen?
Any other suggestion you want to give me?
Answer:
Your qualifications look solid. If you have a Canadian citizenship, you are ok with the current exams you have completed. If you do not, you will likely need to complete the MCCQE2.
Having a reference from a Canadian physician will definitely help, especially if they are in the field to which you are applying, and they are relatively well known in their field or a program director (but this is not always necessary).
You will need to put forward a very good reason in your personal statement as to why you want to switch from your current program to one in Canada and in a new particular specialty.
Also, you must convey to the program that you really want to practice in that specialty. I know it's difficult to get what you absolutely want, and that sometimes you may feel you have to settle for almost anything in order to match, but programs will see that and may question you on why you have selected certain rotations and why their specialty. It may be better to apply to maybe one or two specialties in which you will be 100% satisfied if you match. Do not apply to multiple, unless you have a solid reason and personal statement tailored to each specialty with an amazingly solid and convincing argument as to why you deserve to be in THAT specialty, and have the rotations and letters to back it up (i.e. Radiology and OB/GYN - very competitive, and very niche specialties). Applying to IM, peds and/or family would be easier given your match in the US.
Also note that there are way fewer IMG spots in Canada (Family and IM are growing in number, but they also have many more applicants). You should check the CaRMS website to see the statistics of applicants last year.
Be sure to consider location and lifestyle. Programs in Ontario are all great and there is a major focus on teaching with really strict rules on allowing residents to have their dedicated teaching time uninterrupted by clinical practice.
They are all major university programs, so the training should be great no matter where you end-up.
Some info on Neurology in Canada:
There are few IMG-friendly programs. Most are in Ontario (Western, Toronto, McMaster, Ottawa). These are major centers with a large catchment area, so you will have a good amount of exposure to all of those rare diseases you read about in textbooks, but never thought you'd see.
If you take all of your MCC exams prior to applying, you have more chances outside of Ontario. For Quebec, you will need to take a French equivalency exam as well, even for McGill (which is an English program).
The Neurology program is 5 years long. (In the US, it is 4 years with your first year being entirely in Internal Medicine).
In Canada, much of your rotations in your first 2 years will be medicine subspecialties (this also includes ER and ICU).
At Western (UWO), you would have 2 months of neurology in PGY-1 and 4 months of neurology in PGY-2.
You will also have 2 months of neuro-radiology and 1 or 2 months (your choice) of neurosurgery.
Upper years: urgent neuro clinic, subspecialty rotations (epilepsy, neuromuscular, neuropathology, pediatric neurology, etc.), electives, longitudinal clinics where you manage followup of your own patients.
Some advantages of a 5-year neurology program:
1. More exposure to subspecialties of neuro (Neuromuscular/EMG, Neuropath, Epilepsy/EEG, Movement disorders, Stroke, Neurorads, NeuroICU, etc., with more elective time). This will make you feel very comfortable/competent should you choose to go into general neurology/community practice. Having 5 years of training is also appealing if applying to practice or do a fellowship in the US later on.
2. If you decide to switch early on to a different specialty, it will be easier, because most specialty programs in Canada are 5 years, including Surgical specialties, OB/GYN, EM, etc. and the 5-year funding can be transferred over. (for example, I have a colleague who switched from Urology to EM early in his 3rd year and had no problem doing so). That being said, I don't recommend switching. I hope you get what you truly want right from the start.
You mentioned in your first blog post that med students need to write the MCCEE in order to get the J1 to do residency - is this a hard and fast rule?
Answer:
Yes, you need to write the MCCEE if you plan to get into a residency in Canada or the US right out of med school, without taking a year off. This will help getting a J1. The J1 basically requires two things...matching to a US program and filing the right papers through the Canadian government (see the link I provided on my blog).
9b. Question:
What if I want to get a US residency where the hospital sponsors me on a H1B? Would I still need to write the MCCEE if I don't want the J1?
Answer:
The likelihood of getting an H1B is next to impossible before finishing med school in time to start your residency (this should answer your next questions as well!) Also, they offer these less and less.
9c. Question:
You wrote that I would need time off after I graduate to apply for the H1B visa - why? Is there a long processing time?
What if I begin my residency on the J1 (so that I can start residency right after graduating and so that I'm not taking time off after I graduate to wait for the H1B visa application to go through) and then start looking for hospitals that could sponsor my H1B and issue the J1 waiver to exempt me from having to come back to Canada? Should I ask the hospital I apply to for residency to just start me on a J1 but then later switch to a H1B?
What if I begin my residency on the J1 (so that I can start residency right after graduating and so that I'm not taking time off after I graduate to wait for the H1B visa application to go through) and then start looking for hospitals that could sponsor my H1B and issue the J1 waiver to exempt me from having to come back to Canada? Should I ask the hospital I apply to for residency to just start me on a J1 but then later switch to a H1B?
Answer:
The hospital will have their requirements for non-US citizen IMG's defined as accepting of J1 or H1B. Most accept the J1 because this doesn't cost the hospital anything, whereas sponsoring you for an H1B costs them several thousand $$. You may apply for a waiver down the road. This is based on need by the hospital and if they're willing to support you. Hope this answers your next few questions.
P.s. there are plenty of opportunities to work in Canada after residency in the US...so don't worry about the J1 and having to come back. The J1 is good for up to 7 years, so it should be enough to do a fellowship after residency, unless you plan on going into neurosurgery (which in itself is 7 years long)!
10. Question:
Do teaching hospitals in the US treat Canadians from Caribbean med schools or Canadians from US med schools better?
Answer:
No difference in most places from what I've seen. Most of the affiliated US hospitals have been used to training IMG's for years. A lot of the attendings in many US schools/hospitals were IMG's!
For those who dread the MCAT (My spiel to the wannabe medical student):
What prompted me to write the following is a US News article I just read on their website, titled “Top 3 Reasons Medical School Applications Are Rejected”.
I recommend reading it before reading my blog post below. Here’s the link: http://www.usnews.com/education/blogs/medical-school-admissions-doctor/2012/02/06/top-3-reasons-medical-school-applications-are-rejected
Have faith people! Yes, I agree, grades do matter, and I also agree that an obvious progressive upward trend or a small blip on the radar shouldn't hold you back. Your grades show how much effort you put into your chosen coursework.
I do feel however that your MCAT performance only matters because it is the only “standardized” tool available. I am sorry to those who enjoyed a music degree in undergrad; the MCAT is looking to punish you. I don't believe the MCAT provides a strong correlate with how you will perform in medical school. Unfortunately, it is still being used.
To give a personal example, I took my MCAT while in grad school (far removed from the basic chemistry and physics courses I took in my first year of undergrad) and had very little time to study for it, given my demands in the lab amongst other important aspects of extra-curricular involvement. My MCAT score was let's just say in the "20's". The writing sample was my best section (Scored an “S”, scoring is from J-T). I still had several research publications, presentations, leadership roles in extra-curricular activities and teaching experience in the life science fields, with a 3.7 undergrad GPA and a 4.0 grad GPA. Unfortunately, I did not even get an interview at a Canadian/US medical school (I didn’t bother applying to most, considering I knew the MCAT score would keep me from entering the door). I decided to apply to SGU as I was encouraged by the consistently successful residency matches to great programs in the US. I was accepted to SGU and certainly put the work in! I maintained one of the top GPA’s in my class; did well during my clinical rotations in the US alongside Cornell students, and scored 240+/99 on my USMLE. I eventually obtained many residency interviews in the US and Canada, and matched to a great Canadian residency program and had pre-match offers from US programs.
My medical school experience will be missed. I studied basic sciences in amazing weather with students from all over the US, Canada, the UK, etc., and was taught by American and Canadian professors. I loved living in New York during my clinical years – not many med students outside of those at NY med schools can say that.
I must say though, I am glad to be home and training in one of the top programs in my specialty. So far, residency is going great; I’ve kept up the momentum, and my rotation evaluations/feedback from attending physicians and staff have all been extremely positive. I am now involved in conducting interviews and enjoy providing constructive feedback for successful matching.
There are some students who score in the high “30’s” on their MCAT and have a personality that would not necessarily fit with most in the setting of clinical/academic medicine (and no, I am not referring to those that apply to pathology – my pathologist colleagues are fantastic people).
Point of the story: Clearly, the MCAT score is not reflective of your competence and professionalism as a future physician. Schools need to “ease-up” on the weight they put on this exam as a screening tool for medical school candidacy. Some school have, but unfortunately not enough.
-------------------------------
Additional advice for med student hopefuls:
Do your best, study hard, and enjoy the undergraduate/graduate life. Take it all in. Always be respectful of colleagues, keep the drama at home, be open to criticism and, in the words of Jay-Z, “Wipe the dirt off your shoulder”. All of these will be reflected in your letters of recommendation when it comes time to apply to med school.
When you decide to take the MCAT, try taking it shortly after you’ve completed your core basic sciences. Take a review course only if you have the time for it and willing to spend the money or if you need the strict defined scheduled lectures and practice sessions. If you’re involved in research, many research supervisors do not accept “studying for your MCAT” as a good reason to take time off. I understand from my own personal experience that taking this much time off is not always feasible.
Mature applicants looking to switch careers may not be able to take any time off without losing their job in the “hopes” of getting into med school.
Do not re-take the exam if you don’t feel any more prepared the second time around. Don’t sweat the small things. Remember, we are not applying to be rocket scientists; maybe brain surgeons, but trust me, rocket science in my opinion is way more complex than neurosurgery.
If you truly wish to be a physician, but do not wish to prolong the torture of trying to get into a US or Canadian school, apply overseas. The training in most places will prepare you well and the programs teach all of the same evidence-based practices (or should). The one caveat I have is this. If you plan on applying to a Canadian residency program (as a Canadian citizen), going to the UK, Australia, etc. is just as appealing to the programs, if not more so, than going to a Caribbean school. If you plan to apply to a US residency program, Caribbean medical schools (SGU, Ross, AUC, SABA) may be a better option given the opportunity to do all of your clinical rotations in the US. I do not recommend completing too many clinical rotations in the UK coming from a Caribbean school, as some residencies may not accept those rotations as transferrable.
Subscribe to:
Posts (Atom)