Because the hospitals are malignant and IMGs hoping to come here take whatever they can get?
The next question is "why don't good hospitals take IMGs, then?" I would say that's due to a variety of factors (including visa issues), but largely likely due to optics. IMGs have been matching at the malignant hospitals for so long that having an IMG at a program makes people have some assumptions about the program itself. Programs in turn want to avoid these perceptions. I would say this is similar to the reason why some hoity-toity residency programs have no DOs when the top DO grads are just as good as the top MD grads. After a particular interview back when applying for residency, one of my co-interviewees said something along the lines of "that program seemed amazing, but it's kind of concerning that they have so many DOs". That interaction always stuck with me in regards to how some people evaluate programs at a glance.
Am I saying these HCA residencies are not bad? Absolutely not--they likely have no business educating residents and will likely do a disservice to these trainees and their future patients. But I do think it's unfair to indiscriminately say that "IMGs from 3rd world countries" are by definition "unqualified" when the ones who come here often have a higher bar to clear than some unqualified American grads.
I'm sure if you filled these HCA residencies with American grads the programs would still be bad and they would turn those grads into bad emergency physicians.
Yes, stating IMGs are unqualified essentially shows a lot of ignorance.
I'm not an IMG myself, i went to med school in Dallas. But i was in b Pakistan until highschool. Which means i have a lot of IMG friends that are in US training programs.
Almost every single one of them has 240/240+ scores in their usmles if not 250+ or more. It is almost impossible to get in without that bare minimum score. It is very common to see some of them with 270+ usmle scores still only get 8-10 interviews after applying to 120+ programs. Two of my 270+ high school friends who likely would have been considered for the best residency spots in the country if they were AMGs, were accepted to Buffalo and Detroit, not the worst, but definitely not the most desirable places. And those guys are absolutely brilliant.
One friend of mine 256/244 in his usmles got accepted on THE THIRD ATTEMPT. How many AMGs do you know with those scores that don't find anything after applying to 100 plus spots? He's now at Omaha.
My IMG wife is hands down considered the best resident of her class, she's chief resident now. Her AMG co residents have at least 30 points less than her on the usmle, and their lacking medical knowledge is very obvious.
My wife's first cousin IMG 270/270+ is probably the smartest person i know. She was the number one grad at agha Khan hospital for her year, which is the equivalent of being number one from Harvard med school essentially. She was also considered the best resident at the Cleveland clinic, and was chief there.
The point is.... IMGs have several hurdles to cross, have to have better scores than their AMG counterparts to be able to compete with them. And they do. Eventually the ones that make it, are very smart and hard-working people. These crap new York residency places offer strong IMG candidates pre-match offers. They know they are malignant, so they pick very good candidates, offer them a pre Match position. It's very hard to say no to a guaranteed residency spot, even if at a malignant place. My sister, another IMG, went to one of these malignant places too 12-15 years ago, NY presbytarian i think, her scores were in the 99th percentile as well. She had 2 pre match offers.
the point is, these imgs will likely not be the best communicators, not have the best English speaking skills, so they might not impress you in a 15 minute conversation, but rest assured they are probably very hard working, and the cream of the crop to successfully get a US residency. It's so hard to get one as an img.
And just so you know... Getting into med school in the US is ridiculously easy. Try getting into a government med school in Pakistan. 2500 spots in total with 100,000 candidates taking the entry test.
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