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i think i'll never get in regardless of being a US citizen due to having a past residency. i have tried many times and usually get one bogus prelim interview from the same old place that probably invited me to fill a quota number of interviews. they haven't picked me for 3 straight years in a row. i don't even want to apply for next year because it is the exact same thing year after year. i hope to God i get this urgent care job cuz maybe it will be something i like..

i was just helping some other people fight for their US citizen rights, not really about me. personally, im a dead duck.

Originally Posted by docu

i think i'll never get in regardless of being a US citizen due to having a past residency. i have tried many times and usually get one bogus prelim interview from the same old place that probably invited me to fill a quota number of interviews. they haven't picked me for 3 straight years in a row. i don't even want to apply for next year because it is the exact same thing year after year. i hope to God i get this urgent care job cuz maybe it will be something i like..

i was just helping some other people fight for their US citizen rights, not really about me. personally, im a dead duck.

I'm sorry for your situation but I'm still not sure why you think that residency is a "right" of all graduates of medical schools who are US citizens. If a US citizen goes to medical school in Kyrgyzstan (picked totally at random) at a medical school not recognized for licensure in the US should that person be entitled to a US residency spot? How about a US citizen who graduates from a US medical school at the bottom of their class after three attempts at step 1 and 2 and who has been cited for unprofessional behavior? It's a privilege to practice medicine, not a right. No one owes you anything just because you're an American who graduated from medical school.

Originally Posted by physicsnerd42

I'm sorry for your situation but I'm still not sure why you think that residency is a "right" of all graduates of medical schools who are US citizens. If a US citizen goes to medical school in Kyrgyzstan (picked totally at random) at a medical school not recognized for licensure in the US should that person be entitled to a US residency spot? How about a US citizen who graduates from a US medical school at the bottom of their class after three attempts at step 1 and 2 and who has been cited for unprofessional behavior? It's a privilege to practice medicine, not a right. No one owes you anything just because you're an American who graduated from medical school.

i know that physicsnerd42,i dont think its a right, its a right within reason. you took what i said out of context. but there are PHD's out there, people that completely redeemed themselves and still never picked. its that there's no redemption or remediation in medicine, they only allow you one shot and one mistake and you're career is over. i think there should be measures to take to improve and become a good doctor despite one slight mistake you may have made during ur education. there is nothing of the sort in the career of medicine.

Docu,

I worry that your anger may be somewhat misplaced here. On this thread (and several others) you complain that US citizens who train in foreign schools get excluded from training in place of non-US citizens. As I mentioned above in this thread, this is a real concern/issue and deserves discussion.

However, your story appears to be somewhat more complicated than this. You haven;t been completely clear with your background (which is understandable on a public website). However, in this post you describe that:

1. You are a US IMG 8 years of ouf training (in 2011)
2. You have low step scores and several "attempts" (i.e. you failed some steps)
3. You were in a residency program, and were let go.

I hate to say this, but even if you were a US grad, getting a residency spot with that history is going to be difficult. You're situation is going to be seen as "high risk" -- you've already failed out once, you've been away from the insanity of inpatient clinical medicine for some time, your USMLE scores are low. You have not used up your funding (as suggested in some of your posts), it's these other things that are preventing you from getting a spot.

Thanks aProgdirector. I realize my situation is not very good. I'm really tired of applying. I think i wont even apply for next year unless i have some connections, which i dont have. Luckily I have job ops in line, which is better than nothing, although not ideal.

Originally Posted by Obnoxious Dad

Where did you get the stupid idea that medical school admissions is entirely based on merit?

State of residence has a tremendous bearing on an applicant's probability of getting accepted to medical school. Look at the average matriculant's MCAT and GPA table from AAMC broken down by state of residence. https://www.aamc.org/download/161700/data/table21.pdf

You will see that applicants from states such as West Virginia, South Dakota, Illinois and Louisiana are held to a much lower standard than applicants from Wisconsin, Iowa, Minnesota and New Hampshire. I've examined these data over the last 15 years and I can tell you that some states are ALWAYS much tougher than some other states.

Furthermore admissions officers are too lazy and stupid to normalize applicants' transcripts to account for the rigor of the undergraduate college and major. This is the reason that less than 15% of the matriculants to medical schools are physical science majors and 33% have majors that include phys ed and art.

Furthermore I don't want to see U.S. tax money being spent on the residency training of people who may not practice medicine here. I don't care if some resident pays $12,000 of his/her salary back in federal and state taxes. The residency they are taking cost the U.S. taxpayers about $150,000 per year. That money should be spent on Americans who will practice here.

The fallacy in that argument is there is nothing requiring US citizens to stay in the US and practice, and some do choose to practice elsewhere after completing training.

I'm a GP and have a license and I've been looking for job opportunities (besides home care). I haven't been able to find much on craigslist or simplyhired.com or even googling it. I read somewhere that one can work in a rural ED non BE/BC, but where exactly do you find such jobs?

Any help would be much appreciated.

Thanks.

Nursing homes or urgent care.

is there a particular website or recruitment company where i can find those sorts of jobs. I have been having a hard time finding anything non BE/BC.

prison system

try the web site of physician recruitment/locum tenems firms

I'm not sure if i want to apply this year or not. i never make the match. my scores are low. i passed all 3 steps though. i was in residency before, but i got it in the post scramble scramble. should i completely give up or are there certain programs that might take me ( a person who was in residency before)? or should i completely give up.
any specialty is fine.

Thanks.

What hurts your app is the multiple attempts on the Steps, being let go from a previous residency and the number of years that have passed since you graduated from an offshore med school. Unfortunately the odds are stacked against you. Without significantly changing your application in some way since the last time you applied, you're not going to have any success.

Originally Posted by Buzz Me

What hurts your app is the multiple attempts on the Steps, being let go from a previous residency and the number of years that have passed since you graduated from an offshore med school. Unfortunately the odds are stacked against you. Without significantly changing your application in some way since the last time you applied, you're not going to have any success.

what exactly are programs looking to see for someone like me?
i own a company that does house calls and i also am about to be part owner of an urgent care where i'll be working. is that enough?

Originally Posted by docu

i own a company that does house calls and i also am about to be part owner of an urgent care where i'll be working. is that enough?

Then why in the name of all that's holy would you want to do a residency (unless you're lying)?

Honestly, with your CV, what most programs are looking for is the quickest way to round-file your app. Do you have "a chance?" Sure. Just as I have a chance at winning MegaMillions and Powerball in the same week. You've already gone through multiple app seasons (3 or 4?) and even when you got a spot it was only post-Scramble. Your CV is obviously beyond redemption from the standpoint of getting a residency spot. And while your business success is good for you, from the standpoint of a PD it's actually a negative. If I were a PD looking at your CV with prior unfinished training, I would just assume that, as soon as things got hairy, you'd just bail since you already have a solid backup plan. You're an incredibly high flight risk.

So my honest advice is that you should just move on. You already have a successful medical career without completing residency. You're one of the lucky ones. Enjoy it.

Originally Posted by gutonc

Then why in the name of all that's holy would you want to do a residency (unless you're lying)?

Honestly, with your CV, what most programs are looking for is the quickest way to round-file your app. Do you have "a chance?" Sure. Just as I have a chance at winning MegaMillions and Powerball in the same week. You've already gone through multiple app seasons (3 or 4?) and even when you got a spot it was only post-Scramble. Your CV is obviously beyond redemption from the standpoint of getting a residency spot. And while your business success is good for you, from the standpoint of a PD it's actually a negative. If I were a PD looking at your CV with prior unfinished training, I would just assume that, as soon as things got hairy, you'd just bail since you already have a solid backup plan. You're an incredibly high flight risk.

So my honest advice is that you should just move on. You already have a successful medical career without completing residency. You're one of the lucky ones. Enjoy it.

My backup plan isn't that solid just yet, since it is in its beginning phase, and im not making a whole lot of money right now. i would definitely bail from what im doing and go to residency, because my dream is to do inpatient, not outpatient. actually i'd hire a PA to cover me and let the business run itself.

should I convey this on my application, maybe my personal statement or is it still a no go? all i want is to be BE/BC. I don't care how hard i have to work to get it and i promise to stick to it. Then I will be happy.

Originally Posted by docu

I don't care how hard i have to work to get it and i promise to stick to it.

The problem is, your past track record indicates that you had some academic/professional problems. Makes PDs not want to take a risk with you.

anyone know how to get credentialed in as many insurances as possible as a GP who is not BE/BC? i am credentialed in medicare and possibly medicaid and blue cross blue shield, my biller said i can accept PPO's too, but what about other insurances?

an elaborate scam, (as everyone already probably knows because it even seems scammish) called the american board of general practice uncovered..... http://www.abgpscam.com/abgp

And so is the rest of all the other boards. All scams. They make you renew your licenses every 2-5 yr because they want fees. They make you be a member for fees. All a scam. And what do they provide you? Nothing really.

Originally Posted by GOMERE

And so is the rest of all the other boards. All scams. They make you renew your licenses every 2-5 yr because they want fees. They make you be a member for fees. All a scam. And what do they provide you? Nothing really.

It is clear that you have no idea what you're talking about here.

Thread 1


Thread 2

Originally Posted by GOMERE

And so is the rest of all the other boards. All scams.

Not true.

They make you renew your licenses every 2-5 yr because they want fees.

Licensing and board certification are completely different. Each state has it's own licensing requirements and timeframe for renewal. Board certification simply requires you to be licensed, but has a different set of requirements to maintaining certification. Many specialties (mine included) have a 10 year certification.

They make you be a member for fees. All a scam.

You have to pay to be board certified, yes. You do not have to pay annual dues. And it is not a scam.

And what do they provide you? Nothing really.

Incorrect. Try getting a job without being BC/BE. See where you can and cannot get hired, and where you can or cannot get privileges. It does make a difference, especially as a young physician with little experience.

Board certification has been discussed on SDN at length. If interested, just do a search.

Start about 6-9 months at least before you want to start practicing. Some insurances take an inordinately long time to get you credentialed.

I'm a gp that hasn't finished residency and I'm thinking of opening up a clinic--mostly medicare or bcbs. How much do they gross? Some people tell me i may be making half a million a year. is this true?

and how exactly does one achieve a salary of 500k? what type of procedures and tests does one do?

thanks.

Originally Posted by docu

I'm a gp that hasn't finished residency and I'm thinking of opening up a clinic--mostly medicare or bcbs. How much do they gross? Some people tell me i may be making half a million a year. is this true?

and how exactly does one achieve a salary of 500k? what type of procedures and tests does one do?

thanks.

Sure you could gross 500k, but your costs are going to cut your actual profits down a lot, maybe 200k.

If you are gonna actually take home 500k, you'd better be prepared to do office hours from 8 AM to 8 PM every day.... and see 1 patient every 5 minutes.

Originally Posted by Socrates25

Sure you could gross 500k, but your costs are going to cut your actual profits down a lot, maybe 200k.

If you are gonna actually take home 500k, you'd better be prepared to do office hours from 8 AM to 8 PM every day.... and see 1 patient every 5 minutes.

I think it depends on how "business" savy you are...reducing overhead will increase salary. I know of a physician who has no staff, no nurses, and pts schedule appointments online through some website. Imagine how much money is saved by not hiring/managing all of those people. Also that guys charges $200/pt/year fee to be part of his practice...needless to say he easily passes 500K and isn't seeing a patient every 5 minutes.

But I think average salary is closer to 200K for more of a traditional office setup for a gp?

Sorry to quibble but this is a pet peeve of mine.

Salary means a fixed amount of money paid someone on a regular schedule for services.

If you plan to open a clinic, i.e. start a small business you will not get a salary*. You will have income. Or not. But not a salary unless you work for someone else. It is very unlikely you will get exactly the same amount every month and what you do get may not be on a regular schedule.

So few doctors are compensated based on a salary model that it is important for med students and resident to understand the difference.

(If you run your business as a corporation you can pay yourself a "salary" for bookkeeping and tax purposes. This is not really the same as a real salary.)

OP: Go Concierge.

Our family physician (internist) is switching to a retainer model. Seems smart.

Imagine this - 75 per month per patient to be apart of your practice. You grow to around 3k patients in your community. Minimal staffing lands your overhead around 30-40%.

$75*12 months*3000 patients = $2,700,000 * 0.6 or 0.7 = $1.62 to $1.89 million take home

That is what I call winning. Well okay - either figure is large - that is what I call bi-winning.

Originally Posted by pseudosquam

OP: Go Concierge.

Our family physician (internist) is switching to a retainer model. Seems smart.

Imagine this - 75 per month per patient to be apart of your practice. You grow to around 3k patients in your community. Minimal staffing lands your overhead around 30-40%.

$75*12 months*3000 patients = $2,700,000 * 0.6 or 0.7 = $1.62 to $1.89 million take home

That is what I call winning. Well okay - either figure is large - that is what I call bi-winning.

3k is a higher patient panel than a physician in a regular practice has. I think it is typically 6oo patients in a typical concierge panel.

You probably have to have impeccable credentials (Harvard etc) to convince that many wealthy and healthy (healthy because otherwise you can't sustain a panel of 3000) patients to sign up for your concierge subscription. Like all businesses, to the winners go all the spoils. The average MD is not going to be able to set up such a nice practice.

Originally Posted by michaelrack

3k is a higher patient panel than a physician in a regular practice has. I think it is typically 6oo patients in a typical concierge panel.

I think even 600 is probably a lot if you are solo. You have to realize that in the concierge system, you are going to be giving access to all of these people 24-7. People are not going to pay above their insurance unless you are providing them round the clock access and response. With a big group in the hundreds, some percentage of them will be sick and injured at all times. And they won't hold off calling you like they might for a regular doctor visit, because they are paying a premium. Any resident who has cross covered 50 patients can tell you that you'll get a lot of stupid calls that will not allow you to get any sleep, and that's just 50 sick people (ie less than 10% of your customer base, more of whom will be sick during cold and flu season).

You also have to realize that concierge business is market driven. You need to find a wealthy area where there isn't much competitive business. Most neighborhoods cannot support two concierge businesses, because it's already a hard sell to get people to pay for that which their insurance already covers. And if you want 600 or thousands of people to shell out cash, you will have to find and market to them, which is a big financial and time expense not likely included in your original figure.

Basically the concierge business model can work for one or two doctors in a region if they are willing to give their entire lives over to the business, don't bite off more than they can chew, and are savvy marketers on top of being well liked doctors. For everyone else it sounds good on paper but is a quick sojourn into bankruptcy.

I would love to do something like that, but most of the patients here are at poverty level on medicare/medicaid.

Moving to Practicing Physicians.

Originally Posted by J-Rad

Moving to Practicing Physicians.

do the non-attendings who are interested in this topic have access to this forum?

Originally Posted by michaelrack

do the non-attendings who are interested in this topic have access to this forum?

They're not supposed to. That defeats the whole purpose of the forum. So many residents just do NOT have a clue, but think they know it all. What they need to is get their butts kicked in the real world a bit, which will add some wisdom and (hopefully) humility to their knowledge and hubris.

And, honestly, I don't know that there is much of a market on SDN for people who haven't finished residency and aren't trying to get back in, who want to open a practice. Someone finishing residency and looking to open a new practice is another room in the same house.

Originally Posted by Blue Dog

FWIW, I have reported the post as well as PM'd J-Rad. Threads should not be moved from public forums to private forums. If this thread belongs anywhere, it belongs in the FM forum.

Actually, the OP IS a member of this forum, as she is a practicing physician, and has posted threads in this forum previously.

However, as docu did not complete a residency, moving this thread to FP or IM did not seem appropriate either. She's not asking how to open her own FP or IM clinic, but how she, as a GP, should go about opening her own clinic. Perspectives from individuals, currently in practice, in varying fields may be helpful, which is why it was moved into this forum.

docu has self-identified as a non-resident and as someone who is in active practice (i.e. practicing physician, albeit not board eligible/certified) as a GP. We certainly have struggled as to where to place GP-related threads and decided that they would generally be placed in TIH (if more broadly applicable to healthcare-related issues) or into PP if that area seems more germane and the member has appropriate group membership.

As a sidelight, did this docu disclose their gender? I don't see it on their profile page. Or did SDN breach this user's privacy? I haven't looked at all of docu's posts to see which pronoun was used.

i feel weird putting myself at attending status, but maybe i am, because when i sign 485's or other forms, i sign under the blank, "attending physician".

the people who are helping me set up the clinic have high hopes for me, so hopefully it will turn out okay. it would be nice to make all the money instead of earning a percentage of someone else's practice. but hopefully i will have that kind of patient volume.

I thought this was a closed forum, including viewing. Why does it say "3 guests viewing"? If I try to access the Chief Resident forum, for example, I get an error message that I am not authorized.

hello. yes -the path to "board certification in general medicine" through the requirements of the"american board of general pratice" is fraudulent. don't spend thousands of dollars and years of time pursuing this phony board certificate. find the facts at aagpscam.com.

i think this clinic will do well...if i can get 20 patients a day....we shall see i guess

has anyone ever heard of this?

http://www.theleadingphysiciansoftheworld.com/

they called me and wanted me to pay to join and to get a welcome packet. i was like what the heck and joined for $34/month. but i can cancel anytime. she waived my main fee cuz i kept refusing to pay the high prices.

im not that excellent by any means, at least i think so. lol....

sounds like a scam...is it?

they said i could put it under awards in my cv.

You can join DeadCactus's Physician Honor Roll for a one time payment of $25 so yea, I think you're getting scammed...

This doesn't really have anything to do with Residency. Moving.

And no, it does not look legit. Just because they said they'd cancel at anytime does not mean they actually will. And now they most likely have your credit card number. I'd check your statements.

I used to get mailings from this one: http://usplaques.bestdoctors.com/ when I was in residency (I must have been an awesome resident!). Pretty good deal. Only $250 for a plaque saying I was one of the best doctors in the country. I didn't do it.

has anyone ever heard of a hospital that will allow a licensed non-BE doc to work there?

I have a few questions:

Does anyone know: Will there be more spots available this year? and if so, about how many? what about in the near future?

For one, india is passing a law where the medical grads have to return to india after their residency. Will that affect program director decisions to hire them as residents?
Will that make more spots available for grabs to others? or is the system unlikely to change just to boost program stats?

Also, there has been talk of more residency spots in the future to offset the physician shortage. I have heard that 2,000 spots are being created (but not entirely sure), and also heard that a bill *might* be passed that creates 15,000 residency spots. How likely is this to become a reality?

Originally Posted by docu

India is passing a law where the medical grads have to return to india after their residency.

How is India proposing to enforce that law?

Nope.

Originally Posted by shopsteward

How is India proposing to enforce that law?

By refusing to issue NORI letters (no requirement to return to India) which are required for residents looking for J1 visa waivers.