Is it fair that foreign residents get residency spots in US hospitals?

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Originally Posted by mac_kin

*not to bash any residents at all in terms of competence or potential.

But, in terms of the residency matching system - is the "system" fair? Should it accept foreign residents on par with citizens who plan to then devote their education/financial support/research grants to help people in the country that educated them??
Esp with an ailing, aging, growing (literally) population?

nothing to say, just glad i made it in before the lock down

t

Are there really that many people who come here just for residency? I always thought nearly everyone wanted to practice here afterwards as well. Truth is, though, that I don't really think it's fair either way; although, to be fair, most residency programs do not accept fmgs on par w/ students from this country.

Originally Posted by mac_kin

*not to bash any residents at all in terms of competence or potential.

But, in terms of the residency matching system - is the "system" fair? Should it accept foreign residents on par with citizens who plan to then devote their education/financial support/research grants to help people in the country that educated them??
Esp with an ailing, aging, growing (literally) population?

Hahaha you make it sound like everyone's in it for purely altruistic purposes.

8

Originally Posted by mac_kin

*not to bash any residents at all in terms of competence or potential.

But, in terms of the residency matching system - is the "system" fair? Should it accept foreign residents on par with citizens who plan to then devote their education/financial support/research grants to help people in the country that educated them??
Esp with an ailing, aging, growing (literally) population?

1. FMGs are at a disadvantage.
2. it would be a minority that don't plan to stay after residency.
3. Since when is life "fair"?

Love it or hate it..foreign grads do help fill the spots in primary care..

And the truth is for an FMG to get into a super competitive specialty, they have to be even better than anybody else stats and resume-wise, which, in my opinion is more than paying your dues.

If you get denied a residency spot because a FMG took it from you, you're doing it wrong.

The group I think it is the most *unfair* to to allow FMGs to come train/practice here is the people of their original country. Many FMGs get to go to medical school for free, and then they leave the country after getting their socially-funded education.

Not that this problem affects me/citizens here directly, but if I were a citizen of the country which the doctor got his/her free education and left I'd be pretty pissed. I'm surprised they don't have laws to prevent this from happening.

But aren't they going for no body else want? If is very hard medical admission and at India it is only four year after 12th. Lots of schools for M.B.B.S
Do they pass USMLE?

Originally Posted by Smachadams

Love it or hate it..foreign grads do help fill the spots in primary care..

And the truth is for an FMG to get into a super competitive specialty, they have to be even better than anybody else stats and resume-wise, which, in my opinion is more than paying your dues.

I don't think so. The average American student is 6 figures in debt by the time they start residency. That's not the case with many FMG's.

Also, how you are on paper does not correlate with how good you are as a physician. Not to forget, ALL FMG's spend months to years preparing for step exams. We spend weeks only.

Originally Posted by lazymed

I don't think so. The average American student is 6 figures in debt by the time they start residency. That's not the case with many FMG's.

Also, how you are on paper does not correlate with how good you are as a physician. Not to forget, ALL FMG's spend months to years preparing for step exams. We spend weeks only.

Lets not nitpick here what makes a good doctor here..Im talking about what residency programs actually look at.. if you have a 250+ step score, honors in everything, publications, good personality etc.. You will have a good chance of getting a good residency, and if someone took a spot that I wanted with those stats, I wouldn't whine that FMG's shouldn't get spots in the US... I'd deal with it.

And btw, they don't spend years preparing for the steps.. -_-;

thats coz you prepare for step 1 from day 1 of your med school. All your med school exams and grades are in the formats for usmle. So you dont need special preparation. And regarding FMG's getting into residency, I dont think a american graduate has to worry about it. In my vast experience I have never seen/known a american medical graduate who has not gotten into residency....If there are any thats coz he is not fit enough to get into residency....

I've never heard the word "fair" used in reference to the real world.

By and large, American residencies are taking highly qualified FMGs. The competition for them is so steep that the middling candidates don't really have much of a shot. So we're pretty much getting the cream of the crop. I think America absolutely benefits from attracting many of the best doctors, scientists, artists, businessmen, etc from around the world to our country. I don't even really see where fair comes into it. It's not like there's any appreciable number of American medical graduates who can't match into any residency program.

Originally Posted by phltz

By and large, American residencies are taking highly qualified FMGs. The competition for them is so steep that the middling candidates don't really have much of a shot. So we're pretty much getting the cream of the crop. I think America absolutely benefits from attracting many of the best doctors, scientists, artists, businessmen, etc from around the world to our country. I don't even really see where fair comes into it. It's not like there's any appreciable number of American medical graduates who can't match into any residency program.

Unfortunately, even if these are some of the smartest of their classes in their original countries, most were trained in a different system that might not be on par with ours. Then, they end up training at below average US residency programs, so you end up with some of the worst practicing physcians being FMGs. I know there are exceptions, and I have seen some amazing FMG's, but that's not the norm (in my experience).

Originally Posted by lazymed

Unfortunately, even if these are some of the smartest of their classes in their original countries, most were trained in a different system that might not be on par with ours. Then, they end up training at below average US residency programs, so you end up with some of the worst practicing physcians being FMGs. I know there are exceptions, and I have seen some amazing FMG's, but that's not the norm (in my experience).

Those guys don't sound as worthwhile. Most of the (few) FMGs I've know have been stone-cold ballers. But it raises the question, why would residency directors be taking subpar FMGs? It seems unlikely they'd want mediocre candidates if they had viable better alternatives.

Are you guys talking about me

No, you'll be an IMG... I'm assuming you are american.

Originally Posted by Morsetlis

Are you guys talking about me

No, You and I be trained in US hospitals during clinicals so we gone know dat der system. But prepare your anus for those gunner pretentious phages that gone talk **** when we get there.

Originally Posted by phltz

Unfortunately, even if these are some of the smartest of their classes in their original countries, most were trained in a different system that might not be on par with ours. Then, they end up training at below average US residency programs, so you end up with some of the worst practicing physcians being FMGs. I know there are exceptions, and I have seen some amazing FMG's, but that's not the norm (in my experience)..

You're pulling this out of nowhere.

http://www.ama-assn.org/resources/do...fairs-imgs.pdf

Originally Posted by Jorje286

You're pulling this out of nowhere.

http://www.ama-assn.org/resources/do...fairs-imgs.pdf

Hard data does have a way of spoiling a good argument. I often see a lot of FMG hate on SDN. Looks like it's more based on simple prejudice than facts.

nm

They took our jobs!

Why not? If I were a patient, I'd sure as hell want the best doctors in the world working on me. It's not a foreign resident's problem that someone else can't out compete them.

The following is taken from the MSU Kalamazoo website concerning the admissions process for residencies.

"The MSU/KCMS Med-Peds Program strives for excellence. We are seeking applicants with the qualities that make an excellent physician. We seek candidates that have outstanding interpersonal, communication, leadership and teaching skills, and are dedicated, compassionate, altruistic, self-motivated and take the initiative in the care of their patients. Applicants should have a passion for medicine and caring for adults and children and should plan on a career that involves both age groups. While academic performance in school is important, for a variety of reasons we feel that USMLE and COMLEX scores do not reliably predict residency performance.

For applicants who have taken and passed the USMLE and COMLEX examinations while in medical school, we review each applicant carefully regardless of the score to identify those with the qualities we seek and invite them for an interview. Osteopathic applicants can submit either exam and do not require USMLE, however, many allopathic residency programs require USMLE even of the DO candidates and you should clarify this requirement with the programs for which you are applying. We receive a very large number of applications from cadidates who took the examinations after completion of school. Regretfully, we can not review each of these in detail. Because these candidates have had one year or more to study for the examinations, we use a minimum score of 95 on both USMLE steps I and II to identify applicants for a more thorough review. Only after a thorough review applicants with the qualities we seek will be invited for an interview."

I don't know why this same topic pops up on SDN so often.. The people who post these questions are slacker AMGs that are afraid of not getting a residency.. Truth is if your an average or even slightly below average AMG you should have no problem finding a solid residency in most fields(besides the uber competitive fields and even there you will only very rarely find an IMG/FMG)..

If you re afraid of anyone "stealing" your spot then you probably didn't have a good shot to start with.. Even uber competitive IMG applicants (when it comes to the steps,research..etc) have trouble landing mid-tier programs.. Most ended up in spots AMGs refuse to go into in the first place..

Many FMGs end up in programs that AMGs don't want anyway, so I don't see how FMGs are stealing AMGs spots. Most FMGs I've met are pretty darn smart and work their butts off, because they have to continue to prove that they deserve to be there. I think the system favors AMGs. If you do the work and have your stuff together, you should be able to land a decent residency spot on your first try. Many bright FMGs have to apply two or more times before they can get a residency....which is commonly in the primary care sector that many AMGs don't go into anyway.

And back to immigrants taken er jurbs.

Originally Posted by Masticate3Xaday

Why not? If I were a patient, I'd sure as hell want the best doctors in the world working on me. It's not a foreign resident's problem that someone else can't out compete them.

Second this.

It is just an excuse for laziness.

The US has more residency slots than there are American medical school graduates. The only way to fill the rest of them is to import physicians from abroad.

http://content.healthaffairs.org/con.../1461.abstract
According to this study:
1. Doctors who graduated from foreign medical schools, and who were not US citizens when they went to medical school, who then went on to practice in the US, had significantly lower mortality rates than a) doctors who went to US medical schools and b) doctors who went to foreign medical schools and who were US citizens when they went to medical school.
2. No significant difference in mortality rates between a) all international medical graduates and b) graduates of US medical schools.

Originally Posted by MD Odyssey

The US has more residency slots than there are American medical school graduates. The only way to fill the rest of them is to import physicians from abroad.

This should have been the first and last reply to this thread.

Why not? If they earn less than 10% of what a US attending earns yet still fork the $$$ to pay 4000 dollars to pay for all of the USMLE exams (not adding the expensive plane ticket to do Step 3 and 2 CS.. or the annoyance of getting a US tourist visa which is an ordeal as of itself). Good for them for their initiative. Plus the exams are in english, imagine doing an 8 hour oral exam in your non native language. I did a 4 hour oral exam once in my non native spanish and thought the exam was brutal enough.

I don't see why Americans are complaining, they have an excess of residency slots whereas most countries have more GP doctors than available residency seats. The mexican residency system has only a bit more than 1000 residency slots and over 25,000 applicants each year and the residency match scores are going up higher each year because the government has failed to keep on opening slots to meet demand yet urge the need of specialists (without really increasing specialist salaries that much). There's so few specialists in Mexico that they give special credentials and diplomas to GP's that have worked extensively in a specific service of a hospitals (mainly as IM or ER docs) to supply the urgency of specialists. Most of the 2000 municipalities in Mexico don't have any specialists, the few that do exist mostly live in less than 150 of the 2000 (mainly metropolitan Mexico City, Guadalajara and an ever decreasing amount of specialists in Monterrey). In a way, if you know where to work and live, a GP can outearn a specialist by a couple thousand MXN each month and work only 1/10th what they work.

Many mexican GDP's also choose to go to Spain because they also have a surplus of residency seats and the advantage that there is no language barrier but the US and Australia are still other popular choices for those that have the money and patience to do all of the board licensing exams. If the person that used the education returned to their home country, don't see it as a negative, see it as a positive because that person could change mexican health policy in a good way with better surgical techniques and suggest new drug guidelines. The advantage of being a specialist in Mexico is that they can get into bureaucratic positions more easily and change the system from within.