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

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

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.

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 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

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.

they're talking about me

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 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.. -_-;

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.

I think a proper definition or differentiation needs to be made between FMG/IMG (although suppose to be the same).

Does a person who goes to any Carribean university (still in 6 figures of debt), deserve to be shunned? They are equally in debt (was one of the criteria according to a few guys above), write the same exams, train in American hospitals.

The only bitterness factor is the fact they might have had mediocre MCAT scores and such.

In terms of the other Non-Carrib grads: No debt, No US Clinical experience (I would like to make note that IMG's consider Observership / Externships as clinical experience -- basically paying for volunteering / LoR), NO MCAT (not required).

Does that suffice? Which rules will apply to whom?

Also you have to note, many IMG's have permanent residence status, so that ''filtering'' method doesn't work.

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.

if you can take Step I, II, III and get 99 percentile on them in a different language, and learn medicine alllllllllllll over again in a completely random language (medicinal English), and understand all the cultural barriers etc in the US, by all means, we need you! (most foreign medical grads can only get into primary care)

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.

It's unfair to those countries that these docs come from, most of these countries desperately need them... No unfairness to slacker AMGs that are fearing for their own residency spot (to reiterate average and even slightly below average AMGs have no problems at all getting very solid residencies and at good locations also)..

Originally Posted by NRAI2001

It's unfair to those countries that these docs come from, most of these countries desperately need them... No unfairness to slacker AMGs that are fearing for their own residency spot (to reiterate average and even slightly below average AMGs have no problems at all getting very solid residencies and at good locations also)..

It depends on the situation. A friend of mine is Malaysian, but attended medical school in the UK. His wife is an American citizen. I believe she's the reason he came to the US. He recently started residency here. I don't feel like this is unfair to anyone.

Originally Posted by osumc2014

if you can take Step I, II, III and get 99 percentile on them in a different language, and learn medicine alllllllllllll over again in a completely random language (medicinal English), and understand all the cultural barriers etc in the US, by all means, we need you! (most foreign medical grads can only get into primary care)

The vast majority of IMG/FMG's who successfully match do not have 270+ on both steps

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.

Originally Posted by Amemus

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.

I remember this study. Makes sense. They are the cream of the crop. They are top docs. They're the best grads from their school.

They can study months, years, for USMLE. And they are smart. They can certainly outscore American-mainland rejects, who resort to Caribbean for-profit schools.

Many US-IMGs from many caribbean schools have higher mortality rates.

Originally Posted by Shoushu

I remember this study. Makes sense. They are the cream of the crop. They are top docs. They're the best grads from their school.

They can study months, years, for USMLE. And they are smart. They can certainly outscore American-mainland rejects, who resort to Caribbean for-profit schools.

Many US-IMGs from many caribbean schools have higher mortality rates.

Where's the proof in this conjecture.

Originally Posted by Shoushu

I remember this study. Makes sense. They are the cream of the crop. They are top docs. They're the best grads from their school.

They can study months, years, for USMLE. And they are smart. They can certainly outscore American-mainland rejects, who resort to Caribbean for-profit schools.

Many US-IMGs from many caribbean schools have higher mortality rates.

Remarkable that the thread died on such an inflammatory statement.

Originally Posted by Shoushu

I remember this study. Makes sense. They are the cream of the crop. They are top docs. They're the best grads from their school.

They can study months, years, for USMLE. And they are smart. They can certainly outscore American-mainland rejects, who resort to Caribbean for-profit schools.

Many US-IMGs from many caribbean schools have higher mortality rates.

If you read the study it says both AMG AND IMG have worse outcomes than FMG.

Per the study: FMG > AMG/IMG.

Many of these people had to get into medical schools in countries where it's a lot harder than here. Then they had to pass exams emphasized in that country - followed by passing exams in the US - in a non native language many times. If you're good enough to do that, I'd be more than happy to have you as my doctor.

If someone does my job better than me, the world doesn't owe me that job.

#1. America claims to be the land of the free. You cant have your cake and eat it too. FMGs have every right to be here as you do. They have the same tuition, they pay the same taxes, and they ultimately help the same American people when they practice here.

#2. If an FMG is better qualified than an AMG, is it selfish for you to say that they dont deserve the spot. That is highly unfair to sick Americans who just want the best possible healthcare.

#3. If an FMG can out compete you, well you dont deserve that spot and clearly did not work hard enough.

#4. FMGs fill the primary care spots that would normally be empty

Fact: The US NEEDS fmg's to fill in the spots in rural locations and provide health care to people who normally might be able to find it. This will change in a few years, but for now you should be thanking FMGs that they were willing to leave their country and family to come to the US to be a family physician (in most cases) and deal with fat complaining people who dont understand why eating at McDonalds 3x a day is making them unhealthy.

Originally Posted by docnotsopc

#1. America claims to be the land of the free. You cant have your cake and eat it too. FMGs have every right to be here as you do. They have the same tuition, they pay the same taxes, and they ultimately help the same American people when they practice here.

#2. If an FMG is better qualified than an AMG, is it selfish for you to say that they dont deserve the spot. That is highly unfair to sick Americans who just want the best possible healthcare.

#3. If an FMG can out compete you, well you dont deserve that spot and clearly did not work hard enough.

#4. FMGs fill the primary care spots that would normally be empty

Fact: The US NEEDS fmg's to fill in the spots in rural locations and provide health care to people who normally might be able to find it. This will change in a few years, but for now you should be thanking FMGs that they were willing to leave their country and family to come to the US to be a family physician (in most cases) and deal with fat complaining people who dont understand why eating at McDonalds 3x a day is making them unhealthy.

Well said. I see this only as a positive thing for the US of A. We are like a giant magnet sucking up all the best talent and brains from the rest of the world. It's brilliant. I hope all the best and brightest FMGs all want to come the US.

The main point here is that if you're worried about FMGs taking "your spot" (as if you deserve a spot just for being in the US) then you should spend less time worrying and complaining about that, and more time kicking ass in the clinic and on the boards.

Think people are forgetting that our taxes pay the salary and cost of training residents. So yes american citizens should get dibs thats a no brainer.

Originally Posted by sylvanthus

Think people are forgetting that our taxes pay the salary and cost of training residents. So yes american citizens should get dibs thats a no brainer.

The obligation is to the patients, not to the doctors.

And somehow having american citizens getting first dibs on residencies will somehow treat fewer patients or treat them in a subpar manner? The obligation to the patients will be fulfilled regardless of who gets priority on residency placement. Im all for FMG filling vacancies but think any american citizen should get first priority.

Originally Posted by sylvanthus

And somehow having american citizens getting first dibs on residencies will somehow treat fewer patients or treat them in a subpar manner? The obligation to the patients will be fulfilled regardless of who gets priority on residency placement. Im all for FMG filling vacancies but think any american citizen should get first priority.

That the patients should get the most talented docs is what I meant. As stated above, if the American applicants aren't up to snuff, they don't deserve the spot, or get dibs or whatever, in favor of a more qualified FMG. American taxpayers fund the system because they want the best care when they are patients.