How an IMG Went from Medical School in the Caribbean to Matching in a U.S. Residency Program

 

I had the opportunity to sit down recently with one of my favorite IMGs I know, Dr. Tamer: a practicing physician out of Southern California. Dr. Tamer helped shed some light on a number of helpful concepts for any IMG looking to match in the Residency Game these days.

Topics Discussed:

• Importance of your board score
• Selecting the right programs during the matching process that fit your skills and experience
• Tips and tricks for acing your residency interviews
• Overcome the barriers of being an internationally trained doctor during the U.S. matching process
• How to get an internship as an internationally trained doctor
• Pros and cons of going abroad for med school for U.S. residents
• How to strategically rank residency programs
• How to choose a specialty
• Importance of not giving up hope
• and more . . .

Interview Transcript

Kevin: Hi there, I’m Kevin with GME Prep, and I’m joined here today by my good friend and practicing physician, Dr. Tamer, who is a practicing physician in Southern California. And he’s gonna join us and talk today about his experience with matching going through medical school abroad and the whole process that a lot of you guys are going through and you need to know about.

Your story is, you went to undergraduate in the United States. You obviously grew up here in Southern California. But you decided, you went to, where did you went to underground? And where again?

Dr. Tamer: I went to UCI

Kevin: You went to UCI.

Dr. Tamer: University of California, Irvine in Southern California. Yeah, it’s a good school.

Kevin: And afterwards, I think you were thinking about medical school. When was it that you knew you want to be a doctor?

Dr. Tamer: You know, I wanted to be a doctor since I was very young, like I was in 5th grade. I always loved helping people out. And I always loved and was fascinated by biology and how the body works. So, you know, that passion along with the prestigious job of helping people out as a doctor, you know, I was always in love with that idea, and I was just drawn to it. You know, my whole life, I’ve been always…

Kevin: Are your parents doctors?

Dr. Tamer: No. Actually, my dad is an accountant, my mom is also an accountant.

Kevin: So, what’s the something that you felt really connected to and that you really want to go in the medicine?

Dr. Tamer: Well, definitely yeah.

Kevin: So, you knew that time, had you always, when you went to undergrad, you had been thinking pre- med the entire time?

Dr. Tamer: Yes, I was. Yeah. From freshman year, you know, I have many friends who are actually in the UCI med school at that time, and they would give you advice and what not and what to do and all the different routes to becoming a physician.

Kevin: Yeah, and so when did you decide that you’re gonna go abroad to medical school? Cause I knew you had a lot of choices. You could have stayed in the US. What was the deciding factor or you?

Dr. Tamer: I have many friends telling me, many friends and knew other people that want that route as well, and they told me that it was quicker to go to. And you get pretty much the same education in terms of the professors, US medical doctors here that go to teach there. And particularly, the schools in the Caribbean, you know, Ross and St. George’s, those are like the two big schools there, ones that had a lot of rotations in the US. And so, those would be the preferred ones that my friends were, you know, recommending to me as a great option to go, and would give me the opportunity to come back and be a great physician and get the residencies that I wanted.

Kevin: And so, you went to Ross, which is on..
Dr. Tamer: I went to Ross University. It’s on Dominica.

Kevin: Ok, Dominica, which is nice. I mean a nice cherry on top is that you’re going to medical school, but also in a very pleasant and beautiful environment.

Dr. Tamer: Definitely, it’s a beautiful island. But really, you’re really just studying all the time and they have really great professors there and the student professor ratio isn’t so high. So, yeah, it was a good experience, and medical school is hard. It’s the same material you learn there as you learn in the US, you know, identical when they follow the same shelf exams and the end of the theory exams and the preparation for the board are the same. And the professors are all, actually, all of the professors are professors that are teaching in the US med school. They go there to teach a certain course that they specialize in. They really get the best guy at this field or that field, teaching you infectious disease and this and that path of physiology.

Kevin: Interesting. So, how many of your classmates were, again, US citizens or whatever who grew up in the US versus those who have actually, are those folks who’ve come from abroad, even outside the Caribbean because they eventually want to go to become a doctor in the US?

Dr. Tamer: Yeah, they were, but the majority of them, that’s a majority of US citizens who have graduated from Biology degrees in US schools and they went, they applied to Ross or St. George’s. And there were like maybe 20 percent who were from other countries, like England or Ireland or other places all over the world, India. But a majority of them were from US.

Kevin: Now, we talked a little bit about the benefits, the pros and cos of going the route that you went, when you have decided that you’re going to US medical school or going to the route you went, you’d mention that some of the benefits was that it was a little more like a fast track to get through or get started

Dr. Tamer: Fast track to start, really, to begin with. Yeah, but still, it’s about, it comes out to like, the school is still four years. You can start quicker and so uhh,

Kevin: So, there is rotations that . . . what was unique about Ross and some of the schools in the Carribean is that the rotations are still done in the US, on the Mainland, right?

Dr. Tamer: Actually, 95 percent or more of the rotations. The 3rd-4th year clinical training rotations were all done in US hospitals, you know. And the advantage? We have a wide variety to pick from. You can go in California, teaching hospitals in California, New York, New Jersey, Texas, all over actually. Yeah, we have a lot of advantages to that.

Kevin: Alright. Ok, as you are going to medical school, obviously, the boards come up with steps. Can you talk a little bit about what the experience is like and preparing for those in med school.

Dr. Tamer: Oh, yeah. Definitely. Step one is a really tough exam, and step one is the first big test that you do on which the residency programs look as the criteria to determine your standing in terms of offering an interview and a spot. So, definitely, preparing for that requires a lot of studying and what not. You do it along the way your classes and what not cos they focus on me and the two big classes that you have taken in the first two years of your medical training. So, Ross offered a lot of preparatory courses for that. In general though, if you don’t go there, you can kind of prepare along the way with a study review book, and there’s various programs, Kaplan and others, reviews you can sign up for to study questions and everything while you’re doing your regular exams in your courses. And the courses and all, they kinda prep you for the board. So, they include or incorporate that material into the regular test.

Kevin: So, right there you wanna end up, and so you kinda

Dr. Tamer: Exactly. Yeah, they wanna gear it so it’s standardized towards the step one exam. The step two, you do that after you pass step one. Then you start your clinical rotations. You can’t start your clinical rotations if you haven’t passed step one. So, it’s a like a write-off passage to being able to go on to the next step. And the next step is seeing patients hands on, so you kina have that background book knowledge of the diseases and what not because you can see the patients. And on the step two, you take that during or after clinical rotations, which are done during the 3rd and 4th year of medical school training.

Kevin: So, let’s go back to that time when you had just finished up medical school, finished up rotations in the US. You graduated. You’re living Dominica going back to Southern California. I’m guessing, is that where you went? What was that like? And what was on your mind about what was next?

Dr. Tamer: You know what, a lot of my rotations were in Southern California actually. So, you know, I get it all over. So, I was already back there doing my rotations. But yeah, most people, they are applying to the residency spot last year. You know, me, I took a little year off, push in time. It was a little less than a year actually. So, during the application process to do interviews and what not. So, that was the time when I was doing,

Kevin: Was that a common thing?

Dr. Tamer: Yeah, it’s a common thing. To have a six month push in time to travel, cos you are either travelling during your rotations, which can be tough. But people do that. That’s a typical thing to do as well. And they all just take time off to accommodate for that interview season, to have rotations that are easier to do, have lax schedule and school works on that. When you finish that 3rd year up , and then, you’re applying to a residency a year that you’re off, which gives you more power to focus on the application process and the what not.

Kevin: Ok, So, you said you spent about a year off. Where did you go by the way? The trips. Dr. Tamer: No, I was just doing a, I did like research and what not. So, I was doing research Kevin: about where you wanted to go
Dr. Tamer: I was doing a research in a medical school here. USC.

Kevin: So, during that year that you took off, you mentioned you were doing a research. Can you tell us a little about what the research was? And also, why did you to that? Was it to help build that application? And how did that go?

Dr. Tamer: Oh, yeah. Definitely. I was doing the research during med school, during my 4th year of med school, while I was doing rotations here in Southern California. And so, I was in USC doing a nephrology work, studies on like anti-clotting agents and what not. It was a very fulfilling research. And then I just extended it after I was done with my 4th year of med school. I did that because I was doing my time-off as well. I didn’t do it to straighten my application because I already did a 4-year of it in my 4th year as well.

Kevin: So, you actually just wanted to continue. You enjoyed it?

Dr. Tamer: Yeah, I enjoyed it. It was just part of my routine and what not. It was helping me too, in terms of residency and what not cos it was hands on. Kevin: Right.

Dr. Tamer: Patient training and what not.

Kevin: So, in terms of the research project, can you tell us a little bit about how you got that position. What actions did you take? Cause I knew that’s an issue a lot of people face, is they don’t know where to begin, who to reach out to. What are some of the first things you thought?

Dr. Tamer: Well, you know, I just looked on the internet to find different research facilities in the nearby area that I wanted to be in. For me, it was in Southern California. And so then, I looked on the internet what side they tell you to faculty during a research and what field of research they’re doing and you just contact them and e-mail them and tell them, hey, I’m in the area looking for some research in this field I’ve interested in and then they e-mail you back or call you back. It was a too bad finding. And then, you just work out your schedules of them, if you’re doing rotations at that time or if you’re not.

Kevin: How many hours a week did you do when you have that year off?

Dr. Tamer: You know, I would do like 20-30 hours a week. It wasn’t too bad actually. And that was all the same during my rotations as well, which is kind of tough doing that rotations. You have to work it in with the hours. There was actually a lot of foreign grads that were from my med school. They didn’t do rotations in the US, but they were doing research with different professors. So, some students go to, if they are from a foreign country. If they are Indian, they go to different Indian professors. If you’re Egyptian, like I am an Egyptian, I knew some Egyptian professors. And you kind of click with your own nationality. So then, you go that research and you see a whole bunch of other Egyptian people there, or a whole bunch of Nigerian people there who come from Nigeria, or Indian people, you know.

Kevin: Take advantage of that connection you have.

Dr. Tamer: Yeah, that connection, cultural connection. And in fact, mine was a mix. We had Indian individuals, Nigerian all over, you know. So, yeah. And then you just do research, and while you’re doing that, you’re, some of the foreign grads were studying for their step one, which is the biggest thing, studying for that step one. Some of those foreign grads takes years to study for, either because of the language barrier, or it’s been years since they graduated in med school. That’s where the biggest barrier is, the step one score and then how many years since you graduated because the migration process here takes such a long time, they may take years off since the time they graduated med school and then they’re just trying to find a living here and get established here, situate here. And then they start studying for, I mean they’re studying for years because the material, they forget and it’s a different test, different language and what not. So, those are the barriers of getting into residency here. And then, of course, the English skills for some individuals, their English skills isn’t that good. It takes some, and then they come here, it’s a new country, so, yeah, it takes a lot to get used to that.

Kevin: Did you see people make a progress to that when you met them at the beginning of their project, or whatever after a few months you saw them? Are some people adapting better or are getting a hang of it.?Did you see anything?

Dr. Tamer: Well, definitely, definitely, especially in my med school, they had foreign grad, people from foreign countries there, their English is varied. There is accents, British accents. Is that you know, I was able to see them through the years and do the same rotations with them and then some even residency, you know. So, I knew them since med school or in residency, I would meet them at a conference or something. Oh, I went to school with you years ago. So, they’re completely acclimated to the environment and the setting and doing great as physicians. So, definitely, being a doctor here, you’re just used to seeing doctors from multitudes of different countries, different cultures, and backgrounds and practicing. That’s just a typical thing.

Kevin: So, when we talk about the most important things for residency, one being the score, you mentioned, the other obviously being how long it was. What kind of score do you think is the absolute minimum or is ideal in terms of. .

Dr. Tamer: So, you know, getting into residency, you really care about passing step one. That’s very important. There are people that they do really well on step one. They get high scores like 220, 240. Those are great scores. And then they get the pit, the residency selection of the choice, the higher the residency, they set higher scores. There’s a residency program, like lower scores. But as the years are going by, it’s gotten more and more competitive. Back in the day, in the early 2000’s, you could get in even other people failed in step one a couple of times and still got residency, you know, by getting a good step two score or taking the step three, which you don’t have to take until you’re not obligated to take, to get into residency, you could take it during your residency, which a lot of people do. Some people didn’t do well on their step one or step two scores, they take the step three score to show the residency program that, hey, they are competent enough to pass the step three cos step three is actually, you can’t graduate residency until you pass three. So, for some residency programs like psychiatry program where they kinda lose the internal medicine knowledge that you have to know to pass step three, it may be more challenging for them. So, they decided to do to have a tougher time passing step, and they make multiple attempts to pass residency for the step program. And sometimes, some residency programs just drop them from their residency because they can’t just pass it. And in fact they have a limit. Most residency programs, actually all of the residency programs have a limit now. That has been going on for a long time since 2007, 2008, 2009. And so, many people just couldn’t do it.

Kevin: So, the third attempt, for some people or some applicants looks more attractive because it looks like a guarantee of, I’ve already passed it. And so, in a residency program, they can see it. They don’t worry that the person has to

Dr. Tamer: Not the third attempt, but the step three, passing that is a bonus for them, especially if you’re a foreign grad, that’ definitely a plus. But they really care though on step and step two. A lot of programs, they do just cut off, did you pass it not? And then they throw out that application, you know. And so, it is very important to pass step one. And then the tougher programs to get into, they have a minimum score: 220, 210, 200.

Kevin: What else do you think makes for an attractive candidate for a residency program? If you have already passed these 1 and 2, you’ve obviously shown your competancy in terms of your knowledge, but that does not necessarily translate to being a successful doctor, an effective doctor. What else do you look for in a candidate?

Dr. Tamer: It’s good that you bring that up because many foreign grads are very smart, they really do good on that step one or step two exam because they studied for many years, you know, they’re just really smart. They have high scores, and residency programs, they’re not sure about these people, they don’t know if they’d cut it as doctors cos they didn’t do resident rotations here in the US. So, they’re not sure how they’re gonna do. They’re not sure about their English skills and what not. So, another very important aspect is to getting into US programs here for foreign grads is, did you to rotations or internships in the US? And, of course, your interview is very important as well. Your interviewee skills, you know. Are you competent in English? Can you communicate well? You know, it’s ok if you have an accent. That’s fine, but as long as you’re able to communicate well, very assertive, have good people skills, good listening skills. But even the interview can be misleading, they really wanna know you fare with the patients in the US hospital and how you do well with clerkships and internships. So, doing that is a key for US grads or foreign grads getting in. Like myself, the benefit of going in to a Caribbean school and also St. George’s is that you do clinical rotations in hospitals here and you get graded by US doctors here, professors here. So, if you’re a foreign grad, what you wanna do in addition to getting a good step one and step two score, and in addition to doing a good interviewee skill is to apply to clerkships or internships here, whether they are paid or unpaid, either one, so long as they could give you a 4-8 week experience or more. The more. the better. The more evaluations by those professors here in the US, those teaching doctors here in the US, the better, the stronger your application will look. And so, that’s definitely something to get in on that will put you above the other applicants who may have the same scores as you. That will be applause.

Kevin: It shows that US experience, it’s so important.

Dr. Tamer: Yes, definitely, it’s truly important. Another bearing that you have when you apply to do the clerkships, you have to have insurance, you know, to cover your – cause your going to be seeing patients. So, they want the most hands-on experience. So, in order to see patients, examine them, get a good history from them and physical from them and get information from them to present to your attending physician who will grade you on how good of a resident you’re going to be. That’s kinda like your residency, that’s what you’re doing as a resident. You’re a doctor. You’re seeing and examining the patient. You come up with a treatment plan and you present that plan to your professor, your attending physician. And they seek, they question you, they ask you to make sure you know everything, a comprehensive evaluation, evidence based medicine on how to diagnose and treat these patients, and rule out important diagnosis and what not. So, they’re gonna be grading you on that. So, basically, the clerkship and internship is like pre-cursor, it’s like the training ground to being a resident physician, so how good you’re going to be a resident physician depends on how you’re going to do in your clerkship. Or for us, Caribbean grads, how you did in your 3rd year, 4th year clinical. So, that’s very important, what evaluation you had, what program you went, very important. But in order to do that, you really need to, the application process involves getting insured and what not and their availability, their spots. So, there’s a lot of people applying for those clerkships and

Kevin: So, it’s pretty competitive for those sometimes.

Dr. Tamer: It can be competitive, especially with the paid program, most of them are not paid, most of them you actually pay them for those insurance and everything. It can be a little expensive. Yeah. But it’s a money well-spent. It’s worth doing that getting the experience. Both the experience and then it’s like a grade showing them that, hey you can perform as a resident. That’s where you’re gonna be doing.

Kevin: So, in terms of your experience, how many schools did you apply to for residency? And how many did you interview?

Dr. Tamer: Many schools. If you’re a foreign grad, you wanna apply to as many schools as possible. You know, there’s people who really great scores, high scores, so they have a power to narrow their school number down or smaller number. Yeah, I mean did like average or little above average. I passed my steps and everything on first attempt. I did fair in it, you know. I didn’t score exceedingly high though, like some people. So, for me, I did wanna apply to as many schools as possible.

Kevin: So, could it be, the more schools you apply to, the more costs it’s gonna be. How do you know if you spent too much? How do you know if you’re applying to too many schools? I mean, It’s a balance, right?

Dr. Tamer: Yeah, definitely. It depends on how your application looks, how your boards scores are, did you pass your board, or your scores are flying scores. Or your scores are just barely passing the step one and step two scores. Or if you did good in your rotations, you did good in your medicine training. You had a good GPA. That’s important too, they care about your GPA. You know, I you failed on the class, that’s really bad on the application and transcripts. You have to explain that. So, definitely, if your scores are average, you wanna apply to as many places as possible. And you wanna look for the programs that are more accepting of foreign grads. And you can look that up on the internet. There’s a website, scutwork.com, all these different sites that tell you where to apply to. And also, you can just do your own investigative work. Be Sherlock Holmes yourself. Look at each program, look at each of their graduating class of residence, see where they graduate. Look at their bio and everything. That’s how I did it myself. And see which country where they’re from, what school they’re from. And you can look at the ethnicity of the programs as well. If you see a lot of program for Egyptian people, and you’re Egyptian too. That can be a plus for you, you know. And so, there are various ways to go about picking programs.

Kevin: So, when they go to the websites and see actual pictures on, just read the text.

Dr. Tamer: Yes, definitely, especially if you’re an interviewee in that program, you wanna know about the program as much as possible. And it strengthens your application. You know, it’s good if you’re foreign grad and you wanna hone in to programs that you wanna go to. And you wanna do in your rotations there, you know, do internship or internship. Pick the programs that are friendly to foreign grads and also offer internships and clerkships in those programs. So, when you apply to their internship or clerkship, and then you get in good with your program director and their attending physicians, their teaching physicians. They know you. They know who you are. They know what you do. So, then, they know, hey, you’re gonna be a strong resident after program. So, then they could rely on you and they may rank you high in the ranking process. Or they can even offer you a spot outside the match, which many applicants do to secure a spot because the match is like a gamble. It’s like the NBA draft, you don’t know who’s gonna, you rank some, you rank the programs in a certain order to your most favorable to your least favorable program. And then, they rank you from most desirable applicant to least desirable applicant. And, of course, if they don’t rank you, they don’t have a shot there. And if you’re not gonna rank them, you’re not gonna get in there.

Kevin: It’s kinda a contender, isn’t it? Who knew?

Dr. Tamer: Exactly. Yeah, who knew? But if they favor you, the applicant, it doesn’t favor the residency program much. But definitely, you wanna apply to as any programs as possible. 5200 programs, if you really wanna do that. It’s not that expensive. And it’s definitely worth doing. And your competitors are gonna be doing the same thing, you know, applying to as many programs as possible to maximize your hits, cos you definitely wanna get in, if you don’t get in, you’re not gonna be getting any residency positions, you know, unless you go through the route of match day, a day of the match of the people. There are certain number of programs that don’t get filled. And so, those programs now do a separate rank application process to try to fill their spots. So, then it becomes, that’s a whole of another..

Kevin: that’s a sort of a back-up.

Dr. Tamer: That’s a sort of back-up. You don’t wanna be in that situation although there are, if you are an applicant with high scores, you can actually come out favorable on those days because there are good programs that don’t get filled for a certain reason because they are very strict on who they give interviews. So, they don’t give enough interviews out. That pool of interviewees they rank other programs higher. So, they have a couple of spots unfilled in their prestigious programs and they’re sought after programs and they need to fill someone. So, if you are a strong applicant, that day, you can make that day gold for you. But it’s a scary scenario, yes. It’s a risk because then if you don’t match, you don’t match. You’re done for that year until next year. So, it’s always better to have, like me, I have at least ten interviews, or 11 I think, 11 interviews. And most of the programs are pretty strong in matching in, a couple of them more like reach places. They just offer me the interview, but the other applicants are stronger than me, they have higher scores, and scores really are the most important thing. Hands down. Second is the experience here, during the rotation, showing them hat you’re competent practicing in the US hospital interview.

Kevin: With you interview, can you talk a little bit about how did your interview go? What things came up? And what were some of the questions that remembered? Do you remember and questions to that.

Dr. Tamer: You know, of course, the usual typical questions like any interview has like, why did you pick medicine? Or are you good with people skills? Are you good with, are you caring with patients? And then there are those programs that you know have good interviewers and they try to ask you some medical related questions, see how experienced you are because they don’t have the benefit of having you in a rotation program to see how you do. So, they’ll ask some clinical scenarios.

Kevin: Any clinical scenarios.

Dr. Tamer: Definitely. What do you do? There are two patients in the hospital, two in the morning, sits up complaining shortness of breath. You’re called as the on-call physician, what do you for the patient? What test do you wanna order? What is your type of diagnosis for the patient? What do you wanna give right away for the patient? Patient with shortness of breathe. See chest exacerbation and giving some lasix, dosome blood test. You do some x-ray, you know, some basic stuff like that. It’s good to familiarize yourself with that.

Kevin: They’ll see if they can go through these?

Dr. Tamer: Yeah, they wanna if have the real deal. If you don’t look like you know what you’re talking about, they’d think, oh, it’s gonna be a bad resident, you know, cos some programs are like, other programs, they trust your board scores and they don’t do that. And some interviewees who have good scores, they look like that, that that’s like an insult. You have my score. You have my med-school and rotation scores and clerkship scores, I don’t like that you’re doing that, you know. You must have a lot of people with high scores, but did bad in your program. What does that say in your program? Some foreign grads will act that way.

Kevin: ..will take it that way. Why this thing to show that though

Dr. Tamer: Definitely not, unless you’re a strong applicant who has many interviews and you’re gonna match somebody. For sure, most people don’t fall into that range, and so you definitely want to be a good interviewee. And that’s also a good thing to do being a good, having a good interviewee skills is very important when you’re with patients, you know, how emphatic are you to patients, how well you listen and understand what they’re telling you because most of the time, most of the diagnosis is from what they tell you. It’s not what you’re thinking, you know. And so, that’s a very important thing for a physician, to listen and be a good listener.

Kevin: Yeah, not just making conclusions without listening to what they’re saying first. Dr. Tamer: Definitely.

Kevin: I wanna attest to that. We talked a little bit about mistakes people make as foreign grads, what would you say to, you mentioned a little bit about choosing in terms of what specialty you’re going for. Can you talk a little bit about that.

Dr. Tamer: Definitely, so when you’re picking what you love to do, of course, you pick medicine not for the money. You picked it because you love caring for patients, you love to interact with your patients, or that should be the reason you want to mess it, or else it will show that it is not what you like. So, the love and passion for the medicine and the science behind it, the disease behind it, that motivate you to research and do all the things that are necessary to be a good resident. And as a resident, you’re gonna be a good physician and have good people skills, or you also have to research things that you don’t know, or knew treatment modalities out there for different diseases. So, that passion drives you to do that, you know. And so, that’s very important as..so, the same thing to becoming a doctor, that passion for medicine is also important that’s what you wanna do in residency. You know, some people have a passion for surgery or ophthalmology, they love the study of the eye, or some people love the study of kidneys, nephrology, they want everything about it. So, that love drives you. So, that’s important. But in addition to that, also knowing what, knowing your risks of every field, you know. So, if you know, you aren’t good at hands- on, but you’re in surgery, but you have very high scores and you’re friends tell you, yeah, you should go to surgery, they make a lot of money. It’s a great, it’s a fun lifestyle. You love it. You’re impassioned by it, you’re into the whole lifestyle surgery but you’re not very good at surgery, it can be a very risky thing. And you may waste your talent and high score on the program. You might get kicked out on the program at your first and second year because you can’t just cut as being a good surgeon. So, you will know that when you do your rotations. So, that’s very important to take advantage of.

Kevin: Have you met anyone like that?

Dr. Tamer: Yeah. I did. Definitely. Definitely. A lot of people apply to family medicine which was I went to were surgeons who didn’t cut out as surgeons, in their surgery residency. They have high scores, so, they look favorable to the family medicine programs for the high scores. But then, the family residency programs kinda caught on when they’d see that you’re a surgeon. They kinda would get the idea, well, that maybe this person, family wasn’t their first choice. And hence, maybe, they’re not gonna do good in family medicine either. You know, we shouldn’t be fooled by the high score.

Kevin: Also, you spent a lot of time on the other residency now.

Dr. Tamer: So, that’s another thing, you know. Residency programs, they get funded by the government. So, they have a certain number of years they could spend on the resident. So, if you did one year already, you have four years to get money from the government through the residency programs. So, if you use one of those years, you only have three years left. So, you’re kinda limited. So, if you’re going to a family residency program and you wasted one or two years, you just kinda shot yourself on the foot. And they can’t complete your residency there because they won’t get paid by the government. I’m not sure if all residency programs are like that, but I think most of them – at least the one I was in – so that’s a big deal. If you waste two years and don’t do residency and you’re trying to laterally match to a residency program, you know as a second year position spot, it may be tough for you to do that.

Kevin: Choose wisely. Yeah, absolutely

Dr. Tamer: Of course, if you don’t do good in that residency, of course it looks really bad on your programs. So, that’s why you really wanna know that you’re gonna be successful in whatever you’re gonna be doing. So, you wanna know inside that and focus doing in your 3rd, 4th year clinical rotations, you wanna do a lot of, they give you a lot of electives to focus on what you’re gonna specialize in. And so, you really wanna fill up those elective spots with that special thing you wanna go into. If it’s surgery, do a lot of electives in surgery. If that’s family medicine or internal medicine, you do a lot of internal medicine and family medicine.

Kevin: If you’re not doing well, take a feedback, take action before it’s too late.

Dr. Tamer: Definitely, cos they don’t know how good of a resident you until you go in there and if you don’t do well. And some programs are tougher than other programs. Also, doing the background in your program is very important. Know when they usually match in that program. You may be a resident with a very high score, and then you go to a very prestigious program and their grads are Harvard grads, they have hig expectation, they have a reputation for being tough and for cutting people.

Kevin: Real quick with the schools that say, they’ll accept foreign grads so much more all the time, right?

Dr. Tamer: Well, definitely. They say one thing on the nerve, but it doesn’t mean that you’re gonna get in. They may say they’re friendly to foreign grads, but they have one foreign grad. So, really, it’s hard to say.

Kevin: Did it really concern you as you’re going out when you had already seen other graduates from your school match?

Dr. Tamer: So, there’s probably one aspect, I know I can at least make some and I’ll be accepted to some programs. There’s a good number of them. So, how much of a concern was that for you that you have that a bit of obstacle? You know, most of my fellow students, they don’t match in programs. Cos it was a matter of matching what they especially wanted to, the harder sought fields, you know. I didn’t know that many people didn’t actually match at that time. So, I know the number of people don’t match that was growing and growing yearly as there’s more applicants year-by-year. But definitely, yeah, that was also a concern from day one, actually, going that route, definitely trying to improve and enhance my step one, step two scores, do well on my clerkships and my interview skills as well. So, those are all important things that was always in the back of my mind when I was going through med school and rotations. So, yeah, definitely, it was definitely challenging for a grad, an IMG to a residency here or a residency of their choice. But also, there are factors playing into the scores. If you have high scores, you’re probably get into the program, definitely, you can say that pretty safely. Now, it depends on how you did on your rotations. Did you do clerkships, so those are all things that make you better, stronger as an applicant and will kinda seal the deal for you, the icing on the cake in terms of getting into the program of your pick.

Kevin: Dr. Tamer, you have given us so much incredible advice today. I know a lot of the IMGs watching our issue, I so appreciate is especially as a fellow IMG yourself, you know to talk from your experience, to give them these hints, these tips and tricks. Now, if you could give one parting piece of an advice to an IMG who’s just ready to match in the next years, so they finish medical school, a little concerned about the process. What would you say to them?

Dr. Tamer: So, I would say you have to be confident and optimistic and positive and believe in yourself, definitely, that’s very important because the process is very laborious and long and unpredictable. But you have to have the confidence in yourself that you can do this, and to be patient with it as well. And then, of course, ask for help from various resources: from friends, from colleagues, from people who live in the US and people who are practicing positions here. You know, there are many people who would love to give an advice and help. And that help will definitely make a difference in getting into a program versus not getting into a program. So, being very resourceful and persistent about it and never give up on your dream and your goal You know, I’ve seen doctors try and try for years and years and they finally did it, they finally got into a program and now they are practicing positions. And many points in time, in their attempts, there are many failed attempts, they could have given up and quit from the advice of their friends and family and just financial constraints on them, this and that. They wanna go back home and what not and not fitting in to the new environment. But never give up in that drive and desire. That motivation will get you to your final destination and make you successful. And you can just talk to so many people who had that same struggle and they might have them even tougher back then than the time when they didn’t accept foreign grads. And they are so persistent, and so confident, and so optimistic and positive- those are the key things you have to be and just never give up on that dream.

Kevin: Really loved it. I wanna ask you one last thing.

Dr. Tamer: I never gave up on my dream. I’ve always wanted to be a doctor my whole life. And sometimes, it was tough in undergrad. Maybe, I didn’t get the best scores in undergrad, in my undergraduate training before med school, but I never gave up. And the people around me told me, never give up. You could be whatever you wanted to be. I always believed in that. And that drove me to go to med school anyway I can whether it’s foreign route or whatever route, and that drove me through med school through all the various, you know, going to med school and seeing other people fail their first year, do not like being in the island that I studied at, so they went home because they didn’t have a subway there, some other silly reason. Never giving up. I just, being tough and having true grit and driving at what you’re striving for, and just never give up. That was the big difference in my outcome that I want to impart to.

Kevin: I can feel it. I can feel your passion. And I just wanna thank you on behalf of Jimmy Kraft and also on behalf of all the IMGS out there that were listening. I think you’re gonna make a big difference with telling your story. Thank you for coming up and talking to us today.

Dr. Tamer: My pleasure.

Kevin: You’re lovely. Thanks a lot.

Dr. Tamer: You guys take care.