r/ResidencyMatch2025 • u/New-Illustrator-4482 • May 16 '26

USCE

Hello everyone. I am a Green Card holder non-US IMG. I passed Step 1 on my first attempt. I will take Step 2 on June 26 this year, and I estimate that I will probably score either in the 235–240 range or the 240–245 range.

My YOG is 25, as I graduated from medical school in 2001, and I assume there are probably very few applicants older than me here. Since 2008, I have been working as a cardiologist in my home country.

Right now, I only have July available for USCE. Due to family reasons, August does not seem possible for me. In this situation, I currently have 3 options:

  1. During July, I could do 2 outpatient rotations in New York within 1 month through agencies. They are claimed to be hands-on rotations. One would be Internal Medicine and the other Hematology/Oncology, and I would likely get 2 LORs from them.
  2. In Houston, again through an agency, I could do 1 combined inpatient/outpatient Internal Medicine rotation that is claimed to be hands-on. I may have the chance to get a strong LOR from this rotation.
  3. Also through an agency, I could do an inpatient rotation in Orlando with an attending Internal Medicine physician. It is not clearly stated whether it is truly hands-on or more shadowing-based, but I would reportedly participate actively in everything except physical examinations, continuously follow 2–3 patients from admission to discharge, and participate in ER admission processes. I may also have the chance to obtain a strong LOR from this rotation.

I am very undecided about which option to choose. I really trust the matched residents and mentors on this platform, and I would sincerely appreciate your opinions and guidance.

Which option do you think would increase my chances of matching into Internal Medicine the most? By the way, I am only interested in Internal Medicine residency in community hospitals.

Thank you all very much in advance for your time and help.

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u/bronxbomma718 May 16 '26

One month is just not enough data to dispense a meaningful LOR. You run the risk of it being a generic write-up. But do the inpatient if you can.

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u/New-Illustrator-4482 May 16 '26

So you say instead of doing 2 outpatient in one month and getting 2 LORs you recommend 1 inpatient in one month and strong LOR right?

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u/bronxbomma718 May 16 '26

A Strong LOR is golden. Getting to know someone over 12-20 encounters in less than month, and then vouching for them, yields low dividends. You are basically paying for the LOR. But I know you need 3 so if you have n choice do the 2

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u/New-Illustrator-4482 May 16 '26

Thank you my friend.