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Back up plans for IMGs?

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It's no secret that this season is incredibly competitive for all fellowships but it seems that pulmonary and critical care medicine is even worse. For IMGs who are on visas, has anyone thought about any back up plans? Are there any non-accredited fellowships like heart failure and hepatology that many IMGs sometimes do t match in cards and GI? Obviously waiver job is another option but that will take 3 years.

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