FMGs in residency programs a sign they're less competitive?

[kristing]

OK. Here's a potentially ignorant question from a below average medical student who is paranoid about matching for a residency.

If a residency program has many current FMGs in it (ie at least 1/4 - 1/3 or total residents), does it generally mean it's less competitive? (I am not speaking as to whether or not they are good or bad programs, just if they are easy to match into.)

kristin

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[MacGyver]

uhh...yes

 

[kristing]

ok. Be nice. I prefaced it with being ignorant.

 

[scrub monkey]

i actually think it depends.

there are residency programs with some extremely strong and competent foreign med grads, many stronger than us grads.

there are also some frightening residency programs with not-so-strong fmg's. these programs are a bit scary and tend to be 100% fmg.

so if your program is 1/4 fmg, i'd guess those are probably pretty strong fmgs. to really tell, you'd have to spend a little time there to watch morning report and to get a feel of the residents.

 

[hoo]

i dunno.....the chief resident of Rad/Onc at Hopkins may take exception to that notion......she's an FMG!

 

[The White Coat Investor]

Exceptions exist....but yes

 

[lowbudget]

I don't know about this...

A couple of FMG's I've bumped into either went through residency already in another country or were attendings in another country before they moved to the States. And they usually always contribute more to morning report/journal club than anyone else because they straight up just know more.

So it's hard to tell just by looking at the website. But I guess the conventional wisdom is FMG=worse quality, solely based on what others have told me, not by what I've observed.

 

[Apollyon]

Many places in the US are Pro-USMD, discriminating against DO's, FMG's, and whomever else (but I guess there isn't other). Whatever - it's their loss.

At Duke, there are A LOT of FMG's, because Duke doesn't care where you're from - just as long as you are the best - and I mean that. These folks ARE the best of the best.

 

[tofurious]

I think those who have completed 1+ residencies elsewhere and those who are attendings already in other countries somewhat dilute the residency experience for the rest of us. There is probably no question that their knowledge base and practical experiences are much greater than ours. And again, that's like saying the senior residents' experiences are greater than ours, but that's because they have been doing it longer.

I see more and more super-qualified IMGs at the leading institutions (such as Duke; and these super IMGs are not in the same class as the average IMG). That bears the question: how are these leading institutions of medicine doing the country a service by re-training those who obviously already know how to do what they do, and taking away opportunities from those US seniors who could have benefited from the first-class training?

 

[benjee]

I have the same questions too! It is because the re-training of these super IMGs is wasting resources which can be used to provide training to any new med. graduates. I've seen some of these superIMGs know more than some of the US attendings (it's a shame!)

 

[neilc]

so, do you guys think these super IMG's should just be given credit for thier training?

already, in order to compete for the same position, IMG's need to be much better than the US trained counterpart, based on boards, recommendations, etc...

i don't really see what the other option would be. close to IMG's? that is not a realistic option. give credit for prior training? i think that would be a logistical nightmare...i wouldn't mind training outside of the US, but who would verify that my training was adequate?

i think the current atmosphere is pretty darn favorable to US grads in terms of competition. but, there will likely always be those few IMG's that have impeccable credentials, and they will get some primo spots. i don't think overall it is going to screw all that many US grads out of a spot.

 

[tofurious]

I agree that the CURRENT atmosphere is still favorable for US grads, but we are getting on a slippery slope that we may have a hard time getting off in the future. I actually personally think that if Dr. X is a FULL professor of medicine in England and world expert on something, there is no reason why - if some big institution wants to hire him/her as the expert in their hospital - he/she would have to repeat residency. It's similar to the whole recruitment process for department chairs - you don't make them start at the assistant professor level again. That is NOT to say that someone with a doctorate from some small unknown country should be given the same priviledges after practicing one year of medicine. It would be done on a case-by-case basis. This COULD be supplemented by the normal process of getting IMGs in residency, with a strict cap on the number of IMGs. Many hospitals are closing their doors (see MCP) and large number of residency spots are lost. Not to cry wolf or anything, doors may close sooner than you think, and letting people know that there are only so many spots makes everyone's expectations realistic and the sentiments of American seniors against IMGs at a low level. Otherwise, it's you guys who will be targeted by DOs or other US grads who don't get into residency.

 

[neilc]

there already are laws on the books for profs of medicine to come to the states and work without a residency. in fact, there is some contreversy in colorado right now regarding these issues. they have a french dude in charge of peds cardio surg, if i remember correctly. right now the law is something like they have to take the USMLE within 2 years, and they are trying to change it to 5...i believe the thread with the article is here or on valuemd.com

anyhow, i think the high-powered guys that go academic are not the ones taking the residency spots. rather, in those spots you have the hotshots who want to immigrate to the states and work for a living. i would be willing to wager that a lot of these guys are simply clinicians with tons of experience willing to work hard to get a job in the states...so, it would be tough to seperate these guys from all the other IMG's in any fair way.

 

[neilc]

here is the article:
http://www.valuemd.com/viewtopic.php?t=12622

so, it seems to me that the majority of the uber-IMG's are just better qualified/trained versions of all the rest of us IMG's. i think the system right now does a pretty good job. what would be a more fair way of distributing residency spots?

 

[Apollyon]

The FMG's at Duke that I can name, for the most part, are "fresh graduates" from their own countries; if not, a few have done research, and one guy I know did 2 years of FP in the US (his first post-grad position) before coming here. There's only one person I know that completed a residency elsewhere. Then again, there is more than one American grad that has done a residency elsewhere, and is retraining at Duke.

 

[upitt]

There are some fmg's who are just completely terrible and I would never allow them to take care of anyone that I love.
however, there are also usmg's that are just as bad if not worse.

If you think that all fmg's are not as good as usmg's think again. While you were still making a mess of yourself some of these physicians have been saving lives in their own country. The only reason you are not forced to look up to them now is because they have not been able to comprehend the english language very well.

There are also a lot of very good usfmg's out there. Just because they didn't get into a us medical school means absolutely nothing. Undergrad will not prepare you for residency and beyond. Med school will. Those who have put the time and effort in medical school are good physicians and we should not count them out just because they graduated from a non-us medical school.

 

[drlee]

very well said, upitt!! thank you for expressing your sentiments..