Hello from the Mountain West

[Cinderella]

Thank you scarlett09! Is your spouse half Egyptian then? It can be very culture shocking to visit there if one has not been to a predominantly Islamic society before. While living there it took me about three months to adjust from the culture shock. Most US tourists take expansive trips from the Pyramids in Giza to the Pharaonic temples in Luxor. It can be a long bus ride or train ride. The resort towns along the Mediterranean and Red Sea are also popular and fairly safe. The general attitude of the culture is welcoming to all tourists. I'd suggest cultivating some bargaining skills before going because you can bargain for most anything there including at the pharmacy and clinics. Tourists are ok with this though because it's still cheaper than their home country and some insurance covers the cost. They will size one up and take advantage of tourists if they can though. If they offer a ridiculously high price laugh and offer them back a ridiculously low price and go from there. I wouldn't suggest going right now with the turmoil. Some will say it is safe in order to bring in tourism but with reports of chaos and protests still going on every Friday I'd stay away, especially from Cairo. The Red Sea District and Luxor are not largely affected however.

[Cinderella]

Thank you MrsPotts and SuzySunshine!

[MissCrabette]

Welcome! My husband is also an IMG, although from the Caribbean. I hope you stick around.

[Cinderella]

Thank you MissCrabette! It's nice to meet a fellow International Medical Spouse (IMS). I plan to stick around. Looks like there is a long road ahead of us for now. I'm literally counting down the months the next two years until our match. Last year he was adjusting to our society and studied for Step 2 for eight months because someone told him it was easier to take that first and get a taste for success. After the observership in the hospital back east and meeting with other foreign graduates he obtained a lot more information about the process and guidance. He came back and restarted by studying for Step 1 first. He's been very diligent about his study and taking his practice exams and doing better on each one. It makes me very happy to see him working towards our shared goals and having a time table for us to go by. The pace is slow and steady here.

[Momo]

Glad you found us!!

[Cinderella]

Shukran Shazam!

[ides]

Welcome! Like you discovered you do have to take the usmle steps in sequence. What type of residency will your husband be pursuing? Also, residency usually runs from July through June of the next year, not in September like regular educational institutions. I know you generally need one year of residency done before you can take step three. We haven't gone the fmg route but there are a few at dhs program who are from India & are doing their second residency (first one was in India). Is your husband doing research or working while he studies? Research can really bolster your application.

Again welcome! Looking forward to getting to know you better.

[MissCrabette]

Actually, there's no requirement to take the steps in order. Lots of people who are already doctors in their own countries find it easier to start with Step 2 CK because it tests clinical knowledge as opposed to the basic science stuff that they would have to go back and review before Step 1. As an IMG, you can also take Step 3 before you begin residency, unlike American grads. In fact, lots of IMGs take it because it makes them more "attractive" during the application process. Yes, research would be really great, even if he doesn't get published. You mentioned he will be doing an externship. I'm not sure of the details, but he should make sure he gets some hands-on clinical experience out of it, and that it's not just an observership. Lots of residency programs have minimum requirements for clinical rotations in the USA, some of them as long as 6 months. It may be more difficult to obtain these, especially since he's no longer a student in his home country, but it would be well worth the trouble.

[Cinderella]

He was studying first for Step 2 CK like MissCrabette said because others had recommended he take that first to have a taste of success and then feel good about going back for Step 1. After we sent him back East for the observership they told him to study for Step 1 first because it will help with the rest of the Steps. That if you passed a Step with a low score you couldn't retake it and were stuck with that score. If it was in the 70th percentile it would be nearly impossible for him to get a residency and the time studying and money spent would be a wash. He was also told they could only retake the exam if they failed it. So he felt that he better take his time studying all the material to make sure he gets the best percentile possible to get the residency he wants and have the career he wants here.

I'm not rushing him either. I am trying to help him find something he can do to show less gaps on his resume. Since he had graduated and wasn't going for his Masters by the time we married it wasn't possible for him to transfer to a medical school here or obtain a research position. That leaves us with observerships and externships for clinical experience here. While he was at the learning hospital here for his observership they did tell him an observership is better than nothing but it is better if he gets an externship for the hands on experience. I didn't know that about the six months requirement MissCrabette so thank you for the new information. I had only budgeted for a two months to send him for an externship like with the seven week observership. Now I will have to reconsider our options. Seven weeks was a long time to be apart and I don't think I could handle six month apart while he's at an externship, especially after going through a lengthy immigration process.

[ladymoreta]

Welcome! Wow - and I thought the usual medical school/match/residency process was complicated! Looking forward to getting to know you!

[Cinderella]

Thank you ladymoreta!

I've spoken with DrH about the 6 months externship and our options. He mentioned several things to me. He said that he knows several IMG's that take Step 1 & 2 abroad and fly here for the interviews and the match only. They haven't lived in the US nor have clinical experience in the US and they get matched. Without knowing each ones experience or career I couldn't really make a comment on that. He also told me that he knows he isn't able to have an externship unless he's passed both Step 1 & 2. With him finishing in July of 2012 with Step 1 and both Step 2's and registering for the match that Sept and going for the interviews I don't really see how he could do a 6 month externship in time unless he does it during the match process and take interruptions for interviews. It's that or we wait another year to match and he does the 6 month externship and studies for and takes Step 3. That makes for a longer gap though and he's willing to go for the match earlier. I asked him about getting a research position. He told me that he looked into it here and found only one position at the local University for a research job in the Biology department but he'd have to register as a masters student and there wasn't a degree that would really benefit him in his career nor did he feel comfortable taking the loans to get a degree he didn't feel would help.

Then last night I was thinking about the local University and looking through the catalog for what he could take to get some hands on experience and I found the two year surgical technician program. I suggested to him this morning that he could get his medical degree from Egypt translated and evaluated for equivalents and probably apply those credits towards that program to get the degree if they would accept that. I'm not sure how it would work but I know education is a business and they'd probably want to get some benefit of him trying to obtain their degree so they may say you have all the credits needed but you have to do a clinical or take these certain classes. Then he could practice in the medical field here in the area he wishes to go into and this might be something better than getting the $150 phlebotomy certificate. I wonder if that would count as hands on clinical experience too? He was surprised he didn't know about this program before and inquired further about what does a surgical technician do. I told him that I think they assist in surgery but I don't really know and he could inquire with the program advisor about it if he's really interested. I do have a girl friend who ended up going that route because she wasn't accepted to the physician assistant programs out of state. I think she even works here but I haven't spoken with her in years. I could try to contact her and see if she's willing to speak to DrH about it to help enlighten him. My Mom knew a guy who did that here too and made decent money but complained about how many hours he had to work and that they were always needing somebody. Possibly there is a need for a part-time or prn surgical technicians because DrH still has to study for and take the Steps in a timely manner. It doesn't hurt to get information.

[scarlett09]

Thank you scarlett09! Is your spouse half Egyptian then? It can be very culture shocking to visit there if one has not been to a predominantly Islamic society before. While living there it took me about three months to adjust from the culture shock. Most US tourists take expansive trips from the Pyramids in Giza to the Pharaonic temples in Luxor. It can be a long bus ride or train ride. The resort towns along the Mediterranean and Red Sea are also popular and fairly safe. The general attitude of the culture is welcoming to all tourists. I'd suggest cultivating some bargaining skills before going because you can bargain for most anything there including at the pharmacy and clinics. Tourists are ok with this though because it's still cheaper than their home country and some insurance covers the cost. They will size one up and take advantage of tourists if they can though. If they offer a ridiculously high price laugh and offer them back a ridiculously low price and go from there. I wouldn't suggest going right now with the turmoil. Some will say it is safe in order to bring in tourism but with reports of chaos and protests still going on every Friday I'd stay away, especially from Cairo. The Red Sea District and Luxor are not largely affected however.

Yes, he's technically half-Egyptian, although he doesn't really like to claim it. His mother was a baby when they emigrated, so I think he feels more American than part Egyptian. The family hasn't been back to Egypt since they left, except one of his aunts visited with her husband several years back. But they left under duress, so it would explain a lot. Other members of the extended family have moved to places like Israel, France, etc. My MIL's mother can speak four languages: English, French, Spanish and Arabic, and one of MIL's sisters was married in Egypt before they emigrated to France. I don't know too much about all of the family stories about Egypt, it's taken me nearly 8 years to learn this much, lol!

Thanks for the tips on Egypt! I would love to go there and hopefully we can do so in the near future.

[diggitydot]

Then he could practice in the medical field here in the area he wishes to go into and this might be something better than getting the $150 phlebotomy certificate.

My DH worked a certified phlebotomist and in the hospital's lab running tests during undergrad and it helped him tremendously with both patient contact and experience in the field. He'll still occasionally do his own blood draws if it's crazy busy. It's been a pretty handy experience for him.

[MissCrabette]

I only mentioned the 6 month requirement to emphasize how important clinical experience in the US is. Yes, foreign grads match all the time with low scores, no research, and no US clinical experience. The problem is that they match at hell hole programs and in primary care. While surgery is still accessible to foreigners, it's a quite a bit more competitive. Besides, surgery tends to be malignant anyway. Don't settle for matching somewhere, anywhere because he might be absolutely miserable if he matches at a bad program. He should try to do everything in his power to build a strong application instead of simply meeting the minimum requirements. I'm sorry if I come across as a downer. I guess I've looked at the match statistics for too long to have a rosy outlook.

[Cinderella]

Yes, he's technically half-Egyptian, although he doesn't really like to claim it. His mother was a baby when they emigrated, so I think he feels more American than part Egyptian. The family hasn't been back to Egypt since they left, except one of his aunts visited with her husband several years back. But they left under duress, so it would explain a lot. Other members of the extended family have moved to places like Israel, France, etc. My MIL's mother can speak four languages: English, French, Spanish and Arabic, and one of MIL's sisters was married in Egypt before they emigrated to France. I don't know too much about all of the family stories about Egypt, it's taken me nearly 8 years to learn this much, lol!

Thanks for the tips on Egypt! I would love to go there and hopefully we can do so in the near future.

No problem. I do hope that you get to go back and visit someday with your SO. Let me know if you have anymore questions. If I don't know the answers I know plenty of people that do.

My DH worked a certified phlebotomist and in the hospital's lab running tests during undergrad and it helped him tremendously with both patient contact and experience in the field. He'll still occasionally do his own blood draws if it's crazy busy. It's been a pretty handy experience for him.

Thank you for that information! DrH mentioned this morning that he would look into the surgical technician program and it would come down to time and cost. Certainly it's much easier to take the online exams and get the $150 phlebotomist certificate that lets you work anywhere. He said if the surgical technician program is going to swallow his time and money then it may not be the better option for his studies right now.

I only mentioned the 6 month requirement to emphasize how important clinical experience in the US is. Yes, foreign grads match all the time with low scores, no research, and no US clinical experience. The problem is that they match at hell hole programs and in primary care. While surgery is still accessible to foreigners, it's a quite a bit more competitive. Besides, surgery tends to be malignant anyway. Don't settle for matching somewhere, anywhere because he might be absolutely miserable if he matches at a bad program. He should try to do everything in his power to build a strong application instead of simply meeting the minimum requirements. I'm sorry if I come across as a downer. I guess I've looked at the match statistics for too long to have a rosy outlook.

I really appreciate all the information I am given MissCrabette and you have a very valid point. Just like we don't want to aim to high and waste time and money on a match we also don't want to aim too low and lose thousands of dollars in revenue and valuable skills he could be learning. We want him to have the best chances and be the most attractive candidate for the target that appropriately matches his skill set. He told me that back east his medical mentor told him that in a match interview they want to know mainly three things about foreign medical graduate. First what medical school did they go to. Second what are their Step scores. Third what is their visa status.

He sometimes gets down on himself because he knows how competitive it is. I don't know if this is correct but he believes that they're going to take all the American graduates first and then the foreign graduates. I have to cheer him up and tell him I believe in him and know he's smart and capable and can have the career he wants here. That he has to work for it and that there will be hoops to jump through but all you have to know is what those hoops are and meet them and you'll do fine.