# FMG and competitive residencies, what are your chances?



## Sam212 (Apr 3, 2006)

Although I have been a member of this informative website for more than 2 years now, I have not been able to contribute much due to my academic and other activities. However, in my limited visits I have noticed a question that is asked very frequently on these forums. “What are my chances to match in to XYZ as an IMG or whatnot?” Most of the members including me are concerned about competitiveness of various fields in terms of USMLE scores, research and other factors. Add FMG factor to the mix and it probably becomes the most important question for many. I will try to answer this question here to the best of my ability since I was once considering foreign medical schools like many of you. One must also consider that there are many other subjective criteria that come into play at match time. Obviously, one must do a thorough research of his/her own to get a more personalized view on the subject, but I will present some general information here. 

First and foremost, many members here have asked about average USMLE scores for various specialties primarily to gauge their competitiveness for the relative specialty of their choice. Following is a chart that presents average step I scores for most specialties. The chart was compiled by NRMP and does not contain some specialties that use SFmatch. Chart contains average scores for US graduating seniors:








According to the chart, Plastic surgery is the most competitive residency, followed by Dermatology, and ENT and so on. One must also keep in mind that average USMLE step I hovers around 220 in most years. So, contrary to the popular belief, Internal Medicine is somewhat competitive since it requires an average Step I score. Also on the par are Anesthesiology, General Surgery, and Emergency Medicine. On the low end of competitiveness lie Family Medicine, PM&R, and Psychiatry. 

Now, as indicated above, Anesthesiology, General Surgery, EM, and IM, all are about the same competition wise, at least as far Step I scores are concerned. An inevitable question that arises from this information is, “Then how come there are so many FMGs in Internal medicine, but so few in EM, General Surgery, and Anesthesiology?” Even though Step I scores indicate that they are all on the par; IM has far more spots than any other specialty out there. Therefore, a lot more spots are left for the FMGs to take, whereas, Anesthesia and EM have a lot less spots. General Surgery is somewhere in the middle but is more in demand by American graduates because of sub-specialties. PM&R follows the same trend. Although it is easier for FMGs to match in PM&R than some other specialties, however, it is not as easy a match as Family Medicine; less spots for PM&R, way more spots for Family Medicine.

There are also other factors as research and whatnot. Following is a report by NRMP that contains every specialty in NRMP match in 2007. The data is not only broken down in terms of applicants who matched, but also applicants who didn’t match and their attributes. It is a somewhat tougher read than the chart above however; a lot of valuable information can be obtained from this report regarding FMG match chances in certain specialties. The data is divided into two categories, US Seniors, and independents. FMGs are placed in independents, along with DO applicants, and US MD re-applicants. 

http://www.nrmp.org/data/chartingoutcomes2007.pdf


A popular specialty discussed here on these boards is General Surgery. Let’s take a closer look at data available in the report for General Surgery match in 2007. 1164 applicants matched into General Surgery. Out of those, 812 were US Seniors and 352 were independent applicants. 93 of US seniors didn’t match; meanwhile, 379 Independents didn’t match. That’s 90% match rate for US seniors and 48% match rate for independents. Let’s go down further on the chart, and it can be obtained that average US senior Step I score who matched was 222, while an average of who didn’t match was 204. For Independent applicants, average of those who matched was also 222, but those who didn’t match averaged 210. Step II scores are also given but are not as important as Step I scores so I will not discuss those. If you look further, mean research experiences and mean publications are also listed. Those who matched had roughly 2 research experiences and 3 publications. More data is available regarding top and bottom 25th percentile of applicants and what their averages were. Overall, from a prospective FMG's viewpoint, a 48% match rate of independent applicants provides a decent chance of matching, granted you have all your other bases covered. You must also keep in mind that Independents also include DO applicants and re-applicants, so to get a precise data for FMGs is not as easy. But this gives a vague idea as to what might be on your plate. 

Since I am just a lowly medical student, take everything presented here as a grain of salt, and do your own research. However, I can conclude with a fair bit of confidence after studying all the data above that one can pretty much eliminate Plastic Surgery, Dermatology, Neurosurgery, and Radiation Oncology as an FMG. Same can perhaps be said about Ortho, Radiology, and Urology as well. I know some one will be quick to point to some successful FMG Neurosurgeon, but those are anomalies rather than rules. As for mildly competitive fields as Anesthesia, EM, and General Surgery, it can be done but will take a considerable effort for FMGs. So make your choice accordingly when deciding on going to foreign medical schools. Be realistic about your potential as an FMG. One more thing I like to add here is that there are many new medical schools that are currently in process to be opened. Also, medical school enrollment in the US will also increase by 30% in next 10 years. Since residency spots have been somewhat stagnant, it will be more difficult for FMGs to match in the future. There will be more US medical students to compete with while residency spots will not increase by much. So weigh your options accordingly when deciding on the foreign route. Any questions or comments are welcome!


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## MastahRiz (Jan 26, 2006)

Sam212, way to hook it up!

Thanks for the awesome post, I'll be adding to your reputation status shortly


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## Sam212 (Apr 3, 2006)

Not a lot of love, I expected some controversy here. Seemingly everyone agrees with me or what


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## dr.Shafia (Jan 27, 2007)

plus being in pakistan and not having an american visa...i have known many with 99 percentile who didn't get visa..its getting tough day by day...its like history repeating itself...all the best doctors in karachi i know have FRCS FRCP written on there plates..at that time plab was the only talk.and now asians i think are still not allowed,they werent allowed to go for plab 3 4 years ago..because they already have too much of tehre own residents...it has just been recent..take it max.12-15 years usmele is on hype...and now it too is tooooooooooooo difficult to get in...predicting now,alot of people are considering austerlia...my cousin,U.S born resident is doing M.D there and teh only think i understand from her talk is that the competition is going higher day by day...
totally agree on the statement..weigh your options accordingly when deciding


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## MedGrunt (Feb 21, 2007)

That's an excellent post! I didn't get a chance to read it before because it was during exam season, but it's very informative. This should really help clear things up for users(myself included!) #happy


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