Improving your chances in the residency match

Posted by T3012 on June 12, 2011

It has been a while since I posted anything on this blog, blame it all on internship and junior year of residency. I will try to post intermittently from now on, as residency demands.

Many people wonder how they can improve their chances of matching into a US residency. While there is no fail-proof method, it is sort of a combination of different factors. In response to a question from a friend, I am posting my answers to those questions, albeit modified slightly.

I think it is a good idea to undergo a residency in the US, any residency at all. Matching as an IMG is really tough but not impossible ( depending on your specialty of interest). Several criteria play into your success, realizing that all may not apply to everyone.

1. USMLE scores: If you have not written them yet, please make sure you give it your very best. It is not a simple exam you want to hurriedly prepare for. Once you get above the passing score, there is no second chance. If you fail it, that history goes everywhere with you when you apply for residency. Please see my first blog on the different USMLE exams. Rules change frequently, so check for updated information. Good scores are somewhat relative in the definition. Scoring above 200 may get you into some specialties, while some require scores greater than 220. Do not hurry through them, take your time and excel in all the steps.

2.Clinical experience: Most programs ask for this, but not all. Those that ask have different lengths ranging from 3 months to 1 year. Some will only accept those done at ACGME-accredited programs. There is a difference between externship vs observership. A quick google search will lead you to websites that highlight the differences. In summary, with observership, you simply watch, no direct patient interaction. With externship, you may be able to take a history and examine a patient. Some are paid while others are free. It all depends on institutional policies.

3. Research: This is a serious booster to any application. The more published you are, the better your chances. Some think this may be more relevant to academic programs though I beg to differ. Even with community programs, research is a good thing.

4. Your visa status: Some programs care less about sponsoring an IMG for a visa. They can always get a US citizen/LPR into their position. Few sponsor H1-B, others J1and some no visa at all. You need to know these subtle differences, which we can talk about in another blog if the questions arise.

5. Masters/Ph.D. degree: These definitely improve your application especially if you short in other areas. For some specialty, the degree is good enough while for others, I think the skill set you bring to the table is key beyond having a 3-letter degree behind your name.

6. Connections: I will not place much emphasis but it suffices to say your work will make a way for you. I also believe very much in supernatural favors. Pray God brings the right people across your part after you have diligently done your part.

My final advice will be a very honest one. Ask yourself if that specialty is what you absolutely have to do or you have alternatives. Why that one in particular? Are you interested because it is that or nothing else OR because it is “prestigious”?. Though I have simplified it, getting into any specialty is way tougher than that. It can be a very long, arduous and frustrating journey. There are many excellent specialties and subspecialties you can consider which we were poorly exposed to during our medical school days in Nigeria. Please think this through before committing yourself to any specialty as it will be real painful to discover after several attempts at the match that you could have done something else.

I hope this helps someone out there, and I will be happy to answer your questions as time permits.