FAQ#16: Question from a JPA scholar

I received an email from a second year Malaysian medical student who is a JPA scholar. 

Hi Dr Jay,
I am a 2nd year Medical Student in Malaysia and am very interested in pursuing a residency in USA. I am currently preparing for my STEP 1.
 
1. Is residency equivalent to Masters?
Yes. In Malaysia, after housemanship and 1-2 years of MO-ship, you may apply and enter into a Masters training program, which is basically a specialization program such as internal medicine, surgery, orthopedics or pediatrics. In the U.S., after the USMLE, you immediately enter into a residency program such as "internal medicine, surgery, orthopedics or pediatrics".

2. I am a Jpa scholar and thus bonded by the government. Is there any way to pursue a residency in USA by a Malaysia government scholarship like MYBRAIN15?

 

I am not familiar with scholarships. However, if you question is if you need a scholarship to pursue residency, the answer is no. You get PAID to train in the U.S. In Malaysia, you will have to be sponsored by KKM to undergo Masters training. The result of KKM sponsorship is that you will have to be bonded by KKM after graduating from Masters training.

3. I would like to come back to Malaysia after pursuing a residency. What status would I be in? A specialist, fellow or a master student?

Specialist or Consultant. Essentially you will have COMPLETED your training.

4. Is there any expiry for USMLE step 1 score?

 

When applying for residency, most States will have a law that you will be expected to complete Step 1, 2 CK, and 2 CS within 7 years. Means the date which you take your first paper to your last paper must be within 7 years. You will then be "ECFMG certified". The ECFMG certification does not have an expiry date.

5. I am intersted in Neurology/Neurosurgery. I realise that an IMG prospects to get a match in the field is impossible. But still are they are img in neurology/neurosurgery?

 

Neurosurgery would be impossible unless you are willing to spend a few years doing research in the U.S. Neurology is easy to get into in the U.S. About 30% of neurology residents in the U.S. are foreign medical graduates based on my rough estimation.

6. What are the advantages of me doing a residency in neurology/neurosurgery compared to a master programme in Malaysia?

 

I think your question is about pros/cons of each pathway. Right now you are thinking: should I just stay in Malaysia for Masters, or should I head to the U.S. for residency?

 

Malaysian Masters

Pros: 

- get to stay back in Malaysia, be with your family

- familiar with the local hospital system

- familiar with lecturers/educators from same background

- comfortable

Cons: 

- will be bonded with KKM after completion of training

- will be posted to underserved areas after completion. It will be unlikely for you to be able to stay ina big city. KKM will definitely need to post you to small towns to serve as a specialist

- will only start many years after graduating from Medical school as you will have to do housemanship and even some years of MO-ship first

- not recognized in any other country except Malaysia 

- there will be a time gap between completion of Masters training and the start of subspecialty training

U.S. Residency

Pros: 

- recognized globally

- structured training program. Has been in existence since the 1900s. The first residency program was started by Sir William Osler himself

- no bond after graduation

- earn USD while training with estimated take home salary of USD$3500 every month

- you will get to apply for fellowship (subspecialty) training even before completing residency. No time gap between residency and fellowship. Fellowship for example will be: general surgery going into vascular surgery, general surgery going into plastic surgery, internal medicine going into gastroenterology, pediatrics going into pediatric cardiology, anesthesiology going into pain medicine, radiology going into interventional radiology. There also won't be any time gap if you decide to continue on to be a sub-sub specialist: eg: internal medicine into cardiology followed by electrophysiology, or internal medicine into nephrology followed by transplant nephrology.

 

Cons:

- requires completion of the USMLE

- stepping out of one's comfort bubble

- some specialties will be very difficult for a foreign medical graduate to get into. You will need to look at the statistics to find out the % of foreign medical graduates in each specialty to estimate your chance.