pathology residency = puppy mill

[oldfatman]

http://thecareerist.typepad.com/thecareerist/2010/07/young-and-dumb.html

I'm sure some of you will see the parallels here. Only so many puppies survive to be adopted (employed).

---

Members don't see this ad.

 

[turtle1966]

http://thecareerist.typepad.com/thecareerist/2010/07/young-and-dumb.html

I'm sure some of you will see the parallels here. Only so many puppies survive to be adopted (employed).

I do and, as with law schools, it is a crisis, self-made, by our unethical, blind leaders for self-aggrandizement and lucre.

 

[turtle1966]

http://thecareerist.typepad.com/thecareerist/2010/07/young-and-dumb.html

I'm sure some of you will see the parallels here. Only so many puppies survive to be adopted (employed).

The abuse (of right to mint lawyers) by the leaders of legal profession has finally made to the front pages of prominent newspapers.

Our so called "leadership" has done the same for decades. Their deed could perfectly serve as a Harvard Business School case study.

They has made a desert of a tropical forest, they deceived generations of medical students, made their trainees to drink potion of forgetfulness lest they can reminisce yesteryear's dreams, made them feel fortunate in landing a 70K teaching job after 2-3 fellowships and to thank (the culprits of their plight) for the opportunity. They sold us pathologist to servitude of hospital CEOs, commercial labs, in-house office labs, they made us forget that we are MDs and robbed our professional dignity before our professional colleagues.

To rub salt into the wound, they blatantly ignore our complaints and propose to mint more pathologists!!

I cringe and feel visceral revulsion when I am forced to renew CAP membership and lab credentials.

This bizarre situation is truly worthy of front pages of New York Times!!

 

[Sulfinator]

http://thecareerist.typepad.com/thecareerist/2010/07/young-and-dumb.html

I'm sure some of you will see the parallels here. Only so many puppies survive to be adopted (employed).

But what if one was to complete both a pathology residency and law school . . . ?

 

[ruralsurg4now]

Serious question: are you guys just complaining that there are no jobs where you want? Or no jobs AT ALL? Because I had to go work in the middle of nowhere and it sucks, but I did it. And my hospital only has a pathologist for one day a week. I bet they wouldn't mind a full-time guy.

 

[deleted480308]

I do and, as with law schools, it is a crisis, self-made, by our unethical, blind leaders for self-aggrandizement and lucre.

Have they been promising new residents there were tons of jobs? Or are you just mad that there aren't?

 

[turtle1966]

Serious question: are you guys just complaining that there are no jobs where you want? Or no jobs AT ALL? Because I had to go work in the middle of nowhere and it sucks, but I did it. And my hospital only has a pathologist for one day a week. I bet they wouldn't mind a full-time guy.

Suggest reading the thread named "600 residents per year - 49 advertised jobs" started by "BU Boston", the pollyannaish chairman of Boston U. He regular posts how wonderful pathology is and how plentiful the jobs are for "good" trainees; but when challenged to produce the whereabouts of his trainees for the last 5 years, he stays mum.

Four years of residency + 1-3 years of fellowship + residency time spent on worrying in finding any job, while your school mates are busy pondering which job offers to reject + humiliation of networking (aka brown nosing) + having to move to another city, state or country you had not heard of + having to accept 70k teaching job at same Universities that have created over-supply + job insecurity once you land a job + rarefied chances of partnership, more likely a source of cheap labor for commercial labs, older pathologists, yesteryear school mates of yours who were smart enough to go into derm, uro, gi etc. + having to put up with one of the so called leaders (Stan Robboy) apologizing for having created a situation of an impending shortage of pathologists, beginning next year, and proposing an immediate increase in residency spots + constantly having to consider you colleagues as your potential business competitors because there are too many of us + all this for 3 decades now, at least.

In the hospital situation you described, the hospital can not afford a permanent pathologist position, otherwise, someone would have taken it already.

 

[turtle1966]

Have they been promising new residents there were tons of jobs? Or are you just mad that there aren't?

The possibility that an MD would not find a job is such an absurd concept in the mind of medical students, that they do not ask during their residency interviews. Nope, rather there is an active act of hiding the truth by those who should disclose it, and code of silence by those who should speak up.

The closest to "promises" I have heard were the pronouncements by BU Boston, the pollyannaish chairman of Boston U. He regular posts how wonderful pathology is and how plentiful the jobs are for "good" trainees; but when challenged to produce the whereabouts of his trainees for the last 5 years, he stays mum.

The truth of the matter is that the powers that be in Academic pathology do basic research, need money and cheap labor and were granted a minting press, which they have been wielding with total disregard to quality and demand of final product. While other specialties control carefully the supply of their trainees, those in basic pathology research have an absolute disdain for such a mundane financial concept.

The result is a large number of IMG in the field, and the coded message, by the likes of BU Boston, is that "good", i.e., AMG, candidates will find good jobs, and "not good", IMG, candidates will not, and deserve not to find a job.

It is an absolutely baffling and shortsighted thinking! The fact is that Quest and Lab Corps are full of IMGs, who are as competent as AMGs. According to one expert, the average salary for commercial lab pathologist is around 220k, while that of a private practice partner is around 540k. With this cost advantage, it is only matter time before the commercial labs will turn their cheap labor force against those in private and hospital practices.

I hear of recent graduates going into academia for dearth of choices and as a way station to more lucrative private practice.

Folks, American Medicine is a wealthy profession with plenty of well paying and respected jobs, an envy of doctors around world; in midst of this, there is a man-made desert called Pathology.

 

[Thrombus]

Turtle is right on. If you are set to match into pathology, you are best served going into the scramble. Find a career that has a future. Our future not only has what turtle described, but disruptive technology will exacerbate our commoditization further. We only need a few thousand paths in this country and we are putting out 600 per year!!! This is insane! People are doing 2-3 fellowships to get a job. Then academics, corporate labs, and your colleagues who came after you in med school will pay you pennies on the dollar, that CMS just slashed, for the work you do. You have zero leverage and can be replaced at any time with a newly minted foreign national.

 

[Path or bust]

Turtle is right on. If you are set to match into pathology, you are best served going into the scramble. Find a career that has a future. Our future not only has what turtle described, but disruptive technology will exacerbate our commoditization further. We only need a few thousand paths in this country and we are putting out 600 per year!!! This is insane! People are doing 2-3 fellowships to get a job. Then academics, corporate labs, and your colleagues who came after you in med school will pay you pennies on the dollar, that CMS just slashed, for the work you do. You have zero leverage and can be replaced at any time with a newly minted foreign national.

Yes, I agree with above as quite accurate. Medstudents, even FMGs, please watch out for this crumbling specialty.

 

[path24]

Another reason why there will never be a shortage. The numbers are from Aurora Diagnostics...Pathology Blawg Jan 20, 2014 article.

113 pathologists with 2.1 million accessions in 2013 (assuming these are all surgical/cytology specimens which it sounds like it is the case) EQUALS.........18500 specimens per pathologist. SHORTAGE WILL NEVER HAPPEN. (Academics like to think 3-4000 per pathologist at most...complete fantasy and not remotely true in the private world and this is what they base their "shortage" and "need" for pathologists on)

The number of specimens will never remotely increase enough for it to come close. The job market will always be poor and continue to decline. With reimbursement cuts, its going to get a lot worse. It is freaking scary.

1 year fellows + 2 year fellows + 3 year fellows (+ possible 4 year fellows and very naive residents) all applying for jobs in a given year. 1000+ fighting every year for limited jobs.

Sorry if you decided on pathology. Its ugly already and its going to get worse.

 

[WEBB PINKERTON]

Aurora Diagnostics does do PAP tests so that 2.1 million accession number could be misleading. Some labs hype up their accessions and then you find out they are doing 2 or 3 times more cytology than tissue. Most of the labs I've worked at easily had twice as many cytology accessions as histology, thanks to the pap test.

But yes, pathologists are much more productive and will have to continue to find more efficiency.

Evolution will run its course and people will stay away from this field. Law schools are seeing a decline in applicants because word is out that the market is saturated. Same thing will/is happen(ing) to pathology.

 

[2121115]

Another reason why there will never be a shortage. The numbers are from Aurora Diagnostics...Pathology Blawg Jan 20, 2014 article.

113 pathologists with 2.1 million accessions in 2013 (assuming these are all surgical/cytology specimens which it sounds like it is the case) EQUALS.........18500 specimens per pathologist. SHORTAGE WILL NEVER HAPPEN. (Academics like to think 3-4000 per pathologist at most...complete fantasy and not remotely true in the private world and this is what they base their "shortage" and "need" for pathologists on)

Well, 18,500 surgicals per pathologist is not insignificant. I'm not sure that supports your argument.

 

[WEBB PINKERTON]

Out of those 2.1 million specimens, 1 million could be the pap test for all we know. Many of those dont require pathologist review.

 

[icpshootyz]

Not to mention Aurora runs biopsy labs, not full service pathology labs. They're not getting colons, mastectomies, or the like. They probably never bill higher than an 88305 for any of their cases. They probably don't even get lymph nodes from melanomas. They built up to capitalize on the derm/GI/GU craze, and are just meant to pump out biopsy diagnoses as fast as possible. To compare them to full service hospital pathology is not a true comparison at all.

 

[WEBB PINKERTON]

When I read the pathologyblawg post from Aurora, it says they plan to buy up some more labs. I dont know what labs they think they are going to acquire. The hospitals are all merging into large networks. The path specimens will be heading to the main core lab of the university/catholic system. Good luck finding any good path labs to purchase.

 

[Whiskeyjack]

The possibility that an MD would not find a job is such an absurd concept in the mind of medical students, that they do not ask during their residency interviews. Nope, rather there is an active act of hiding the truth by those who should disclose it, and code of silence by those who should speak up.

The closest to "promises" I have heard were the pronouncements by BU Boston, the pollyannaish chairman of Boston U. He regular posts how wonderful pathology is and how plentiful the jobs are for "good" trainees; but when challenged to produce the whereabouts of his trainees for the last 5 years, he stays mum.

The truth of the matter is that the powers that be in Academic pathology do basic research, need money and cheap labor and were granted a minting press, which they have been wielding with total disregard to quality and demand of final product. While other specialties control carefully the supply of their trainees, those in basic pathology research have an absolute disdain for such a mundane financial concept.

The result is a large number of IMG in the field, and the coded message, by the likes of BU Boston, is that "good", i.e., AMG, candidates will find good jobs, and "not good", IMG, candidates will not, and deserve not to find a job.

It is an absolutely baffling and shortsighted thinking! The fact is that Quest and Lab Corps are full of IMGs, who are as competent as AMGs. According to one expert, the average salary for commercial lab pathologist is around 220k, while that of a private practice partner is around 540k. With this cost advantage, it is only matter time before the commercial labs will turn their cheap labor force against those in private and hospital practices.

I hear of recent graduates going into academia for dearth of choices and as a way station to more lucrative private practice.

Folks, American Medicine is a wealthy profession with plenty of well paying and respected jobs, an envy of doctors around world; in midst of this, there is a man-made desert called Pathology.

 

[member0007]

it's worse than a puppy mill. you can work non-stop for years in the residency, and be exposed to formalin, formaldehyde, ethanol, xylene, biohazards etc to do your job, and then be told that despite all the competent work and commitment, you are suddenly bad at patient care and a threat to their operations! meanwhile, these hospitals hire people without checking the resumes, medical school records, and hire chairman to the department who never did a path residency! if i had any idea about the outright lack of quality control in this regard, i would have actually avoided it altogether, this is seriously gross. i also can't make this **** up but that's pathology for you. meanwhile, you got these same lunatics running around covering up med mal cases for the hospital and not forwarding cases to medical examiners, changing death certificates for friends, and whatever else. if i had any idea that this is how it was where i worked, i would have not signed up for the job, it's horrifying.

 

[DermViser]

Suggest reading the thread named "600 residents per year - 49 advertised jobs" started by "BU Boston", the pollyannaish chairman of Boston U. He regular posts how wonderful pathology is and how plentiful the jobs are for "good" trainees; but when challenged to produce the whereabouts of his trainees for the last 5 years, he stays mum.

Seriously? What's the name of that thread?

 

[DermViser]

The possibility that an MD would not find a job is such an absurd concept in the mind of medical students, that they do not ask during their residency interviews. Nope, rather there is an active act of hiding the truth by those who should disclose it, and code of silence by those who should speak up.

The closest to "promises" I have heard were the pronouncements by BU Boston, the pollyannaish chairman of Boston U. He regular posts how wonderful pathology is and how plentiful the jobs are for "good" trainees; but when challenged to produce the whereabouts of his trainees for the last 5 years, he stays mum.

The truth of the matter is that the powers that be in Academic pathology do basic research, need money and cheap labor and were granted a minting press, which they have been wielding with total disregard to quality and demand of final product. While other specialties control carefully the supply of their trainees, those in basic pathology research have an absolute disdain for such a mundane financial concept.

The result is a large number of IMG in the field, and the coded message, by the likes of BU Boston, is that "good", i.e., AMG, candidates will find good jobs, and "not good", IMG, candidates will not, and deserve not to find a job.

It is an absolutely baffling and shortsighted thinking! The fact is that Quest and Lab Corps are full of IMGs, who are as competent as AMGs. According to one expert, the average salary for commercial lab pathologist is around 220k, while that of a private practice partner is around 540k. With this cost advantage, it is only matter time before the commercial labs will turn their cheap labor force against those in private and hospital practices.

I hear of recent graduates going into academia for dearth of choices and as a way station to more lucrative private practice.

Folks, American Medicine is a wealthy profession with plenty of well paying and respected jobs, an envy of doctors around world; in midst of this, there is a man-made desert called Pathology.

Why would employers care if you're an AMG vs. IMG at that point, if you've both completed the same residency? That makes no sense.

 

[turtle1966]

Why would employers care if you're an AMG vs. IMG at that point, if you've both completed the same residency? That makes no sense.

I was going to ask you what specialty are you from? Derm? In Pathology, my statement is not a statement of Logic but of Fact.

If the employer is a LabCorp and Quest, they would not, or would less, a large contingent of their staff are IMGs.
For lucrative partnerships and residencies, IMG are ranked well below AMGs. The quality of depts and residencies are often scored inversely to percentage of IMGs. Possibly due to, language, looks, perception by clients, old boy network, better known quantity?

I know that is not the case in fields where IMGs are very thinly represented, as in Dermatology and Ophthalmology. This thin representation, in itself, is a tell as well.

 

[turtle1966]

Seriously? What's the name of that thread?

I had misquote the name of Chairman, it is BU Pathology.
The thread is "Help needed deciding whether pathology is for me"

Below is the reproduction of BU Pathology's post

It is important to look at the facts about the job market, to dispel the internet rumors about the poor job market. You will find useful information in the attached file, 2011 Resident Forum slides. The job market survey was based on responses from 905 pathologists, which is a much larger sample than the number of postings on this website saying that no jobs are available. The job survey information starts with slide 60. The entire slide deck was too large to upload, so those slides related to the job market were extracted.

Briefly, based on this survey last year done by the College of American Pathologists:

Everyone got a job.

If you look carefully at slide #68, you will notice that
100% of the respondents were invited to at least 1 job interview
100% received at least one job offer
100% of respondents accepted the position

In other words:

Everyone got a job.

This should reduce the anxiety of medical students considering pathology as a career, who are concerned about the postings on the job market on this web site. There will be some who may disparage the survey saying that the jobs are not good enough, that not enough jobs are partner track, that free parking was not included. But at the results of the survey show,

Everyone got a job.

The survey also covers the past 2 years, and it includes participants from US allopathic schools, osteopathic schools, and international medical schools. The results show:

Everyone got a job.

To those considering pathology as a career, you will find it rewarding, challenging and extremely satisfying. During a time period when unemployment in the United States rose dramatically, everyone finishing pathology training were successful in finding a position.

Daniel Remick, M.D.
Chair and Professor of Pathology
Boston University School of Medicine and Boston Medical Center

 

[DermViser]

I was going to ask you what specialty are you from? Derm? In Pathology, my statement is not a statement of Logic but of Fact.

If the employer is a LabCorp and Quest, they would not, or would less, a large contingent of their staff are IMGs.
For lucrative partnerships and residencies, IMG are ranked well below AMGs. The quality of depts and residencies are often scored inversely to percentage of IMGs. Possibly due to, language, looks, perception by clients, old boy network, better known quantity?

I know that is not the case in fields where IMGs are very thinly represented, as in Dermatology and Ophthalmology. This thin representation, in itself, is a tell as well.

I'm from Derm, but my question is more that I'm curious of the answer, not that I don't believe you. If 2 candidates both came from the same residency from the same institution, with IMG having much better performance than the AMG during residency, an employer would choose the AMG over the IMG?

 

[DermViser]

I had misquote the name of Chairman, it is BU Pathology.
The thread is "Help needed deciding whether pathology is for me"

Below is the reproduction of BU Pathology's post

I don't understand where was he challenged by someone and refused to list his residents' career destinations?

 

[turtle1966]

I'm from Derm, but my question is more that I'm curious of the answer, not that I don't believe you. If 2 candidates both came from the same residency from the same institution, with IMG having much better performance than the AMG during residency, an employer would choose the AMG over the IMG?

Only an employer would be able to answer that question. I am stating only a well known fact in Pathology.

How many IMG applicants did you derm PD have last year? How many IMGs did he take, percentage wise? What percentage of derm residents are IMGs? If low, do you think it is because IMG dislike derm? Ask your PD.

 

[turtle1966]

I don't understand where was he challenged by someone and refused to list his residents' career destinations?

I had started the thread and went nowhere:
Sunshine Rule for Residency and Fellowship Programs

BTW, I presume that derm is a lot like pathology, eh?

The following is reproduction of my original post:

I would like to suggest that Program Directors make available a list of residents leaving their programs with types of job(s) obtained. The list should include the last 5 years as well. The list does not have to include the names, however, should be specific enough to be verified in this Board.

This should give a true picture of job market for the newly minted pathologists.

 

[yaah]

I'm from Derm, but my question is more that I'm curious of the answer, not that I don't believe you. If 2 candidates both came from the same residency from the same institution, with IMG having much better performance than the AMG during residency, an employer would choose the AMG over the IMG?

This is a loaded question. Define "better performance."

There are all kinds of reasons people would hire one candidate over another. "residency performance" is not really one of them, although I suppose it could have impact in certain situations. Faculty recommendations are important - if you consider those equivalent to residency performance I suppose that means it is important. But residencies aren't graded.

IMGs are often (but certainly not always) not preferred as candidates for private jobs for a variety of reasons which could include communication skills, educational background, likelihood to stay in the area for more than a year or two, etc. This does not usually apply to individual candidates, of course. This is most definitely not limited to pathology. IMGs are often competing for second-tier jobs in every specialty. In more competitive residencies like derm, IMGs are comparitively rarer, and thus those that do get residency spots are more competitive applicants in general.

There is no such thing as "scoring departments with percentage of IMGs" - that is a ludicrous statement. Departments are valued and respected based on the quality of their work and relationship to other departments. Some of the most respected physicians in our hospital are IMGs.

 

[turtle1966]

There is no such thing as "scoring departments with percentage of IMGs" - that is a ludicrous statement.

It should be ludicrous, however, unspokenly, it is not.

It is simply a matter of logic. Speaking on average, to expect that IMGs would be "better" than AMGs is "ludicrous", a PC statement, for the following reasons:

1-USA spends in training of its MDs more than any other country in the world
2-US medicine attracts the best of best native Americans (it is not the case in many other countries)
3-AMGs have natural advantages in spoken and written language + customs + habits + looks + built in relationships, etc.​

To be otherwise would be a serious indictment to US education system.

This does not mean that an AMG would be a better doctor in any foreign country for obvious reasons. Do you get it?

US is the most welcoming and generous nation towards the foreigners, in the earth, bar none. Many foreigners can not be what they are even in their homeland.

The main reason there are so many IMGs in the USA is because, for decades, the demand had overwhelmed the supply, so much so that for close to 2 decades IMGs where given the most preferential visa status (i.e., no waiting period of any length) to come into USA.

Your mention of "most valued and respected" IMGs is not untrue, but a stale cliche.

 

[WEBB PINKERTON]

Being a physician in other countries must really suck. I noticed at a nearby large reference lab, they have a dude who embeds all day long and he used to be a physician in Russia. Can you imagine going from being a Russian physician to embedding all day long? The person seemed happy so it must be an upgrade sadly.

 

[gbwillner]

Being a physician in other countries must really suck. I noticed at a nearby large reference lab, they have a dude who embeds all day long and he used to be a physician in Russia. Can you imagine going from being a Russian physician to embedding all day long? The person seemed happy so it must be an upgrade sadly.

Because in Russia the tissue embeds YOU!

 

[Whiskeyjack]

It should be ludicrous, however, unspokenly, it is not.

It is simply a matter of logic. Speaking on average, to expect that IMGs would be "better" than AMGs is "ludicrous", a PC statement, for the following reasons:

1-USA spends in training of its MDs more than any other country in the world
2-US medicine attracts the best of best native Americans (it is not the case in many other countries)
3-AMGs have natural advantages in spoken and written language + customs + habits + looks + built in relationships, etc.​

To be otherwise would be a serious indictment to US education system.

This does not mean that an AMG would be a better doctor in any foreign country for obvious reasons. Do you get it?

US is the most welcoming and generous nation towards the foreigners, in the earth, bar none. Many foreigners can not be what they are even in their homeland.

The main reason there are so many IMGs in the USA is because, for decades, the demand had overwhelmed the supply, so much so that for close to 2 decades IMGs where given the most preferential visa status (i.e., no waiting period of any length) to come into USA.

Your mention of "most valued and respected" IMGs is not untrue, but a stale cliche.

Dunno about all this up top.

1) In the UK the government pays for medical education soooo I'd argue more money is spent on education.
2) There is absolutely no doubt that UK medschool attracts the brightest in the UK. There are very few UK doctors in the U.S.
3) Uhhh..... the queens English.

I know someones gonna say... The UK is an exception but Just saying all this IMG talk is a tad silly. Im an IMG and I can tell you honestly that no matter where I trained I'd still be where I am on par with any AMG from top 10 etc. which is where all my partners are from. If your good.... your good and people will see that. Let's not pander to xenophobia here disguising it with polished rhetoric beneath a canope of rational thought and deflecting with the disingenuous.... I'm not saying... or its just a fact that...


This is America. IMG's learn what the game is then bring your A play. AMG's bring yours too. The difference is AMG's know the game already... Home court advantage and they know the easiest way to win is to get you not to play. IMG's/AMG's listen... sdn pathology is the trash talk before the game- if your psyched out by it you were never contenders to begin with. Which is one of the reasons I've never responded to the IMG talk before.

Or Maybe I'm just in a good place and sharing some love. Or maybeeee ( did anyone watch that Louis ck live gig... Hilarious) I'm a real wolf and looking to the future and the lower cost of hiring newly minted IMG pathologists... U'll never know... This is America.

 

[turtle1966]

Dunno about all this up top.

1) In the UK the government pays for medical education soooo I'd argue more money is spent on education.
2) There is absolutely no doubt that UK medschool attracts the brightest in the UK. There are very few UK doctors in the U.S.
3) Uhhh..... the queens English.

I know someones gonna say... The UK is an exception but Just saying all this IMG talk is a tad silly. Im an IMG and I can tell you honestly that no matter where I trained I'd still be where I am on par with any AMG from top 10 etc. which is where all my partners are from. If your good.... your good and people will see that. Let's not pander to xenophobia here disguising it with polished rhetoric beneath a canope of rational thought and deflecting with the disingenuous.... I'm not saying... or its just a fact that...


This is America. IMG's learn what the game is then bring your A play. AMG's bring yours too. The difference is AMG's know the game already... Home court advantage and they know the easiest way to win is to get you not to play. IMG's/AMG's listen... sdn pathology is the trash talk before the game- if your psyched out by it you were never contenders to begin with. Which is one of the reasons I've never responded to the IMG talk before.

Or Maybe I'm just in a good place and sharing some love. Or maybeeee ( did anyone watch that Louis ck live gig... Hilarious) I'm a real wolf and looking to the future and the lower cost of hiring newly minted IMG pathologists... U'll never know... This is America.

I meant no offense, I was simply stating the sad "statistical reality" and formulating possible explanation.

 

[punkedoutriffs]

Or maybeeee

...if touching a nut kills you, you're supposed to die...

 

[yaah]

It should be ludicrous, however, unspokenly, it is not.

It is simply a matter of logic. Speaking on average, to expect that IMGs would be "better" than AMGs is "ludicrous", a PC statement, for the following reasons:

​

I did not say that.

I did say that some of the most respected physicians at our hospital are IMGs. What percentage this is I have no idea nor is it really relevant. It is not because they are IMGs, it is because they are good physicians and good colleagues. There are also IMGs who are not that well respected. This is nothing new. I am not sure exactly what you are trying to argue with me about, it's as if you are making up something you think I said, and then refuting it.​

Your mention of "most valued and respected" IMGs is not untrue, but a stale cliche.

I said "some of the most valued and respected." Whether you think it's a cliche or not it's true at every single hospital in this country. And this fact says absolutely nothing about whether the "average IMG" is better or worse than the average AMG. You made a blanket statement that "IMGs are ranked lower than AMGs" which is patently false on the individual level. It may be somewhat true on a larger level, mostly at the beginning of careers, and it is true that IMGs often have higher barriers to cross to get in the door and get an equal amount of respect to start with. But that's not the whole story. And once in practice for several years the differences and favoritism goes away because there is a body of work to fall back on. AMGs have and should have more advantages and more opportunities overall in this country. This is not an argument. But that does not mean that quality IMGs have no role to play and that those who naturally excel cannot also excel in this country.

I say again, departments are not valued or graded based on percentage of IMGs. That may in fact be a true proxy in many cases for quality, but in and of itself it is not the cause. Again, I am not exactly sure what you are arguing about.

 

[turtle1966]

Again, I am not exactly sure what you are arguing about.

It is a complex subject and peripheral to what I want to argue, i.e., "currently, we have a man-made, not a market driven, disaster requiring our attention."