Advice on applying for EM residency with a UK med degree

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Beowulf272
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#1
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So I’m going onto 5th year medicine at the Uni of Cam and have pretty much fully decided to move to the US for residency and for life, really.

I want to apply for an emergency medicine residency and I’ve researched around it a lot but have yet to do my Step 1.

I was pretty much wondering whether anyone here who has successfully applied for EM (or any other residency) or is planning to do so, has any advice for me on how to approach this?

I know EM is ultra competitive as an IMG, but I’m willing to rlly grind with the Step exams, get US experience (I’ve already gotten into contact with a US doc to arrange my elective in the US next summer - but this won’t be hands on experience, unfortunately), get LORs, get research (does this have to be US research specifically?) etc.

In terms of timings, however, what do you guys recommend? When should I do Step 1? Step 2? When should I get hands on clinical experience in the US?

I know it’s a ridiculously arduous and disheartening process, but I pretty much can’t see myself working anywhere else. Not necessarily for the healthcare system, but just for a general affinity for the country (even with its huge list of issues).

Any advice would be appreciated. And, obviously, I can clarify any points if necessary.

P.s. ignore the cringe username - I made this account when I was a dumb child
Last edited by Beowulf272; 1 month ago
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ecolier
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(Original post by Beowulf272)
...I know EM is ultra competitive as an IMG, but I’m willing to rlly grind with the Step exams, get US experience (I’ve already gotten into contact with a US doc to arrange my elective in the US next summer - but this won’t be hands on experience, unfortunately), get LORs, get research (does this have to be US research specifically?) etc....
Really don't think you can compensate the fact that you are an IMG with any of these. In the US as long as there is even one local grad competiting with you, you're ranked below them.

Perhaps you can choose to work in an "undesirable" location, or just keep trying year after year and hope that one year - no local grad is competing with you.

artful_lounger may be able to help.
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Beowulf272
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(Original post by ecolier)
Really don't think you can compensate the fact that you are an IMG with any of these. In the US as long as there is even one local grad competiting with you, you're ranked below them.

Perhaps you can choose to work in an "undesirable" location, or just keep trying year after year and hope that one year - no local grad is competing with you.

artful_lounger may be able to help.
Yh it’s a tough gig, I’ve seen that being discussed a lot. Is there really no advantage with the fact that I’m coming from an English speaking country and also a respected med school? Surely that would play at least a minor part in it?

People also recommend going for Family medicine or Internal medicine, but I really don’t see myself doing anything but EM over there.
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ecolier
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(Original post by Beowulf272)
Yh it’s a tough gig, I’ve seen that being discussed a lot. Is there really no advantage with the fact that I’m coming from an English speaking country and also a respected med school? Surely that would play at least a minor part in it?
No, you're just "another IMG". I mean if you are competing against someone from Mars you may be. But any local grad and you're back of the line.

People also recommend going for Family medicine or Internal medicine, but I really don’t see myself doing anything but EM over there.
Yep, Family Med is potentially possible since it's so non-competitive. I always use "Family Med in rural Ohio" as an example to what you could do as an IMG.
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ajj2000
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Why are you asking on here rather than checking the numerous threads on other forums and youtube videos on exactly this subject?

I think EM competitiveness has dropped away big time recently so may not be such a tough ask as it would have been 5 years ago. That said you may want to check out the reasons behind this and check whether the type and locations of residencies appeal to you.
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Beowulf272
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(Original post by ajj2000)
Why are you asking on here rather than checking the numerous threads on other forums and youtube videos on exactly this subject?

I think EM competitiveness has dropped away big time recently so may not be such a tough ask as it would have been 5 years ago. That said you may want to check out the reasons behind this and check whether the type and locations of residencies appeal to you.
Well I don’t rlly see much advice on applications for EM in particular - there’s a lot of IM.
Also, I’m quite late to the game, so wanted some input in terms of when to fit in Step in these last two years of med school alongside the other experience and research. Some specific advice to my own situation really. Especially with becoming a UK IMG, which I don’t see a huge amount of info on either.

Not particularly fussed about location. I know that EM jobs are plentiful across the US after residency and so moving shouldn’t be an issue. The residency itself isn’t that long either.
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artful_lounger
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(Original post by ecolier)
Really don't think you can compensate the fact that you are an IMG with any of these. In the US as long as there is even one local grad competiting with you, you're ranked below them.

Perhaps you can choose to work in an "undesirable" location, or just keep trying year after year and hope that one year - no local grad is competing with you.

artful_lounger may be able to help.
PRSOM
(Original post by Beowulf272)
So I’m going onto 5th year medicine at the Uni of Cam and have pretty much fully decided to move to the US for residency and for life, really.

I want to apply for an emergency medicine residency and I’ve researched around it a lot but have yet to do my Step 1.

I was pretty much wondering whether anyone here who has successfully applied for EM (or any other residency) or is planning to do so, has any advice for me on how to approach this?

I know EM is ultra competitive as an IMG, but I’m willing to rlly grind with the Step exams, get US experience (I’ve already gotten into contact with a US doc to arrange my elective in the US next summer - but this won’t be hands on experience, unfortunately), get LORs, get research (does this have to be US research specifically?) etc.

In terms of timings, however, what do you guys recommend? When should I do Step 1? Step 2? When should I get hands on clinical experience in the US?

I know it’s a ridiculously arduous and disheartening process, but I pretty much can’t see myself working anywhere else. Not necessarily for the healthcare system, but just for a general affinity for the country (even with its huge list of issues).

Any advice would be appreciated. And, obviously, I can clarify any points if necessary.

P.s. ignore the cringe username - I made this account when I was a dumb child
As above, to be sponsored for a working visa by a US company (including hospitals for residency) they are legally obliged to demonstrate there are no qualified Americans applying for that job. For any popular specialty then, it's basically impossible to get into. Your options are very unpopular specialties (family med, psych, etc) or in very unpopular areas (i.e. very rural areas) or both.
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ajj2000
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EM was an unpopular residency this year. Psych was highly competitive. Neuro has traditionally been a good option for non US IMGs looking for highly ranked programmes.
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Beowulf272
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(Original post by ajj2000)
EM was an unpopular residency this year. Psych was highly competitive. Neuro has traditionally been a good option for non US IMGs looking for highly ranked programmes.
So i guess I just have to play it by ear? Since I’ll only be applying after F2, which will be in 2026 for me. I assume things will change massively from now until then.
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Beowulf272
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(Original post by artful_lounger)
PRSOM


As above, to be sponsored for a working visa by a US company (including hospitals for residency) they are legally obliged to demonstrate there are no qualified Americans applying for that job. For any popular specialty then, it's basically impossible to get into. Your options are very unpopular specialties (family med, psych, etc) or in very unpopular areas (i.e. very rural areas) or both.
Ah I see. Any particular advice about when to do the STEP exams and when to arrange US hands on experience? Also, will they still see UK medical research as of an equal level to their own? Or do I have to seek out US research opportunities?
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ajj2000
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(Original post by Beowulf272)
So i guess I just have to play it by ear? Since I’ll only be applying after F2, which will be in 2026 for me. I assume things will change massively from now until then.
I suspect thats correct - popularity can be highly volatile and seems to depend on factors far removed from med students and residents.

I would make sure you are checking the major US forums regularly. In particular check how programmes filter based on time since graduation as this can be an issue - as can affording the time to sit STEP 1 and 2, plus potentially STEP 3.
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artful_lounger
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(Original post by Beowulf272)
Ah I see. Any particular advice about when to do the STEP exams and when to arrange US hands on experience? Also, will they still see UK medical research as of an equal level to their own? Or do I have to seek out US research opportunities?
No idea about the USMLE. I would assume research would be seen in much the same way as long as it has a PubMed ID thing?

In terms of US experience your only option is probably to do an elective(s) through your medical school in the US.
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Beowulf272
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(Original post by ajj2000)
I suspect thats correct - popularity can be highly volatile and seems to depend on factors far removed from med students and residents.

I would make sure you are checking the major US forums regularly. In particular check how programmes filter based on time since graduation as this can be an issue - as can affording the time to sit STEP 1 and 2, plus potentially STEP 3.
Alright, will be checking student doctor often then, thanks
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Beowulf272
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(Original post by artful_lounger)
No idea about the USMLE. I would assume research would be seen in much the same way as long as it has a PubMed ID thing?

In terms of US experience your only option is probably to do an elective(s) through your medical school in the US.
I think the only issue there is that my elective only really involves observation. I’ll probably need to take time out post graduation to get actual hands on experience. But like someone mentioned earlier, there’s that balance between not waiting too ling after year of graduation as well.

thanks for the responses
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