Month: December 2018

Writing an Excellent CV as a Foreign Medical Graduate

When you are looking for a residency program as a Foreign Medical Graduate, there are many items that must be covered. Visas, letters of recommendation and ECFMG certification are only a view of the requirements to get started on the path to residency. Possibly one of the most important items residency program directors will look at is your CV.

What is a CV?

CV stands for curriculum vitae, which is Latin for “course of life.” That is an important thing to remember because it is what makes a CV different from a resume. It is not just a list of skills and experiences, and it is a much more detailed account of your accomplishments. It is comprehensive, and it can include all or any aspects of your professional life.

It does not need to include pre-college information, and in many cases, the oldest information you will find on a CV is from graduate or undergraduate education. If there are any time gaps once beginning undergraduate school, they should be accounted for.

Because of the detail required for an effective CV, it is recommended that students begin compiling the information for their CV during the first year of medical school. This document will follow you for the rest of your professional career, and it will be used time and time again for credentialing once the FMG is practicing medicine.

How long is a CV?

While a resume should only be one or two pages, a CV can extend to a much longer length. This is because every relevant accomplishment is included, and every time gap explained.

With that said, a CV should not be too long. CVs should be organized an only include relevant information. Time gaps should not be over-explained, and everything should be succinct. A CV should be jam-packed with information, but wordiness or unnecessary items will fill it with too much fluff, and residency directors will not be impressed.

What should be in my CV?

A CV is not a place for examination scores, as directors will have that from your application. Instead, a CV is a place for educational, leadership, and research experience.

You don’t’ have to use complete sentences in a CV, as it is not a narrative account of your professional life. Instead, short comments with no “fluff” help to keep it organized and remove some of the length from the document.

Employment experience, awards or recognitions, and publications should be included in your CV. What you have to ask yourself is, would my program director want to know this about me? If the answer is yes, then find a way to include it.

There is no set way to write a CV, which makes research necessary to make sure you are covering everything in a manner that is standard but at the same time stands out. There is a TON of information online, and talking to other medical providers or mentors is also a good place to start getting information about what to include.

Lastly, what to include is not standardized but rather dependent on the position you are applying for. For instance, if you are applying for a pediatric residency, volunteer work at an elementary school may be more relevant than that same volunteer work used in a surgical residency.

What are the sections of a CV?

As previously stated, every CV is different, but there are a few things you should expect to include:

  • Personal Data: contact information
  • Education: current first with expected graduation date, then reverse chronological order
  • Honors/Awards: anything that will gain the attention of directors including community awards
  • Professional Memberships: include years and any positions held
  • Employment: only since medical school, include position and dates
  • Extracurricular Events/Activities: volunteer work, second languages, special talents
  • Publications: title, place and date…include things currently being published as “forthcoming”
  • Professional Interests: (Personal Interests too!): this section is to make sure your character is represented on your CV, and sometimes things don’t fit in any other category. Don’t be afraid to add personal interests if it is relevant.
  • References: For FMGs, local letters or recommendation are essential to proving you know how the local healthcare system works. Don’t disregard quality letters from your home country or other places abroad, but make sure to include letters from the residency’s country as well.

How do I use my CV in the Match?

ERAS will create a CV for you during the Match application process, but this information should come from your own, personal CV. A “master copy” of your CV should include all information that may be relevant for any professional application, and information can be removed for specific purposes where some information becomes irrelevant.

A well-written CV is essential for residencies and for a professional medical career. If you have not started one or are unsure about yours, get help ASAP. There are many resources available to help you write a stellar CV that will make you a shoo-in for a residency program.

Health Security and the Foreign Medical Graduate:

Foreign Medical Graduates (FMGs) face skepticism from Americans and healthcare professionals, but that is changing quickly. While many FMGs come to the United States to obtain a quality residency and return to their home country, many stay in the U.S. to continue practicing medicine as a career. This has many switching from skepticism to thankfulness as FMGs fill gaps in the accessibility of healthcare.

By the year 2050, 20 percent of the U.S. population will be made up of adults 65 year’s old and older. That is an increase from 12 percent in the year 2000. Currently, there is a physician shortage of over 30,000. This number will increase to over 100,000 in the next 30 years.

Elderly patients cost the healthcare more than younger populations because of chronic metabolic and geriatric disorders such as type II diabetes, heart disease, and dementia. They need physicians for continued care in order to manage their health. Telemedicine does a lot toward improving healthcare accessibility, but there is still a growing need for physicians in order to meet face-to-face and tele medical needs.

The physician shortage will not be eliminated by nurses or advanced-practice nurses. It will only be somewhat lessened. With the growing shortage of physicians will come an equally burdensome shortage of nursing and ancillary staff. This leaves the mystery of why FMGs are met with skepticism instead of appreciation.

Similarly to residency program directors, the general public does not know if the education FMGs receive abroad is equal to what would have been received within the United States. Of course, FMGs know that they are thoroughly checked out via the ECFMG certification process, but that is hardly common knowledge.

It is important therefore for the American public to understand how FMGs are vetted. It is also important for FMGs to be able to communicate the vetting process, so patients can have faith that they are getting quality care. Americans need to rely on FMGs in order to get access to quality care, so confirmation of quality education will go a long way to building trusting relationships between FMGs and their patients.

How are Foreign Medical Graduates vetted?

Educational Commission for Foreign Medical Graduates (ECFMG):

We already mentioned ECFMG certification, but it is integral to the vetting process of FMGS. It is essentially a Dean’s Office for international medical graduates. It is the ECFMG’s job to make sure that education received abroad meets the standards of the American Healthcare System. It also ensures that a resident has the communication skills necessary to treat English-speaking patients.

ECFMG certification requirements

  • Medical Schools must be listed on World Directory of Medical Schools
  • United States Medical Licensing Examination (USMLE)
    • Step 1 and 2: clinical knowledge
    • Step 2: clinical skills
      • English proficiency requirement
    • Diploma and credential verification

By the time FMGs have been certified by the ECFMG, it is established that they have had sufficient education and can perform well in a clinical setting.

  1. Visa:

It can be very difficult to get a visa to enter and stay in the United States, and travel bans increase the challenges faced by FMGs. However, U.S. Citizens should rest assured that FMGs are not only trained adequately, but they are not criminals and are welcomed by the U.S. government. The hurdles to getting FMGs in the U.S. are controversial, but they can be a positive item too.

USMLE Step 3:

This last stage in USMLE testing is a final assessment of a physician’s ability to practice medicine alone in the United States. It determines their ability to be independently responsible for patients and is a final step in medical licensure.

Residency:

Every state requires at least one year in an accredited residency program. This means that before the FMG is released to practice medicine, he must practice it under the supervision of other physicians. The FMG has to do basically everything every other doctor does, but they also have to prove it.

Health Security and the Foreign Medical Graduate

In order for the United States citizens to have security in their healthcare system, they are going to have to embrace international medical students rather than question their abilities. That does not mean eliminating the vetting process, but it does mean streamlining it.

Americans need to remember that FMGs bring diversity and unique medical knowledge to the healthcare system. They also represent one solution to alleviate some of the physician shortage present and growing in the U.S.

With that said, FMGs must remember that they have been thoroughly vetted, and they are fully equipped to practice in the U.S. They also must be able to communicate that to patients.

Hopefully, as the world continues with globalization efforts and communities become more diverse, FMGs will be looked at similarly to any other trained physician. FMGs are not a questionable entity with a questionable background. They have been scrutinized in many ways more than the American Medical Graduate.

January Agenda: Rank Order List

As 2019 approaches, it is time to consider which residency programs you’d like to attend, and this decision is integral to successful placement in the Match. On the one hand, candidates need to consider residency programs where they feel they’d be a good fit and be able to pursue their medical career successfully. On the other hand, candidates also need to pick programs where they will be successfully matched.

A word of caution: don’t pick residency programs simply because you think you’ll be matched. There are worse things than not getting matched, and you’ll get another chance to be matched through the Supplemental Offer and Acceptance Program (SOAP) where unmatched candidates fill unmatched residency program positions. The Rank Order List should reflect your best picks, not your safest.

Janurary 15th marks the opening day of the Rank Order List entry, which is located on the website of the National Resident Matching Program (NRMP). You should list programs in your order of preference, with those you most want to attend listed first.

Things to consider when ranking programs:

Which program did you simply like the most? This questions does not necessarily mean the program seemed the most challenging or that you would fill a provider gap in your future area of practice. It is more about where you would be a good fit. Did you get along with the people running the program? Did it seem to progress at a desired pace? Is there a good support system? Whatever you are specifically seeking in a residency program should be considered when ranking.

How was the interview? Was it amazing? Did you make connections? Did the interviewers seem receptive, or did you feel unaccepted. Especially for Foreign Medical Graduates (FMGs), this can mean the difference between a successful and an unsuccessful Match. Those who are FMGs should also be considering how the program handles the inclusion of all residents, so an FMG is not set aside as a viewer more than a doer because of cultural or language barriers.

Is the program competitive? Can you succeed at this level of competition? This would include considerations such as your USMLE scores and any education gaps you may have experienced. Especially for FMGs who may have had a different medical school curriculum, this can really impact success.

Is the program good from a logistics standpoint? Is it located in an area that will be acceptable for you to live for a while geographically? Does it pave the path to the medical career you are seeking?

Are the current residents happy? Physician burnout is real, possibly more than ever. Make sure the current residents are satisfied with their residency program. You don’t want burnout to begin early, and a good residency can provide a resident with the tools necessary to avoid it in the future.

It is recommended that you rank around 10 residency programs, but you won’t have to pay additional fees until you reach 20. It is also recommended that you have a qualified person look at your list and discuss any opinions about questionable choices. A mentor or a current physician may be a good choice.

Once you have your Rank Order List Complete, you must certify it in the R3 system. This must be completed by 9 p.m. Eastern Time February 20th 2019.

There are two other things that should be mentioned about Rank Order Lists:

1. If you did not interview with any residency programs, you won’t be able to generate a Rank Order List because no residency programs will be considering you as a candidate. It is not the ideal situation, but don’t forget that this does not mean the end of your residency hopes for this year. There is still SOAP in March.

2. If you are having a lot of difficulty deciding whether or not you should rank a program because you aren’t sure if you’ll be Matched, you can communicate with the programs, and they can reach out to you. Letters of intent may or may not have a positive influence on the Matching process, but they are allowed. Additionally, programs may reach out to you, but it is not recommended that you let this influence your Rank Order List. There is a Communication Code of Conduct that should be followed during this time, which highlights confidentiality and eliminates unnecessary communication.

Remember, your interview days were the time to fully vet each residency program, and your choices should be made based on the positive and negative qualities of the program, not whether or not you think there is a good chance you’ll be selected.

There are differing opinions on how Rank Order Lists should be created, and each person has a different experience based on personalities and professional backgrounds. For FMGs, there may be programs that are friendlier toward foreign education, but again, this should play a minimal role in your selection.

Match week is in March with Match Day falling on March 15th, so if you are in the Match as a Foreign Medical Graduate, your journey is almost complete!