why come to the US?

inthedumps · Nov 4, 2006

I would like to preface this question by stating that it's not meant to be inflammatory, but rather, I'm genuinely interested in your responses and would like to generate some good conversation.

There are a significant number of doctors who come to the US for residency training and from what I've observed most of them continue to live and work here for the rest of their lives. A small number may return to their country of origin and reume working there with their new expertise. I think that most doctors have some degree of altruism, which is what leads us into the profession. Sure, we may become cynical over time, but we still have the patient's best interest at mind in most cases. In leaving your home country, don't you have some degree of guilt for abandoning your own people? Most of you leave impoverished countries with HUGE medical needs only to come to the US to serve a relatively wealthy and well taken care of population. How do you justify that change?

I realize that we all have to take care of ourselves and our families and there may be greater opportunity in the US for you to do that; but how do you leave a needy population in your home country with good conscience? I find it ironic that FMGs come to the US to train/work and that US doctors go to other countries to serve populations that don't receive healthcare otherwise.

Your thoughts...

leorl · Nov 4, 2006

There are plenty of foreign doctors who serve underserved/developed places, just in case you think that's not happening. You only see the US view because that's where you are, obviously. For instance in MSF (Doctors without borders) there are a significant number of internationals volunteering for that organization.

For those who come for residency, the answer is relatively simple. In many places, the length of training is a lot longer and maybe not as concrete as in the US. You can be stuck in more junior positions for a longer period time, as you wait for a spot as a consultant (attending) to open up. Whereas in the US, you're nearly guaranteed an attending position at some time or another. Doing a US residency speeds up the process for FMGs so they're qualified sooner and can ascend the ladder quicker. Not to mention that training with top resources helps bring those resources to their home countries.

For those that end up staying - if you came from your middle class area and all of a sudden got the chance to live in a palace, with servants to do your bidding etc. Would you not take that chance? Would you feel guilty about leaving it? Now obviously that example is exaggerated, but although the American lifestyle is lacking in some ways, in other ways it isn't - relatively inexpensive, luxurious and efficient...and surprisingly enough, less bureaucracy than other places. Also, in situations where physicians can earn more in the US, many would justify it by saying it can help their families back home..by being able to send them more money and provide for them in that way.

It's whatever individuals want out of life. Many people want to come to the US, some in the US want to move abroad. It's all the same, really.

Mayhem · Nov 4, 2006

inthedumps said:
I would like to preface this question by stating that it's not meant to be inflammatory, but rather, I'm genuinely interested in your responses and would like to generate some good conversation.

There are a significant number of doctors who come to the US for residency training and from what I've observed most of them continue to live and work here for the rest of their lives. A small number may return to their country of origin and reume working there with their new expertise. I think that most doctors have some degree of altruism, which is what leads us into the profession. Sure, we may become cynical over time, but we still have the patient's best interest at mind in most cases. In leaving your home country, don't you have some degree of guilt for abandoning your own people? Most of you leave impoverished countries with HUGE medical needs only to come to the US to serve a relatively wealthy and well taken care of population. How do you justify that change?

I realize that we all have to take care of ourselves and our families and there may be greater opportunity in the US for you to do that; but how do you leave a needy population in your home country with good conscience? I find it ironic that FMGs come to the US to train/work and that US doctors go to other countries to serve populations that don't receive healthcare otherwise.

Your thoughts...

But you're assuming that these people don't have guilt. For many of them it was a very hard decision to leave their home and family. I've talked to people who would love to stay in their country but the training is here so they come here. Also, those huge medical needs you talk about also mean that many of their hospitals just can't accomodate them. It might sound stupid but in many countries trained doctors can't get past the intern stage because there are ridiculous caps on the amount of residencies their government can pay for. It's not like here where all doctors can get a residency in something, even if it's not the one they want. I know of places where there are long waiting lists to do everything. Now, would you stay in your country working as an intern and waiting 5 or 6 years hoping for the chance to get a residency or try to get into one elsewhere, where they actually have vacancies. It's a no-brainer. And the reason why some don't go back is because now that they're trained their local hospitals can't afford to hire them and pay an attending salary. I suppose private practice is a choice but then there's the overheard to start it. It really sad actually, sometimes people just have to make hard choices.

Su Little · Nov 7, 2006

😀 hear hear, I would like to second the above comments.

I trained in the UK which you could argue has a well-cared for population, but ironically there is a shortage of doctors 😕 The shortage is mostly in attending positions but paradoxically the government has caps on training positions.

I wanted to to do neurology since I was in med school, if I stayed in UK it would have taken 10+ years to get to attending position and even that is not guaranteed. Last year 1 in 3 senior house officers in the UK (2-4 years post med school) were unemployed In addition the competition for higher training positions is so fierce that in many specialites including neuro you need significant research experience (usually a Ph.D) or overseas experience in order to compete.

I've been for 3 years and almost completed my neuro training and I absolutely love it here 😀 I do not plan to go back to the UK .

Llenroc · Nov 12, 2006

inthedumps said:
I would like to preface this question by stating that it's not meant to be inflammatory, but rather, I'm genuinely interested in your responses and would like to generate some good conversation.

There are a significant number of doctors who come to the US for residency training and from what I've observed most of them continue to live and work here for the rest of their lives. A small number may return to their country of origin and reume working there with their new expertise. I think that most doctors have some degree of altruism, which is what leads us into the profession. Sure, we may become cynical over time, but we still have the patient's best interest at mind in most cases. In leaving your home country, don't you have some degree of guilt for abandoning your own people? Most of you leave impoverished countries with HUGE medical needs only to come to the US to serve a relatively wealthy and well taken care of population. How do you justify that change?

I realize that we all have to take care of ourselves and our families and there may be greater opportunity in the US for you to do that; but how do you leave a needy population in your home country with good conscience? I find it ironic that FMGs come to the US to train/work and that US doctors go to other countries to serve populations that don't receive healthcare otherwise.

Your thoughts...

Get off your high horse.

As the son of an immigrant doctor, and present U.S. medical student, I find your view of the world laughable at best.

The impact that American doctors have that go overseas to work in 3rd world countries is so small, it's absurd to think that these people are the only hope the 3rd world has. If they all dissappeared tomorrow, it wouldn't make a damn bit of difference to overall healthcare.

People come here because they want to and because they can. No one asked for your opinion on whether you like it or not.

Do you feel ashamed that your ancestors left Europe to come over here? Why didn't they stay back in their homeland and serve their people? And maybe you should feel ashamed for staying here.

Lakambini19 · Nov 12, 2006

Llenroc said:
Get off your high horse.

As the son of an immigrant doctor, and present U.S. medical student, I find your view of the world laughable at best.

The impact that American doctors have that go overseas to work in 3rd world countries is so small, it's absurd to think that these people are the only hope the 3rd world has. If they all dissappeared tomorrow, it wouldn't make a damn bit of difference to overall healthcare.

People come here because they want to and because they can. No one asked for your opinion on whether you like it or not.

Do you feel ashamed that your ancestors left Europe to come over here? Why didn't they stay back in their homeland and serve their people? And maybe you should feel ashamed for staying here.

LMAO
This is the same controversy we have in IDP
In the Int'l Dentistry forum as FTD's we are attacked in a constant basis as to what are our hidden agenda why we are here in the US. I have posted just this morning about it. As seldom as I come to this forum there is always an irate US grads that is complaining about us being here.

I said the same thing ,visit the International Dental it is on Financial Motivations behind FTD's. What an idiotic mentality this can be coming from the most prestigious professionals in existence. I do wonder about the IQ requirements in both US meds & dental students must have in common considering the comments like the one above manage to get into meds/dental school. I am not in anyway insinuating the morality behind this kind of mentality at all. What seems so disturbing the most to me though are the responses from the FTD's defensiveness themselves that is resonating beyond belief to me, that if money is the prime mover of us being here it is almost like a crime, that should be not tolerated & a moral issue or an insult to them. I am more aggravated by the responses more than the commentary. I say exact the same thing whatever is the reason of us being here is none of their goddamn business.

People come here because they want to and because they can. No one asked for your opinion on whether you like it or not

You hit it so hard to the core, I love it so much....

And who said that this country's population is well serve healthwise? Damn if they can only see people walking around with no front teeth .Its like natural Halloween all the time. And don't stay too close when carrying a conversation as you'll gonna get a free shower as ssss escapes along with saliva.

UERM/FTD/Phils

leorl · Nov 13, 2006

Now now, there's no need to respond like this. You may find it very difficult and laughable to accept that this viewpoint exist, but it does. Call it ignorance, call it whatever. Not very many Americans actually do have what we call a worldly experience and thus...do not actually know better, regardless of their education or professional standing. For instance, not many people outside the US would know that progression to consultancy/attending takes so long and much more work than doing it in the US.

The original poster posted to try to understand another viewpoint and learn something larger than him/herself. He/she should be encouraged to try to understand where we're coming from, not ridiculed.

Miami_med · Nov 13, 2006

Why is it wrong for someone to want to improve their situation? As fast as its falling apart, US healthcare is still better for its providers than most any other country on earth. Salaries are higher, training is shorter, technology is better, access to the technology is higher, and practice options are more diverse.
After the ridiculous amount of time it takes to become a physician, of course many people want to actually be able to do stupid things like provide for themselves and their families. To the poster of this question; have kids, put yourself in SEVERE debt, train for 8+ years, and the post this question again.

Lakambini19 · Nov 14, 2006

--------------------------------------------------------------------------------

Why is it wrong for someone to want to improve their situation? As fast as its falling apart, US healthcare is still better for its providers than most any other country on earth. Salaries are higher, training is shorter, technology is better, access to the technology is higher, and practice options are more diverse.

HAVE YOU LIVED IN NORWAY BEFORE?
In my State 85% people are running around with no front teeth. No dental health insurance. I heard this same thing a lot in any States & part of Europe.
I am not sure that the US have better providers, higher technology is at par but technology alone is not a guarantee. Many poor countries if given the opportunity to have the technology, many many geniuses will do so much as good maybe better but just has no chance to explore.

People that never get a chance to travel tend to have this kind of mentality.It is actually pathetic but since we are the one who has the wisdom to understand , just tell them like Llroc said. People come to the US because they can & they want to that no one ask you whether you like it or not.

After the ridiculous amount of time it takes to become a physician, of course many people want to actually be able to do stupid things like provide for themselves and their families. To the poster of this question; have kids, put yourself in SEVERE debt, train for 8+ years, and the post this question again.

They cannot grasp this, their values is quite different , some of them they are all self absorb to their own worlds.

misakimd · Nov 16, 2006

Lakambini19 said:
People that never get a chance to travel tend to have this kind of mentality ... People come to the US because they can & they want to that no one ask you whether you like it or not.

I'm gonna speak for me now, since i'm pretty sure i'll be finally doing my residency there in two or three years...

After my first over-a-month international trip i realized I didn't want to live in Spain forever. I love to travel, I like living in different places, and I know residency+fellowship is a long, ardous process... So I had to choose very carefully where to do it.

Why the US? It's the best place from my POV. I can get good training, a good place to live, quality of life similiar to what i have in Spain, and i will find people from very diverse places...

And well, it's very difficult to get a residency spot in NZ or Australia, which were my first options.

ROBINHO · Nov 17, 2006

There are so many factors

1. Sometimes pple stay becos by the end of the day the make bigger impacts in the lives of their family back home. They make enough money which relatively is very good money, which when sent back to their xtries(ex Africa) can feed a significant number of family members. Working in AFrica....it is tough to make a lot of money to be able to take care of your needs and your family(becos there being a doctor comes with responsibility). I don't think this way though.

2. Becos of residence training. Example...I would love to do a residency training in Neurosurgery. Meanwhile Ghana my homeland has less than 5 Neurosurgeons and there is no residency training here. So it is natural to want to travel to the USA or Europe.

3. Politics. Well I got lots of friends who are Africans(citing Africa cos I don't know for other xtries). Some can't stand the bad governance there and most atimes lack the motivation to 'die for their countries' becos some stupid man at the top is fvcking and bleeding the xtry dry. By the end of the day AFrica looses significant doctors to the West becos of these factors.

Well personally I would love to return to Ghana after my training cos IMHO Medicine is about saving lives. And though in USA or any other continent my services could be useful...I think I am likely to make a bigger impact in the lives of pple in AFrica than in the USA.

I hope all other African brothers will join in doing similar. It is only us that can save our Health System

Ajalatravel · Nov 18, 2006

I rarely get involved in these conversations but i have to respond to this one. I am British, Medical school in Nigeria then internal medicine residency with MRCP and now finishing off a residency in the US and heading for an ID/HIV Fellowship. While i am suspicious about the motives of the person who started this thread, i will give him a chance because i do find some of the insular American attitudes quite amusing. For example, for US graduates the index of a good quality medical residency program is a low number of FMG`s, so it was quite amusing when my PGY3 nearly choked as i went ahead on my second day as an intern to correct his patient management decisions with clincal evidence.

People come to the US to train and many end up staying for personal, professional and economic reasons to mention a few.

1. Economic : After graduating i worked as a house officer in one of the poorest communities in Nigeria because i wanted to. i did not get paid for 6 months and my wages were not enough to either rent an apartment, buy a car or dream of living the life of a member of the middle class. Working in that environment i could not provide 50% of the quality of life that my parents provided me for my own kids.

Professional: In Nigeria most of the medical equipment at my medical school which was one of the best in Africa were dead. X-rays were a luxury so forget about CT scans. It devlops your clinical skills greatly but you are practicing out of date medicine. I want train to be the best at what i do not read about it in book, so postgraduate training would have been more of the same. I was over commited to my patients. I spent one night on call replacing IV lines with candlelight in a young girl with tetanus secondary to a septic abortion. if i gave up she died. She lived. Forget about codes if we rescuscitated you there was no ICU, so what was the point.I watched as a consultant i worked under was sacked because the State governors wife did not like him after 30 years of honest service. When i moved back to England i decided i wanted to train in HIV and ID, there were 2 training post in the whole country and it would take a phD and wait for someone to die or retire to become a consultant. My own consultant told me to move to the US.

Personal: I am driven to be the best at what i do, the US is simply the place that provides the best opportunities on every level. When i finish my HIV/ID fellowship i plan to work in Africa but i am very aware that it will be charity work, funded by what i make in the USA. I am grateful to have the opportunity to train here and never take it for granted. I was asked to be Chief Resident.

IT IS QUITE IRRITATING WHEN AMERICANS TALK ABOUT GOING TO AFRICA FOR VOLUNTEER WORK FOR 2 WEEKS, LIKE THEY`RE GOING ON SOME EXOTIC CONSCIENCE ABSOLVING MEDICAL SAFRI TO SOME EXOTIC LOCATION TO SEE HOW THE NATIVES LIVE AND BUFF UP THEIR RESUMES. WE LIVED AND GREW UP THERE AND YOU HAVE NO MORAL RIGHT TO CRITICIZE THE CHOICES WE MAKE. TRY LIVING WITHOUT CLEAN WATER AND ELECTRICITY FOR A YEAR, NOT 2 WEEKS. PLEASE NOTE THAT IS NOT WHAT I THINK ABOUT EVERYONE WHO VOLUNTEERS TO WORK IN AFRICA AND I THANK GOD FOR THOSE ALTRUISTIC GENUINE PEOPLE.

I hope this serves an eye opener for some of the condescending attitudes around. I believe we add to this country AND US MEDICINE JUST AS THIS COUNTRY BLESSES US and and it would be nice if US medical GRADUATES IN WORD AND ACTION ACKNOWLEDGED THIS.

f_w · Nov 19, 2006

When I left my country for the US, there where not enough jobs for junior doctors to go around. In the US, I had little problems getting a residency. It is as simple as that.

neurodoc · Nov 23, 2006

Lakambini19 said:
--------------------------------------------------------------------------------

HAVE YOU LIVED IN NORWAY BEFORE?
In my State 85% people are running around with no front teeth. No dental health insurance. I heard this same thing a lot in any States & part of Europe.
I am not sure that the US have better providers, higher technology is at par but technology alone is not a guarantee...

.

This dental stuff has always irritated me. For some reason or other, even the most socialist "universal" healthcare countries don't think that "root canals are a right, not a privilege," even if they believe that "CABG is a right, not a privilege." For some reason dentists are allowed to let people who can't afford endodontic surgery to lose their teeth, but cardiothoracic surgeons are expected to provide services free-of-charge. 😕

Nick

Lakambini19 · Nov 23, 2006

neurodoc said:
This dental stuff has always irritated me. For some reason or other, even the most socialist "universal" healthcare countries don't think that "root canals are a right, not a privilege," even if they believe that "CABG is a right, not a privilege." For some reason dentists are allowed to let people who can't afford endodontic surgery to lose their teeth, but cardiothoracic surgeons are expected to provide services free-of-charge. 😕

Nick

I did a lot of research about this part of our healthcare system.Besides those States that has dental schools,poor people or even the middle class who are screaming for the high premiums they have to pay for dental services cannot afford a 400$ /root canal.One molar can have up to 4 roots. Imagine if the HMO will only covered 50% of that.After root canal you need a post & core restore the crowns.One molar will cost you around 4K-50% you end paying a good 2K.Most States do not have this options for the adult population both on Medicaid & Medicare. The State will pay one time cleaning a year & extrction.So if you have a tooth that can still be save by restoration ?fillings,dentists won't do it as they won't get paid for it,in other words they will asked you to come back when it is really really bad & you are in so much pain & the tooth is a candidate for extraction.
Check this out ,there is no law that requires Dentists in any State to attend to an emergency cases.

This is barbaric. So many poor people,the sick ,the disabled,the old ,are so deprived by the very basic healthcare needs.

I am at this point now that I am willing to challenge the monopoly of dentistry in my State. If someone can donate a dental chair for me ,I will open a practice ,non profit ,to alleviate this horrid problems. The more I get deeper in my research I get angrier every day.I don't really care if I don't get paid.

I have a friend that has no health insurance & she has an acute tooth pain for almost 2 weeks but when we call dentists we emphasize that this is a Emergency.They told us come back in 2 weeks?

We all take the Oath of do no harm. As a healthcare community we should break this monopoly that we should put the health of the people as our first priority. We need to gather our forces to address this issue in our community. I will volunteer my services for no money. Dentists charges ridiculuosly high.Most of them are crooks.

UERM/FTD/Phils

f_w · Nov 23, 2006

Dentistry is the last vestige of capitalism in the US medical system. You actually have to pay in order to receive services.

erichaj · Nov 25, 2006

neurodoc said:
This dental stuff has always irritated me. For some reason or other, even the most socialist "universal" healthcare countries don't think that "root canals are a right, not a privilege," even if they believe that "CABG is a right, not a privilege." For some reason dentists are allowed to let people who can't afford endodontic surgery to lose their teeth, but cardiothoracic surgeons are expected to provide services free-of-charge. 😕

Nick

You know what, if they wanted their teeth fixed they would find a way to do it. It's not that expensive. You live in NORWAY not Sudan.

A few less nights out on the town, a few less packs of cigs or a few less drinks at the local pub and there you go, your teeth are shining new.

erichaj · Nov 25, 2006

Lakambini19 said:
I did a lot of research about this part of our healthcare system.Besides those States that has dental schools,poor people or even the middle class who are screaming for the high premiums they have to pay for dental services cannot afford a 400$ /root canal.One molar can have up to 4 roots. Imagine if the HMO will only covered 50% of that.After root canal you need a post & core restore the crowns.One molar will cost you around 4K-50% you end paying a good 2K.Most States do not have this options for the adult population both on Medicaid & Medicare. The State will pay one time cleaning a year & extrction.So if you have a tooth that can still be save by restoration ?fillings,dentists won't do it as they won't get paid for it,in other words they will asked you to come back when it is really really bad & you are in so much pain & the tooth is a candidate for extraction.
Check this out ,there is no law that requires Dentists in any State to attend to an emergency cases.

This is barbaric. So many poor people,the sick ,the disabled,the old ,are so deprived by the very basic healthcare needs.

I am at this point now that I am willing to challenge the monopoly of dentistry in my State. If someone can donate a dental chair for me ,I will open a practice ,non profit ,to alleviate this horrid problems. The more I get deeper in my research I get angrier every day.I don't really care if I don't get paid.

I have a friend that has no health insurance & she has an acute tooth pain for almost 2 weeks but when we call dentists we emphasize that this is a Emergency.They told us come back in 2 weeks?

We all take the Oath of do no harm. As a healthcare community we should break this monopoly that we should put the health of the people as our first priority. We need to gather our forces to address this issue in our community. I will volunteer my services for no money. Dentists charges ridiculuosly high.Most of them are crooks.

UERM/FTD/Phils

You know what, you say you don't care that you don't get paid. But afte you've done about 100 of them for free, you will start to change your tune.

You know why? because when you go to buy bread or milk, the grocery store won't give it to you for free. When you go to get on the bus (because you won't be able to afford a car) you won't be able to get on there either. You will be walking until your shoes wear out. over time you won't be able to get to work or even afford toothpaste, soooo you teeth will go bad. But by then you won't be able to afford to get your teeth fixed. Now you also end up toothless and homeless.

If a government tells me that they will take care of me for the rest of my life and I will never have to worry about money again and they pay all of my medical school and my childrens college, then I will say great, lets fix those teeth.

Does the TV salesman with the bad teeth give you a tv for free? Is college for free?

I have a huge medical school loan I have to pay back. So do most doctors and dentists. Who is going to pay that? Will you volunteer to take extra shifts for me so I can get rid of the loans?

When a doctor goes to purchase as house, it is really like purchasing a second house. the student loans were the first.

I understand that things cost money and the cost of healthcare is high, I also understand that many can't afford it. but it goes both ways.

Shinken · Nov 25, 2006

Ajalatravel said:
IT IS QUITE IRRITATING WHEN AMERICANS TALK ABOUT GOING TO AFRICA FOR VOLUNTEER WORK FOR 2 WEEKS, LIKE THEY`RE GOING ON SOME EXOTIC CONSCIENCE ABSOLVING MEDICAL SAFRI TO SOME EXOTIC LOCATION TO SEE HOW THE NATIVES LIVE AND BUFF UP THEIR RESUMES. WE LIVED AND GREW UP THERE AND YOU HAVE NO MORAL RIGHT TO CRITICIZE THE CHOICES WE MAKE. TRY LIVING WITHOUT CLEAN WATER AND ELECTRICITY FOR A YEAR, NOT 2 WEEKS. PLEASE NOTE THAT IS NOT WHAT I THINK ABOUT EVERYONE WHO VOLUNTEERS TO WORK IN AFRICA AND I THANK GOD FOR THOSE ALTRUISTIC GENUINE PEOPLE.

It always amuses me when US docs go to other countries to help out because of the "medical need" of those countries. Heck, there are more than 40 million uninsured in the US. Stay here and treat people without insurance, and donate your airfare money to a local church.

You're correct in that some physicians do it to get some sense of inner sanctity of some sort. I can't help but chuckle inside when some hot-shot plastic surgeon goes to Nicaragua once every other year and fixes a dozen cleft lips and comes back feeling all superior morally when there are primary care physicians making a pittance day after day, year after year caring for the Medicaid and uninsured populations of the US.

I actually like the work of physicians like Paul Farmer who not only spend significant amounts of time abroad helping people medically, but also attempt to create some infrastructure in the host country so that the country can help itself once the missionaries are all gone. I think that's more useful than simply going and leaving after a month or two.

As far as the US and the people's attitudes...well, it's something annoying but not very different from other industrialized nations. When I came to the US I was initially irritated by what I perceived as arrogance, but once I thought about it, it was pretty much the same way in the country I came from. And the US is still the land of opportunity as long as you work hard for those opportunities. The opportunities just won't fall on your lap (unless you're incredibly good at sports, are incredibly beautiful, or can sing very, very well...unfortunately I'm neither of the three so I have to work hard).

Lakambini19 · Nov 27, 2006

You know what, you say you don't care that you don't get paid. But afte you've done about 100 of them for free, you will start to change your tune.

Before I move in the US I did this for many years (10+ yrs) both in my country & in Norway.More than anything else this is the only part of this profession that gave me enormous rewarding feelings.And also I know so many Drs. who shares the same sentimental craziness like me who are willing to donate time,money & services antwhere in the world.

You know why? because when you go to buy bread or milk, the grocery store won't give it to you for free. When you go to get on the bus (because you won't be able to afford a car) you won't be able to get on there either. You will be walking until your shoes wear out. over time you won't be able to get to work or even afford toothpaste, soooo you teeth will go bad. But by then you won't be able to afford to get your teeth fixed. Now you also end up toothless and homeless.

In worst scenario that I end up this way. It is even more fitting that in my agony at least I complied my Oath dearly against the detriment of my own necessity. Toothless or homeless or both ,my services is even more worth giving away then rather than confine my practice only to those who can only pay me so I can pay my loans.Everyone is entitled to our own prerogative,of course.

If a government tells me that they will take care of me for the rest of my life and I will never have to worry about money again and they pay all of my medical school and my childrens college, then I will say great, lets fix those teeth.

Scratch my back & I will scratch yours. This never happen in the real world..We cannot pass on the inability of the people at any circumstances they maybe to obtain their basic needs to their government as their govt.as it is the same govt. nevertheless cares for your loans nor mine or the future of your children.I would not put one iota of trust when the govt. tells me help the uninsured,the disabled,the sick,the hungry ,the ill etc...& will gave you the sun & the best medal of honor the universe had made for you & your children's children. If I may add my opinion, ill or otherwise ,I will do the things that gives me solace & contentment for my own gratification ,not by on someone else's promise of justification e.g. even a "place in heaven".

Does the TV salesman with the bad teeth give you a tv for free? Is college for free?

The TV salesmen can tell his boss that a dentist on the corner took me in even I cannot pay.The boss who has a dental insurance said ,o good ,I will go there when I needed my teeth fix. Yes ,if you are smart enough you can get around grant,stipends, loans.

I have a huge medical school loan I have to pay back. So do most doctors and dentists. Who is going to pay that? Will you volunteer to take extra shifts for me so I can get rid of the loans?

Who in hell ask you to go to meds school why ask me? I am paying mine. No doc, volunteer my ass for whoever? You have money ,you don't need me.Get another job like washing toilets.

For my own safety , can you tell what part of the country you are practicing? I make sure ,I don't up end up in your hands.

No offense/Just blatant truths

Lakambini19 · Nov 28, 2006

erichaj said:
You know what, you say you don't care that you don't get paid. But afte you've done about 100 of them for free, you will start to change your tune.

You know why? because when you go to buy bread or milk, the grocery store won't give it to you for free. When you go to get on the bus (because you won't be able to afford a car) you won't be able to get on there either. You will be walking until your shoes wear out. over time you won't be able to get to work or even afford toothpaste, soooo you teeth will go bad. But by then you won't be able to afford to get your teeth fixed. Now you also end up toothless and homeless.

If a government tells me that they will take care of me for the rest of my life and I will never have to worry about money again and they pay all of my medical school and my childrens college, then I will say great, lets fix those teeth.

Does the TV salesman with the bad teeth give you a tv for free? Is college for free?

I have a huge medical school loan I have to pay back. So do most doctors and dentists. Who is going to pay that? Will you volunteer to take extra shifts for me so I can get rid of the loans?

When a doctor goes to purchase as house, it is really like purchasing a second house. the student loans were the first.

I understand that things cost money and the cost of healthcare is high, I also understand that many can't afford it. but it goes both ways.

PLease accept my apologies for being so blunt. I understand completely what you meant , there are people that shares these sentiments,but I do acknowledge that I don't have to dump it all on you. I do hope that when you find this kind of people in your office someday,please don't turn them away. Give them samples.Do the best you can.

Again my apologies,

UERM/FTD/Phils

erichaj · Nov 28, 2006

Lakambini19 said:
You know what, you say you don't care that you don't get paid. But afte you've done about 100 of them for free, you will start to change your tune.

Before I move in the US I did this for many years (10+ yrs) both in my country & in Norway.More than anything else this is the only part of this profession that gave me enormous rewarding feelings.And also I know so many Drs. who shares the same sentimental craziness like me who are willing to donate time,money & services antwhere in the world.

You know why? because when you go to buy bread or milk, the grocery store won't give it to you for free. When you go to get on the bus (because you won't be able to afford a car) you won't be able to get on there either. You will be walking until your shoes wear out. over time you won't be able to get to work or even afford toothpaste, soooo you teeth will go bad. But by then you won't be able to afford to get your teeth fixed. Now you also end up toothless and homeless.

In worst scenario that I end up this way. It is even more fitting that in my agony at least I complied my Oath dearly against the detriment of my own necessity. Toothless or homeless or both ,my services is even more worth giving away then rather than confine my practice only to those who can only pay me so I can pay my loans.Everyone is entitled to our own prerogative,of course.

If a government tells me that they will take care of me for the rest of my life and I will never have to worry about money again and they pay all of my medical school and my childrens college, then I will say great, lets fix those teeth.

Scratch my back & I will scratch yours. This never happen in the real world..We cannot pass on the inability of the people at any circumstances they maybe to obtain their basic needs to their government as their govt.as it is the same govt. nevertheless cares for your loans nor mine or the future of your children.I would not put one iota of trust when the govt. tells me help the uninsured,the disabled,the sick,the hungry ,the ill etc...& will gave you the sun & the best medal of honor the universe had made for you & your children's children. If I may add my opinion, ill or otherwise ,I will do the things that gives me solace & contentment for my own gratification ,not by on someone else's promise of justification e.g. even a "place in heaven".

Does the TV salesman with the bad teeth give you a tv for free? Is college for free?

The TV salesmen can tell his boss that a dentist on the corner took me in even I cannot pay.The boss who has a dental insurance said ,o good ,I will go there when I needed my teeth fix. Yes ,if you are smart enough you can get around grant,stipends, loans.

I have a huge medical school loan I have to pay back. So do most doctors and dentists. Who is going to pay that? Will you volunteer to take extra shifts for me so I can get rid of the loans?

Who in hell ask you to go to meds school why ask me? I am paying mine. No doc, volunteer my ass for whoever? You have money ,you don't need me.Get another job like washing toilets.

For my own safety , can you tell what part of the country you are practicing? I make sure ,I don't up end up in your hands.

No offense/Just blatant truths

In the REAL WORLD we work to sustain ourselves and have a better life.

If you think your life is better by doing services for free for all, then all the power to you.

However, You posted on this site and critisized others for NOT doing that.

My post was in response to your criticism. If you don't like that, then as YOU SAID, No asked you the HELL to post on here.

Telling it like it is.

By the way, you assumed that I or other doctors don't give free services.
You know what they say about assumptions.

Just out of curiosity, why did you move here, from Norway?

Lakambini19 · Nov 28, 2006

erichaj said:
In the REAL WORLD we work to sustain ourselves and have a better life.
If you think your life is better by doing services for free for all, then all the power to you.
However, You posted on this site and critisized others for NOT doing that.
My post was in response to your criticism. If you don't like that, then as YOU SAID, No asked you the HELL to post on here.
Telling it like it is.
?

In any business I patronized, & I noticed this with a lot of good people, we tend to do business with people that is actively involved in community services.I certainly do care of Drs. who volunteers in our community health centers. The point is those who cares enough about the underprivelege,chances are ,they are more dedicated over the others.

By the way, you assumed that I or other doctors don't give free services. You know what they say about assumptions.

You can certainly do what kind of practice you prefer.In my last post I said "of course everyone is entitled to its own prerogative".

COLOR="red"]Just out of curiosity, why did you move here, from Norway?[/[][/COLOR]
You are lucky I have a good dinner tonight to asked me this Q? otherwise I can be really cranky as hell.

One, the jackass I was married to drop dead
Two, I cannot speak Creole
3rd,the rest is not your goddamn business.

How's that? Does it suffice your satiety?

erichaj · Nov 29, 2006

Lakambini19 said:
In any business I patronized, & I noticed this with a lot of good people, we tend to do business with people that is actively involved in community services.I certainly do care of Drs. who volunteers in our community health centers. The point is those who cares enough about the underprivelege,chances are ,they are more dedicated over the others.

By the way, you assumed that I or other doctors don't give free services. You know what they say about assumptions.

You can certainly do what kind of practice you prefer.In my last post I said "of course everyone is entitled to its own prerogative".

COLOR="red"]Just out of curiosity, why did you move here, from Norway?[/[][/COLOR]
You are lucky I have a good dinner tonight to asked me this Q? otherwise I can be really cranky as hell.

One, the jackass I was married to drop dead
Two, I cannot speak Creole
3rd,the rest is not your goddamn business.

How's that? Does it suffice your satiety?

Its a good thing you give your services away for free. :laugh:

I could have done soooo much more with that. Oh how far I could have taken all that. But I let you off the hook.

f_w · Nov 29, 2006

Lakambini19 said:
One, the jackass I was married to drop dead

Sorry to hear that.

Two, I cannot speak Creole

? Last time I checked, norwegians spoke norwegian (a fairly well structured and easy to learn language).

3rd,the rest is not your goddamn business.

The initial question of the thread was 'why come to the US', so in that respect it is our business.

Lakambini19 · Nov 29, 2006

f_w said:
Sorry to hear that.

? Last time I checked, norwegians spoke norwegian (a fairly well structured and easy to learn language).

The initial question of the thread was 'why come to the US', so in that respect it is our business.

? Last time I checked, norwegians spoke norwegian (a fairly well structured and easy to learn language).
The last time I checked too, Chinese speaks Chinese. You know, I have so little tolerance towards idiots. Keep it to yourself.

Why leave Norway vs. Why come to the US>these 2 doesn't speaks for each other. Its actually infantile... & a health hazard in a long run.

Guys,keep your good comments to yourself as the more you open your mouth ,the more I wonder if you should pursue Medicine.

f_w · Nov 29, 2006

Lakambini19 said:
The last time I checked too, Chinese speaks Chinese. You know, I have so little tolerance towards idiots. Keep it to yourself.

Why leave Norway vs. Why come to the US>these 2 doesn't speaks for each other. Its actually infantile... & a health hazard in a long run.

Guys,keep your good comments to yourself as the more you open your mouth ,the more I wonder if you should pursue Medicine.

I can imagine that with your impeccable manners you where a real hit in Norway.
Or maybe I just don't understand what you are trying to say.

erichaj · Nov 29, 2006

Lakambini19 said:
? Last time I checked, norwegians spoke norwegian (a fairly well structured and easy to learn language).
The last time I checked too, Chinese speaks Chinese. You know, I have so little tolerance towards idiots. Keep it to yourself.

Why leave Norway vs. Why come to the US>these 2 doesn't speaks for each other. Its actually infantile... & a health hazard in a long run.

Guys,keep your good comments to yourself as the more you open your mouth ,the more I wonder if you should pursue Medicine.

You said you could not speak Creole, but after this last post I'm not sure if you can speak English.

but we love you anyway.😍

Ajalatravel · Nov 30, 2006

Shinken said:
It always amuses me when US docs go to other countries to help out because of the "medical need" of those countries. Heck, there are more than 40 million uninsured in the US. Stay here and treat people without insurance, and donate your airfare money to a local church.

You're correct in that some physicians do it to get some sense of inner sanctity of some sort. I can't help but chuckle inside when some hot-shot plastic surgeon goes to Nicaragua once every other year and fixes a dozen cleft lips and comes back feeling all superior morally when there are primary care physicians making a pittance day after day, year after year caring for the Medicaid and uninsured populations of the US.

I actually like the work of physicians like Paul Farmer who not only spend significant amounts of time abroad helping people medically, but also attempt to create some infrastructure in the host country so that the country can help itself once the missionaries are all gone. I think that's more useful than simply going and leaving after a month or two.

As far as the US and the people's attitudes...well, it's something annoying but not very different from other industrialized nations. When I came to the US I was initially irritated by what I perceived as arrogance, but once I thought about it, it was pretty much the same way in the country I came from. And the US is still the land of opportunity as long as you work hard for those opportunities. The opportunities just won't fall on your lap (unless you're incredibly good at sports, are incredibly beautiful, or can sing very, very well...unfortunately I'm neither of the three so I have to work hard).

I have to agree Shinken. The free clinic in my Hood is always overstretched. It could do with some extra hands!!! Paul Farmer is one of those people who just challenge you to get out there and do something. He is a living legend. Definitely one of the men i want to be like when i grow up! As always, the problems of poverty and healthcare are complex and can be found in every section of the world. If everyone of us does his part we can solve these problems.

qtrlifecrisis · Dec 19, 2006

To the OP: After looking at all your posts on SDN, I doubt the sincerity of your intention "not to be inflammatory".

Nevertheless, the answer to your question is simple -- economics.

The price system ensures that human capital flows where it can be most productive. If wages measure the price of human capital, maximum capital accumulation is possible where wages are highest.

In the short run, it may seem as though FMGs are "bailing out" by going West, but in the long run, skilled migration (and subsequent capital accumulation) creates wealth and new inventions. This isn't apparent in the short run only because it takes time for wealth to spread to poorer places. The "Brain Drain" is not as malignant as it's made out to be. Decrying the process that leads to progress and wealth-creation only makes all of us less well off in the long run.

Faebinder · Dec 24, 2006

As a person not born in the US but migrated to the US right after high school, I find the concept of Brain Drain to be disgusting. If the other 'whining' & 'bitching' countries wanted to keep their 'Brains' then they would have done a better job paying them than paying their 'generals', 'interior minister', 'minister of commerce' or 'minister of education' who chances are they got put in that position not because of their 'high education' or 'experience'... but most likely because they are the son in law or cousin of someone important.

Conclusion: They deserve everything they are getting.

Miami_med · Jan 10, 2007

qtrlifecrisis said:
To the OP: After looking at all your posts on SDN, I doubt the sincerity of your intention "not to be inflammatory".

Nevertheless, the answer to your question is simple -- economics.

The price system ensures that human capital flows where it can be most productive. If wages measure the price of human capital, maximum capital accumulation is possible where wages are highest.

In the short run, it may seem as though FMGs are "bailing out" by going West, but in the long run, skilled migration (and subsequent capital accumulation) creates wealth and new inventions. This isn't apparent in the short run only because it takes time for wealth to spread to poorer places. The "Brain Drain" is not as malignant as it's made out to be. Decrying the process that leads to progress and wealth-creation only makes all of us less well off in the long run.

You hit the nail on the head.

Miami_med · Jan 10, 2007

Lakambini19 said:
--------------------------------------------------------------------------------

HAVE YOU LIVED IN NORWAY BEFORE?
In my State 85% people are running around with no front teeth. No dental health insurance. I heard this same thing a lot in any States & part of Europe.
I am not sure that the US have better providers, higher technology is at par but technology alone is not a guarantee. Many poor countries if given the opportunity to have the technology, many many geniuses will do so much as good maybe better but just has no chance to explore.

Nope, I've never lived in Norway. I also didn't realize that Norway was having any difficulty maintaining a minimum number of physicians in the country. I don't think that tooth-to-person ratio has ANYTHING to do with the concepts of autonomy, income capacity, and technology that I mentioned as reasons to practice in the US.

The "never had a chance" argument is crap. Many of these poor countries that you speak of are torn by civil war, riddled with corruption, and beholden to practices that are antithetical to technological development. Sure, some individuals have trouble in those countries. They come here, to be subsequently criticized by you. These problems have nothing to do with chance, and everything to do with violence and corruption.

People that never get a chance to travel tend to have this kind of mentality.It is actually pathetic but since we are the one who has the wisdom to understand , just tell them like Llroc said. People come to the US because they can & they want to that no one ask you whether you like it or not.

I've actually traveled quite a bit, and I live in the most international city on earth (National Geographic says so 😀 ) By not traveling, do you mean not traveling through Europe. I actually have, but I must assume that you aren't simply taking an ethnocentric European approach as a moral high ground to the American ethnocentrism you perceived in my post.

They cannot grasp this, their values is quite different , some of them they are all self absorb to their own worlds.

I don't understand you here.

cool_vkb · Jan 11, 2007

Iam an Indian with nearly all my family members in healthcare (either physicians or in diagnostics). Plus i have met and spoken to many Indian, Pakistani and Bengali doctors. The truth in atleast a majority of the Foreign Physicians is that they are here in USA just for the sake of money and many opportunities. Coming to America, is like craze in South-east asian countries.

Have you seen any any foreign MBBS after doing completing their residency heading back home. There might be few of them , but many just stay here. Why? Its pretty simple, in USA a MD earns the highest like $180K above, in India, he might just make Rs.40k-60k (hardly $2000 per month). Now do you really think , someone is a fool to go back. I know some go, but majority stay back.

And now speaking abt Foreign Medical Graduates serving in areas of shortage and helping the poor in deprived areas. That is a BIG BIG BIG BULL **** CRAP, developed by some FMG. They dont really give a damn abt it.The reality is Green Card sponsorship. Many state govts, federal govt and VA. Will sponsor a foreign medical graduate who serves in these areas. If they really wanted to serve under-deserved, hey why not go to their own home countries and develop. No Sir! Oh no! it aint gonna happen. Its just a deal to get their green card. once they get their green card, they move back to cities. And its a fair deal. Nothing bad abt it. USA has a charm which very few can resist. Once you come to USA, its very hard to go back. there is a magic in this place which no one can resist, people can do anything to stay here.

No doubt, FMGs are great contributors in US healthcare system (especially rural and primary) but hey, it aint no big favor. We pay them, we give them green card, we give them the opportunities they never get in their home country. So its a pretty deal. And thats the reason why everyone dies to come to America. If you dont believe me, just visit any US embassy in asian countries, people stand in lines which are so huge, that u will not believe it.

while many of these FMGs from India are from both private and public medical schools. One bad thing abt studenst from Public Medical school is that they are not paying back their country. In public school medical education is free. The government pays for your school thinking you may contribute to indian society. But these people, start writing USMLEs, application for visas,etc and as soon as they get their MBBS. They are off to USA. What abt the governemnt who paid all ur expenses. Thats treachery and shame. thats the only bad thing.

Tired · Jan 11, 2007

Ajalatravel said:
I hope this serves an eye opener for some of the condescending attitudes around. I believe we add to this country AND US MEDICINE JUST AS THIS COUNTRY BLESSES US and and it would be nice if US medical GRADUATES IN WORD AND ACTION ACKNOWLEDGED THIS.

Fascinating. What precisely is it that you think FMGs do for this country that we can't do for ourselves? If you were an engineer or a computer science major, I would agree 100%, seeing as how there are a shortage of such people in this country. But physicians? We have plenty of doctors, and if we need more, we can just expand medical school admissions. No residency program is begging for FMGs to apply.

f_w · Jan 11, 2007

Tired said:
We have plenty of doctors,

Maybe the situation is fine where you are, but you shouldn't generalize.
Yesterday our group lost our oncologist. Now patients have to travel about 90mi in each direction to get onco care.
For the past 2 years, every fractured hip has to be transferred out because there are not enough orthopods around willing to take this financially highly attractive practice.

No residency program is begging for FMGs to apply.

You are wrong on that one. A good share of internal medicine residency programs would probably cease to exist if it wasn't for the 40% of FMGs who fill their positions these days.

mmed · Jan 11, 2007

Fascinating. What precisely is it that you think FMGs do for this country that we can't do for ourselves? If you were an engineer or a computer science major, I would agree 100%, seeing as how there are a shortage of such people in this country. But physicians? We have plenty of doctors, and if we need more, we can just expand medical school admissions. No residency program is begging for FMGs to apply.[/QUOTE]

Being an FMG does not mean that you are not from this country you may be natural born citizen from natural born parents. I know personally families send their kids overseas to get MDs despite they are very competitive for medical schools here. And many AMG are foreigners and struggling for visa. Many residency programs cant find even one AMG to accept residency position there. To the best of my knowledge, engineers and computer scientists are not included in shortage list, may be physiotherapy and nursing in that list, I am not 100% sure.

Tired · Jan 11, 2007

f_w said:
You are wrong on that one. A good share of internal medicine residency programs would probably cease to exist if it wasn't for the 40% of FMGs who fill their positions these days.

I guess I stand corrected.

cool_vkb · Jan 11, 2007

The FMGs take the most unwanted residencies. They do residencies in areas where no AMG wanna do, they go to places where AMGs dont wanna work, they provide service to areas where AMGs dont even think in dreams to go.

Not to be harsh, Just as Hyenas and vultures come to eat the rotten meat and bones from the carcass after the tiger is done eating. FMGs come to take residencies and jobs which have been left behind the AMGs.

Basically they are here to full jobs which regular american MDs dont wanna do. he he! thats why they make up nearly 30-40% of Primary Medicine. Do you find any FMG boasting they make up 50% of anyt Specialized field. No way!!!! AMGs go to Derm, Ortho, Neuro, Surgery,etc. A few do go to primary but they are very few. On the other hand, FMGs pick up the left over residencies and are happy with it.

If AMG population increases and they start applying to Primary residencies also. All these FMGs will be kicked out in a single day bcoz no one will sponsor their visas as all will get AMGs in their residencies. Because, preference is always given to the Tax Payers (i.e Americans) over FMGs. Its a universal rule. I personally dont want my tax money to be used to pay salary to FMG if there is an american MD available. Do you want yours?

Tired · Jan 11, 2007

mmed said:
I know personally families send their kids overseas to get MDs despite they are very competitive for medical schools here.

That's just nonsense.

mmed said:
And many AMG are foreigners and struggling for visa.

"Many"? Again, nonsense.

mmed said:
Many residency programs cant find even one AMG to accept residency position there.

Can you name me one, much less many? Bet you can't . . .

You don't seem to know very much. But thanks for your input.

mmed · Jan 11, 2007

Tired said:
That's just nonsense.
Search for threads in international discussion in this forum to find out, I will not say many, stories for people who like to get their MDs from overseas.
This is one example http://forums.studentdoctor.net/showthread.php?t=307432

"Many"? Again, nonsense.
I agree with you erase many and say very few but there are still. This is one example from this forum.
http://forums.studentdoctor.net/showthread.php?t=337207

Can you name me one, much less many? Bet you can't . . .
I do not have data for programs with only FMG (Being an IMG, I had interviews with programs hardly to find AMG, I cant post the names here but it is quite easy to search for) but I said many because I read this from AMA web site with examples of programs complaining from visa issues. If you would like to say few not many that is OK too. I just copied and pasted from AMA web site to give you an example with programs depending on FMG not because they like them! here is the link http://www.ama-assn.org/ama/pub/category/11928.html
Visa problems have been a major difficulty for our residency program. Three of our five residents (we are a small rural training track) are on J-1 visas. The third is still waiting for hers to arrive, and has been unable to start residency as planned. We are hoping to have her start next month but have no assurance of that
The majority of trainees in our pulmomary disease/critical care medicine fellowship are IMGs

What I mean here is; I think, the market in US is in need for FMG at least for the time being and because of that there are FMGs and simply one day when the system can fill with AMG you will not see high percentage of FMGs in medicine and other non competitive specialties. Thanks

f_w · Jan 11, 2007

cool_vkb said:
Not to be harsh, Just as Hyenas and vultures come to eat the rotten meat and bones from the carcass after the tiger is done eating. FMGs come to take residencies and jobs which have been left behind the AMGs.

Lets see, the tigers are near extinct, something you can't say about hyenas.

Do you find any FMG boasting they make up 50% of anyt Specialized field. No way!!!!

Well, there are more US grads than FMGs throughout medicine, so why should the ratio be different in specialties ?

AMGs go to Derm, Ortho, Neuro, Surgery,etc. A few do go to primary but they are very few.

What body orifice did you pull that nugget of information from ?

Lets see:
In the 2006 match, 56% of positions in IM where filled by US graduates, 73% of positions in Peds where filled with US grads.
Out of 14059 US seniors who got PGY1 positions in the match, 5459 went into either IM, peds or FM.
A few ?

All these FMGs will be kicked out in a single day bcoz no one will sponsor their visas as all will get AMGs in their residencies.

Not quite. Even in specialties like diagnostic radiology, rad-onc or orthopedic surgery, you will find a number of foreign grads (19%, 9%, 10% respectively).

Because, preference is always given to the Tax Payers (i.e Americans) over FMGs.

Actually, FMGs will pay the same taxes as US graduates (with the exception of a 1 year exemption on payroll taxes during residency). Also, foreign grads didn't get their education subsidized by the US taxpayer through school district taxes, goverment guaranteed student loans and tax credits to the parents.

Its a universal rule. I personally dont want my tax money to be used to pay salary to FMG if there is an american MD available. Do you want yours?

Thankfully, you are part of a minority here.

Tired · Jan 11, 2007

f_w said:
Thankfully, you are part of a minority here.

Well, I'm not sure how I feel about it either, to be totally honest. As a typical xenophobic American, I am not totally comfortable with FMGs getting spots when AMGs do not, especially in the case of non-citizens.

I suppose I would feel better about it if there weren't such obvious and glaring language difficulties with many of the FMGs I have worked under.

f_w · Jan 11, 2007

Tired said:
I suppose I would feel better about it if there weren't such obvious and glaring language difficulties with many of the FMGs I have worked under.

After struggling through the post of our contributor 'cool_vkb', I don't believe that this problem is limited to foreigners.

Tired · Jan 12, 2007

f_w said:
After struggling through the post of our contributor 'cool_vkb', I don't believe that this problem is limited to foreigners.

I'm among the first to jump on these fools who struggle to put a coherent sentence in print, so I'm with you 100% there.

But in my mind, it's a little more serious when ESL residents are trying to explain a diagnosis and treatment options to a patient, and neither can understand the other.

f_w · Jan 12, 2007

Tired said:
But in my mind, it's a little more serious when ESL residents are trying to explain a diagnosis and treatment options to a patient, and neither can understand the other.

Read the 'medical ebonics' thread in the EM forum, again the problem is at times at both ends of the communication pipleline.

cool_vkb · Jan 12, 2007

f_w said:
Well, there are more US grads than FMGs throughout medicine, so why should the ratio be different in specialties ?.

even if you bring 1000000 FMGs, then also they wont get in Speciazlied residencies. Because as i said, preference is always given to US Medical Graduates. Because they have to fill in US grads (who have good stats) to fill in their spots.There may be few bright FMGs who like always may get in. But a majority of them will never get in more competitive residencies.

Plus, didnt you heard the famous "Post match scramble". I have witnessed scenes where FMGs sit right beside to fax machine and send like 60-100 faxes to different residency directors as soon as they find this spot is unfilled or that spot is unfilled. I even saw some professional agents helping them. They charge like $1000-2000 to help. Now thats a good business. Did you ever found any US medical graduate doing that? May be few unlucky ones but in general i dont think US medical grads have any problems like that. Post-match scramle is a classic example of Hyena's coming to eat the food left over by Tiger.

And plzz dont assume this is my opinion for all FMGs. Those who are bright, intelligent always go to top places. Iam speaking only about the average applicant.

f_w said:
Lets see:
In the 2006 match, 56% of positions in IM where filled by US graduates, 73% of positions in Peds where filled with US grads.
Out of 14059 US seniors who got PGY1 positions in the match, 5459 went into either IM, peds or FM.
A few ?

You are right! and that is bcoz times are changing. More and more IMGs are rejected. And go and visit any Foreign Medical Doctors medical associations website and see what do they say you. They say they make up nearly 40% of Primary Care medicine. Now i dont know where they get their info from. Plus AMA's website also says 30-40 % of Primary Care physicians are FMGs.

f_w said:
Not quite. Even in specialties like diagnostic radiology, rad-onc or orthopedic surgery, you will find a number of foreign grads (19%, 9%, 10% respectively).

Those good old days of FMGs are over. In 90s, many FMGs were able to get into these residencies and thats why you find them. But the newer FMG grads are finding it extremely difficult to make it bcoz of higer USMLE requirements, Visa requirements,etc. Ofcourse, those who are highly academic always get in.

f_w said:
Actually, FMGs will pay the same taxes as US graduates (with the exception of a 1 year exemption on payroll taxes during residency). Also, foreign grads didn't get their education subsidized by the US taxpayer through school district taxes, goverment guaranteed student loans and tax credits to the parents.).

No sir, the centre of Medicaid and medicare pays the grants to hospitals to pay for residents salary. So in a way they are paid tax money. And FMGs bcoz of their status pay even higher taxes. But that doesnt matter, they are foreigners. They have to pay it bcoz they are enjoying so many benifits. If an american goes to India, he has to do the same. Nothing great abt it. And govt never pays loans to schools outside unless they are of higher academic standard.

f_w said:
Thankfully, you are part of a minority here.

We'll see this after 20yrs.

cool_vkb · Jan 12, 2007

f_w said:
After struggling through the post of our contributor 'cool_vkb', I don't believe that this problem is limited to foreigners.

Hello! i guess you didnt read my first post properly. Iam an Indian😀 graduated from Indian High School😀 .

So please dont put my english skills as a represantation of US population. I write this way, because i am lazy. And this is not what i learnt from India. Indian Schools gave me a good education. This is my own personal habbit. This is just a forum for me. So iam really not that particular abt grammar or half words. But that doesnt mean i would use this this in my professional life.

cool_vkb · Jan 12, 2007

Tired said:
I'm among the first to jump on these "fools" who struggle to put a coherent sentence in print, so I'm with you 100% there.

Sir, Why use words such as "fool" to adress people on a forum. Dont you think this is insulting and against professional standards. I dont think, as a MD you wanna call any of your patient "fool" if he uses bad english. Everyone has their own style of writing. SDN doesnt have any policy on writing. Then why this Inquisition? May be you could use more gentle language.

heech · Jan 12, 2007

All about the benjamins.

Medical care as "service" is one of those self-gratifying myths some choose to buy into. And yet, how many practicing doctors in the United States actually offer a significant amount of charity care? How many hours per day will *you* spend treating uninsured patients for free?

How much additional tax are you willing to pay as a doctor (as discussed in the 'socialized medicine' thread) in order to provide health insurance to the poor in this country? Are you willing to live in a small apartment + ride a bike + throw away your expensive toys and financial security for your children for the priviledge of providing medical care to those who 'need it'?

If you aren't willing to make that kind of a sacrifice, what leads you to believe those from other countries would feel differently?

There's great delusion amongst some about the importance of economic security. Keep in mind that there are human beings, not too different from you and I in moral integrity and intellectual construct, who're willing to risk death + random arrest... just for the opportunity to clean your toilet for a few dollars an hour. It really is all about the benjamins.

why come to the US?

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