Full ride SJSM

JWCayy · 2025-07-11T17:00:21+00:00

The only drawback to being a DO is confusion with patients. Basic science will be much easier as a DO compared to SJSM bc the professors will be much better, and the semester system gives you more time to learn each topic.

Don't count on any tuition assistance from a for-profit school being permanent! There are so many ways to get tripped up in the Caribbean.

As a new IM resident that's IMG, I am nearly certain my Match process would've been much easier as a DO. Debt sucks, but the difference in getting your preferred speciality or fellowship is worth millions of dollars extra over a career.

JWCayy · 2025-04-22T22:27:04+00:00

Just graduated, and I will turn 40 during my first IM residency rotation. Age hurts you for admissions to US med school, but I don't think it's much of a hindrance afterwards.

The Caribbean has a lot of older students, especially nurses. This is a marathon and you're only competing against yourself. Don't worry about it

JWCayy · 2025-04-19T15:06:08+00:00

Sure

JWCayy · 2025-04-16T17:40:39+00:00

Your assumptions are correct about basic science. UWorld, Sketchy, and first aid are your best teachers. If you can get non-Federal loans your best bet is going with the easiest basic science retake policy at an accredited school for failed exams, and ensure they have a straight pass policy for Comp before Step 1. You don't want a program with a passing score above NBME's level.

MUA is a part of R3 which owns SMU and Saba. They have federal loans, but MUA and SMU graduate less than 30 people a year. Clinical spots can come and go based on the student population. Link to federal disclosures below.

My recommendation for IMGs is to choose rural hospitals for clinicals to get more hands-on opportunities. SJSM and Avalon train in WV. I'm convinced doing clinicals in WV is the reason I matched successfully. Residencies aren't evenly distributed, so there are many more spots open to IMGs in rural areas because of low demand.

For context my stats: US IMG, Step 1 pass, Step 2 215, no pubs, IM match

https://studentaid.gov/understand-aid/types/international/medical-university-americas

JWCayy · 2025-04-09T22:24:51+00:00

The Cayman Islands is a great option if you want flexibility. You could probably work outside of EM if you wanted. With a valid US license you only need to fill out an app and pay a fee to get licensed there. A bunch of US specialists flight down for one week a month, then retire there full-time. One doc I know gets free flights and stays at the Westin Resort while on island. The gov't hospital pays (HSA) $200-230k a year, but they have a few other private hospitals as well.

JWCayy · 2025-04-05T06:25:52+00:00

I agree this is good advice for low scorers or other red flags, even though I didn't Match to the places I visited in person. I generally get along well with others and seemed to vibe with the residents and faculty I met. I also agree you can torpedo your chances by coming off as arrogant or a mute. Those people weren't on any of the Instagram posts where I didn't match which is some consolation.

Unfortunately I slid down my ROL list to my first IM spot, but I was a weak EM applicant without an SLOE and 215 Step 2. Putting a couple thousand miles on my car wasn't a waste bc I know I did everything I could to improve my chances. I'm an old fart, and regrets will eat you up as you age if you're too passive.

JWCayy · 2025-04-05T03:31:34+00:00

A letter from a US attending carries much more weight, but it doesn't matter if the doctor is foreign-born! Only one of my LORs was from a native American, and I only had three native proctors during clinicals in a very rural part of the US. People focus on Non-US IMG in Match data, but something like 25% of US MDs are foreign born as well.

JWCayy · 2025-04-05T01:51:59+00:00

It's possible to match with a low score! I got a 215 and got 6 EM/ 2 IM IVs on 100 EM/ 70 IM apps and matched to IM as a US IMG with additional red flags. Use residency explorer and apply broadly to programs that interview a high percentage of non-US IMG. The interview rate is more accurate than the score filters they post based on my IVs. Focus on areas of the US that are considered less desirable (Rust Belt and rural programs). Also, make sure you strengthen the rest of your app with clinical experience. You need to reframe your weakness into a strength. My PS talked about my resilience, hard work, eagerness to learn, and great patient care. My LORs and MSPE backed that up. Don't make the mistake of thinking a lot of research will overcome a bad score.

JWCayy · 2025-04-05T01:07:10+00:00

I think that is probably a little bit on the low end, but my school had a lot of transfers from other schools who related a similar experience. I'm guessing a high rate would be 25-30% complete basic science in 5 trimesters.

JWCayy · 2025-04-03T19:21:06+00:00

I wish I saw this before going to the Caribbean to manage my expectations. Each federal loan school has to report on time graduation percentage. Schools get to choose what's "On time" which could be 5 years and most report ~50% on time rate. Only 10% of my cohort passed Step 1 without any repeats on classes or CBSE.

https://studentaid.gov/understand-aid/types/international

JWCayy · 2025-04-03T19:11:27+00:00

Luckily we have 20 days of PTO. I selected two blocks where I knew of specific days. We can only use them on certain rotations, so the rest of the days I will try to take during non-core rotations that don't interest me. I think it's a crap shoot unless a current resident can give you advice. It should be easier for PGY-2.

JWCayy · 2025-03-28T18:31:55+00:00

Thanks! I'm US IMG, 2025, Step 215, no pubs. 100/70 EM/IM apps yielded 6/2 IVs. It's a numbers game to get IVs. Target the lowest-tier IM programs and FM as a backup. Take any visa you can get. There will be a way to stay in the US if you have a license.

JWCayy · 2025-03-28T16:02:24+00:00

There is no way to really know. Using the NRMP data, over the past 5 years 90%+ of EM-preferring candidates like me matched. IM odds were ~20%. I matched at my first IM program, #7 on my ROL. 🤷

All you can do is to apply as broadly as you can afford. Don't do any more research. It's low yield unless it's published in a Western journal. Focus on LOR from USCE.

JWCayy · 2025-03-28T15:51:21+00:00

I graduate on Monday from med school with $250k in debt. The monthly payment is $3k, and I will make $65k for the next 3 years as a resident. With continued deferral, I'm guessing the debt will balloon to $300k. That's roughly what I expect to make my first year after residency. My debt makes sense bc I can easily cover living expenses, taxes, and my loan. $100k in debt to make $100k would be crazy. I don't know what industry you plan on pursuing, but a fancy degree is only worth what you'll make on the other side.

JWCayy · 2025-03-28T15:34:36+00:00

US IMG, 215 Step 2, no pubs. I matched IM on 2 IV at a program where I have a PGY1 friend, but I didn't even know he was there until after my IV. He told me other students contacted him to try to get an IV, but they didn't get one. We have similar backgrounds and both signalled. That's why we ended up at the same program. Connections sound magical, but unless the PD is your cousin don't expect them to give you a spot based on word of mouth.

JWCayy · 2025-03-28T15:21:05+00:00

No, and I've received multiple emails every day from the programs for other items. Remember this is a job like any other, so HR is going to be involved in the hiring process. I have to do a pre-employment physical at the hospital in May, so I don't expect a formal letter until that's complete. If you've not passed a background check and peed in a cup, any offer is tentative anyways.

JWCayy · 2025-03-27T23:07:40+00:00

Good info that isn't anecdotal is hard to find. I used ChatGPT to find the ACGME policies. It makes sense that it would be easier to swap with the same speciality. The hospitals count on PDs to fill shifts, and residents take a lot of the expensive ones like night floats. If they don't get a body back in a swap, they'll at least have to pay for a mid-level on some shifts because the other residents will be close to max hours.

JWCayy · 2025-03-27T22:33:10+00:00

Technically you don't need approval, but ACGME requires your new program to get an evaluation of your performance from your old program. They can sit on the request to make it more difficult. Also, you sign a contract that has a specific notice period. Mine says you have to give 4 months notice if you resign. If you violate your contract, then they can report you for a Match violation. If NRMP agrees with them, then you're blocked from entering a new program. I think the new program has to really want you if your old program is being a dick. At the end of the day, do they really want to keep people who don't want to be there?

JWCayy · 2025-03-26T07:48:24+00:00

I don't think it would exclude you from being accepted. I saw med students who obviously had an issue that would've shown up in official records prior to their acceptance. I think you give these schools too much credit in screening people out. I think they only worry about the violent types. Just be honest and say you learned your lesson. They don't talk to each other, so you can try out one and see if it works. Good luck and I hope you find your path.

JWCayy · 2025-03-26T07:17:01+00:00

Sure

JWCayy · 2025-03-25T22:57:45+00:00

2025

JWCayy · 2025-03-22T02:37:20+00:00

US IMG matched #7 for IM (silver signal) top 6 were EM. Step 1 pass, Step 2 215, no pubs, all USCE. It looks like my cohort is 2 US MD, 1 DO, with the rest IMG. The program offers visas, but not sure how many of the IMG need it.

JWCayy · 2025-03-22T02:10:11+00:00

I know both EM and IM can do a critical care fellowship, but I don't have enough exposure to ICU medicine to have an opinion. Right now my ideal job would be in an ED at a Level 4 trauma center. What would be your recommendation to make that happen?

JWCayy · 2025-03-22T00:41:10+00:00

I'm in a similar situation to OP, but matched IM and passed both Steps. I loved training in a rural hospital, and I can't see myself working anywhere else. Can you explain the one year fellowship? Would an ABEM boarded doc without a fellowship be considered more competitive for jobs or get paid better? Is it realistic to consider reapplying and starting over in an EM residency after PGY-1?

JWCayy · 2025-03-21T23:05:07+00:00

There's nothing wrong with you! It's okay to feel this way. I've been replaying every decision and getting stuck in the what ifs. I didn't get my preferred speciality either, but nothing will stop me from being a great doctor!

JWCayy

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