DIP Episode 170 - The IMG Guide (ERAS, USMLEs, General Recommendations)

Okay, welcome. My name is Divine, I'm a resident. This is episode 170 of the Divine Intervention Podcast. This podcast is a little unusual, but I'm gonna call this the International Medical Graduate Guide. Again occasionally I try to make podcasts on topics that you know are not necessarily like like USML based but they're kind of pertinent to the medical profession. So let's go ahead and talk about the IMG guide. And to be honest I'm not gonna use any particular order here. I'm just again I've I mean I've worked with a ton of IM Gs that have thankfully successfully matched and also like on the USML exams and what not so. But I will give a you know I'll kind of give my thoughts on things especially with regards to the much process for international medical graduates because again being an international medical graduate whether would like to admit it or not you know it kind of puts you at somewhat of a disadvantage with a much process. So anything you can do to sort of put yourself in a good light ends up being extremely helpful. So let's jump right into it right. So the first thing would be in an IMG. So an IMG is a person that essentially being graduate from a med school in the US. There are people that are US IM Gs right.

So like people that are you know the US citizens or the graduate from from what you go to foreign med schools or you know you can be like just a straight up IMG like you're not from the US and you go to a foreign med school like a med school in your home country and then you plan too much to residents in the US. The thing is one of the things I would say that again in this information each again is becoming you know less and less but it's actually still a pretty significant problem amongst the IM Gs and that's the fact that there are certain things that are kind of obvious to medical students in the US that are not very obvious to international medical graduates right. And the thing is I mean like I strongly believe in this term that knowledge is power right. So the thing is as an international medical graduate one thing you really should try to do is just literally acquire knowledge right because really I've worked with a lot of IM Gs and it's actually kind of surprising that well some people are just fairly clueless about a lot of the things that kind of make for like a successful much process or like a successful interview or like a successful personal statement right.

Because the thing is one thing I've actually noticed from working on a lot of IM Gs is IM Gs like pretty decent number actually have pretty impressive applications right you know like you can tell just from speaking with them one on one that you know they have like you know pretty impressive resume these people actually like pretty hard work in right and they are people that can contribute positively right to like the medical system in any country right. But the thing is unfortunately again it's just and some of this is also cultural right. IM Gs may not be able to present themselves in the best possible light or they may not know how to present themselves in the best possible light to feed in well with a foreign medical system like the US medical system or like the Canadian medical system for example right. So hopefully in this podcast I'm going to talk about a couple of things that you know you should kind of keep at the back of your mind to again sort of help you set the best foot forward with regards to the much process and getting into residency in the United States right. So obviously right the first thing first most important thing are your scores right. So the thing is again remember you are competing with people from med schools in the US in a much process that is getting even more and more competitive every year right. So as an international medical graduate you really want to do the best possible that you can on your US Emily exams right.

And one thing I've kind of noticed with a lot of IM Gs again I've kind of worked with a lot of people in these Caribbean medical schools you know you kind of see them they're like doing poorly in their like their preclinical coursework on their shelf exams and then they kind of expect like oh you know just kind of magically boom they just bring it on step one or step two so you can do extremely well. That's usually not the case like people that end up doing like poorly on these US Emily exams they've actually had a track record of just performing poorly on exams in general like they're preclinical exams they show off exams and again I'm not saying this in fact this podcast because I can't imagine that this podcast you know may ruffle a few feathers and to be honest that is no my go right. But the thing is I like being a strict shooter with people right. So I just you know one I want to give you again the best information possible because if I'm the kind of person that just tells you all the nice words you want to hear right to be honest I'm probably not helping you much on that those circumstances right. So I'm gonna be brutally honest here again I'll you know try to be a little nice with the way I see things but I'll be brutally honest because the thing is it's better that you know the truth right.

I mean like there's this part of the Bible that says that you shall know the truth right and is that truth you know that will set you free right so I want to you know just be truthful in this podcast and hopefully you find this to be helpful again especially if you're an international medical graduate right. So the thing is if you're an I.M.G. and you got to do well on your USMLA exams and the thing is doing well on these USMLA exams just kind of starts from the one in Med School right. So like don't just say oh I'm an I.M.G. I'm gonna focus on the USMLA's and then you neglect your coursework the thing is you can really neglect your coursework and then just suddenly do well on the USMLA's you need to take personal responsibility because the thing is many of these again they are many good for in Med schools but there are also many bad foreign med schools okay so they may not have the best curricula they may not have the best teachers right so you need to take personal responsibility for your own learning right and that will involve putting a you know pretty decent amount of work as an I.M.G. right so don't don't fall into the trap of saying I'll just neglect my coursework and study for the USMLA's study hard for your coursework because those study habits and that knowledge you pick up from studying for like your pre-cleaned coursework or for your 30-a-shelf exams right now ultimately end up helping you helping you on the USMLA's but to be perfectly honest if you're an I.M.G.

from a step one perspective it's extremely important to at least try to get in the two 30s on step one at least try to get in the two 30s if you're an international medical graduate on step one for step two CK your target should be again probably something in the high two 30s or to be perfectly honest something more along the lines of the 240s and obviously right the higher the better if you score a 250 if you're going to 250s or the 260s obviously you're gonna have a much better chance of matching than someone that does not now one important thing that I think I am just sort of keep at the back of their minds is before you apply for residency in the US it is very imperative that you take step two CS again having a step two CS score or even a step two CK score is not absolutely necessary to apply to residency but I promise you again I have worked with tons and tons of I mean I've worked with I'm currently working with a ton of I.M.G.s if you don't have a step two CS pass on your on your on your like your iris application your chances of getting an interview as an international medical graduate especially for internal medicine because I know a lot of internal I.M.G.s apply for internal medicine your interview chances are vastly vastly vastly limited right I will tell you this again I'm not gonna light you anything like that if you don't have a step two CS score if you're an international medical graduate you're essentially playing the odds with applying to residency you really want to make sure that if possible have a step one a step two CK and a step two CS score before you're throwing your applications so obviously again if you know that you're planning to match the residence in the U.S.

it's not that it's not a decision you just make on a whim and say oh in July oh you know what I want to apply to residence in the U.S. no you don't want to do that right it's something you sort of begin to think about like a year in advance so that you can prepare yourself well and set yourself up for success and if you have graduated from medical school like if you again if you've already graduated from medical school then the smart thing to do is to try to take step three the thing is having step three again I'm not saying again I'll say this right obviously if you've not graduated from medical school you cannot take step three but the thing I will say to you is that if you're an international medical graduate and you've graduated from medical school already having a step three score gives you a very nice edge with the ERS application process that is something you definitely want to keep at the back of your mind and then the next thing I'll talk about is this whole concept of like clinical rotations in the U.S. right so like observations and things of that nature the thing is if you're an international medical graduate you really want to have at least like one or two I will say two is probably preferable like two clinical observations in the U.S. right because the thing is when you have those clinical observations one big thing that I think is kind of underrated by a lot of people is that it just gives you exposure to the U.S.

medical system the truth is the way that medicine is practiced in the U.S. is not necessarily the way it is practiced in other countries of the world right I mean I know this personally from experience because again I've seen medical systems in other countries in some African countries and I've seen medical like again medical and obviously I went to medical school here I've seen medical like the medical system here in the U.S. and again it is vastly different because the thing is you may think that oh I'm just participating in this experience to get a recommendation letter but the thing is when you run observation you get exposed to just the way like U.S. medical students function the way U.S. attendants right so like U.S. to provide in physicians function right you just get that exposure because the thing is you want to begin to build a mindset as a practitioner of medicine in the U.S.

medical system because once you begin to build that mindset it actually begins to almost in an informal way prepare you for interviews it begins to adjust your thinking to like the ways that people think in this society right and that can really again help you with just again interacting with people because as you'll see later I'll sort of comment on this later in this podcast your personal interactions really play a huge role in the way you're viewed as a medical graduate so again it's just one of those things you don't want to play around with it ends up just being very very very important with like the interview setting with getting recommendation letters from people so that's again something to keep at the back of your mind so these observations again you'll introduce it to the U.S.

medical system but it will also help with networking right so like again getting to meet people like meeting program directors and things of that nature that again really does help again doing these observations really helps with that process and the thing is when you're doing an observation don't waste that experience right try to request like one on one meetings with like people in the department right like you know try to hang around with the residents try to meet like the program director if you're doing an observation try to meet the program director try to meet like professors in the department because the thing is these are people that can go to bat for you after like even with like scoring interviews in the first place or even with like residency selection committees or even with just making calls on your behalf as the era's process matches right so these are just key things to keep in mind don't like shop for an observation and then you don't really meet anyone no that's not product right want to meet program directors want to meet faculty members again this will ultimately help you with the much process and then obviously already want to get recommendation letters and again the kind of person get a recommendation letter from matters try to make sure that it's a good recommendation letter but make sure it's from someone that is notable right a person that is well known in the department where if they see their names signed on a recommendation letter they'll pay attention to it right so again key things again these are like common sense things right but again as the same goes common sense is not necessarily common right so again just keep these things at the back of your mind as you're applying for residency in the US and then another important thing is to have someone in your application as an international medical graduate the thing is again I'm just saying

this again again not as an insult to anyone just but with again with my experience working with a lot of international medical graduates the thing is international medical graduates many times you know they have a pretty good message that we can pass across in like an era's application in a personal statement in describing their experiences in their era's apps but the thing is many times I am G's again it's not is not every I'm G that does this but there's a pretty good chunk of I am G's right that may not necessarily present their message or present their stories in the best way possible right so the thing is the way you get your message across as an I and G really does matter because again you may have all the best course in the world but a poorly written personal statement or a poorly written application can end up doing you in from from a from an interview perspective and from an era's perspective right so the thing is this is incredibly critical it's incredibly important have someone a dedu application right and also do more interviews because again I have done more interviews with a lot of international medical graduates and you know you just ask them like just like basic questions on like like basic US interview questions and again they give you responses but again the thing is these responses may not come across in a way that impresses a person that's interviewing you like a program director or things of that sort right so again have someone with good knowledge of the US medical system a dedu application right do walk interviews so that again you can refine because the thing is I'm not saying to like prepare to the point where like oh when you're interviewing you sound like you're like you've rehearsed the interview no that is not the point I'm getting across the point I'm getting across is you do these mock interviews and you have people a ditch applications

on your personal statements so that you tell your story in the best possible like like essentially this is just like putting your best foot forward it's just like the like I kind of think about it is almost like what you see in the media these these were like you can see someone take a person's again I'm not saying to do this but you can see someone make this quote and different people can interpret it many different ways like you can see people take a quote out of context or you can see people take a quote and turn it around to something that you did not intend to pass across right so the thing is it's important from that perspective because the thing is as an international medical graduate you know you have this background you've worked hard you've done this you've done that or you have life like you have like you know like life circumstances like maybe you graduated from med school like five years ago or you did this two years ago or you have this breaking transmission with your with your medical studies and things of that nature or you have to transfer from one medical school to another right these are all common problems that are faced by international medical graduates but the thing is you can almost like I'm not saying you can necessarily overcome those problems but you can present those problems or those black marks in your application in a certain way that gives people less costs for concern as they're reading your application and as they interview you so again I will encourage you a person that has good knowledge of the US medical system and the US residency much process have those people that did your applications have those people do more interviews with you and give you like feedback that you can then incorporate again it's very important in the you in the US much process and the thing is with your application right you need to make sure that you're telli

ng like a good coherent story this is one again common problem of encounter with many people again that I've worked with that again I've thankfully been able to correct is you need to have a coherent coherent story right so you cannot have like a story where like oh you did this between 2001 and 2005 and then your application is blank from like 2005 to 2010 no that's not very productive so you want to have like a good coherent story like essentially want your application to have a theme like if for example you're playing for internal medicine you want the way you present like your research in your iris application the way you describe your experiences in your iris application the way you write to a personal statement in your iris iris application to tell people that oh this person almost has is almost like this person like over the last couple of years this person has been building up to this moment of applying to internal medicine residency again this is not something that again I don't want to you know keep going off on all these tangents but again you want your story to be coherent because many times international medical graduates they tend to have like personal statements or descriptions of the experiences in iris applications that are very disjointed right doesn't tell a coherent story so the thing is when a person is reading the application they didn't end up kind of like confused they're like what is this person getting at like why like I've read some applications I'm like okay like why do you really want to go into medicine in the first place again like after speaking with you oh I see what you mean but it may not mean again necessarily get that point across in an interview in a personal statement when an application so again these are all things to watch out for and again more interviews very important because again you want to have a normal one or one inter

action when you do your actual interviews and the thing is your personal statements they have to be compelling you need to have because the thing is right a personal statement oh you may say oh it's not super important in the application process but the thing is that a poorly written personal statement will definitely tank a person's application what do I mean by that the thing is maybe let me put it this way what are some common problems with personal statements again with international medical graduates right common problems are one grammatical errors you can see people have grammatical errors in their personal statements or two you can see people have like you know they describe like an experience like oh this is why I have this experience or that experience but you put it in a certain way that when a person like again it it may look be mine from the IMG's perspective but a program director or person of the US medical system that reads that it may be like hmm interesting this is a little worrisome for this person's application right so again this is why you need to have some video applications because again if you don't if you don't present like your unique story your compelling story if you put out like again certain like terms and certain sentences that give people cause for concern that can negatively impact your application right so again you don't want to be like a stock applicant what do I mean by a stock applicant I just mean like a generic applicant oh I want to go into medicine because I want to help people yeah yeah yeah yeah no you don't want to do that right again you want to have a good application that tells a coherent story that tells a compelling story and gives good timelines in a succinct fashion right and the thing is if you have like a because I've noticed this again with a lot of IM Gs you see them when they're describing their experiences you p

ut like 40 different experiences in the errors applications that actually is essentially hurting your errors application is not that having like 20 experiences is going to help you and you then you then see people you know when you're describing these experiences they read like these long paragraphs right like long long paragraphs on things again that is not very product that is not very product you again you the thing is as a person is reading your application you also don't want to like tick them off right you don't want to make them like angry right so again you need to be very targeted in the way you present your application again these are things that you can kind of you can kind of prevent by again having someone with a knowledge of the US medical system review application so again you got to be careful you don't want again you don't want to be verbose in your applications you don't want to what do I mean by the word verbose you don't if you're describing your experiences it should probably be like one to three sentences right it's only if it's like a very significant very unique experience like all like you cured this disease or something like that that okay maybe you can you know maybe put a little more thought and maybe make it like a small paragraph but in general one to three sentences is all you need to describe your experiences in your era's application and then I also see this then about like international medical graduates where you see them they take the US Emily the field take the US Emily the field the US Emily the field the thing is you need to be realistic right you need to be realistic right the thing is having a like being an international medical graduate again already puts you out somewhat of a disadvantage with applying to residency and then if you have failures on your US Emily exams that even puts you at a bigger disadvantage so if you're no

t scoring well on practice exams do not take the US Emily's if you're not doing well in your practice exams do not take the US Emily's and one of the thing I've noticed is many times international medical graduates they have like very ineffective studies strategies again I'm not saying this again please don't like in fact maybe let me go ahead and see this take everything I'm seeing with a grain of salt what I'm saying does not necessarily apply to everybody right but it's just something that I'm again I'm not speaking this from just oh the vine is just talking from his mind no I'm just talking based on experience again I have worked with tons and tons and tons of mind so I think I have you know somewhat decent knowledge of the way this process kind of plays out on the common pitfalls that are faced by by international medical graduate so the thing is you say like international medical graduate you say oh I took off a year I studied for a year for my exam and then you ask what did you do and then they say I did this I did this I did this I did this I did that I knew you just kind of shake your head you're like hmm why did you do all these things again right so the thing is as an I&G before you even start studying for your USMLE's come up with a good plan right look on Reddit look on SDN look at what US medical students have done right and then try to craft a reasonable plan based on that like many international medical graduates like I feel like I mean this is becoming less and less of a problem as the years go by but a lot of people just use some very ineffective like study tools or ineffective study resources or ineffective just approaches to even MBME questions like I've noticed like probably one of the biggest areas I tend to work with internal lab international medical graduate son is just testing strategies right because the way exams are in the US and not neces

sarily the way exams are in foreign countries right so take for example right like many times in the like essentially every major exam in the US is a multiple choice test right but if you look at foreign countries like I remember right because again I grew up in Nigeria right when you look at exams the way they are written like in the UK or in India because again I've worked with a lot of Indian medical students like in India or in some of these like Eastern European countries and things like that many times these medical schools actually have theory exams they call them theory exams because they're like open and dead you need to like you know kind of like write paragraphs to answer the questions right and the thing is even the multiple choice exams in these in these foreign countries many times if you study for those exams if you just like take the textbook read the textbook you'll crush those exams but unfortunately that is not necessarily the case with US multiple choice exams that is one thing I came to realize when I moved to this country essentially because at first my thought process was oh you know what just like I did in my home country you know I read the textbook I once I read the textbook and I know everything boom I'm gonna crush the exam and then I kind of noticed initially that you know this does not really appear to be the case especially on these US ML Es and once I came to that realization although I came to that realization way before I took the SML is I probably think came to that realization in college but the thing is US exams do not just depend on knowing the material they also depend on being good at taking tests that's why you may see like international medical graduates they see that define I studied for nine months but my score is not budget one reason your score is not be budget because some of these people like I've seen some people like li

terally I've worked with people where like when I have like one or one two sessions with him I ask them all these questions and I say like oh what is the mechanism of action of this boom this bit out the answer how does this work boom this bit out the answer but you're like but how you getting like in the low 200s on your practice exams or how have you failed this US ML exam so many times one very common reason is just in the way they approach these tests okay so the thing is unfortunately the US medical system at least with regards to tests does not just revolve around how much you know it also involves revolves around how you take exams right so again as an international medical graduate as you are reviewing MBME exams your questions even just try to ask yourself ask yourself this question is there a pattern right and again this is something that you can either come to the realization on your own or if I let me put it this way when you're reviewing your tests I think this is probably a good way to put this when you review your exams do not just review your exams for content review your exams for patterns because I can tell you this again haven't worked with again tons and tons of US medical students international medical graduates when you review exams you should typically be able to come up with patterns in the kinds of errors that you're making in answering questions because the thing is once you spot those errors you can begin to make significant improvements with your scores again there are many people have worked a really like man this person's knowledge base is amazing well you see their scores not great and then you just tweak a few things here and there in the way they approach questions and you notice that they just begin to perform super well right so again as an international medical graduate if you're taking a US based exam like the US MLA's don't just t

hink in terms of content also think in terms of test taking strategy and for step two CS especially with international medical graduates again you see like oh 96% of US medical students pass the step two CS exam the thing is international medical graduates the section of step two CS that you know tends to kind of get them down quite a bit is the ice portion right and the thing is the ice portion almost involves like a specific set of skills that may not necessarily be emphasized in foreign medical curriculums right so the thing is because many times you know people kind of work on their spoken English proficiency and they get good with that or the CIS portion where you know you express empathy they get good with that but the ice section of the US MLA step two CS exam is something that again tends to put international medical graduates in trouble on step two CS so again make sure that you focus on that domain of the exam as you prepare for the US MLA step two CS again the fact that 96% of US medical graduates pass the step two CS exam it doesn't mean that 96% of international medical graduates pass the step two CS exam again and I've kind of mentions like if you if you go back to I think it's one of my earlier podcasts that I made on the website where I talked about like how to prepare for step two CS I kind of highlight some of the problems that people face especially with like the different sections of the exam and then just some quick common sense things because I want to go ahead and end this podcast because an IMG you got to have research right like I have their countless number of people have worked with and they're like I'm like oh yeah so do you have any research they are like no if you don't have any research you are severely limiting your chances of matching into a residence in the US you want to have a research that is published even if it's not published in

a US journal even if it's published in like an international journal any research helps okay so like research presenting at presenting at conferences in the US again that certainly helps from your application perspective and then another thing that also helps is joining organizations again I'm not saying join 10 different organizations but say for example right you're an IMG and you're trying to apply to residency it's probably not out of place to apply to like they're like to join like the American College of Pediatrics and sometimes some of these things are just like two or three-minute applications you can do real quick and just join because the thing is think about it if you're a member of her if just again put yourself in the perspective of a residency selection committee member in the US right they look at this you're like oh this person went to medical school in India or this person went to medical school in I don't know like Russia or something but this person you know is a member of like the American College of Pediatrics it shows them that by signing off for the American College of Pediatrics again I'm just giving this as an example for like a pizza applicant it shows them that okay this person is already beginning to look ahead to medical practice in the US this person clearly wants to know more about medical practice in the US so they are already like making foot holds in these areas by joining professional organizations that can give them even like more information about the specialty in question right so these are easy things you can do to boost your era's application as an international medical graduate and then another thing is if you've graduated from med school like if you've already graduated from a foreign med school don't like see that home and do nothing right try to do things that can keep you clinically engaged right even if you're doing thing

s that are keeping you clinically engaged not in the US that's absolutely fine and the thing is when you're talking about these things you want to actually describe them in your application like I've worked with some international medical graduates these people have essentially like being like attendants in foreign countries well you see them like you're read through their era's applications you read through their personal statements and the don't make mention of this or if they make mention of it they talk about it in like very like subdued terms you don't want to do that believe it or not this is actually something that can because think about it right if you're a program director in the US and let's say you have someone that is applying to like for like an seizure residency right you're like an international medical graduate applying for an seizure residency and let's say like back in your home country let's say you know you've graduated from med school like five six years ago but you've had a clinical career where you've done a lot of procedures like you've placed I Vs you've placed that tier of lines you've managed patients that are critically ill that are like superceptic and things like that going into those specifics and again in a unique way you don't want to like present it like proud oh I have done this and that and this and that no you don't want to do that but you can present those points in a way that really causes a member of a residency selection committee in the US or like a program director to take notice right so the thing is that is again that is it all comes back to this whole thing of having someone a video application having someone take a second look at your personal statement right these things these may be experiences that you have but you just an I.M.G.

may just think that oh this thing does not matter but it ends up mattering a lot to a person that is reviewing your application in the US so again these experiences you have these like high-level clinical experiences you have in a foreign country present them in a good light in your application because again that can give you an added advantage as you apply and then obviously write your English has to be good right so again this is something that you can work on the easiest way to work on your English personally like at least personally I found it to be very helpful is just reading journals reading like US news just reading like US news articles really does help again you want your essentially any communication you put out like in your era's application because think about it right how would what do you think will come off an era's application where there's lots of grammatical errors or there's lots of grammatical errors in your personal statements or let's say like you're emailing a program director and you know you're putting out this email but your email has just tons of grammatical errors tons of errors with like sentence structure these are all things that can hamper your application right because like for example I've worked with some international medical graduates where like you know you look at the emails they want to send out to programs let's say you know they've put out the errors application and then they want to send like a letter of interest to a program and then you see like you know they put comments in the wrong places or they put semi-colons in the wrong places or they put full stops in the wrong places right again these are all things that can cause concern to a person that is reviewing the application so anything you put out be it spoken communication or written communication make sure that that is devoid of as many grammatical errors as possible

and then you know get your things done on time again don't wait till the last minute don't wait till the last minute again if you want to apply to medical's a mental residence in the US look ahead like almost like a year in advance right don't wait till like two months before your ass opens to start putting things together because again typically if you're an international medical graduate there are probably some significant things that you need to do that may get delayed that you need enough time to accomplish like the ECFMG like certification process or getting just certain things back from people may just take more time because you're an I.M.G okay so again start early I can not stress this point enough start early is extremely important and then another thing is you want to apply super broadly right so even if you have good scores as an I.M.G even if you have like 260's don't apply to just 10 programs right you're gonna be putting yourself at significant risk the thing is unfortunately the much process is very expensive but in the end it will pay off right so apply broadly and one thing I've actually found to be helpful is checking a Frida I think it's like spelled like F-E-F-R-E-I-D-A right check Frida look at programs that are friendly to international medical graduates you can even go on like the programs website look at their residence list look at where the residence graduated from med school if you see like a program that has a resident that graduated from the med school you graduated from believe me that's a great networking opportunity you can reach out to that person see they can put in a good word for you right and the thing is if a residency program has accepted residence from your foreign medical school the chances are you have a pretty good chance again assuming you don't have again significant like red flags in your application chances are you have a

pretty good chance of matching into that program or getting an interview at that program because the fact that they've accepted someone from that medical school into the residency shows that they almost give that medical school like a vote of confidence with regards to the application process and again you got be flexible on location Zaini and you can say all like California or burst no right again even people in the US want to have trouble getting into California residences right so again just again just be realistic right again it's unfortunate but that is just the truth that is just the nature of the game so you know be flexible on location be prudent with your specialty choices right so again I'm not saying it's impossible but again you have to be prudent and you have to be realistic right so being an international medical graduate and seeing that oh you know I've always dreamt of being a neurosurgeon again I support that dream and I mean obviously if you want to get into like let's say you're your foreign medical graduate I want to match into your surgeon the US is it impossible no it's not right but the thing is when you need to work hard your application has to be essentially almost perfect you need to have like super high US Emily scores you need to have like probably like like you've probably done like a research fellowship in the US right you must have done many things to sort of set you on the right path to be able to match into that specialty but the thing is if you're going for the hyper competitive specialty in the US as an I am so let's say you're going for like neurosurgery or you're going for orthopedic surgery you're going for plastic surgery or you're going for dermatology you want to apply to some backups okay you cannot say that oh it's neurosurgery or nothing right I mean I guess you kind of have to have your priorities you're like okay if I don

't match into the research in the US at rather not practice medicine in the US then that's fine but if you one of your priorities is like okay you know what I want to get to practice in the US then again you need to be prudent you cannot say it's neurosurgery or nothing else right because again neurosurgery how many IM Gs you see matching into neurosurgery every year right again I'm kind of picking like the most competitive of whatever right but again you just need to keep things in perspective you may not be able to match into neurosurgery but guess what you may be able to match into neurology right or you may be able to match into radiology and become a neuroidologist and they may be going to like interventional neuroidology because the thing is as an international medical graduate one of your big priorities should just be getting into the system in the US right again from a wise perspective the thing is once you get into the system right so let's say you're like oh I'm an IMG and I really like the brain I would really like to do like brain interventions yeah neurosurgery is a nice way to get into brain interventions but the thing is there are other ways to get into brain interventions after you've got into the system in the US for example if you're a person that's an I-engine you know you match into neurology and then after that you're going to like some interventional fellowship with neurology right then you can do some brain interventions it may be like a minimally invasive brain intervention but that may get you some of the things that you're passionate about well let's say you're a person again I am you're like oh I really like neurological interventions you can try you know matching to radiology residency going to interventional neuroidology right and with that again you can do a lot of brain interventions because the thing is once you get into residency in the

US if you work really hard in residency and do a solid job right and you do like good research you know people see that your hard worker you do well on your training exams right those can set you up for very competitive fellowships after residency that again can get you closer to your dream than what your residency may have been able to accomplish for you and then as an international medical graduate one other problem I've noticed is people not knowing the applications well so you see people you know they spend like weeks and weeks and weeks working on the applications and then they are going on interviews and they don't even bother to read the applications that is not prudent you got to know your applications you need to know your applications because the thing is is the stuff you're putting your application that an interviewer will likely ask you about during the course of an interview so please please please no your applications so I think I'm gonna go ahead and stop here again if you have any questions you know reach out to me through the website or send out an email to the Vine Intervention podcast with an S at gmail.com and yeah so I think that's you know all I'm gonna say for now so as I do at the end of every podcast I do offer tutoring for many exams right so like step one step two CK step two C.S.

step three pre clinical medical exam 30th shelf exams and if you're like a medicine resident I tutor for like the internal medicine in training exam the internal medicine board IBM board exam and then you know if you're a med student and you need to I mean if you're a college student you need to learn for like general chemistry or organic chemistry physics biochemistry histology histology and physiology alpha tutor for those things and then if you're a med student applying to a residency in the like a residency in the U.S. so like an era's application or a college student applying to like a med school like an Amcass application again I do offer like one-on-one advice in coaching for those things right so like like rec letters personal statements editing applications mock interviews those are all things that I that I do again I've done this with tons and tons of people and the vast majority of people have worked with have matched right so and most of them have actually matched that their first choices even amongst the IM Gs and there's this thing I do that I call a longitudinal tutoring right so you feel like a first year second of 30 a med student I can tutor you for like your block exams or like your shelf exams and then at the same time tutor you for your upcoming U.S. Emily exam again the people have done this with the vast majority of them have been overwhelmingly successful on the U.S. Emily exams and then I also do this offer this thing called a U.S.

Emily booster course where it's like 10 hours for step two CK and step three and also the internal medicine like in training exam but it's 20 hours for for the step one exam and basically this is something that I typically do with people at the end of the dedicated periods already feel like you know I feel like my knowledge base is pretty good and I want someone to you know kind of put things together for me in a way that I'll likely see on the test this is something I offer again most people have done this with I've done this for like a pretty long time and again people many people have found it to be extremely helpful it's a Q&A format but I'll integrate multiple disciplines for you that's one and then a second thing I'll also help you accomplish is I will talk about the material with you but I'll talk about it in an MBM context in the context of the way you most likely see it represented on an exam so I do hope you found this podcast to be helpful again reach out to me if you have any questions and I wish you success with the much process and I wish you a great rest of the week have a wonderful night and God bless you I'll see you next time

They are inherently at a disadvantage compared to US graduates, requiring extra effort and strategic planning.

Their chances of getting an interview, especially in Internal Medicine, are vastly limited.

Membership in specialty-specific organizations (e.g., American College of Pediatrics) shows the residency committee that the applicant is proactively engaging with US medical practice.

They must review for patterns of errors to improve test-taking strategy.

Being verbose or listing too many disjointed experiences; the description should be concise (1–3 sentences) and contribute to a coherent story.

They should start thinking about it at least a year in advance, allowing time for complex processes like ECFMG certification.

Developing a coherent narrative/story that ties together all experiences (research, clinical work, personal statement) and presenting it effectively.

It provides essential exposure not just to medicine, but specifically to the unique operational mindset of the US medical system.

The Interview Communication and Interpersonal Skills (ICI) portion, which requires skills often not emphasized in foreign curricula.

They must present them in a unique way that causes the reviewer to take notice, without sounding overly boastful or "proud."

Generally, 1–3 sentences; only truly significant/unique experiences may warrant slightly more detail.

It suggests that the program views your medical school with a "vote of confidence" regarding the application process.

Developing a coherent narrative/story that ties together all experiences (research, clinical work, personal statement) and presenting it effectively.

It provides essential exposure not just to medicine, but specifically to the unique operational mindset of the US medical system.

The Interview Communication and Interpersonal Skills (ICI) portion, which requires skills often not emphasized in foreign curricula.

They must present them in a unique way that causes the reviewer to take notice, without sounding overly boastful or "proud."

Generally, 1–3 sentences; only truly significant/unique experiences may warrant slightly more detail.

It suggests that the program views your medical school with a "vote of confidence" regarding the application process.