How Caribbean students do in the match (from my personal experience)

I think the big question people have when looking into Caribbean medical schools is whether or not they can get the residency they want. Or maybe the big question is *if* they can even get a residency. The answer is yes. The official stats haven't come out yet for AUC, but based on the highly accurate facebook posts and word of mouth news, the great majority of my classmates matched. Naturally we don't tend to match into the ultra competitive fields of plastic surgery, orthopedic surgery, neurosurgery, otolaryngology, dermatology, or ophthalmology (actually we had one person match in optho this year) but we have a good number of people matching into internal medicine, pediatrics, family medicine, OB/GYN, general surgery, psychiatry, radiology, anesthesiology, pathology, emergency medicine, and PM&R. And people not only match in their desired specialty, but the majority match into one of their top 3 choices.

With all that being said, however, I'm not going to lie to you... coming out of the Caribbean is tough during interview season. It will be used against you. You won't get interviews at many places just because you come from a Caribbean med school. I know excellent students with amazing board scores, high class rank, all honors in clerkships, and what's the result? They still get pigeon-holed into the same programs that are IMG friendly and are unceremoniously ignored by the majority of other programs. Even when they can get interviews at well-known and respected institutions, more often than not, they will be ranked lower than their US grad counterparts. It's not fair, but that's just the way it is.

I'm going to take myself as an example. I applied to both child neurology and pediatrics. I was a competitive enough applicant in my chosen fields.

My stats:
224 for Step 1 (first attempt)
226 for Step 2 (first attempt)
Passed CS (first attempt)
In the top 1/3 of my med school class
Numerous community service experience
Held a leadership position
Received an "Outstanding" recommendation in my MSPE letter
Had 3 strong letters of recommendation (2 of which were from Massachusetts General Hospital).

The results:
Out of the 49 child neurology programs I applied to, I was offered 12 interviews.
Of the 123 pediatrics programs I applied to, I was offered 19 interviews.

As sad as this may sound, coming from a Caribbean medical school, I did well for myself. To anyone else outside of the Caribbean system, those are some tough numbers to swallow.  Hell yes this was expensive, but the more you spend on applications, the higher your odds of getting an interview, and the higher your odds of matching. So that is why Caribbean medical schools encourage their students to apply to as many programs as they can afford.  If you are considering Caribbean, definitely know this before coming in.
  

A Little about Child Neurology

I’ve been getting a lot of questions from people regarding child neurology. It’s not a well-known specialty; it’s barely discussed in medical school, and there’s little to no opportunity to do rotations in it. I believe at AUC specifically, we only have one green book rotation option at the University of Florida in Gainesville, in which special permission is needed from a faculty member to even rotate there.  With so little exposure, it’s no wonder why so few students know about it.  

So what is child neurology? What do child neurologists do? What sort of cases do they see? 

Child neurologists take care of children with any sort of neurological condition.  It’s mostly an outpatient specialty where the bread and butter cases include AD/HD, Tourette’s (tics), epilepsy, autism, headache, and cerebral palsy. A great deal of the time, child neurologists examine and work up patients who are referred for questions in developmental delay of speech, fine/gross motor skills, social skills or learning disabilities. Other pathologies child neurologists see are children with genetic disorders such as Angelman’s, Down, Fragile X, Tuberos Sclerosis Complex, among others and on rarer occasion children with brain cancer, muscular dystrophies, and mitochondrial disorders. I personally have an interest in concussions, chronic traumatic encephalopathy, and traumatic brain injury within the pediatric population, so we’ll see how well my training deals with those issues.

Although much of child neurology is centered in outpatient clinics, there are a huge number of child neurologists who work in the inpatient setting. Getting consulted to the NICU for newborns with floppiness or brain injuries (i.e. intraventricular hemorrhage), performing lumbar punctures, overseeing the epilepsy monitoring unit, reading EEGs, getting called to the ER for patients with question of seizure, cases of status epilepticus, etc.

If any of this sounds interesting to you, then maybe a career in child neurology is something you should consider.

How to apply to child neurology?

Child neurology used to be part of the Philadelphia Match, and it only just recently joined the main NRMP match (it’s in its third year). Like adult neurology, you can match into pediatric neurology directly. There is no fellowship necessary after doing 3 years of pediatrics, although you can do child neurology after doing the 3 years of pediatrics.

Child neurology is a small world. There are only 72 programs in the United States with the majority being university-based at major teaching institutions. You can enter a program as either a categorical, advanced, or reserved resident. Historically, most doctors entering child neurology would do 2 years of pediatrics and leave before their third year to enter a 3-year child neurology program. The problem with this of course, is that most pediatric residency programs aren’t thrilled about losing a resident for the third and final year of residency. Of recent years, most programs now offer a combined pediatrics/child neurology 5 year categorical residency program where you spend all 5 years training at the same institution. You do 2 years of pediatrics like any other pediatric resident (a few elective blocks are swapped for inpatient blocks), and then you move on to neurology for the final 3 years. By the end of the 5 years you can be double boarded in both pediatrics, as well as for neurology with “special qualifications in child neurology”.  Although most residents opt to only take the child neurology boards since most never practice general pediatrics.

When I applied this past year, I only applied for categorical positions.  I did end up applying to pediatrics as a back up but had I matched into a pediatrics residency position, I’m not entirely sure I would have gone the neuro route.  I decided early on I would finish my full 3 years and re-assess where to go from there.

"Where Did I Match?"

My post title is the subject heading of the email everyone receives from NRMP. I had a mini panic attack when the email finally came at 1 pm, so I let my friend read me the results and it looks like I'm moving to Houston, Texas! I matched for the 5 year Child Neurology categorical program at UT- Houston!!!!!

The Texas Medical Center

The program at UT-Houston, as well as University of Virginia (UVA) and St. Louis University (SLU) ended up being my favorite programs that I interviewed at. I had a really tough time deciding how to arrange my rank order list hence the constant changes, but I was going to be ecstatic to match at any of my top 3.  Honestly, I could not be more thrilled about where I landed!!!! The Texas Medical Center (the largest medical center in the world) was the most impressive sight I saw on my interview trail. Over 20 hospitals, 8 research institutions, 50 health related colleges and universities in the medical, dental, pharm, and nursing fields. Anything that I could possibly want to do with my career as an M.D., I know I can accomplish by training here. 

Memorial Hermann (the two buildings in the foreground) will be my primary hospital site over the next 5 years. I also will spend some months at MD Anderson Cancer Institute and LBJ General Hospital (not shown).

I Matched!!

Yes, I found out Monday I matched. Yes, I find out tomorrow where, and I will be sure to update my blog for it! Just a celebratory drink post-work/post- run on Monday. Looking at your newest pediatric resident come July!

Countdown to Match

My rank order list has been submitted (deadline was Feb 25th), I've packed up my stuff and left New York City for good, roadtripped down to Miami, and now I'm on my final rotation of medical school at an outpatient pediatric neurology office in Hialeah. March 16th is the day we find out *if* we match, and the 20th is the day we find out *where* .

You may not be aware but I applied to both child neurology and pediatrics for this match cycle and I was lucky enough to get over 30 interviews. I went on 18 of those, and ended up ranking 16 programs-- 10 child neuro, and 6 pediatrics.

Two more weeks!