Medical Subspecialty Spotlight: Bariatric Medicine

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If you want to dedicate your career to the prevention and treatment of obesity, you may want to consider an educational track that leads you to subspecialize in bariatric medicine. Physicians who choose this subspecialty work with adults and/or children who are overweight or obese. As a bariatric medicine specialist, you would help your patients manage their weight and the associated complications, and you would devise prevention strategies for at-risk patients who want to avoid becoming obese.

Understanding Obesity

According to the World Health Organization (WHO), “Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health.” More formally, overweight is defined as having a Body Mass Index (BMI) of 25 or above, while obesity is defined as having a Body Mass Index (BMI) of 30 or above. Being overweight or obese puts patients at a higher risk for a wide range of other health problems, including:

  • Heart disease
  • Stroke
  • Type II diabetes
  • Cancer
  • High blood pressure
  • Osteoarthritis
  • Gallbladder disease
  • Sleep apnea
  • Asthma

Obesity is a growing problem around the world. The WHO estimates that the population of obese individuals has doubled since the 1980’s. In 2014, an estimated 1.9 billion adults were overweight, with 600 million of them meeting the criteria for obesity. In the same year, the WHO estimated that 41 million children under the age of 5 were either overweight or obese. Obesity is a particular problem in the United States. According to 2011-2014 data from the Centers for Disease Control and Prevention (CDC), 36.5% of adults in the United States were obese, and 17% of children between the ages of 2 and 19 were obese.

The Bariatric Medicine Subspecialty

Given the increasing severity of the obesity epidemic in the United States and around the world, many American medical schools have started offering fellowships in bariatric medicine. To get a bariatric medicine fellowship, you need to have previously completed an ACGME-accredited U.S. medical residency program in a relevant specialty area. Some of the residency specialty areas that schools accept include:

  • Internal Medicine
  • Family Medicine
  • Pediatrics

These three residency focus areas provide the general medical education that you need in order to succeed in a career as a bariatric medicine specialist. In each one of these programs, you learn about diagnosing and treating patients with a wide range of conditions, which is important bariatric medicine specialists work with overweight and obese patients who have highly diverse physical and mental health histories. Importantly, these three residency specialties were also the top three specialty areas in which foreign medical graduates got matched in 2015, according to data from National Resident Matching Program (NRMP).

What to Expect from a Fellowship Program in Bariatric Medicine

After completing your residency, you can apply to a one-year fellowship program that focuses on bariatric medicine. It is important to note that most fellowship programs that focus on bariatric medicine are officially titled Obesity Medicine and Nutrition Fellowship programs.

Because obesity is such a complex health condition, bariatric medicine fellowships tend to be highly interdisciplinary. You will likely study prevention and treatment strategies that involve nutritional programs, behavioral changes, pharmacological interventions, and bariatric surgery. Upon completion, you will be prepared for the board certification exam offered by the American Board of Obesity Medicine (ABOM).

Getting Into a Fellowship Program

So far, there are only a few Obesity Medicine and Nutrition Fellowship programs in the United States, so entrance is competitive. However, you can boost your chances by demonstrating your commitment to a career in the field. Here are a few things you can do as a medical graduate and as a medical resident:

  • Complete a graduate externship program in bariatric medicine before you apply for a U.S. medical residency. Not only can this boost your odds of getting matched to a residency program in the United States, but it can also indicate to future fellowship application readers that you know what you are getting into and and are ready to take on the challenge of a career in bariatric medicine.
  • Do bariatric-medicine related research while you are a resident. Many U.S. medical residency programs in internal medicine, family medicine, and pediatrics allow you to do conduct scientific research as part of the program. Whether you do lab research on pharmaceutical treatments for obesity, or population studies on obesity risks in certain demographic groups, having already done research on bariatric medicine may give you an edge over the other fellowship applicants.
  • Complete a fellowship in a related field. At some schools, in order to enter the Obesity Medicine and Nutrition Fellowship program, you need to have already completed another one-year fellowship in a related subspecialty area, such as endocrinology, gastroenterology, critical care medicine, or nutrition. Be sure to look into the requirements of the programs you are interested in before you apply.

If you want to pursue a career in bariatric medicine, FMG Portal is here to help. We offer graduate externships in the field and other services that can improve your chances of getting into a U.S. medical residency program. Contact us today for more information!

Choosing a Medical Residency Setting: Urban or Rural?

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As a foreign medical graduate, there are many factors that you must consider when applying to medical residency programs in the United States. With so many different residency programs available at universities and medical centers, it can be hard to narrow down the list, even after you have identified your specialty area of interest. One of the factors that you should take into account is the setting of the residency program — that is, whether your choose a program in an urban area, a rural location, or a small city / suburban area. The setting that you choose can make a big difference for your residency experience, in terms of both your medical work and your life outside of the program. Read on to learn more about what you might expect from U.S. medical residency programs in urban and rural areas.

Choosing a Medical Residency in an Urban Area

U.S. medical residency programs in urban areas offer distinctive opportunities for foreign medical graduates. In cities, you can find lots of hospitals, outpatient care centers, and community health centers, so your clinical rotations may take place at many different sites around the city. This can give you a broader range of experiences than you might get from a residency program in a rural area or a suburban setting.

Many of the cities in the United States are also characterized by significant racial and socioeconomic diversity. Indeed, a 2015 study by the  Brookings Institution found that the 50 largest cities in the United States had a significantly larger gap between the rich and the poor than smaller cities and rural areas. Therefore, if your residency is in an urban area, you might have the chance to work with patients from a wider range of cultural and economic backgrounds. Depending on your country of origin and the city in which you choose to work, you may have foreign language skills that can come in handy when working with the diverse populations of American cities.

Choosing a residency program in an American city will also significantly impact your lifestyle outside of the program. One of the benefits of living in a large city is that you will never need to worry about being bored — from restaurants to museums to concerts, there is no limit to the cultural experiences you can find in American cities! However, one of the drawbacks is that living accommodations are more expensive in American cities, so you may need to live with roommates. At the same time, public transportation systems are better in cities than in rural areas, so you may not need to own a car.

It is important to note that there is no “typical” American city, so if you are looking for a residency program in an urban area, you should do additional research about the cities you are considering. As of 2015, the 10 most populous metropolitan areas in the United States were:

  • New York City, New York
  • Los Angeles, California
  • Chicago, Illinois
  • Dallas – Forth Worth, Texas
  • Houston, Texas
  • Washington, DC
  • Philadelphia, Pennsylvania
  • Miami, Florida
  • Atlanta, Georgia
  • Boston, Massachusetts

Choosing a Medical Residency in a Rural Area

The opportunities that you would get as a medical resident in a program in a rural area are different from those that you would get in an urban area, but they can be just as educational and fulfilling. According to the Centers for Disease Control and Prevention (CDC), health risks for Americans in rural areas are significantly greater than for those living in rural areas, so as a medical resident, you may have the opportunity to gain experience with more serious cases. Here are a few statistics from the CDC about health disparities in rural areas that can provide insight into some of the challenges that medical residents in rural areas face:

  • Compared to Americans in urban areas, rural residents are more likely to die from heart disease, cancer, chronic lower respiratory disease, and stroke.
  • Death from unintentional injury is 50% higher in rural areas than in urban areas — primarily due to motor vehicle crashes and opioid overdoses.
  • Children living in rural areas are more likely to have mental, behavioral, and developmental disorders than those living in urban areas.

Because there are fewer physicians in rural areas, residency programs in rural areas are more commonly available in the broader specialty areas of family medicine, pediatrics, and internal medicine. That’s good news for foreign medical graduates, since the NRMP reports that these were the top three areas in which foreign medical graduates got matched in 2015.

The rural areas in the United States are located primarily in the Midwest, the South, and the West, each of which offers different cultural opportunities and lifestyle options. For example, in many rural areas in the West, there is easy access to outdoor activities like hiking, rock climbing, and rafting. On the other hand, the South is famous for comfort foods like fried chicken and pecan pie. Rural Midwesterners are known for being particularly friendly. On a more practical note, if you are living in a rural area, your housing will probably be less expensive, but you may also need to own a car in order to get around.

Clinical Externships in Rural and Urban Areas

Researching rural and urban areas in the United States can be helpful as you decide where to apply for a U.S. medical residency program, but there is no substitute for real-world experience. A great way to learn what life is really like in one of these settings is to complete a clinical externship. FMG offers clinical externships in many areas around the country, including rural and urban settings, as well as small cities and suburban areas. Contact us today to learn more about all of the resources we offer for foreign medical students and graduates!

Medical Specialty Spotlight: Adolescent Medicine

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As you look ahead to your medical career, one specialty area that you might want to consider is adolescent medicine. As an adolescent medicine specialist, you would provide care for pre-teens, teenagers, and young adults. The period of adolescence starts when the patient reaches puberty and ends when the patient is in their early twenties, so you would have the opportunity to work with patients during a crucial period of development. Read on to learn more about starting a career in this rewarding field.

The Educational Steps for Aspiring Adolescent Medicine Specialists

After earning your medical degree, you can expect to spend another six years in residency and fellowship programs before you can become a Board-certified adolescent medicine specialist. Specifically, you need to complete a three-year medical residency program and a three-year Adolescent Medicine Fellowship.

The first step is to complete a three-year residency program in one of the more general medical specialty areas. According to the National Resident Matching Program (NRMP), applicants for an Adolescent Medicine Fellowship must have previously completed a three-year medical residency in one of the following specialty areas:

That’ good news for foreign medical graduates, since internal medicine, family medicine, and pediatrics were the top three specialty areas in which foreign-trained physicians got matched in 2015, according the the NRMP.

After completing a three-year residency in one of those specialty areas, you can apply for a three-year fellowship in Adolescent Medicine. Unlike some other fellowship programs, the matching process for Adolescent Medicine Fellowship programs is facilitated by the NRMP. Therefore, after you have completed your first residency program, you would go through the ERAS process to get matched to an Adolescent Medicine Fellowship program, just like you would for any other residency program.

What to Expect From an Adolescent Medicine Fellowship Program

All Adolescent Medicine Fellowship programs last for three years. The time that you spend in the program is typically divided between clinical experience, research training, and didactic coursework. In general, the first year is spent mostly on clinical training and coursework, while the second and third years involve more academic research.

However, it is important to note that the proportion of time spent in each of these areas can vary depending on the program. Some programs are primarily intended for aspiring adolescent medicine clinicians, while others focus on training adolescent medicine specialists who spend more time on academic research that supports their practice. As you look at the different programs that are available in the United States, make sure to find out about the emphasis of each one of the programs that you are considering.

Clinical Training in an Adolescent Medicine Fellowship Program

During your clinical training, you will probably have the opportunity to gain experience in multiple settings. You may complete rotations in hospitals, outpatient care centers, behavioral health clinics, substance abuse clinics, gynecology departments, school-based health clinics, and even homeless shelters. If you are interested in public health, adolescent medicine can be a great choice, because many programs offer opportunities to work with teens and young adults from a wide variety of socioeconomic backgrounds.

Because adolescent medicine is such a broad discipline, your clinical training will equip you to treat young people with many different physical and mental health conditions. Some common topics of study include:

  • Eating disorders
  • Gynecology
  • Substance abuse
  • Nutrition
  • Sports medicine
  • Chronic diseases

Research Training in an Adolescent Medicine Fellowship Program

In addition to your clinical training, an Adolescent Medicine Fellowship involves academic research. In most programs, the research opportunities have implications for public health. For instance, you may conduct epidemiological research to try to understand disease frequency in certain adolescent populations, or you may conduct lab-based molecular biology research to develop sexually transmitted disease therapies that are safe for young adults. At some universities, your research can serve as the basis for a Master of Public Health (MPH) degree, which you can earn as part of the Adolescent Medicine Fellowship Program.

Starting Your Career as an Adolescent Medicine Specialist

Once you finish your fellowship program, you will be ready to take the Adolescent Medicine Certification Exam. This exam is developed jointly by the American Board of Internal Medicine (ABIM), the American Board of Family Medicine (ABFM) and the American Board of Pediatrics (ABP). The ABP administers the exam once a year to candidates who have completed an Adolescent Medicine Fellowship program. Passing this exam means that you are Board-certified in the subspecialty area of Adolescent Medicine.

Advice for Aspiring Adolescent Medicine Specialists

Even if you are still in medical school, there are steps you can take that can help you prepare for an Adolescent Medicine Fellowship program in the United States. Completing a student elective or a graduate externship in the field is a great way to learn more about the subspecialty area and increase your chances of getting matched. FMG Portal offers clinical externships for foreign medical graduates in Adolescent Medicine, as well as the three other relevant specialty areas: Internal Medicine, Family Medicine, and Pediatrics. Contact us today for more information about what we offer!

Polishing Your Personal Statement: The Editing Process

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If you’re participating in the 2018 ERAS process, you’re probably spending part of your summer working on your personal statement, which is a key component of your application for a U.S. medical residency program. Over the course of the last few posts, we’ve been going over the major steps of the process: from the early stages of brainstorming, to the first draft, to the later revisions of your personal statement, there are lots of important things to keep in mind so that you can create a personal statement that will impress the application readers at your desired residency program. Once you are happy with the general content and overall organization of your personal statement, it is finally time to move on to the last step of the writing process — editing and polishing.

Steps within the Editing Process

When you submit your personal statement to a medical residency program, it is essential for the document to be free from errors in spelling, grammar, and punctuation. Even if you are telling a great story that shows your application reader exactly why you are an excellent candidate for their residency program, your reader can be easily turned off by a minor mistake. Mistakes can suggest sloppiness or a lack of true interest in the program — and you don’t want your reader to think either of those things! In order to ensure that the personal statement you submit is error-free, here are some key steps to take:

  • Run the spelling and grammar check in your word processing program. These tools are NOT comprehensive, so you should NOT rely solely on them to edit your paper…but they are still valuable tools that are readily available. You might as well use them.
  • Read the paper out loud. You might recognize this tip from the post about the revision process, but it can also help you as you edit your paper. When you read your personal statement out loud, it’s easier to catch minor wording errors, such as using “a” instead of “an,” because they just don’t sound right when you hear them. Reading your paper out loud can also help with the identification of grammatically incorrect sentence structures.
  • Print your paper out. Again, this tip applies to both the revision process and the editing process. Often, when you see the words directly on paper, errors in spelling and grammar are more likely to jump out at you.
  • Ask multiple friends to read your personal statement. At this point, you’ve been staring at your personal statement for days, weeks, or even months. People who have never read it before are much less likely to overlook spelling mistakes and grammatical errors. Also, it’s a good idea to get multiple perspectives on your personal statement. Sometimes, a sentence structure that makes sense to one person is confusing for another, so it can be helpful to have more than one person weigh in.
  • Ask an expert in American English to help you edit. If English is not your first language, it may be a good idea to have a native speaker look over your personal statement. Ideally, this person should be most familiar with American English, since you’re applying for a U.S. medical residency program. An American English expert might be able to detect subtle in grammar or diction that detract from the overall message of your paper, and they can help you tweak it so that it reads smoothly for an American application reader.

What To Watch Out For When Editing Your Personal Statement

When you edit your personal statement, or when you have a friend edit the document, it can be helpful to think about exactly what you are looking for before you start. That way, you’re more likely to notice the errors that exist in your personal statement. Here are a few of the things you should keep in mind:

  • Spelling. Misspelled words look bad in your personal statement. If you come across a word and you’re not sure of the correct spelling, consult a dictionary.
  • Punctuation. Does every sentence end with a period? Are the commas in the right places? If you used quotes or parentheses, did you make sure to close them? Are colons and semicolons used appropriately?
  • Grammar. Look for common mistakes, like errors in subject-verb agreement and the use of singular and plural nouns.
  • Capitalization. Make sure that names and other proper nouns are capitalized. All other nouns should not be capitalized.
  • Presentation. Although you may not be able to control the font size and style of your personal statement when you enter it into the ERAS system, make sure that the overall layout of the personal statement is visually appealing. Rather than having one long block of text, it should be divided into cohesive paragraphs that look good on the page.

By carefully editing your personal statement for problems in each of these areas, you can be sure to make the best possible impression on your residency application reader. As a result, you will maximize your odds of being accepted into your desired program!

For foreign medical graduates, landing a U.S. medical residency can be a challenge, but FMG Portal is here to help. Contact us today to find out more about the resources we offer!