Tag: medical residency

Preparing for a U.S. Medical Residency Interview

Although many U.S. allopathic seniors have a chance to complete mock interviews at their medical schools, some foreign medical graduates may not be fully prepared for the interview process. Completing all the required medical exams and meeting the basic requirements for acceptance is an important first step. However, it does not guarantee admission. Candidates must also impress the interviewer. In this article, we’ll outline how foreign medical graduates can prepare themselves for a successful interview.

Review your own background

Interviewers often ask questions about a graduate’s past experiences. While many graduates can talk confidently about past experiences, reviewing them prior to the interview can be helpful. Perhaps you had forgotten about that volunteer experience you completed three years ago. Reviewing your background can bring more memories to the surface. Then you will be prepared when the interviewer asks a question about your experience.

Research your chosen specialty

At a U.S. medical residency, you will be interviewing for a particular specialty. Having extensive knowledge of this specialty is likely to impress the interviewer. To prepare, keep up to date on the latest developments in your selected specialty. You can subscribe to journals on the specialty or even just set up a Google Alert to send you notifications of new developments. Interviewers may ask your opinion on major issues facing the specialty and this research will help you provide a valuable response.

Research your chosen program

Interviewers will likely ask why you chose the specific school program. Knowledge about the program will help you develop a good answer. For example, the program may be ranked highly. This is a somewhat generic answer, however, and greater specificity will reveal how much you researched the program. A more specific answer would be because you want to work with a specific doctor who is an expert in a procedure that you would like to learn. The second answer, which demonstrates how much research you did, is more likely to impress an interviewer.

Matching with a U.S. medical residency requires more than a stellar resume and high scores on the ECFMG examinations. While the resume and exam scores will get you in the door, you will also have to impress the interviewers. Being knowledgeable about your own experience, your chosen specialty and the interviewing program itself is likely to impress interviewers. When it comes time for the medical residency to rank possible candidates for the match, you want them to rank you toward the top.

Three Benefits of U.S. Clinical Externships for Foreign Medical Graduates

Clinical externships allow foreign medical students to test their skills at U.S. medical institutions. In a clinical externship, a foreign medical graduate (FMG) is placed with an attending at a U.S. institution. Depending on the length of the externship, FMGs may have the chance to learn from multiple attendings in different specialties. Not only is this an excellent learning opportunity, FMGs that complete clinical externships are more likely to match with a U.S. medical residency. They have more of the tools necessary to successfully interview and match.

Meet Requirements for U.S. Medical Residencies

Many U.S. residency programs require time spent working in the U.S. This is an easy requirement for U.S. allopathic seniors, who can complete clinical studies at their medical schools or neighboring institutions. Foreign medical graduates, however, must relocate to the U.S. for an extended period of time to meet these requirements. Unfortunately, every U.S. medical residency has a different requirement for the amount of U.S. clinical experience. While a 3 month externship may be enough for one program, it’s not enough for another. FMGs should review the requirements of their preferred medical residency program to determine the length of externship that is required.

Receive Letters of Recommendation

Letters of recommendation from U.S. doctors are a great tool for foreign medical graduates during the interviewing process. The interviewing program is likely to trust known U.S. doctors more than unknown foreign doctors recommending a graduate for a program. For some schools, it is a requirement that faculty member write a letter of recommendation for a foreign medical graduate. It would not be possible for a FMG to match with this type of school unless they completed a externship with a faculty member or knew a faculty member through other means.

Learn U.S. Terminology and Common Ailments

Externships also prepare FMGs for the U.S. testing required to match with a medical residency. There is a clinical section to the exam. A foreign medical graduate who has already spent time working in a U.S. institution will not be surprised by any differences in protocol. They already learned the basics at an externship. The skills gained at the externship can immediate translate to the exam. FMGs who complete externships will also become more familiar with common U.S. ailments, which are more likely to appear on the clinical exam.

Clinical externships are not only beneficial for FMGs, but, in many cases, they are a requirement for matching with a U.S. medical residency. Selecting the right externship can make the difference between matching with a U.S. medical residency or not being able to do so.

U.S. Residences have Additional Requirements for FMGs

Unlike U.S. allopathic medical school seniors, foreign medical graduates (FMGs) must meet additional requirements to be considered for U.S. medical residencies.  These additional requirements may be one reason that FMGs are not placed in the NRMP Match Program at as high of rate as U.S. allopathic seniors. To be fully prepared for the NRMP process, foreign medical graduates can educate themselves on typical U.S. medical residency requirements. The University of Washington’s internal medicine application site provides an example of the additional requirements that FMGs face when trying to match with a U.S. residency.

If applying to the University of Washington medical program, FMGs have to meet these requirements (in addition to the typical personal statement, transcripts and letters of recommendation).

Must be a permanent resident of selected states OR sponsored by faculty

Because most foreign medical graduates are not permanent residents of Washington, Montana, Wyoming, Alaska or Idaho, most applicants will have to meet the second requirement, faculty sponsorship. The faculty member must write a letter explaining how he or she knows the foreign medical graduate and what qualifications the FMG possesses. Foreign medical school graduates may be able to find a link to a University of Washington faculty member through their medical school. Another option for FMGs is to try to obtain a clinical clerkship or internship with a University of Washington faculty member. This can be a difficult requirement to meet and it is only the first of three.

Must have 2 weeks of clinical clerkship at an LCME-accredited medical school OR four months of residency at an ACGME-accredited program

The University of Washington also specifies that these clerkships and residencies must be at a Puerto Rican, Canadian or U.S. location. Foreign medical graduates that have only worked in their native countries will not meet this requirement. To be able to apply for residency at the University of Washington, FMGs will need to obtain one of these clerkships or residencies. For the LCME clerkship option, there are 155 qualifying schools. For the ACGME residency option, FMGs can select from schools listed on the ACGME list.

Must apply through the ECFMG ERAS Program

The online ERAS application program certifies that FMGs meet the same clinical standards as U.S. allopathic seniors. There are three exams that FMGs must pass in order to apply through this program. It is likely that foreign medical graduates will have to visit the U.S. for at least one of these exams. Therefore, it is imperative to have enough time to meet these requirements before the application and interviewing process for NRMP begins.

Many U.S. medical residencies, including the University of Washington, have additional requirements for foreign medical graduates. FMGs should examine what requirements are needed long before the fall application and interview process. Some requirements, like a 4 month residency or 2 week clerkship, require travel and take weeks or months to complete. By researching these additional requirements early, FMGs can be prepared for the NRMP matching process.

NRMP Matches 52.4% of Foreign Medical Students to U.S. Residencies in 2017

The National Resident Matching Program, or NRMP, announced the largest number of medical residency applicants and placements in 2017. The program places medical school students and graduates in residencies using a Nobel-prize winning algorithm. To be included in the program, medical school students submit applications and interview with programs starting in the fall and continuing through early winter. The program directors and applicants then rank their order of preference. The algorithm matches applicants to residency programs. This successful program continued in 2017 with over 35,000 medical school student and graduate applicants.

In 2017, these medical school students and graduates competed for over 31,000 positions. 94% of U.S. allopathic seniors were successfully matched. This is a consistent number from year to year. However, the placement rate for non-U.S. citizen international medical school graduates and students (also known as FMGs) is much lower, only 52.4%.  Over 7,000 FMGs applied in 2017 and less than 4,000 were placed. NRMP notes that this is the highest match rate since 2005, so 52.4% is better than average.

The lower match rate of international medical students suggests that these students may need additional support to successfully match with U.S. residency programs. Comparing the experiences of U.S. seniors and foreign medical students might illuminate some difference that account for the lower match rate. U.S. allopathic seniors follow a standard process for medical residency matching. They know when to take their USMLE (United States Medical Licensing Examination). In many cases, their medical school can support and guide them through the process. For foreign medical students, their medical school might not be able to provide the support and guidance needed to obtain a residency in the United States. The medical school’s process might be set up for medical residency in the local area.

U.S. students might also have an advantage during interviews. Resumes are written and interviews are conducted in their native language. Additionally, many U.S. school provide workshops on resume writing and interviewing. Foreign medical students may not have access to this support.

Hand-on clinical experience might also help U.S. students rise through the ranks. Many medical schools including clinical experience as part of the curriculum. These schools partner with U.S. hospitals and clinics for training. Foreign medical students may have clinical training in their native country. However, interviewing residencies may be more comfortable accepting students with training at known U.S. institutions.

It seems as though foreign medical students are at a disadvantage when it comes to medical residency placement. However, additional support can enable international medical students and graduates to be successfully matched to a U.S. residency. Hands-on clinical experience in the U.S., resume advice, and interview preparation are likely to increase the chances that a FMG will be matched with his or her preferred medical residency.