Choosing on the Basis of Your First
Preference
If you decide to apply only for your dream field but realize
that it is very competitive, then careful research of programs
becomes even more important. You will need to search out programs
that have taken IMGs in the past, thus indicating at least some
degree of IMG-"friendliness." One way to determine this is to
simply tp call programs to ask if they consider IMG applicants,
whether they have current or past IMG residents, and if they say
they do consider IMGs, then also ask what minimum USMLE score
requirement they have. Make use of the other techniques outlined
in the Researching Programs section as well.
If you are shooting for a competitive specialty, it makes
sense to take a realistic look at the available statistics to
estimate your chances for success. Look through several years
issues of the JAMA Medical Education journal and you will find
that some specialties rarely, if ever, take IMGs. For instance,
in 1998 emergency medicine and orthopedics each reported having
only 2.1 percent IMG residents. Miracles do happen occasionally,
and it is possible to pick up a residency in your favorite
specialty. In one case, a resident happened to be in the right
place at the right time when a surgery resident was dismissed
from a program. This IMG with previous surgery experience in
another country was able to step into the position mid-year on a
moment's notice. You can never plan for these serendipitous
events, but they do occur.
Be prepared to explain why you would do well in the specialty
for which you are being interviewed. It is damaging to say, "I
think I would do well in this field," and then not be able to
articulate any reasons for why you think so.
Choosing on the Basis of Probability of
Success
Another approach is to pursue a specialty with the higher
probability of success. Here, too, you must be prepared to answer
interviewer questions about why you decided to change your
specialty. Good, credible answers are honest, but must also
include specific reasons about what you find appealing about the
specialty, and evidence of why you feel that you would be
well-suited to succeed in that field.
For example, a physician from Africa who had completed
residency and practiced in Neurology in his home country applied
for and was accepted into a Psychiatry program in the United
States. He gained this residency by making use of the obvious
connections between the two specialties. More particularly, he
was able to articulate those connections and how he would use his
experience in each specialty in his future practice of medicine.
His past experience in Neurology became a huge asset that helped
him to be highly ranked by psychiatry programs.
Another example is a foreign-trained surgeon who was applying
for a position in an internal medicine program. Surgeons are
known to be highly organized and to work "by the book," i.e., to
be guided by principles and protocols. The candidate with this
background therefore capitalized on it by mentioning how good he
was at following directions and accepting constructive criticism.
Since these are qualities preferred by program directors in any
specialty, it increased his attractiveness as a candidate.
The bottom line is that program directors who are interested
will be well aware that you probably have previous specialty
experience. This is something that US applicants can seldom
offer. Use it to your benefit by building on and relating your
past experience to the specialty you are pursuing in the United
States. Your past experience is an asset to be used, not ignored
or discounted, and this applies to your personal statement as
well as to how you present yourself during interviews.
Choose based on what is best for you
Carefully think through what is best for you. Do not follow
the herd and find yourself pursing specialty training in a field
that you neither want nor know much about. If you carefully think
through your own skills, traits and talents, you will select a
specialty for which you can make a strong case for your
qualifications. Then you will come across as more credible, and
be more likely to match. Remember, you will have to live with the
consequences of this specialty decision for many years of
practice.
