Being a foreigner!

[Planktonmd]

For the past 9 years I have been on this forum and I interacted with many people... I learned from many people and I hope I taught some people but it was overall an amazing experience...
During that same time, actually for the past 14 years I was in a private practice setting that was relatively stable (or so I thought)... until about a year a go when the hospital decided that we were too expensive and decided to give our contract to an AMC that agreed to do the same job with zero money subsidy!
Since that time things have changed and although the AMC did not fire me I now work twice as much for much less money.
I said to myself... it's life... the world has changed and you have to adapt.
But... that's not the end of the story... recently I realized that I am too experienced and too popular with the surgeons and other staff for the AMC to be comfortable... I realized that they are building a file against me and it's a matter of time before they eliminate me!
So... I said OK... let's take a short cut and just leave!
The surprise was... being a foreign graduate has now become a determining factor and many places would not even talk to you if your medical school was not in this country!
They don't tell you that ... but it is very obvious!
I am a very good anesthesiologist... I have excellent skills... but... I was not born here!
Is that a fatal mistake?
Does that shock anyone?
Let's discuss it!

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[urge]

recently I realized that I am too experienced and too popular with the surgeons and other staff for the AMC to be comfortable... I realized that they are building a file against me and it's a matter of time before they eliminate me!

The surprise was... being a foreign graduate has now become a determining factor and many places would not even talk to you if your medical school was not in this country!
They don't tell you that ... but it is very obvious!
!

1 Wouldn't you like to keep you best employees? Why would they want to eliminate you?

2 How are you so certain that the reason you are not getting interviews is the fact that you are foreign trained?

 

[Planktonmd]

1 Wouldn't you like to keep you best employees? Why would they want to eliminate you?

2 How are you so certain that the reason you are not getting interviews is the fact that you are foreign trained?

Urge...

1- Unfortunately... I have been at the same practice for too long... I know everyone and I am well respected by all surgeons... that does not work well with the new
leadership
2- I know because some of these groups at certain states that I am interested in would not even talk to me... I am not foreign "trained" I just went to medical school somewhere else and I have an unusual last name... My residency was in this country... but here in the south... when the job market is not the greatest... they don't want foreigners!
They immediately assume that you are the typical foreigner that their mommy warned them about and that would end the conversation before it starts!

 

[urge]

Urge...

1- Unfortunately... I have been at the same practice for too long... I know everyone and I am well respected by all surgeons... that does not work well with the new
leadership
2- I know because some of these groups at certain states that I am interested in would not even talk to me... I am not foreign "trained" I just went to medical school somewhere else and I have an unusual last name... My residency was in this country... but here in the south... when the job market is not the greatest... they don't want foreigners!
They immediately assume that you are the typical foreigner that their mommy warned them about and that would end the conversation before it starts!

1 What kind of employees do they like according to you?

2 If you were American born and schooled, what would be the reason for not getting interviews?

 

[Planktonmd]

1 What kind of employees do they like according to you?

2 If you were American born and schooled, what would be the reason for not getting interviews?

I miss debating you...
OK... They want new hungry residents who would not object to anything and would do what they are told
If I were american born and schooled... then my level of knowledge and experience should be the determining factor... unfortunately that does not come to play if you have a last name they are not familiar with!
Any other questions?

 

[urge]

I miss debating you...
OK... They want new hungry residents who would not object to anything and would do what they are told
If I were american born and schooled... then my level of knowledge and experience should be the determining factor... unfortunately that does not come to play if you have a last name they are not familiar with!
Any other questions?

1 Are you objecting to your new employer?
2 Have you considered the possibility that said groups are not interviewing new people?

 

[Planktonmd]

1 Are you objecting to your new employer?
2 Have you considered the possibility that said groups are not interviewing new people?

I am not "objecting" I just happen to have opinions based on my experience... is that wrong in your "opinion"?
2- No... they are interviewing... but not interviewing foreigners!... trust me... they don't talk to foreigners... it's not an illusion or an accusation... it is the truth!

 

[Mad Jack]

Change your name to something mundanely caucasian like Robert White, problem solved.

 

[Planktonmd]

Change your name to something mundanely caucasian like Robert White, problem solved.

I thought about that... but I like my current name: Saddam Ossama Muhamed!

 

[Consigliere]

Plantonmd - I am so sorry to hear that - and I genuinely mean it. Residents take heed: no job is forever, no position guaranteed. This is an unfortunate example of the cancer that is the AMC which is ravaging anesthesia. Their metastatic growth is too rapid and untreatable. I've been saying this for the last 5 years: anesthesiology is dead. R.I.P. You'll have to adapt a new mindset - you will be an AMC slob who is just, in their estimation, an overpaid tube monkey. Tow the company line, keep your head down, be a good little soldier and collect your paycheck. Don't make waves future anesthesiologist for you will go the way of Planktonmd. I've been in this game for over 15 years and examples such as these are becoming more and more frequent. Great, great guys who are phenomenal anesthesiologists are being uprooted and tossed aside like rubbish. It's criminal. Medicine may suck, but anesthesiology swallows.

 

[Planktonmd]

Unfortunately... Consigliere is right!

 

[urge]

I am not "objecting" I just happen to have opinions based on my experience... is that wrong in your "opinion"?
2- No... they are interviewing... but not interviewing foreigners!... trust me... they don't talk to foreigners... it's not an illusion or an accusation... it is the truth!

1 Opinions based on experience... what does that entail? Are you cancelling cases that your new masters are deeming as inappropriate?
2 How come your name did not impede you from obtaining a residency slot... IN THE SOUTH, but it does for jobs?

 

[Planktonmd]

1 Opinions based on experience... what does that entail? Are you cancelling cases that your new masters are deeming as inappropriate?
2 How come your name did not impede you from obtaining a residency slot... IN THE SOUTH, but it does for jobs?

"Opinions based on experience" means doing anesthesia and practicing medicine based on being a consultant anesthesiologist and based on patient's interest. It means directing mid-level providers and being the team leader not someone who just signs the record and hopes for the best.
The AMC wants you to be the one who blesses the CRNA and just stand by and handles disasters... this is not how I practice.
The reason I got a residency spot in the south... is because I was interviewed by an amazing physician who actually decided to let me in out of the match... and because I was an exceptionally good candidate!

 

[deleted171991]

Unfortunately... Consigliere is right!

+1. I am learning it myself.

 

[urge]

"Opinions based on experience" means doing anesthesia and practicing medicine based on being a consultant anesthesiologist and based on patient's interest. It means directing mid-level providers and being the team leader not someone who just signs the record and hopes for the best.
The AMC wants you to be the one who blesses the CRNA and just stand by and handles disasters... this is not how I practice.
The reason I got a residency spot in the south... is because I was interviewed by an amazing physician who actually decided to let me in out of the match... and because I was an exceptionally good candidate!

1 Where are you that you cannot get involved with your cases?
2 How do you explain so many foreigners in anesthesia?

 

[deleted126335]

Part of your situation doesn't quite fit. Being respected by the surgeons is always an asset. Maybe being a little too outspoken against administration or against your new employer is the problem. Not towing the company line, e.g., refusing to be a preop monkey only and a rubber stamp for a CRNA practice can also be a huge problem.

Agree that being a foreigner is never an asset. Even being US born US educated and trained is frequently not enough in smaller communities. I am a non local boy in a small town. I experience a much milder form of what you are experiencing. In fairness, I expect that this is not just a U.S. phenomenon. If U.S. born citizens moved to to other countries, they would have "funny names" from the locals' perspective. Even if they were educated and trained in their new country of residence, I would expect them not to enjoy all the natural advantages that arise from being a "homie"

 

[deleted171991]

2 How do you explain so many foreigners in anesthesia?

There was a period in the 90's when few American grads wanted to do anesthesia, the same way they don't want to do primary care today. Today's foreigners represent less than 5% of the anesthesia residents nationally.

 

[Planktonmd]

1 Where are you that you cannot get involved with your cases?
2 How do you explain so many foreigners in anesthesia?

Man why are you so argumentative?
Not a surprise though you did that since you were a med student.
The new structure the AMC established is based on telling the CRNAs that they are the anesthesia providers and that we are there only to help them if needed.
If you criticize what they are doing they will report you and the management will not support you.
When you ask why there are so many foreigners in anesthesia is it because you don't know the history or are just being the usual Urge?

 

[deleted171991]

The new structure the AMC established is based on telling the CRNAs that they are the anesthesia providers and that we are there only to help them if needed.

This is not the future; this is the present. Residents, take notice!

You should never forget that 1. all AMCs care about is profit (and academia is not far behind); 2. many hospital administrators are nurses who take special pleasure in stepping on doctors, especially when that helps other nurses (this especially applies in academic hospitals).

Most CRNAs are smart enough to have decided that they don't want to be independent, and do more work for the AMCs for the same money. But they can have their own anesthesiologist monkey, to do all the dirty work for them.

 

[Planktonmd]

Part of your situation doesn't quite fit. Being respected by the surgeons is always an asset. Maybe being a little too outspoken against administration or against your new employer is the problem. Not towing the company line, e.g., refusing to be a preop monkey only and a rubber stamp for a CRNA practice can also be a huge problem.

Agree that being a foreigner is never an asset. Even being US born US educated and trained is frequently not enough in smaller communities. I am a non local boy in a small town. I experience a much milder form of what you are experiencing. In fairness, I expect that this is not just a U.S. phenomenon. If U.S. born citizens moved to to other countries, they would have "funny names" from the locals' perspective. Even if they were educated and trained in their new country of residence, I would expect them not to enjoy all the natural advantages that arise from being a "homie"

Doze,
You are right xenophobia and prejudice against others is not a US only phenomena, but for a while i was sheltered from it but now I have to wake up and deal with reality

 

[Planktonmd]

There was a period in the 90's when few American grads wanted to do anesthesia, the same way they don't want to do primary care today. Today's foreigners represent less than 5% of the anesthesia residents nationally.

On topic: as (relatively) tolerant as Americans are, you will always be a foreigner, Planktonmd. They don't want to hear anything negative from a foreigner. Remember that every single time you open your mouth.

The problem I am a foreigner with a big mouth!

 

[deleted171991]

The problem I am a foreigner with a big mouth!

Join the club.

 

[sevoflurane]

Sorry to hear this Plank.
These curve balls are never pleasant.
Heck, maybe getting out of your current gig is exactly what you need. Leaving it may lead to something better. You never know. Good luck.

 

[urge]

Man why are you so argumentative?
Not a surprise though you did that since you were a med student.
The new structure the AMC established is based on telling the CRNAs that they are the anesthesia providers and that we are there only to help them if needed.
If you criticize what they are doing they will report you and the management will not support you.
When you ask why there are so many foreigners in anesthesia is it because you don't know the history or are just being the usual Urge?

Just trying to get you to reflect.

So basically, you are not getting along with the team. I'm not valuing whether you are right or wrong. However, looks like you have been unsuccessful at getting the AMC see to the CRNAs as the problem. Now I'm beginning to understand why they would not want you around. At this rate it is probably wise to look for another job. With the ever disappearing groups I am not surprised that you cannot find one that is hiring.

It bothers me your sense of entitlement portrayed, where you accuse the American people of discrimination because you have forwarded a few CVs and have not gotten any interviews. I'm sure that if you had gotten some interviews, but not the job, then the same thing would apply. Whatever it is, if it does not go your way: discrimination!

That's so childish.


I have been an attending all along my days in SDN, btw.

 

[deleted126335]

Doze,
You are right xenophobia and prejudice against others is not a US only phenomena, but for a while i was sheltered from it but now I have to wake up and deal with reality[/QUOTE]

The problem I am a foreigner with a big mouth!

The logical response is to compromise when necessary or deal with the fact that you are on borrowed time in your present position. Ability and willingness to do this change at different points in one's life. Try to control the "big mouth". One suggestion to cover yourself and still maintain control of the anesthetic plan is to document as much as possible of the anesthetic plan preoperatively. E.g., Beta blocker with induction, no intrathecal narcotics, avoid use of midazolam and N2O, Oxygen/fire precautions. Not hard to do if you are a fast typist and have an EMR. My experience is that this is often perceived as less confrontational to some CRNAs as opposed to verbally instructing them. It also makes it riskier for them to be defiant since the directed plan is in writing.

 

[deleted171991]

Just trying to get you to reflect.

So basically, you are not getting along with the team. I'm not valuing whether you are right or wrong. However, looks like you have been unsuccessful at getting the AMC see to the CRNAs as the problem. Now I'm beginning to understand why they would not want you around. At this rate it is probably wise to look for another job. With the ever disappearing groups I am not surprised that you cannot find one that is hiring.

It bothers me your sense of entitlement portrayed, where you accuse the American people of discrimination because you have forwarded a few CVs and have not gotten any interviews. I'm sure that if you had gotten some interviews, but not the job, then the same thing would apply. Whatever it is, if it does not go your way: discrimination!

That's so childish.


I have been an attending all along my days in SDN, btw.

Wow, just wow!

 

[Planktonmd]

Just trying to get you to reflect.

So basically, you are not getting along with the team. I'm not valuing whether you are right or wrong. However, looks like you have been unsuccessful at getting the AMC see to the CRNAs as the problem. Now I'm beginning to understand why they would not want you around. At this rate it is probably wise to look for another job. With the ever disappearing groups I am not surprised that you cannot find one that is hiring.

It bothers me your sense of entitlement portrayed, where you accuse the American people of discrimination because you have forwarded a few CVs and have not gotten any interviews. I'm sure that if you had gotten some interviews, but not the job, then the same thing would apply. Whatever it is, if it does not go your way: discrimination!

That's so childish.


I have been an attending all along my days in SDN, btw.

I am pretty sure you were a student or a first year resident when I first saw you here.
but I appreciate your insight and thoughtful advice

 

[urge]

I am pretty sure you were a student or a first year resident when I first saw you here.
but I appreciate your insight and thoughtful advice

No.

Maybe you got that impression because I have never come here to say I'm the best at intubating gravid fire ants, can do the fastest always working blocks, or any other nonsense "seasoned attendings" seem to do all the time.

 

[Planktonmd]

No.

Maybe you got that impression because I have never come here to say I'm the best at intubating gravid fire ants, can do the fastest always working blocks, or any other nonsense "seasoned attendings" seem to do all the time.

But all these things you mentioned are true though!
I actually intubated a pregnant ant this morning and my blocks never fail

 

[pgg]

OK... They want new hungry residents who would not object to anything and would do what they are told

Age discrimination, or foreigner discrimination, both? What do the new resident hires look like? Are they all US-born US grads?

Sorry to hear about all this.

 

[BLADEMDA]

Age discrimination, or foreigner discrimination, both? What do the new resident hires look like? Are they all US-born US grads?

Sorry to hear about all this.

Most likely age (over 50 isn't good or definite negative if over 55) and foreign med school leads to major discrimination. Your best bet is to get a job with another AMC (ironic) or hospital based employee.

 

[ryanjmy]

Unless you're exceptionally qualified it's hard to get a desirable group to talk to you if you don't have an inside connection. Being an fmg, older or even a female might be strikes against you getting an interview with some groups. Large amcs and hospitals would be less likely to discriminate, and have deeper pockets if someone could prove discrimination.

I trained with 3 second generation anesthesiologists. They all got jobs at their dad's group. It's not what you know but who you know...

 

[sevoflurane]

To the young attendings out there: This is why you live below your means. Pay down your debt, maximize retirement accounts and have a nice FU account ready.
Once you meet these goals you can relax a bit. This situation is not unique to Plank. It happens in anesthesia all the time and with more frequency as of lately. Also, look for PP and Hospital Employeed positions. Don't feed the Devil and join those greedy AMCs. AMCs bat for themselves, not the physicians they hire. Also be aware that some groups manage their partners like AMCs.

Plank, you are in one of the most malignant parts of the country for anesthesia employment. Are you trying to stay in the Southeast?

 

[BuzzPhreed]

Plankton tells a cautionary tale to be sure. The cookie-cutter anesthesia is winning. No one wants a consultant anymore who understands the subtle nuances of a good anesthetic. They just want a fireman and someone to sign the papers.

I had a discussion with a general surgeon at my last gig. I told him to imagine that after he did the H&P and signed the consent that his PA would take the gallbladder out while he watched. Why not? I'm sure his PA could be trained to do this. Then I told him to imagine that he wasn't even in the room while the PA was doing this and, after doing a few of these, his PA would cop an attitude when he came in the room to offer constructive criticism or check on the case. Meanwhile I told him to imagine that this was going on simultaneously in four rooms and that they may or may not call you if there was a problem. And that he would still be legally responsible for the outcome of each case. Welcome to our world!

We created this monster. It's our responsibility to fix it. Somehow. Some way. Too many places have rolled over and played dead. We've allowed this.

One suggestion to cover yourself and still maintain control of the anesthetic plan is to document as much as possible of the anesthetic plan preoperatively. E.g., Beta blocker with induction, no intrathecal narcotics, avoid use of midazolam and N2O, Oxygen/fire precautions. Not hard to do if you are a fast typist and have an EMR. My experience is that this is often perceived as less confrontational to some CRNAs as opposed to verbally instructing them. It also makes it riskier for them to be defiant since the directed plan is in writing.

Who has time to do this? Especially at 4:1?

 

[k12balla]

Great analogy. However, I doubt we will ever be successful in getting other specialties to have sympathy for our plight....we did it to ourselves. The common misperception is that anesthesia is not that difficult, anybody can do it. Even people straight out of college with degrees in call of duty. By logic alone, the more rooms you are able to safely "supervise" the easier that job must be. A surgeon wouldn't dare leave his 20 yr old trauma pt, hemorrhaging away be repaired by his resident or P.A., while he goes and starts an elective lap chole. The reward, is not worth the risk...but we do similarly all the time and cross our fingers.

As for the OP, it appears it's residency all over again. Work hard, keep your head down, and tow the party line, or you will be replaced by a younger more agreeable version with better " credentials" who will work for less. It's a sad state of affairs.

 

[deleted126335]

Who has time to do this? Especially at 4:1?[/QUOTE]

You shave wherever and whenever you have to.

 

[chocomorsel]

Plankton, agree with Noyac. Get the hell out of Florida. Or maybe Blade can hire you. You hiring blade?
I am also one of those foreigners with a big mouth. Got in trouble a lot in residency. Didn't know how to keep my mouth shut against the dingus PD; and stupid nurses and techs and secretaries who thought they ran the place. In reality, they did, as I was a lowly resident.

Glad that part of my life is over. I can't imagine having to tow the line, keep my mouth shut, and lay low as an attending though. There's a lot more leeway once residency is over.

 

[gasp]

Is any of this surprising? NO.
Even when applying for residency, you could clearly see that with excellent stats/top of class/scores etc, there was always hesitation from PD and Chair on the fact that you are foreign. Many people including me were told many times that if I was not a foreign grad, I would get any residency I wanted with those numbers and personality. Well that carries over with you once you're an attending. I have been to PP groups who states they are not seriously looking and then someone from the group who I knew would come and tell me the truth which is that the director is afraid to hire foreign grads. Board certified? who cares. Great skill set? who cares.

Unfortunately you also have guys saying "keep your head down, do what you did in residency..etc" and that just adds to the problem because now everyone else in your boat who agrees with your experiences is not speaking up anymore because they are afraid. Now you are the only one speaking which makes you a direct problem/threat and you need to be replaced. You will never "get along with the team" if you have balls in this business and always speak your mind. Almost all physicians are looked upon as HELP unless proven otherwise while you are looked at as ROAD BLOCK until proven otherwise.

My advice? Pick and choose your battles because odds are that you will lose if you engage in everything (even though you might be right). Given the right balance, you will at least be mostly happy and still keep your job..

 

[Arch Guillotti]

until about a year a go when the hospital decided that we were too expensive and decided to give our contract to an AMC that agreed to do the same job with zero money subsidy!
Since that time things have changed and although the AMC did not fire me I now work twice as much for much less money.

Unfortunately not an uncommon scenario these days. Not all AMC takeovers involve a big buy-out with the partners getting rich. You may simply get scooped on a contract.

 

[BuzzPhreed]

Now you are the only one speaking which makes you a direct problem/threat and you need to be replaced. You will never "get along with the team" if you have balls in this business and always speak your mind. Almost all physicians are looked upon as HELP unless proven otherwise while you are looked at as ROAD BLOCK until proven otherwise.

My advice? Pick and choose your battles because odds are that you will lose if you engage in everything (even though you might be right). Given the right balance, you will at least be mostly happy and still keep your job..

I don't know what that means anymore. What battles do you pick and choose? The problem is no one is choosing any battles anymore. They are like the beta dog bowing their head, tucking their tail, and rolling over to show their soft underbits.

I had a spine surgeon come to me with a complex patient problem before I left my last job. Why? Because he recognized that I would give him a straight answer. Essentially the patient was a pulmonary cripple with metastatic disease to the spine who was going to require a kyphoplasty. Did he want a CRNA's opinion about what to do? No. He wanted a physician's opinion. The details are unimportant. But the fact that he recognized that he was talking doctor to doctor meant something. That is what you lose. Making surgeons recognize the distinction is paramount.

 

[deleted171991]

Plankton, agree with Noyac. Get the hell out of Florida. Or maybe Blade can hire you. You hiring blade?
I am also one of those foreigners with a big mouth. Got in trouble a lot in residency. Didn't know how to keep my mouth shut against the dingus PD; and stupid nurses and techs and secretaries who thought they ran the place. In reality, they did, as I was a lowly resident.

Glad that part of my life is over. I can't imagine having to tow the line, keep my mouth shut, and lay low as an attending though. There's a lot more leeway once residency is over.

Depends on the place. (As in I still have to find one where free speech by FMG attendings is actually encouraged.)

My advice to every FMG is to keep your mouth shut and not trust anybody with your thoughts. There is a lot of envy in the system, and the so-called tolerant people don't really like to see a successful foreigner; it's not about (dis)trust, it's about envy and (unconscious) discrimination. They want to see a foreigner who does worse than they do, eats more **** than they do, smiles about everything like they do, is grateful that s/he can be here and only says "Yes, master" (figuratively).

Because you are "not like them", very few truly appreciate what you bring to the table by having a different perspective, different life experience (many times with experience living under hardship or dictatorship), different education (many times with 6 full years of medical school on top of a much better high school system) etc. They never stop to wonder why the foreigner has achieved so much despite being obviously disadvantaged by a system that favors American grads; they will ascribe it to luck and "test-taking skills" (even if you come from a country with no multiple-choice tests), because you are obviously not smarter, harder-working or better in any way than they are. Or, if you are, all that matters in the end are your social skills.

Just remember what they did to Piers Morgan (whom I can't stand) when he started lecturing Americans about their laws.

Just do your job and go home. If you don't like it, just move on. Think that you live under a dictatorship and everything you say will put you and your family and danger. Whatever makes you keep your mouth shut.

One more thing: treat like royalty those few who truly appreciate you and stand up for you.

P.S. This is a post written for myself, so I can re-read it every single ****ing day.

 

[chocomorsel]

You got it FFP. There's so much "unconscious" discrimination out there. And you hit on so many points. I am pretty easy to get along with at work (just don't ask hubby) so it make things easier for me. But I am aware of my limitations as a minority woman in this field. See it plenty at work, the difference in treatment of my partners (middle aged caucasian Americans) and myself. But, such is life. Can't dwell on it though, just keep it moving.

 

[BuzzPhreed]

You got it FFP. There's so much "unconscious" discrimination out there. And you hit on so many points. I am pretty easy to get along with at work (just don't ask hubby) so it make things easier for me. But I am aware of my limitations as a minority woman in this field. See it plenty at work, the difference in treatment of my partners (middle aged caucasian Americans) and myself. But, such is life. Can't dwell on it though, just keep it moving.

The problem you're gonna have, chocomorsel, is that you will be seen as a mommy tracker. Many of the female anesthesiologists I have worked with and have treated as complete equals get snubbed. It's ruined by the few (recently one married to a CT surgeon the other to a plastic surgeon both of whom are part time) who are seen as day trippers more interested in getting home to take care of their kids than being actual professionals, despite the fact that they are expert at their jobs and far more valuable than even the most seasoned CRNA. This won't change until your kids are latch-key and you're ready to be seen as a true full-timer. Expect this to be the case up and until you're out of your childbearing years. It sucks for the female docs who are truly the bread winners in the relationship.

 

[chocomorsel]

Haha FFP. That is hilarious. Remember, beauty is in the eye of the beholder.

 

[Planktonmd]

Plank, you are in one of the most malignant parts of the country for anesthesia employment. Are you trying to stay in the Southeast?

Not anymore... I am looking all over the country.

 

[Planktonmd]

Depends on the place. (As in I still have to find one where free speech by FMG attendings is actually encouraged.)

My advice to every FMG is to keep your mouth shut and not trust anybody with your thoughts. There is a lot of envy in the system, and the so-called tolerant people don't really like to see a successful foreigner; it's not about (dis)trust, it's about envy and (unconscious) discrimination. They want to see a foreigner who does worse than they do, eats more **** than they do, smiles about everything like they do, is grateful that s/he can be here and only says "Yes, master" (figuratively).

Because you are "not like them", very few truly appreciate what you bring to the table by having a different perspective, different life experience (many times with experience living under hardship or dictatorship), different education (many times with 6 full years of medical school on top of a much better high school system) etc. They never stop to wonder why the foreigner has achieved so much despite being obviously disadvantaged by a system that favors American grads; they will ascribe it to luck and "test-taking skills" (even if you come from a country with no multiple-choice tests), because you are obviously not smarter, harder-working or better in any way than they are. Or, if you are, all that matters in the end are your social skills.

Just remember what they did to Piers Morgan (whom I can't stand) when he started lecturing Americans about their laws.

Just do your job and go home. If you don't like it, just move on. Think that you live under a dictatorship and everything you say will put you and your family and danger. Whatever makes you keep your mouth shut.

One more thing: treat like royalty those few who truly appreciate you and stand up for you.

P.S. This is a post written for myself, so I can re-read it every single ******* day.

This my friend... is the best post I ever read on this forum... Thanks!

 

[BuzzPhreed]

Not anymore... I am looking all over the country.

There are plenty of places who will highly regard and are in dire need of a seasoned anesthesiologist. Just be prepared to buy a winter jacket and drive far for modern conveniences. A guy I was recently working with told me about a $500K W-2 job in rural WV where they are desperate for someone. Note that: rural. But you can live like an absolute king in that kind of set up if you don't mind Jethro and the boys picking "dueling banjos" every night outside your window as you're nodding off to sleep...

 

[nimbus]

There are unspoken biases between foreign grads too. The handful of foreign grads in our practice have been white native English speakers from the UK, Canada, and South Africa. Not Asia. Though we have many foreign born US grad partners of Asian descent.

 

[BLADEMDA]

You guys hear of a high paying job in the rural south let me know. I prefer the Deep South.

Really rural is just fine

 

[IkeBoy18]

There are plenty of places who will highly regard and are in dire need of a seasoned anesthesiologist. Just be prepared to buy a winter jacket and drive far for modern conveniences. A guy I was recently working with told me about a $500K W-2 job in rural WV where they are desperate for someone. Note that: rural. But you can live like an absolute king in that kind of set up if you don't mind Jethro and the boys picking "dueling banjos" every night outside your window as you're nodding off to sleep...

I wonder if I could make it in a place like that without ending up standing under a tree and my feet not touching the ground.