I agree with your first sentence but pakistan MBBS does NOT cost more than US MD or carribean route. It's like $5000-$10,000 USD a year for 5 years and can be done right after high school so no premed or MCAT required. The Caribbean route costs $250,000-300,000 total plus the required premed years another $160,000 potentially.
The people who go to pakistan from US just need to score well on the USMLE Step 1 and Step 2 CK which can be done with all the resources now out there and the time they have to study (12+ months for each exam, in comparison US students only get 6 weeks to study.) I have friends who took this route and are now physicians and these people had only gotten into community colleges after high school--it was a pretty good deal for them. The MBBS (a bachelors degree) gets autonatically converted to a MD (a doctorate) when they apply for residency, which I never understood. I personally would never go to a US born pakistan trained physician--they really cheated the system. But it can be done and happens all the time and is an alternative for people who would never even have the opportunity to become a physician in the US or even carribbean.
Alright...never did I for a minute suggest that the foreign seats cost more than US schools. I know they cost around 10k. But compared to local students studying in government schools who pay around $1000 dollars that's still significantly less. My sister who went to King edward paid $100 a year 9-10 years ago.
Now I also agree with you claiming that people can take the USMLEs and come into the US. Sure with 240+ both USMLE step 1 and step 2 one gets into a IM residency. And sure they can take upto 6 long months to study for each USMLE exam. In theory all of this sounds like a sweet deal right? But here is the reality
🙂 And this is coming from someone who did high school in Pakistan but chose to take the US MD route (8 damn years) rather than the 5 year Pakistani route. Would I have gotten an acceptance in Pakistan? Hell yes
🙂 But this is why only people without fore sight try to save 100-150k when it ends up costing them a lot more in the long run. Here are the facts:
Misconception no. 1: It takes less time in Pakistan (5 yrs vs 8 years).
Not true. I have 20 class fellows from high school atleast who are now doctors in Pakistan. Care to venture a guess how many of them will find out where they are going for residency on March 18th this year? One. The rest will apply next cycle. So despite everyone graduating 2 years ago, only one person was actually able to apply this cycle, and his application itself was a haphazard attempt at having something this year. So why in this world are people who are graduating so much earlier still not able to get into residency the same time as someone whose had 8 years of secondary education? First reason - its not 5 vs 8, its 5.5 vs 7. After the 5.5 years IMGs start studying for the USMLEs. They take 6 months for step 1 on average. Why? Because they somehow are brainwashed into believing that Kaplan is a legit resource that needs to be done for step 1. I don't have time to rip apart the false belief that somehow US grads have superior background knowledge, but anyway I'll let that go. Then they take another 3 months to study for step 2 CK. Then they come to the US and study for another month or two and take step 2 CK. All the ones who need a H1 visa will then take Step 3. The fact that humans take a couple weeks of break between each exam, it ends up being a total of 1 year to take all these exams. Now....the next struggle starts for US observerships
🙂 Because these guys need US experience and US recommendations. And then the struggle starts for sending out random emails and hoping for a response from somewhere
😛 Also observerships cost $$$ and time
🙂 And THEN when everything is complete do these IMGs start their application, and that process itself is 1 year in total with interviews, eventually matching, and eventually waiting for residency to start. Whereas US grads, finish 3 year and fill up their application and essentially start interviewing BEFORE graduation and do everything while in school. So in short, you can say an mbbs takes less time, but realistically 20 of my class fellows from high school who are all Mbbs doctors will die to be matching march 18th as I would
🙂
Your second misconception: It costs less.
Actually doing an mbbs is a ridiculously bad financial decision. Here are the facts. How many IMGs do you know who can go into plastics, derm, radiology, EM, urology, opthomology, ENT and all the high paying specialties? Almost no one. All the super lifestyle friendly fields which are highly competitive are exclusively US grads. Only the least competitive specialties like FM, IM, psych, peds, neurology are where IMGs can go. Now here I am heading into EM, guaranteed a 350-400k income while my IM counterparts will be making 180-250k as hospitalists. Try getting into EM or any competitive high paying specialty as an IMG and then we'll talk
🙂 So over a 35 year career, that 150k pay difference translates into an opportunity cost of a few million. Now you'll make the argument that one can do a fellowship in Cards, GI in IM. Then I'll just have to remind you how competitive these specialties are
🙂 People from top notch residency programs, all of whom want cards and GI, eventually take those spots. IMGs are handicapped, they usually get accepted into crap residency programs, middle of nowhere essentially, programs that US grads essentially dont want. Only the 260+ brilliant folks break in to the top tier IM programs where they can later go into comeptitive specialties. Otherwise most IMGs go to non competitive programs whose match rate for competitive fellowships are pretty dismal.
Your 3rd misconception: It's easy to get into a residency for IMGs
It is 10 times more difficult for an IMG to get into a residency program. Gone are the days where the number of applicants were equal to the number of spots in the US. Now there are 25k residency spots and 40K applicants. Guess which people mostly don't match? Mostly its IMGs
🙂 Most IMGs DO NOT match. Residency programs have a huge preference for US grads. US grads are sent interviews as a preference over IMGs. Any IMG that scores less than 230 (60th percentile) can absolutely forget matching. That's it. It's the end. Have you taken the USMLE? 20% of questions are a crap shoot. There is a LOT of guesswork. On a bad test day, someone scoring in the 240s can easily fall below 230 on a stressful test day. And that's almost game over (unless they go psychiatry). Less than 220, it's mostly gave over for every IMG. So average intelligence IMGs get screwed over all the time which is why MOST imgs don't match. The physicians that are already working, applied ages ago when there weren't DO programs springing up in the US everyday. Now the US grads itself surpass the total number of spots available.
Summary: I personally paid an extra 100k on my education and avoided doing an mbbs from pakistan, which I easily could have easily done as my own mother was a professor in a medical school in Lahore -_- Yes, the entire family wanted me to do medicine in Pakistan, but like the rebel that I am, I did what I wanted. Here is what I bought myself for an extra 100k that I spent on my education - An opportunity to go into lifestyle high paying specialties - You name it. I looked into anesthesia, optho, ortho, EM, Urology - I eventually picked EM. I could have gone into any of those. Next, the extra 100k on my education meant huge career opportunities. Not only is matching easy, I got to interview at programs like Harvard, Hopkins, Emory, Duke, Baylor, UTSW, Cincinnati (no. 1 in EM). All in all got a total of 21 interviews after applying to 55 programs (IMGs apply to 100+ and hardly get 5-10 and that too in a low competitive specialty like IM). Now having Harvard on the resume itself creates opportunities which are theoretically worth more than 100k. EM isn't big on fellowships afterwards, but if I went into Anesthesia then I could have gone into pain, transplant, cardiac, and all the most lucrative specialties after a brand name residency program. So..really...if anyone has an opportunity to go to a US MD school, they should, even if it means paying an extra 100-200k in education expenses. It pays off. Big time.
