¶ Residency Placement for International Medical Graduates
Anybody who trains in a different country . You have to do residency again to come to United States , correct ?
Yes , yes , and this is what I feel personally the most horrible about some of these physicians are not just well respected , but known . They're famous in their home country . They've done big things , innovative things , and in America they don't care .
You can be so famous that you're consulting physicians in America , but when it comes time that you want to go practice in America , they'll treat you like a PGY one , or really a PGY Europe .
Yeah , what exactly is it that we're not trusting if ?
I had to choose one . The fact that they're they went to medical school abroad , especially older program directors . They are just not gonna trust someone who did not get top medicine in the States . They don't care where you come from was good everyone .
This is dr Ne . I am joined by dr Simrack Gill With residents medical . This is a little bit of a different episode . Listen , we are coordinating .
We are , you know , combining our powers and working with groups that we think align with our Audience , and what we found out through our survey and through our studies is that we have quite a few International medical graduates who listen to docs outside the box , follow us on Instagram as well as with residents medical .
Residents medical is a residency placement as well as fellowship placement Organization company that really focuses on getting international medical graduates into ACG and me accredited programs . And Listen , I know it's hard out there .
It's really hard out there for IMGs to travel , to pay for all of these or these tests and board examinations and try to get into residency in the United States .
It's very difficult and you know we talk about all the different soft skills that you need to do to Really succeed as a physician here in the United States , and I think sometimes we forget about some of the extra added burden that our IMGs have to face , whether it's in the Caribbean or Anywhere else in the United States . So that's what this show is about .
That's what this episode is about dr Simrack Gill . Welcome to Docs outside the box . Man , how you doing ? I'm doing good . Thank you for having me on . I appreciate it . So I'm looking at the background . We got a whole bunch of pictures there . Now , for those who are watching on YouTube , there's a whole bunch of pictures that are behind dr Gill .
I'm gonna assume are these candidates or Doctors that you've helped , or these like consultants ?
Exactly . No , they're candidates that we've helped in the past , over the course of 20 years , whether it's in residency or fellowship , throughout various specialties that they all of these people have reached out to us . We were able to guide them at any point of the stage that they came to us and we got through their dream position .
Hmm , so listen , why don't you just tell us from the get go what is residents medical ? What is it about ? How does it work ? How long have you guys been out there ? Because I hear that you guys are often duplicated but you can never really get the original . So tell us about that .
Yeah , yeah , thank you for asking . So . Residents medical . We're an educational consulting firm that specializes in assisting IMGs . We have a model that uses a network of residency programs affiliated with US Teaching schools and hospitals , and we've been doing this for over 20 years .
Really , what we were doing is we were helping , back in the day , gmes get created and assisting hospitals and getting ACG me accredited .
So by doing so , we we did this with a stipulation with these programs saying hey , because we've helped you , we want the programs to be diverse , we want them to be filled with IMGs , and if we have Candidates of ours that meet the criteria of your program , then we would wish our counties to be considered for a position in your residency or Fellowship .
So as a result , over 20 years later , we've have established a network of over a hundred programs throughout the country . We've helped almost 2,000 candidates achieve residency , as well as fellowship , and Not to to our own , our own horn , but our success rate is in the high 90 percentile .
Essentially , if I had to describe it in one sentence , what we do is we take on the responsibility of getting you into residency . In terms of how we're able to do so , we we act as your mentor where your guide throughout the journey .
Whether you're already ECF and you certified and you're Just applying for programs ready for to achieve residency , or you're starting off fresh and you're about to Prefer your step one , you just finished med school , at any stage in your journey we're able to assist and guide you and making sure you're making the right decisions in the right calls .
¶ Challenges of IMG Residency Programs
Hmm . So I know a lot of this stuff is proprietary . I get it , but how does the mentoring look ? What does that look like ? Is that something as simple as guiding them as to the specific residences that you guys have been able to get folks into ? Is it like a different , like a change in the type of , maybe personal statement shadowing ?
Talk to us about , like the specifics without I know you can't get into too much specifics , but talk to us about that mentoring process . How does that work ?
No , thank you for the question . It's a good question , for sure . The , the mentoring is one-on-one first and foremost .
You know I every week it's mandatory for all the counselors on staff that we meet with all of our candidates one-on-one over a zoom call and we all are reachable on our cell phones so at any point of day and night if there's any issue or any concern , they , all of our candidates , know to reach out and we'll be able to help them .
As far as the pathway that's constructed was like a , therapist , exactly exactly the , the pathway that's constructed . It's really about having them showcase their clinical skills when it's time for them to apply for residency .
Though Our model has always been about prove yourself , we will open the doors for you , because most of the time , img's don't have any doors opening for them .
What we specialize in really is opening the doors for you to go prove yourself , and by doing so , it allows the program directors , the APDs , to see that they should be giving this candidate and IMG a chance . And the way they prove themselves is either through extensive clinical work or research .
Typically , what we do is we place them in a program when they do hard hours , 14 , sometimes 16-hour days , hands-on externships , showcasing their patient care , or it's the research they're doing , deep diving and in all their research that they're doing . And we do this .
One for a chance to program directors to see them , but two , if they have any red flags that exist on your CV , right , whether it's a low score or failed attempt on their on their boards , or whether they just don't have enough clinical experience .
It's a chance to rehabilitate , because a lot of times these IMG's , what they're facing is their applications aren't even being viewed , they're yeah , right , and they get siphoned out easy , exactly , I filter it out Exactly . And so what we ? What we really are known for , is making sure that you , these programs within our network , they're not allowed to do that .
We , they , we want our candidates to have an equal chance To be viewed , and if they don't meet the criteria , they don't meet the criteria , it's nothing . Oh , it's a fair play . But you , what we specialize in is making sure that , no matter what , you're going to have a fair shot and you're going to have a chance to go prove yourself .
So where are most of these candidates coming ? Are these because we have a huge , at least in the United States ? We have a huge amount of IMGs that come from the Caribbean . We have IMGs that come from Southeast Asia . Where are the majority of your clients coming from , if you can tell us that ?
No , no , no worries . So we have helped people from literally all over the world . Primarily , it is clients or candidates that come from India and Pakistan .
We do have a lot of Nigerians that reach out for help , but we really have a strong foothold in India and Pakistan , where the word of mouth has spread about what it is that we can do for these candidates , these doctors who feel that they don't have a chance .
So in the past 20 years we've helped many people from there , people that are now become friends of mine personally , that are willing to speak on my behalf , on the company's behalf , if anyone is interested but still has doubts .
Why is this so hard ? Like , let's set the stage . Why is this so hard as an international medical graduate to practice in the United States ? Because we always hear the stories .
Even before or while in medical school I heard the story of there's a janitor at the job who's working at the hospital , who was in their own country , was like an amazing either hospitalist or internal medicine doctor , what have you ? For various reasons , they come to the United States and they find it difficult to get into a residency .
Or maybe they're middle-aged and they find out they have to do residency all over again . Set the stage as to the difficulties , the hurdles , what it looks like for someone who graduates and goes through all the hard work in their respective country or their respective medical school and then they want to come to the United States . Talk to us about that .
What makes it so difficult ?
Yeah , it's definitely an interesting question . There's a lot of underlying layers to it .
There's a lot of bias .
Yeah , exactly , there's a stereotype , there's a stigmatism to anyone who goes to med school abroad or practices abroad .
If they stayed in their home country for a few years , programs in America they judge it in a way and it's not to talk bad about programs in general they see so many applications and they just a lot of times don't trust the clinical skills that come from learning medicine in a different country .
As time went by you see the trend of these programs don't want to take IMGs because of that . They don't trust the clinical skills that are being taught in other countries .
When I've experienced it firsthand , I went to medical school in Poland and when representatives from programs would visit our school as a kind gesture because they knew some people that were part of the administration , they sort of told us they said look , you have to work twice as hard to go prove that you're worthy of patient care because we don't trust you .
We , as in programs majority in the United States Now there are programs that are IMG friendly , which is great , but a lot of programs especially programs where they're well known and they have a great pathways into fellowship after you graduate from their residencies A lot of them don't take to IMGs , a lot of them still don't take DOs as well , if we're really
talking about the bias that exists .
Absolutely .
That's still there too , exactly On a smaller scale . So what they're looking at and what they're judging in terms of red flags to determine whether or not they'll give you a chance to interview red flags that aren't as strict when it comes to American graduates . You have your USMLE scores , which is first and foremost .
They're going to look at that to see how many times you've failed . They're going to look at your year graduation date . Nowadays , a lot of programs are looking to see if you're three years or older , but it usually , or it used to be five years and older . If you're right now , a 2018 grad or older , you've missed the cutoff for a lot of these programs .
If you're an old grad , that's a major red flag and they're not looking at your application because a lot of these programs only want a 2019 or newer and some of them really want a 2021 or newer . That's a major red flag there as well . They're also looking to see how your clinical experience is .
Img knows that if you don't get at least three months of clinical experience in America , then it's going to be really tough for you to get an interview when you're applying for the interview season . If you get three months . That's the basic requirement . The problem is that a lot of rotations they're only observerships or they're not inpatient , outpatient .
You're facing the small hurdles which end up building up into a big hurdle , a big red flag . You can't touch the patient , you can't even write notes .
Exactly , that's really important , because if these programs already have a bias of saying your clinical skills are not up to date or not on our part , then how can you showcase that if a majority of programs that do allow IMGs to rotate are not hands-on , they're only observerships , so it's just a back and forth for IMGs to face .
What about visas and all that ? Does that ? Play a part too ? Is there ?
like a residency . That don't want to deal with that also 100% because at the end of the day , medical residency is still a business . To have a visa sponsorship they have to pay . The GME office has to order that there's two types of visas . There's a J visa and an H visa .
The H visa is the one that's really the most sought after because it allows you to leave the country , potentially apply for a green card . But on a J visa you're locked into your job . You can't move jobs , you can't leave the country . Some of these programs , they just flat out refuse to deal with the visa issues .
Now , luckily , the network that we have built , the programs within our network , they are all IMG friendly so they are well known to give out visas or sponsor your visa . But that just comes part of the extra time that IMG has to do the research that they have to do because you're not just going to apply to any program .
You have to go see are they willing to sponsor you to go work for them ?
Is there any external signs that a like ? For example , when I finished my osteopathic medical education in 2006, .
There was always these things that either on student doctor net or just kind of word of mouth that people would just be like , yeah , you know , they're probably not ideal friendly because they don't accept Comlex scores or they've never had an osteopathic grad before right . Is there things like that that someone can see by scouring either the website of a residency ?
Or is there word of mouth that people know that you can say , like that program that ain't IMG friendly . Are there things like that that you can see just from looking at a website or something like that ? No , that's a good question .
I think If this question was asked 10 years ago , it would have been primarily word of mouth . But nowadays , with how society is , the internet , how modern is , people are constantly communicating . And these IMGs , they have big WhatsApp groups , they have Twitter pages , twitter groups .
So they are they're individually or collectively and , most importantly , privately telling each other and their people in their home country hey , don't apply there , it's not worth your time , I had a bad experience and you're going to waste your money on the application .
So these , some of these groups , they're not public , but I've seen them , I've heard about it from current candidates of mine , past candidates of mine , and they tell , they tell me , you know , we already knew about this program because someone that's my senior from four or five years ago told us not to apply here .
So it's very interesting on how quick the word of mouth is , but via social media and how , how private they are with this information . Because , at the end of the day , you're also competing with other people who are applying and you're trying to receive an interview and you're , if you receive the interview , you're trying to get ranked .
So these people , they're not trying to share their secrets . They're , they're , they're holding on to it Understandably so , because it's it's a survival game , it's it's doggie sometimes .
You know , a lot of times I feel like the more people are quiet , the more persistent like either biases or stigmas or just whatever advantage that someone who has the ability to let people in or not , that stuff continues , right , like it happens in the doctor realm , where you know doctors will be at a hospital and that you can have , literally you know ,
multiple doctors in the same specialty . They don't tell each other how much they make and that advantage ultimately falls to the hospital , right , because they can low ball here , they can high ball there and you know they have the ultimate say so , you know it's . It's very interesting perspective within that realm . Question for you yeah , the like .
What's the profile ? Because I know you said there's a majority of your clients come from Southeast Asia . What's the profile ?
¶ Medical School Debt and IMG Residency
Because in the United States the average medical school graduate is going to be graduating with a significant amount of debt , right , at least they're saying right now close to about $240,000 .
That includes medical school and undergrad , right , and then obviously , you go through residency and then you know , depending on what you do , that's going to determine , in terms of specialty , how quickly you're going to be able to pay that back . Right , we would be able to pay that back five years , 10 years post . What is ?
How's the financial profile work for students from ? For IMGs , right , like there's always the star process that , like medical school , is free . How does that work ? Is that a myth ? Is that a lie ?
And then also , at the same time , like , talk to us about the whole process of trying to the financial prospects of trying to get into the United States to do residency . Talk to us about that .
No , that's a good question and the further first part , the . It is true that a lot of medical schools for in a prospective home country .
They won't charge their students that are coming in , whether the tuition is free , if they meet the criteria , if they scored well on their home exam , and a lot of times , like in India for example , they're called government medical colleges .
These schools are really good , they're really talented , filled with amazing students who are going to be amazing physicians , whether it's in their home country or they decide to leave to America or somewhere else .
And then you have other schools that are like in America , private schools , not public schools , who are still good medical schools , but they didn't meet the threshold in terms of their scores and so with the students that are going to those schools , they're going to have a little bit of debt . A lot of these home countries they don't even give loans .
It's just flat out you have to pay cash or you're not going in . For example , my school in Poland . The tuition was cheap . It wasn't that expensive relatively speaking to American med school and most people . They didn't take loans .
They just they paid out of pocket because it was affordable to an extent as far as the financial implications of trying to come to America . It's heavy , it's heavy .
Yeah , because I mean it's a couple of stacks for step one , step two , like in order to start to do this , like you would recommend . They do all the steps , right ? Is that how it works ?
Yeah , yeah , we I have all of my , my candidates , and so does every other counselor here . They have to take step three . It's not , it's mandatory . If you want our help then you have to prepare for step three prior to us assisting you into getting into residency . Because that three for an IMG is so clutch .
It allows them to stand out because these program directors tying into the point earlier of wondering whether or not you have the clinical skills they don't want to be worried about you multitasking or not having the ability to multitask , going through residency as well as studying for your step three . A lot of times I hear stories of IMGs .
They go to their program director and they say I need a couple months off from my residency to study for step three . And no one wants to hear that . Everyone's working , everyone's tired , these PDs , these attendings , they have to teach and they don't want to be stressed about that .
So a lot of these programs within our network will tell us hey , if they don't have step three done , then don't bother presenting them to us because we don't want to be stressed about them .
So that's a G . I'm looking at the EC , fmg . Ec FMG excuse me fees overall and step one a thousand , step two CK a thousand . Let's see pathways application 925 for the application to a pathway yeah , this could get pretty expensive . And then we're talking about applications for J1 visa sponsorship $370 .
So this stuff can really add up , not to mention possibly needing some tutorials or even some type of board prep .
Oh for sure . If you're buying you worlds , the Q bank that's hundreds of dollars right there you have to pay for your flight to go to America to take your step three , as well as to pay it for another flight potentially to do your clinical rotations . Then you got to go to the United States to take the test . Yes , step three can only be done in America .
You can't do it in any other country in the world . It can only be done in America yeah . So a lot of these IMGs , what they do , the people that are being smart about it and are planning it out .
They take their step one and step two in their home country and then they go crazy with their studying for step three and when they come to America to do their clinical experience , they set time in between one of the months with another month and they'll take their step three in America . They'll knock out two things in one trip .
So those who get in , you get them in . What's the average time that it takes ? Because for us , applying to medical school , it's a one-year process , at least a one-year process On average . What are we looking like when you're working with clients who want to get into the United States ? Like what we talk about a year , two years , three years ?
So this is a very interesting question . I'm glad you brought it up . It's all a case by case basis because it's dependent Just what have they are , it's like a lawyer . It depends it's true , it depends on what they've done , first on their own , prior to asking us for help .
And then , two , it depends on the climate of the year , that specific year , because I'll give you an example Someone that signed with me that asked for help , she's already ECF and she's certified . She already took step one . Step two , she already took her English exam , because you have to pass that as well .
She was already living in America , she was on a green carder , so they're in Chicago , and when she signed with us she hadn't taken step three yet , and so we prepared for step three . She was already in the middle of her studying and she took her exam within
¶ Navigating IMG Residency Pathway
a month . And we had a unique opportunity where one of the programs within our network offered or had a physician off-track physician . So for any listeners that don't know , off-track can pop up for a multitude of reasons .
One , if a program is newly accredited , or two , they recently fired someone , or someone quit , which means they have to fill that position quickly , and so the program reached out to us saying do you have anyone that may meet the criteria ?
Now , one thing I tell IMGs all the time is do not think that just because you have a good profile on paper that means you have a good shot of getting to residency , because how you present yourself over Zoom , how you present yourself over the phone , matters .
If you cannot articulate yourself well , then in their mind your scores don't matter , because how are you going to talk to your patients ? So the one good thing about alongside other good things , of course , but one of the good things about this specific candidate is she radiated good energy on screen . So I got to her the interview and they loved her .
She killed the interview , so she got her off-track position when she was expecting to wait the full year . This was months ago . She started her residency back in October .
So , to answer your question , if they're already ECFMG certified , we have the ability to get them interviews right away if their profile is decent , or we know that they can kill the interview If they're ECFMG certified but with red flags , such as attempts or low scores , we have them do the clinical work first to go prove themselves .
If it's someone who is starting out fresh on their journey , what I tell everyone is the same thing the step one and step two timeline will determine how quick we can get you into residency because if you , what happens not as step one is pass fail .
Did that change anything ? The mathematics , the calculus on any of this stuff ?
No and honestly for our candidates , the way we approach in the trend that we've seen since they changed the pass fail , it's been the same for our candidates when they're already our candidates Now . I know there's been a statistical change for people in general that are taking the test .
I know the percentage has dropped slightly in terms of how many people are successful , but in terms of our candidates , our approach has stayed the same .
So , basically , are you forcing it ? I'm not forcing it , but the emphasis has to be on really killing . Step two then right .
Exactly because IMG's in the past , up until the rule change , have used step one to their advantage to showcase hey , this American didn't score as high , but we're killing it . But now they lose that advantage . So step one being changed to pass fail has made it even harder for IMG's and people have complained . I've seen them complain some line .
So what about ? The one I want to ask you about is clinical skills . What's the thought on all that being gone now ? Is that like ? Do you guys are like thank goodness ? Like , from my standpoint , I'd be like thank goodness , but what are your thoughts on that ?
I think from an IMG's perspective it's a good thing , because clinical skills the PE is what I'm talking about .
Yeah .
Exactly , yeah , it's . I think that IMG's struggle historically with that specific step two exam . I've seen people say for them people that are older than me that that was the exam they struggled the most .
The other exams straight MCQ , straight knowledge or case study knowledge they've been able to kill , but the talking aspects made it a little difficult for them and that's because these rumors they started that exam for that type of scenario .
That's what I heard . We don't know the , but that's kind of the rumor and stuff .
I wouldn't be surprised . I would believe that rumor for sure . But yeah , it's just IMG's . Whatever they can get away with in terms of not having to speak , they're going to do it because they know that they're at a disadvantage because English is not their natural born language . So they're already up against the wall when it comes to the speaking aspect .
What I tell everyone that's a candidate of mine is you're still making the choice to come to America . So don't think that because of your cynical knowledge and test taking skills , that that's enough . If you don't present yourself well , you can have a 290 or 280 on your step two and step three .
They're not going to take you , because patient care and having the ability to empathize with not only your patients but your coworkers , your staff , from PD to janitor all of that they take into account . So you'd have to be able to articulate yourself well , you have to be able to showcase your emotions well All of that matters .
Yeah , it's got to be really stressful though , because I mean , not only now are you leaving your country , particularly if you're deciding to work with residents medical you're leaving your country , particularly if you have some red flags and you need to do some clinical rotations . Like how does that work in terms of you got to find housing ?
You know like you're in a different country and you're not sure if this is going to work out , but there's an expenditure on that . Like , talk us through that . Like how do you coach people through that ? Because I'm sure there's a lot of hesitation , there's some nervousness .
Obviously , to a lot of folks who come to you guys , you guys are like their lifeboat , you know their life jacket . Talk to us about that , how serious that is and how that works .
It's very serious . You know what I make sure I do is , prior to you know , having them sign with us . I break down everything with them , I break down from the get go Look , this is what you should be expecting to pay , because this is where we're sending you in terms of your clinical experience .
So let's say , hypothetically , it's in Miami , the program's in Miami . So we , as you know you and I both know my fellowship there it was dope , there you go . Miami's dope . All right , okay , so that's then . I'm sure , as you know , it can get a little expensive there . You got to , they're going to be living there .
If they have a bad profile , if they got multiple red flags , you can end . You know , especially if they're an old grad , you can expect them to be integrating , doing the clinical work for as long as eight , nine months .
Because what these programs are going to be telling us and we communicate with the programs frequently they tell us , hey , they're progressing along , but they need to keep showcasing the clinical skills . They need to go , continue to prove themselves .
So what I tell all of these candidates , prior to them even signing with us , you need to expect to pay this much , because it's not just paying us as a residence medical that it's guaranteed , no , it's . This doesn't work like that . What we're all doing is opening the doors and allowing you to go prove yourself . And all of that still costs extra money .
Because you got to go pay for accommodation , you got to pay for your U-worlds , your study material . Our tutors are going to take care of you , but the material itself you still have to go get . You have to pay for food and you have to pay for anything the hospital the program requires you to have in order to be learning from them .
So all of that , as well as the flights , right , that comes with the terrace , and so all of it's filled up . And I tell everyone , look , I'm never going to be the one sitting here trying to coerce you to commit to us financially . I'm not going to do that If you have the financial means .
What I am going to do , what I'm going to make sure I do , is get you this residency that you're dreaming for , as long as you commit to me and are willing to put in the work , because you still have to put in the work . That comes with anything in life .
Man . So okay , got you on that point . So when they're doing rotations and they're rehabbing themselves , this is rehabbing like , almost like a sub-internship , or is this more on the medical student side , or are they actually on working with residents and they're basically considered part of the team , but this is like a tryout . How does that work ?
No , that's a good question . So what I ? And that's a common question too that people ask when I'm doing my consultations . It is technically a sub-I as a graduate . So they're working with the residents and they're listening to the attendings , but the program knows that we're the ones that sent them .
So they know that we have the intention to network on their behalf , that we have the intention to nominate them their candidacy for one of their interview slots when it comes to time for interview season .
But they treat them like sub-I's because they want them to go showcase why they deserve a chance , while we're working in the shadows in the background , internally contacting the PD saying , hey , how's my , how's my candidate doing ? Is he or she putting in the work , what are her strengths , what are her weaknesses ?
And then , when I find all that information , I relay it back to my candidate on my weekly call with them , or I'll give them a surprise call and say hey , I heard you're doing really strong in this , but you're weak in this specific area . You need to step it up . Because they're not happy with that .
I communicate all of it with my candidates because I want them to know that I'm an open book and the program is an open book . They're willing to give you a chance , but you have to go showcase that you're willing to rehab these weaknesses that you have , whether it's clinical or whether it's just to showcase that your scores don't represent who you are .
Your clinical skills represent who you are , but they do get treated as sub-I's , with sort of a good asterisk next to their name that this is a residents medical candidate . So they're hoping to get an interview from us .
Yeah , sub-i's a tough though . Yeah , because I remember doing sub-I's for Jen Serge . I was at the hospital by four , leaving by seven , writing doing power points for M&Ms and all those different things . So sub-I's are no joke . I still remember that man .
So the because there's got to be people that you look at and you're like , yeah , you're not going to be a good fit . So talk to us about those who residents medical is for and who it's not for , and be honest .
No , no for sure . And that's a good question too , because obviously these people with the horrible profile come to us , right , someone with many , many failed attempts , or their scores are just absolutely horrible .
But most importantly , it's the people that are super old graduates and I empathize with them because it's not their fault that they moved to America at a later stage in their life , right , a lot of these doctors are respective physicians in their home country , but them and their family decided they wanted a better life and they moved to America .
But they're already 45 , 50 years old . Their graduation date was 1995 or 2000s , like that , and so they come and talk
¶ International Medical Graduates and Residency Opportunities
to us . What we do first and foremost is we evaluate what skills they have and if they have skills that we can use to our advantage when speaking with programs , and these skills outweigh their weaknesses on their profile , even if they're a 1995 grad , we know we can get them in . We have a chance Now with these , these horrible profiles .
I tell them straight up you are going to integrate , you're going to integrate and do the clinical work for a year straight , and I don't want to hear you complain saying it's too , it's too long of a work , because these programs I can't just set up direct interviews .
They're going to look at us like we're crazy and say why are you offering us a 1995 grad with a couple of attempts ? It's sort of disrespectful , honestly . So what we tell them is we send them to programs that are known to give old grads a chance , especially if they're a program that knows us already .
We have a , again , a proven track record of these old grads still doing well . So they'll give these old grads a chance . But it requires a long , long process of rehabilitating them and they have to commit . And it does get pricey sometimes , right , because they're not in America for a few months .
We're having them essentially move here for a year just to do clinical and they're not getting paid right . It's an externship , oh yeah .
That's the other thing . I forgot about that . Yeah , you're not getting paid , you're not being an income during this time .
No , no , they got to earn that . They got to earn that . So it can get pricey , right . And I tell them from the get go I'm not trying to play you , I'm not trying to fool you this is what it's going to take . This is the approximate cost .
If you have the financial means , we can assist you in getting your dream residency , as long as you put in the work . If you don't have the financial means , there are other avenues for you to be working clinically . It's just that residency is tough Sometimes . It is what it is .
And no doubt anybody who trains in a different country , and they've already practiced . You have to do residency again to come to the United States , correct ?
Yes , yes , and this is what I feel personally the most horrible about . You have these physicians . Some of these physicians are not just well-respected but known . They're famous in their home country . They've done big things in their home country , innovative things , and in America they don't care . These programs , the system does not care .
You can be so famous that you're consulting physicians in America , but when it comes time that you want to go practice in America , they'll treat you like a PGY1 or really a PGY0 . They don't care .
I need labs in the morning . Where's my soap note ? Yeah , that's bad , that's horrible , and is a lot of that based off of something like ? Is it just beyond like ? Is it based off of like a real bias or is there something to that ? What exactly is it that we're not trusting ? Is it the educational system we're not trusting ?
Is it just cockiness on the United States medical training system ? What do you think is the number one issue with that type of thought process , where people can be even at medical schools that are well-respected , right , like this would be an issue , right ?
No for sure . I think all of that comes into play a part , a combination . But if I had to choose one , I'm still going to choose the fact that they went to medical school abroad .
Yeah , that's a big issue .
Yeah , I think that program directors , especially older program directors , you know from back in the day they are just not going to trust someone who did not practice or get top medicine in the States . They don't care where you come from .
Even recently , it took up to recently for them to even give the Caribbean a chance right , and I've heard stories of these programs slowly not wanting to take Caribbean school students anymore either .
So it's come to a point where and we still have shortages in the United States like crazy , particularly in the Midwest and so forth .
Yeah , yeah , but recently I mean , a couple of these states are slowly starting to change their rules where if you are a prospective candidate but you don't want to go through residency , if you qualify they'll let them get their GP license a limited GP license and you can put that way , under the mentorship and guidance of an PD , of a residency .
Now I think in terms of all 50 states , it'll still take like 20 , 30 years for that to happen , but there are a few states that are considering and almost their bill has passed . So I think when you and I are a lot older , the times will be changed , but for now it'll stay the same
¶ Navigating the IMG Residency Match
. Be tough .
I know you mentioned that they have direct access to you guys through your cell phones . I'm sure you have to do some type of pickup call or like a pick me up , because that's got to be tough During this time . You're probably away from your family .
You're not sure , like we said , what's the mindset , because we already got physician burnout as a major issue , even among residents and medical students , and now you're talking about people who are spending money to do something that's not even guaranteed , at least if you're a medical school in the United States .
You feel like you're plugged along that highway that's going to eventually get you to practicing as a physician and there's no guarantees in this situation . What's up with that ? Talk to us about that mindset .
No for sure I can speak in terms of what my candidates go through , and these candidates , essentially , we've promised them that , if you come , do the clinical work and spend the time in America , away from your family , whether it's away from their family in the States or away from their family in their home country . But we need you to go .
We need you to go prove yourselves . Even now it's February , right ? They're feeling the pressure . They're feeling the pressure because it's all coming to an end . They don't know yet if they've done enough .
They start to get high anxiety , they're homesick , and it's my job to make sure that I help them along the way , especially right now , because we're the ones we as in residents , medical , we as a counselor I'm one of the counselors we're the ones who assure them that , if they go along this path , that you will end up having your dream residency announced , and
so it's my job to make sure that I take their call every night , every day , every night , whether it's once , whether it's multiple times . I'm going to talk to you .
I will be available at any stage of the day and reassure you that , although it's gonna be really hard right now and it's not even March yet , so it's gonna be really hard , six weeks up until match week and you're gonna be really stressed . But Don't give in to that anxiety and that stress , because you made it to the finish line .
And that doesn't just go for all of my Canada , it's . That goes for IMG's in general . Don't don't have a panic attack , even though if it's , you know it's natural , but don't you have to be staying calm because it's it's the last leg of the marathon .
So if you feel that burnout now when Residency gets announced next month , then you know It'll all be for nothing . And I think it's really important to say and if I'm stepping on your toes , I'm sorry , but Even if match you don't match next month , that doesn't mean your , your season is over , because soap and post match exist .
Yeah .
I've I've seen IMG's who don't get the announcement on the Monday of match week Just have a complete fallout and you know they break down and I want people that , I know that that happened to them . I tell them hey , you know you have to , you wanted this . So you have to start thinking logically and smart . Your , your time isn't done .
You still have to go through soap and these positions that don't get filled in match and soap , the , the programs have to fill them , so it's not like they just go away . So from soap up until June , these positions are still available .
So you need to do your part and make sure you're presentable both physically , emotionally and , most importantly , clinically To showcase to them . All the way up until June I've had candidates of mine who have scratched and clawed and they proved themselves . It took a while . I got them an interview second week of June . They got the residence that far in .
Yeah , and we can go .
We can . We can go even farther . It's People think the the stereotype of you need to match by March . So you start residency in July . They , they think in those lines . It's not black and white , it's really not , and that's not just for IMG's , that's for AMG's .
If you go through Twitter and you can , you scroll , scroll through the trends right now in terms of residency . I've seen so many Americans Tweet , saying and telling them their stories .
That's a good point .
You know we didn't go the traditional route . It was unorthodox . What happened to us and we're successful attendings or in fellowship . So the story doesn't end for you just because you don't match the story . It will continue to go as long as you have the willpower and the fire to do so .
Yeah , I think Twitter , social media in general , that's really taken the you know it's . It's , let's just say , used to be very opaque , the whole system , right , and you never know who went through their issues . Like I've , on my show , been very clear and letting people know that I applied to medical school twice , you know .
But to some people , like you know , depending on when you grew up and what your generation is , you know , having to reapply to medical school or not , getting into match and going through the soap process , some people may look at that as like a , like a scarlet letter .
You know , and I think that Twitter , social media , you have more people who are normalizing that . Hey , you know , for a lot of us this process is not a smooth road . Sometimes you hit potholes , sometimes you got to take a detour and you know what .
I'm much better for it , right , and you know , I think the more people that we have doing that , the better . So I'm really glad that you mentioned that , because I think a lot of people like man , it's when you don't , when you find out that you don't match , you know it's heartbreaking .
I've seen my family , I've seen my friends . You know , some are celebrating and at the same time , on the same couch , some are crying .
Yeah , you come from a family of doctors .
I have cousins and a lot of friends that that went through medical school route , whether it's as an IMG or as a as an AMG in American grad . I've seen both . I've seen both routes . So I've seen both Hurtations , both struggles and some some of it is the same struggle but a lot of it is different hmm , well , listen guys , residents , medical is like that .
We actually did an Instagram like video live Several months ago and it was very well received . I think in that discussion we were talking about Are we talking about mental health ?
Yeah .
Yeah , we're as we talk . We were talking about mental health and I kind of talked about me doing locums , which is basically kind of my way of kind of de-plugging from the system . I still may be able to take care of people , but it gives me the opportunity to be in the system and then kind of check out and so forth .
So you guys might find me in residents medical doing another live , hopefully in the future . But For anybody who wants to get in contact with residents medical , for anybody who wants to learn more , give us the ways that people can get in touch with you . You know , learn more about the organization , the company , take it from there .
I Appreciate you having me and I appreciate Everything that that you guys got going on and I can't wait to to hop back on here so we can continue to talk about the the struggles that that IMG's face , as well as doctors in general . So to get in contact with residents medical , feel free to go on our website , uh , residents medical calm book a consultation .
Our consultations are free . If you have a specific counselor you want to talk to , our counselor profiles are on the website , as well as DM us on all our socials , whether it's Instagram , twitter or LinkedIn , and if you see my LinkedIn my personal work LinkedIn feel free to DM me as well .
I'm always active on there , I'm always responding and and one of the counselors , including me , will definitely reach out to you as well and we'll schedule a free zoom for you .
How long is the consultation only take ? At most an hour .
I think on average between 30 minutes to an hour . It's really where we we get all the information , your background information provided by you , and we go over your pathway where you are currently , what is expected for you to do and how we can help you , but typically in between 30 minutes to an hour .
So when someone is working with you guys or decides to work with you guys , the onboarding process to actually Possibly being placed you know to do some clinical work or maybe even getting Mentorship from you guys officially , how long does that process take ?
so I've seen it happen as quick as two weeks where someone , after meeting with them and Typically what I do , after having a consultation , and they go back and speak with their families or their friends family friends and I Give them references .
So once they're speaking with the references and they're convinced , once they sign with us , we get them on board within a couple of days and if they're , if they're already in the states and they're willing to to fly to wherever we need them , we can get them in a clinical setting as fast as a week after that .
Oh , wow .
Okay .
So that's . That's pretty fast , depending on if you are in the United States or not .
Okay , yeah , if they're in a different country , let's say India or Pakistan , it'll take them a couple weeks to buy their flight . Because we're not , we understand the flight prices and if you buy a international flight a couple days prior is gonna cost you a pretty penny .
So we tell them don't worry about it , take the two to three weeks to get the price back to normal , and then , once you fly out here , then you'll be ready to go . But don't they have to get like a visa and all that ? So most , most of the candidates of ours should at the very least already have a travel visa . Be one , be two .
If they don't , then we assist and we have immigration lawyers that are friends of ours and what sort of expedite the process To gain them the travel visa , which has happened for sure .
Friends in high places . I see I see , okay , okay . Well , everyone , that's dr Simrod Gill , representing residents medical . Listen , these are your folks . If you are an IMG student or IMG graduate and you are looking for placement in medical residency or in fellowship , this is the organization , this is the company that you want to align yourself with .
Listen , we will put the show notes on how people can get in contact with you guys Below if you're watching on YouTube , or it will be in the show notes if you're listening on the podcast . But , once again , guys , if you need help and you're an IMG student , this might be your lifeline that you need . Dr Gill , thank you for your time .
Everybody I've residents medical . We appreciate you collaborating with docs outside the box . And listen , guys . We're going to catch you guys on the next episode .
Thank you for having me , and I appreciated this .