How being an old medical graduate can help you get into competitive specialties?

Don't spend time beating on a wall, hoping to transform it into a door.

Coco Chanel

One word I always hear from applicants with a shameful tone is “ But I’m an old graduate” and you can almost hear the sorrow and sadness in their voice.  The emphasis on being a “Fresh” graduate defined by some programs as graduating within the past 3-5 years, has made many older applicants weary of their ability to get into US postgraduate training programs.

Now this makes sense if you have not being practicing medicine for a long time, but for those of you who have been actively involved in residency in their home country and worked after residency the story could be completely different.

How you may ask ? ….. Well, if you have already done a residency in your home country you may be eligible to apply for a fellowship position which is usually an area of subspecialty in your current specialty. The amazing thing here is that some really competitive specialties (mostly surgical) don’t fill all their fellowship spots and they need experienced fellows to help with patient care, so this would be an ideal way of entering the US medical system.

Why is this a big deal ? ….. Because fellowships can sometimes be much easier than residency to get into the US training system, and it might be a stepping stone to get into a residency program after that, or even allow you to bypass residency altogether in some specialties and become an attending right away. That means that some US programs actually value that you are an older graduate and understand that you have spent those years after your graduation in rigorous medical or surgical training.

So what does this all mean for all you older graduates out there? …. It means that you need to capitalize on the training you acquired over the years after graduation and try to apply for fellowships in your field even if they are not accredited by the ACGME since they will be an excellent stepping stone to get you into the US medical system. There is no reason (if you have the experience) to compete with the thousands of “Fresh” graduates knocking on the residency wall, while there is a less crowded fellowship door right in front of you…

Do not follow where the path may lead.  Go instead where there is no path and leave a trail

-Ralph Waldo Emerson

M.Soliman