Medical residency in the US (part II)

I once wrote about Medical Residency in the US – how tough is it? Now that my attempt to take USMLE Step 1 during summer holidays 2008 failed miserably due to failure of either ECFMG (Educational Comission of Foreign Medical Graduates) or NNSMA Deanery to verify my medical students status, perhaps it’s time to weigh and rethink residency in the US all over again. As of now, 13th January 2009, I am prone to think that residency in the US is a bad idea. While I might change my opinion as time goes by, let me tell you what I think now:

  1. The Programs – while the US has best teaching hospitals in the world with the best programs of medicine, it is tough to get in as well. While US-trained medical students can get into these programs with mediocre scores, the international @ foreign medical graduates (IMGs @ FMGs) need to score much higher and work twice harder (researches, publications, externships etc) to get into excellent programs. Usually entrance to residency programs like surgery, radiology, anesthesia, orthopedics, ophthalmology, obstetrics, dermatology and emergency medicine is real tough for IMGs. IMGs usually resort to Family Medicine, Psychiatry and Internal Medicine (in which cardiology, gastroenterology and nephrology specialties and fellowships are tough to get in due to its competitiveness and high market value)
  2. The Timing – usually IMGs applying for residency in the US had to gain 3-5 years of experience of medical practice from home country. It sucks real bad for Malaysian Medical Officer at his/her 5th year of practice needing to start the residency again from scratch (internship). Although the residency programs in the US are short (5-7 years for surgical and 3 years for other specialties), the process of restarting the whole thing again is frustrating.
  3. The Work – the work of residents demands perfection out of their sucky systems. Although that is good for the training of a physician, the demand is far too overwhelming for IMGs. To get into excellent programs of post-residency fellowships, an IMG has to work twice harder than their American counterparts. Stress level is always to the roof. Thus, it is always reported that physicians in the US has low job satisfaction.
  4. The Money – although at this time of economic recession, physicians in the US have job security. With starting salary 40K (above median and average national income per capita), the  tax rate is 25%. That doesn’t include other taxes, apartment rents, bills and credits, foods and clothing etc. Well, it is hard to argue with this point as US residents make better money than any other countries in the world. But with the introduction of UD41 (RM3,768.39) at first year of housemanship and UD44 (RM6000+) at third year of practice, I ‘d say I’m more satisfied with the current Malaysian government pay scheme for doctors. Haha, doctors don’t make money! Wanna make more money, quit medicine!
  5. The Others – social factors, far away from home, culture shocks, economic collapse of the US, high crime rate, despicable foreign policy, their support of killing innocent people and all that stuffs.

That’s all. Resuming studies now 🙂 Thank you all for the birthday wishes.


5 thoughts on “Medical residency in the US (part II)

    • Nope. Even if it is, that usually takes place at the pre-residency matching process instead of simply taking one Step exam. Taking step exam doesn’t require sponsorship verification. One of them Deans or ECFMG missed the first step of med student verification.

  1. Hi, well I want to tell you my experience. After passing all the required tests I matched to a Hospital in NY. I am an old graduate (14 years) my scores weren`t too good (step 1 84, step2 79; first attemp), but a matched in an internal medicine program.
    It was overwhelming, not because the amount of work (that was huge) but because I notice the house staff, the attendings, the senior residents want to bully the interns and I am pretty sure of that. They don`t care if I was doing a good job, they don`t even care if I was trying to do the best for the patients, What they care is that I was the new guy and they can shout at me if they want for any or no reason and they want to do it. They show a kind of team spirit in doing it.
    I quit and left the USA. I think it was which is called a “crappy” program and there are a lot of these in NY.
    Now I think if you want to go to USA, try to score as high as posible in the steps in order to have interviews in good hospitals. Not all in the USA is good, they have a lot of crap. I know intership is hard, but I think there are really, really bad medical programs in the US.

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