This is my third try to get into a residency.
In the United States licensing and practicing medicine is not federally regulated,
each state licenses a physician with its own rules and laws so if a physician is licensed in one US state and practice for 10 years, they want to move they must apply and their license may or may not be granted in the next state. For an American Medical School Grad (AMG) this is not an issue, for an International Medical School Grad (IMG) this can be a nightmare.
While the US states differ on rules and laws such as how many USMLE attempts will be acceptable for license, they agree on all of the following:
at least 1 Year of Residency for AMG to be licensed 3 years of Residency for an IMG to be licensed ( one state still allows 1 year to fulfill this requirement)
Passage of USMLE (United States Medical Licensing Exam) all three steps ( different rules on this in each states from unlimited time to 7 years to complete and Unlimited attempts to 3 attempts per step)
IMG must be ECFMG certified this is when the IMG passes Steps 1,2CK and 2CS, the medical degree is certified and clinical rotations.
What is new is the FCVS verification, see below from the site
FCVS OverviewFCVS was established in September 1996 to provide a centralized, uniform process for state medical boards to obtain a verified, primary-source record of a physician's core medical credentials. This service is designed to lighten the workload of credentialing staff and reduce duplication of efforts by gathering, verifying and permanently storing the physician's and/or physician assistant's credentials in a central repository............
Yes the ECFMG may certify the all this but the Federation of State Medical Boards was not making enough money and the states were not uni-formally accepting the ECFMG certification and passage of the USMLE and a completed residency of 3 years in the USA as enough so now some states want the FCVS. Whats next? A third verification company that each state board gets a fee too? It may be in our future.
What the average IMG pays for the match:
for 100 programs applied to $2175 in 2014
Funds for travel to residency interviews is around 300 to $500 in the USA from other countries more.
From 100 programs applied expected interviews for average scores on USMLE and complete application package is 5 to 10 max. So usually less than 10% and if 5 interviews you will need at least $1500 for interview money.
This year and what has happened:
We waited at our computers on the Morning of 9/15/2014 ready with a list to apply to and a Credit Card to pay our fees with ERAS running and crashing for over 6 hours. Few if any were able to apply to the programs. If we are to believe that at least 20,000 IMG's apply ( some say 40,000) and average 100 programs at least ( I know of many 200 plus) then the one day revenue from the 20,000 applications to ERAS is $42,000,000 gross for applying to programs. This is all done by computer software and servers. So the crashes? What is the most important part of this process? What makes ERAS a service? The application delivery, you see ERAS is a post office for the Residency programs.
ERAS stands for Electronic Residency Application Service. The sole purpose for the collection of fees from applicants is to deliver the residency application to programs.
So on the system crashed on 9/15/2014 and then we had an Email crash, messages from programs dissapeared and were not going through. Programs report difficulty in downloading applications and crashes on their end. After paying these fees and days trying to apply we have this from a service that had time to prepare and has been collecting these fees for years. I have my own thoughts on this and I have to tell you I think its a shame no one regulates this. Last year I found out about the software functions, a function to the programs is screener software. The screeners can be set to Year of Grad, Scores and Attempts on USMLE, ECFMG certified, Visa status, Citizenship. and probably other.
So the screener stops the application the applicant paid for ERAS to delver to the program. The program screens out your application and never see the application thanks to ERAS who you paid to deliver. The US Mail would never do this, we pay for the application to be delivered to the program it would reach them, if not the service was not provided. So if your application was screened out by ERAS own software, was service provided to you? Did you get what you paid for? You just paid a fee to have an application delivered but ERAS did not deliver it because the same computer system blocked it. Hmm think about it for a minute.
I applied to 41 FM and 10 IM programs I hand picked because they say they look at the application.
I chose states I can be licensed in.
I chose programs who claim to care more about the applicant than scores.