Training Opportunities for Foreign Medical Graduates (FMGs)

By Vinay A. Shah, MD (Senior Editor of International Ophthalmology) and Rahul Bhola, MD

Basic

The American medical educational system consists of 8 years of primary school, 4 years of high school, 4 years of premedical education at a college or university, and 4 years of medical school (at a Liaison Commission on Medical Education approved institution). The World Health Organization (WHO) tabulates the world directory of medical schools. Additionally, the Foundation for Advancement of International Medical Education and research (FAIMER) publishes an international medical education directory (IMED). This provides an accurate and up-to-date list of medical schools recognized by the government agencies. These agencies are usually represented by the Ministries of health of each country. Some foreign medical schools have developed relationships with several USA states with regards to those US citizens studying abroad in foreign medical schools. They allow for limited exchanges of medical student clerkships in American hospitals.

Related Resources

American Association of Colleges of Osteopathic Medicine
Association of Faculties of Medicine of Canada (formerly the Association of Canadian Medical Colleges)
Educational Commission for Foreign Medical Graduates
Federation of State Medical Boards
National Board of Medical Examiners

Specialty: ACGME approved Ophthalmology Residency Program

There are in total over one hundred residency programs with a total of approximately 434 residency positions. The total residency is typically 4 years (one year of internship and three years of ophthalmology training). Every residency program is organized differently. Most programs rotate residents among hospitals and services, mixing comprehensive clinical and surgical experience with subspecialty experience. Some programs also send their residents to different countries in Asia and Latin America for enhanced surgical and clinical experience. This also provides an opportunity for cultural exchange between trainees. Adequate instruction and clinical experience is available in all subspecialties. Although there are structural differences among programs, the requirements for accreditation are identical. Some programs use hospitals remote from the primary training hospitals for some of the residency experience; other do not. Some programs send their residents to regional basic science courses; others provide the instruction intramurally. In some programs, instruction and surgical staffing are provided almost exclusively by full-time faculty, while other programs rely heavily on volunteer clinical faculty.
For more information and links to individual programs visit: http://www.sfmatch.org/ and http://www.ama-assn.org/ama/pub/category/2997.html

Subspecialty Training

Visiting observer: The visiting observerships mostly range from 1-4 weeks in duration. This track is the easiest to get and mostly does not require any stringent documentation. In order to apply for these track applicants need to directly contact the program director/departmental chair with their CV and recommendation letters. This track is extremely beneficial to individuals who have prior postgraduate training in their country and want to, in a short period of time, experience various ways of practice in academic institutions in the US before returning back home to join either private practice or an academic institution. One of the limitations of this track is limited patient contact

Short term fellowship: These fellowships are usually established to support promising young ophthalmologists to improve their practical and research skills and broaden their perspectives in ophthalmology. This has a flavor of both research and clinical gratification. The prerequisites may vary among states but being ECFMG certified is universal for patient contact and licensure. Getting a clinical fellowship (especially in a good institution) would involve passing all three steps of USMLE with strong letters of recommendations, and existing publications in peer review journals (similar requirements for long term fellowships). Fellows are expected to bring their acquired knowledge and skills back to their own country and participate in clinical, research and teaching programs in their country.

Long term fellowship (>6 months): These fellowships involve formal application to academic programs around the country usually via the official match website (http://www.sfmatch.org/). Fellowships can be of two types: clinical or research. Subspecialty training that includes clinical responsibilities require a license to practice medicine, but research oriented fellowships may be able to take foreign students without a U.S. medical license. We strongly advise contacting each program and state board (http://www.fsmb.org/usmle_eliinitial.html) individually for specific requirements for the application and licensure. Most fellowships require prior completion of a three year ophthalmology residency program.

The various subspecialty programs offered in ophthalmology are:
Anterior Segment Surgery
Cornea-External Disease
Glaucoma
Neuro-Ophthalmology
Oculo-Plastic Surgery
Ophthalmic Pathology
Pediatric Ophthalmology
Retina-Vitreous
Uveitis - Immunology
Miscellaneous Fellowships

For more information and links to individual programs visit: http://www.sfmatch.org/

Note: To provide direct patient care, physicians in the United States are required to complete a three to seven year graduate medical program -- accredited by the Accreditation Council for Graduate Medical Education (ACGME) -- in one of the recognized medical specialties.