Advice for Top Calibre FMG

Dear Attendings,

I'm an orthopaedic resident from Australia who attended a highly regarded medical school in Australia, has rotated at top hospitals in Australia and has excellent references from highly regarded Australian surgeons. However I married an American girl and so am keen to relocate to the US.

I entered the US match in 2005 but wasnt offered a single interview and so have continued to train in Australia ... but am still knocking on the US door ...

Now I realise that the majority of 'foreign' medical schools are looked upon with a fair degree of apprehension in the US (as they are in Australia) but I'm feeling very frustrated that someone such as myself with comparable training to any of the top medical schools in the US should have such trouble getting a foot in the door.

Is there any advice you could give as as I am contemplating reapplying soon. I am perfectly prepared to take a step back and repeat an american internship but I dont want to compromise my training and future career by 'settling' with a bottom tier american program. I am, with all due modesty, a good candidate ....

Many thanks.

"Is there any advice you could give as as I am contemplating reapplying soon. I am perfectly prepared to take a step back and repeat an american internship but I dont want to compromise my training and future career by 'settling' with a bottom tier american program. I am, with all due modesty, a good candidate ...."

My advice to you is the same advice I give to our students from Columbia P & S Medical School (arguably a top 10 medical school in the US) is that you definitely need to "broaden your horizons". When I meet with our rising 4th year students interested in pursuing Orthopaedic surgery in May, I will speak alot about "passion". You have to have it to get through the system and obtain a residency.

Many of our students are fortunate enough to get "top" programs but not everyone can given the incredible competitive nature of this specialty. If they really want to be an orthopaedic surgeon, however, they do not view matching at any program "settling with a bottom tier program". Either you want it or you don't - and if you will only accept matching at a "top tier" program then you are setting yourself up for failure I'm afraid (whether you are Australian, American, or anything else).

You face much stiffer obstacles coming from training outside the US to be sure, but I fear you may be making the goal much less attainable by how you've set your standards.

wnl

Dear Dr Levine,

I absolutely agree that one needs to have the passion if one is to be an orthopaedic surgeon and so if I was a medical student applying we'd be having a very different conversation as I'd be happy to travel to the ends of the earth to get onto ANY program .... but the question isnt whether I want to be an orthopaedic surgeon as I am already on a perfectly good program in Australia ....
My question therefore is when a good calibre orthopaedic-trained or orthopaedic-resident level FMG is looking to relocate to the US without compromising his/her training .... what can one do to convince american programs to take you seriously??

Not sure the best advice for you therefore since it's very difficult to transfer into a program. There are usually a few spots that open up each year around the country due to change of heart, etc... but more often than not these are filled by people who are already at that specific institution (a "known" entity).

Are you willing to start from scratch as a new intern? If so, then applying through ERAS and demonstrating that earnest desire would probably give you more access and exposure than simply trying to transfer into a program.

I have a partner in my department who was completely trained at one of the finest Orthopaedic Residency Training programs in Korea but wanted to come to the US so he re-did an entire orthopaedic residency program in the US. It just depends on what you're willing to sacrifice to make it happen.

wnl

Ozortho,

you have posted often about how to get over here and that you are from a good program and want to be a good orthopaedic surgeon, yada yada yada.

thing is, so do many american grads. regardless, you will be placed in the pool with a bunch of very good to excellent american grads scratching to get in to a program. they have 2 things over you: they are american grads, and they are a known entity to 1 or more programs. you are an unknown.

you are an FMG, and because of that some programs may not interview you. the best way of getting into a us program is to become a known. get a research fellowship or clinical fellowship (if you have the prereq's for a license) then you will be known here in the states by someone who can go to bat for you. the question for you is what are you willing to do?

there are plenty of FMG's applying to orthopaedic residencies that have great scores and many who have been orthopaedic surgeons in their own country. they still have to go through the process.