Educating Residency Fellowship and Academic Programs on the United States-Puerto Rico Relationship Status.pptx

1. Educating Residency, Fellowship, and
Academic Programs on the United
States-Puerto Rico Relationship Status
Gabriel Colón-Estarellas & Paola Caldas-Font
Fourth Year Medical Students
Universidad Central del Caribe School of Medicine

2. Background
● Medical students attending Puerto Rican medical schools have historically
faced many hurdles in their away rotations and residency application
process as they are commonly misperceived as International Medical
Graduate (IMG) students by other medical students, physicians, and
healthcare professionals from the mainland US.
● A study in progress shows that recently graduated physicians from Puerto
Rican medical schools have reported that during the process of away
rotations and residency interviews, they had to explain their citizenship,
the accreditation status of Puerto Rican medical schools, the board
exams taken, clarify about not being an IMG and their application being
denied both in away rotations and residency programs due to
misinformation regarding these topics.

3. Flyer - Promo
A collaborative effort by the four medical
schools in Puerto Rico inviting graduates
to participate in the study.

4. Preliminary results
Key Items in Questionnaire
● N=129
● Mean age: 29 years old
Representative Participants from All Four Institutions (N=129)

5. Preliminary results
Representative Participants: Demography
Gender (N=129)
Current Academic Year (N=127)

6. Preliminary results
Home State (N=129)
○ 82.9% Puerto Rico
○ 17.1% Continental US
■ 7% Florida
■ 1.6% California
■ 1.6% Texas
■ 0.8% Idaho
■ 0.8% Illinois
■ 0.8% Massachusetts
■ 0.8% Missouri
■ 0.8% New Jersey
■ 0.8% New Mexico
■ 0.8% New York
■ 0.8% North Carolina
Important: Most students/graduates in Puerto Rican medical schools are U.S. citizens.

7. Visiting Rotations
Considered an International Medical Graduate
Positive and Negative Factors in Away Rotation Application Process
Positive Factors (N=83) Negative Factors (N=64)

8. Visiting Rotations
● Overall experiences with fellow medical students, residents, fellows, and attending physicians:
Positive Experiences:
○ “Had a great experience with fellows, attendings and other members of the team. Continued
friendship with people from the program”
○ “Everyone was kind, helpful, and eager to teach”
Opportunities to improve:
○ “Despite rotating 8-16h and having comparable steps and gpa I didn’t even get an interview there.
An attending there said “you have a great application, but being from PR doesn’t help, your letters
of application are not from famous people and unfortunately that is something they look at here” ”
○ “The fellows and attendings were the best overall; very respectful and always asking questions. A
faculty from a specific program called me an international student and told me that I would not be
considered due to being international; I went on to correct the faculty member but that person
continued to call me international, albeit unconsciously.”

10. Visiting Rotations
Treated/considered as an International Medical Graduate testimony:
Opportunities to improve:
○ “Everyone assumed I was an IMG. One program called me to cancel interviews because
of my IMG status.”
○ “I just had to clarify to one of the attendings that asked how was my training as
international student different from training at US mainland. I just clarified that I was
not considered IMG, and we have all the same training (boards, etc...) as any other US
medical school.”
○ “Told me I would not be considered for a residency position because I was
"international".”
○ “It was mostly I got confused with IMGs by saying I was coming from a school in PR but
once I explained we are fully accredited and LCME the perception changed.”

12. Residency Programs
Treated/considered as an International Medical Graduate testimony:
Opportunities to improve:
○ “Didn’t know PR medical schools are LCME accredited.”
○ “Letters of rejection for interview because of "being" an IMG.”
○ “A lot of MS, Residents, Attendings when they looked at your identification
badge that said Puerto Rico they asked me if I were an IMG.”

13. AMA Policy

14. Resolution passed as official
Policy of the AMA Medical Student Section on
November 7th, 2020.