Hello, again!

February 25, 2014

Hi, Readers,

Checking in again, as promised before the Match. Has been an interesting few weeks at home; took a while to settle down as this is the first time since 2009 that I haven’t had something pressing to study for/apply to–no board exams to prep for, no semesters to shop for, no rotations to set up. It’s a good feeling, relaxation, but I’m still nervous about the upcoming Match. I’ve gotten good news from many of the programs with which I interviewed–correspondence that they will be ranking me, which is great to hear, but it makes my ROL decision tougher. While I haven’t changed my original Rank Order List since I certified it shortly after my birthday, I think about changing it daily, sometimes hourly. There are so many factors to consider: location, program size, available fellowships, program reputation, graduate placement, research opportunities, facilities, gut-feeling, program director and faculty, call schedule, patient population, benefits. My head is swirling.

I’m facing the last big hurdle a student from the Caribbean must face. There’s a lot of nasty opinions and forum posts out there about how Caribbean grads never match and how there won’t be enough residency spots available in the coming years to support Caribbean grads.

I think it’s clear at this point that I will match somewhere, but now my dilemma is where to go.

A big concern of mine when choosing a Caribbean medical school was California approval. Ironically, I ended up going to a school which has not been visited by the California inspectors yet, but is not on their disapproved list. While I’m not pursuing a program in California, their list has had an impact on the licensing requirements of many state boards of medicine. I’d found comprehensive resources back in 2010 which stated that most of the states I was interested in settling down in, were not specific about IMG requirements in order to obtain licensure. Some states require careful scrutiny of a student’s Core clinical rotations and require them to be completed at a hospital either directly affiliated with a medical school or at a hospital in which there is a residency program in that field (“Greenbook”). Others are fine with core rotations which have been completed at a hospital which has residencies, but not specifically in that field (“Bluebook”). Some states have no requirements at all, as long as a student has successfully graduated from a medical school, has completed his/her clinicals in the US, has ECFMG certification, and has passed the USMLE Step 1, Step 2 CS, and Step 2 CK exams. My research back in 2010 revealed that most of the states in which I was interested, fell into the latter category–there were no requirements.

During my 3-week hiatus, I took the time to contact the State Medical Boards of some states that I had interviewed in, just to make sure that things hadn’t changed and I wouldn’t have a problem obtaining licensure there, only to find out that they had changed their requirements. Uh oh. It’d be horrible to match to a great program and then not be able to go there because the state won’t recognize your clinical training and therefore won’t license you.

I’m waiting to hear back from the folks in my school’s clinicals department–surely they have dealt with licensure issues in the past and can offer some insight. Kind of coming down to the wire, though, since ROL’s are due at 9:00 this coming Wednesday. Might have to change my list and go with a more conservative option in a state where I know I won’t have licensure issues. #thoughtIMGproblemsweregone

Will keep you all updated on what I find out.

7 Responses to “Hello, again!”

  1. Becky said

    Just wanted to thank you for always taking the time and effort to update and share such valuable Caribbean IMG information. I go to MUA as well (just completed Step 1 and waiting to be placed in rotations) so I find your blog an incredible source of what I can expect in my near future.

    When I was in Med 5 and also while studying for Step, I read your entries on your Comp and Step experiences back in 2012. You writing out your experiences truly gave me a sense of comfort like I was not alone. Again, a huge thank you for doing what you do!!!

    • jenningers said

      Hi, Becky!

      Great to hear from you and congratulations on getting Comp and Step behind you! I’m so glad you’ve found the blog useful! We learn, early-on on the island that you have to take what most of your classmates say with a grain of salt, because they’re usually lying or at least exaggerating, but it’s only when you leave the island that you realize you’ve grown accustomed to hearing from them and drew comfort from hearing their reactions to what was going on in our little world of academia. It’s a little like in the 4th Harry Potter book/movie where Harry goes from the loud cheering and bright colors of the folks outside of the third task, the maze, and then enters the dark, monochromatic maze where there’s this eerie silence and he’s suddenly all alone with only unknown challenges ahead of him. We go from being surrounded by anxious, opinionated classmates to silence, even on the social networks and no one’s really in a hurry to tell you what’s coming next, or even if you pry it out of them, they give you vague generalizations at best. Folks delete facebook and don’t return emails under the guise of “I have to study!” but then time passes and you start to wonder if it was really “to study” as they said or because they failed comp or keep postponing their Step because they’re scared or run out to take a review course after a practice test doesn’t give them the results they wanted. Then the rumors start. “OMG did you hear ____ failed comp and has to go back to the island?!” “Clearly ____ cheated if she made a 90 on the comp but then failed her Step!” There are some people, either because we got split up and sent to different clinical sites or they deleted facebook and then must have de-friended me, that I have not seen or heard from since leaving the island. It’s sad, really sad because you spend 2 years really closely interacting with these people and now have no idea what has happened/will happen to them.

      The happy news I have to share is that you will make new friends once clinicals start. Even though the classes seemed so separate on the island, you end up doing rotations with kids who were semesters ahead of/behind you as well as kids from other schools, and you realize that you still share a commonality with them–this great unknown that you’re adventuring through, together–and you bond and become good friends like those folks you knew so well on the island. Except this time you get to bond over exciting North American comforts like café trips and mani/Pedi’s between rotations, browsing Barnes and Noble together while looking for Step 2 study books, and having on-calls together where you laugh about the stupidest things at 3:00 in the morning after your 8th admission.

      Clinicals still have that slight air of cut-throatedness that existed on block weekends on the island, but everyone is at different points in their clinical progress and they all have different goals, so it really just comes off as intimidation and envy. It’s pretty scary the first time you meet someone (during one of your first rotations) who is matching that year (and they tell you everything they’ve done thus far), or when you get down-time during that first rotation and you sit there with a giddy look on your face because you’re just so excited to actually be in a hospital and there are all these late third-year kids around you who simultaneously whip out their Step 2 Secrets book and start reading and growl at you when you ask them where they’re staying–then you feel awkward and confused because you’re still on vacation-mode after just studying your butt-off for the Step 1 and have the gut-wrenching realization that you have another hurdle to study for which feels years away but in actuality is only a few months away. Don’t worry, we all have that feeling and then rush out and get a Step 2 study book to carry around with us just so we look normal. I think that feeling is a right of passage into clinicals, but then you realize that there are, in fact, other more pressing academic engagements to worry about before Step 2 (unlike the folks cramming because their exam is in a month), and you calm down and go back to studying for your first shelf exam. It’s like riding a bike–feels really awkward at first and you are awestruck by these folks zooming past you on bikes and wonder if you’ll EVER get where they are, but then you’ll get the hang of it, just like you did on the island, and before you know it you’ll be submitting your rank order list for the Match!

      Best of luck to you and keep in touch!


  2. Becky said

    Loved your reply, Jen! You highlighted important ups and downs in life post-nevis in just a few paragraphs. Your words are authentic and encouraging … especially the last part where you mentioned about how we may feel awkward or uncertain at first but will all eventually get the hang of it, just like how we did on the island.

    Best of luck with the match this year!!!

  3. Anonymous said

    Hey Jenn, do you happen to have an email? Ive been reading your blog for awhile..and thoroughly enjoy everything you write. its actually been quite helpful for me..and its nice to talk to someone who is going through all this. If you don’t mind, Id like to email you. Thanks!

  4. L Williams said

    Hello Jenn, I have been accepted into September 2014 class of MUA. I have read your entire blog and looking forward to seeing your update on your match….. March 17th I believe is the date for results. Anyway I too would like to email you if you don’t mind. Thank You.

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