Competitive applicants and uncompetitive residencies

[f_w]

And to waste all that hard work seems like, just that, a waste.

I still don't see your problem.
You seem to have reasonably good credentials, you shouldn't have a problem to get into an excellent university IM program. From there you write your own ticket. If you want to do cards or GI, go ahead do it. If you want to practice plain IM, no problem. In day to day life, outside of the inbred microcosm of a medical school class, most physicians deal with each other in a respectful and professional way. Nobody gives a rats $$) where you went to medschool and what 'prestigious' residency you have done. If you are competent and professional, your colleagues will respect you, regardless of your specialty. If you are an arrogant self-conscious prick, people will look down on you, regardless of whether you come from Harvard or Kanbraska State college of medicine.

The only waste would be if you went into something because it has more 'prestige' but hated every day of it while someone who would have been happy in your position has to slave away in IM.

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[Poety]

I still don't see your problem.
You seem to have reasonably good credentials, you shouldn't have a problem to get into an excellent university IM program. From there you write your own ticket. If you want to do cards or GI, go ahead do it. If you want to practice plain IM, no problem. In day to day life, outside of the inbred microcosm of a medical school class, most physicians deal with each other in a respectful and professional way. Nobody gives a rats $$) where you went to medschool and what 'prestigious' residency you have done. If you are competent and professional, your colleagues will respect you, regardless of your specialty. If you are an arrogant self-conscious prick, people will look down on you, regardless of whether you come from Harvard or Kanbraska State college of medicine.

The only waste would be if you went into something because it has more 'prestige' but hated every day of it while someone who would have been happy in your position has to slave away in IM.

very well said f_w, but don't you ever wonder why ya bother sometimes?

 

[BKN]

I wonder if our disagreement here is due to a generational gap. Perhaps this is a relatively new phenomenon in medicine? I have noticed that the sentiment tends to be more widespread among younger atttendings.

No, I don't think it's a new phenomenon. However, it's always been a sign of immaturity and insecurity and it was just as distasteful when I trained as it is now. The "designated idiots" change, however. In the 70's the top members of a class usually did IM and perhaps a fellowship. The second quartile was the surgeons and surgical subspecialists. Neuro and Pediatrics were in the middle and Psych was all over the place. And the losers? Well here's the joke from 1973:

"How does the bottom quarter make their specialty decision?

Well you put them in a dark room and pith them. Those that crawl out get to be the pods, those that don't go into OBG."

Nobody would say that today. BTW the other unpopular specialities in those days were Rad, Gas, and Derm. FP and EM were brand new and nobody knew what to make of them.

OP, do whatever you want to do and pay no attention to "prestige" specialities. Also, nobody will know or care where you did your residency 10 years down the road. the only thing that will matter is how good a doctor you have become.

 

[Poety]

No, I don't think it's a new phenomenon. However, it's always been a sign of immaturity and insecurity and it was just as distasteful when I trained as it is now. The "designated idiots" change, however. In the 70's the top members of a class usually did IM and perhaps a fellowship. The second quartile was the surgeons and surgical subspecialists. Neuro and Pediatrics were in the middle and Psych was all over the place. And the losers? Well here's the joke from 1973:

"How does the bottom quarter make their specialty decision?

Well you put them in a dark room and pith them. Those that crawl out get to be the pods, those that don't go into OBG."

Nobody would say that today. BTW the other unpopular specialities in those days were Rad, Gas, and Derm. FP and EM were brand new and nobody knew what to make of them.

OP, do whatever you want to do and pay no attention to "prestige" specialities. Also, nobody will know or care where you did your residency 10 years down the road. the only thing that will matter is how good a doctor you have become.

FINALLY!!! Where have you BEEN?

EDTA: Back by popular demand ... da da da... the avatar - brand new tonight, isn't she cute?

 

[f_w]

Where is the pic with todays newspaper ?

 

[Poety]

Where is the pic with todays newspaper ?

wait a minute.. wait one minute... DO I KNOW YOU? SAZ?

 

[orientedtoself]

Poety- she knows she's cute, she's blushing!

 

[Poety]

Poety- she knows she's cute, she's blushing!

Yeah, shes stuck up already - see what 6 mos does to a girl? We lose em younger and younger nowadays

 

[Doctor Bagel]

No, I don't think it's a new phenomenon. However, it's always been a sign of immaturity and insecurity and it was just as distasteful when I trained as it is now. The "designated idiots" change, however. In the 70's the top members of a class usually did IM and perhaps a fellowship. The second quartile was the surgeons and surgical subspecialists. Neuro and Pediatrics were in the middle and Psych was all over the place. And the losers? Well here's the joke from 1973:

"How does the bottom quarter make their specialty decision?

Well you put them in a dark room and pith them. Those that crawl out get to be the pods, those that don't go into OBG."

Nobody would say that today. BTW the other unpopular specialities in those days were Rad, Gas, and Derm. FP and EM were brand new and nobody knew what to make of them.

OP, do whatever you want to do and pay no attention to "prestige" specialities. Also, nobody will know or care where you did your residency 10 years down the road. the only thing that will matter is how good a doctor you have become.

Most brilliant post ever!!

 

[DrNick2006]

249 on step I is approx. 90-95th percentile, so what do you consider a astronomical score?

With good letters, evals and going to a top 10 school you WILL get interviews at at least half of the top 10 IM programs in the country.

"Desireable" specialties are cyclical, just like the last poster said, it used to be said that if you wern't smart enough to do IM or skilled enough to do Surgery then you went into OB or psych.

IM subspecialists can make great money if that is your goal (providing good care and promoting health in my community is my goal however)

IM has a bimodal distribution, the very top of the class and the lower half generally go into IM. There are an awfull lot of Gunners who want to do cards or GI, Also I think medicine attracts those brilliant people who really make the new discoveries and strides in the medical field (of course I'm biased cause I am doing medicine).

IM has the greatest tradition of any specialty maybe other than surgery, and it seems very prestigous to me to be a part of that.

 

[Mumpu]

This thread is depressing and frightening.

Apparently a lot of people went into medicine to impress that girl Jenny who wouldn't go to the school dance with them in eighth grade. Boy, y'all really showed her, didntcha?

Are you really so unbelievably insecure that you care what random people in the hospital think about you?

News for ya. Respect among professionals does not come from schooling or test scores or wads of cash. People will look at your work, at your patient interactions, at your staff, and they will decide whether to respect you. Do what you love and what you are good at and you will have all the respect in the world.

More news for ya. All doctors make great money. $100,000 a year is a wad of money. If you don't think so, come out of your sheltered little world. More news for ya. Medicine is hard work. If you don't want to work hard, do your patients a favor and quit now.

 

[GoPistons]

I think I can understand the original poster's problem... it may have something to do with FMGs... internal medicine/family practice/peds is loaded with FMGs who may have had no other choice to go into these fields... by going into peds or internal medicine one may feel that you lack some type of exclusivitiy... why bother working so hard, getting to a top 10 med school, incurring loads of debt to get where somebody else maybe didn't work as hard or worse yet did not even have to go to undergrad to get to... most FMGs from India didn't do an undergrad degree and are much younger than us... that's simply a kick in the teeth to somebody with 100k+ debt and an undergraduate degree and more gray hairs...

I can understand to some degree his/her apprehension about going into one of these fields...

I am doing a transitional year residency and most of my patients are surprised I can even speak English... that's how much FMGs have disrupted the internal medicine/peds fields...

 

[sdnetrocks]

All doctors make great money. $100,000 a year is a wad of money.

I disagree with this whole-heartedly. The lifestyle one can afford on $100k is vastly different than $200k, which itself is significantly different than $300k/$400k/etc. I cannot imagine how intelligent, reasoning people can buy into the nonsense that salary A = salary B as long as salary A > $100k and salary B > $100k. And, by the way, $100k isn't all that much. If you're trying to raise a family in the suburbs with a total income of $100k, you will NOT be living the "doctor" lifestyle by any means.

I think I can understand the original poster's problem... it may have something to do with FMGs... internal medicine/family practice/peds is loaded with FMGs who may have had no other choice to go into these fields... by going into peds or internal medicine one may feel that you lack some type of exclusivitiy... why bother working so hard, getting to a top 10 med school, incurring loads of debt to get where somebody else maybe didn't work as hard or worse yet did not even have to go to undergrad to get to... most FMGs from India didn't do an undergrad degree and are much younger than us... that's simply a kick in the teeth to somebody with 100k+ debt and an undergraduate degree and more gray hairs...

I can understand to some degree his/her apprehension about going into one of these fields...

I am doing a transitional year residency and most of my patients are surprised I can even speak English... that's how much FMGs have disrupted the internal medicine/peds fields...

Yes, this is indeed a concern.

 

[EctopicFetus]

I think I can understand the original poster's problem... it may have something to do with FMGs... internal medicine/family practice/peds is loaded with FMGs who may have had no other choice to go into these fields... by going into peds or internal medicine one may feel that you lack some type of exclusivitiy... why bother working so hard, getting to a top 10 med school, incurring loads of debt to get where somebody else maybe didn't work as hard or worse yet did not even have to go to undergrad to get to... most FMGs from India didn't do an undergrad degree and are much younger than us... that's simply a kick in the teeth to somebody with 100k+ debt and an undergraduate degree and more gray hairs...

I can understand to some degree his/her apprehension about going into one of these fields...

I am doing a transitional year residency and most of my patients are surprised I can even speak English... that's how much FMGs have disrupted the internal medicine/peds fields...

Agreed Look at the AMA stats.. for IM http://www.ama-assn.org/vapp/freida/spcstsc/0,1238,140,00.html

50.8% are "international medical graduates"

For Peds - http://www.ama-assn.org/vapp/freida/spcstsc/0,1238,320,00.html

31.9% are "international medical graduates"

Thing is you have to do what will make you happy!

 

[sophiejane]

I guess it's human nature to constantly compare ourselves to one another, but it seems like such a waste of time to me to sit around worrying about being in residency with too many FMGs, "wasting" high marks on exams and prestigious-named school attendance on an inferior specialty.

Where are your priorities? What do they mean, in the end?

Once you have all that money and all that prestige from that all-white, all-American prestigious institution and everyone thinks you are superhuman and your wife is gorgeous and your kids have straight teeth...well, then what? Are you going to be happy then? I doubt it. There will always be Dr. Jones next door with the bigger boat or the bigger practice who went to the better program and chose the more prestigious specialty.

Ugh.

Call me idealistic, but I try to think about what really matters most when I make decisions like this. I try to live my life in such a way that when I look back at the end of it, I'll be certain I've spent my time doing what I love, being a good person, and giving and receiving love from family and friends.

 

[sophiejane]

I am doing a transitional year residency and most of my patients are surprised I can even speak English... that's how much FMGs have disrupted the internal medicine/peds fields...

Please tell me how filling unfilled residency spots is a "disruption." That's about as boldly racist remark as I've heard anywhere.

Yes, I said racist. Shame on you. The Indian and Pakistani FMGs I've worked with are some of the smartest and best docs I've run across. I'd be proud to be their colleagues any day.

An analogy is migrant farm workers in California. Since the tighter border security, fewer migrants are crossing over. Crops are going unpicked. Grocery prices are getting higher.

See what I mean?

 

[EctopicFetus]

Sophiejane, perhaps you arent aware that FMGs can sign contracts outside the match before the US grad has a chance at it. So in reality FMGs ARE taking USMGs spots.

Thing that is really really sad is we are creating a brain drain in their country and in turn hurting their original countries. Of course many of them are super smart since they are the best of the best. Thing is a lot of FMGs were attendings in the past.

To compare farm workers to physicians is silly because physicians have a certain level of education that is required to work. The farm workers (I give them a ton of credit BTW) are what we refer to as "unskilled" labor. They have no marketable skills except that they work their tails off.

Anyhow 2 different things. We should figure out a way to deal with the docs we have so we dont make conditions in 3rd world countries even worse! Keep in mind many many of them get spots that then are no longer available to USMGs.. Just something to think about before you claim they are filling "unfilled" spots.

Also, dont bring the race card. I think that is kinda weak. Truth is many of these FMGs work in the inner cities and their english and cultural skills are lacking (for obvious reasons) and this creates a tough environment for providing healthcare to the underserved.

yes they are smart but I am not sure that is what is best for healthcare in the US!

 

[f_w]

Funny how it boils down to this. The OP is afraid of working with people who look different from him and might talk different from him (and might supervise him). I suspected this from the beginning, I am glad someone else brought it up.

 

[sophiejane]

Sophiejane, perhaps you arent aware that FMGs can sign contracts outside the match before the US grad has a chance at it. So in reality FMGs ARE taking USMGs spots.

We should figure out a way to deal with the docs we have so we dont make conditions in 3rd world countries even worse! Keep in mind many many of them get spots that then are no longer available to USMGs.. Just something to think about before you claim they are filling "unfilled" spots.

Don't want to hijack this thread, which is actually a dead horse anyway, but I still don't see how there can be so many unfilled spots every year in IM, peds and FM and yet you say that US grads are being denied spots. If they have to scramble, they scramble. There are still unfilled spots at the end of the day.

And yes, I am aware of the differences between migrant farm workers and physicians. That's what an ANALOGY is. I never said they were similar. I said the situation was similar, especially if we close the gates to FMGs. We'll have a serious crisis on our hands, with dwindling numbers of US docs who are willing to practice in underserved areas.

Over and out. Sorry to get off course.

 

[sophiejane]

Also, dont bring the race card. I think that is kinda weak. Truth is many of these FMGs work in the inner cities and their english and cultural skills are lacking (for obvious reasons) and this creates a tough environment for providing healthcare to the underserved.

okay, I have to say one more thing...

Until the English speaking US medical grads start volunteering to work in underserved areas, the underserved will be fortunate to be treated by FMGs.

Furthermore, English is spoken as a first language (albeit with an accent) among many Indians, Pakistanis, and east Asians. And I'm not sure what being from a different culture has to do with anything but exclusionary, prejudiced thinking. Certainly it's not a barrier to providing good care.

And exactly what are "cultural skills"?? I've never heard of such a thing, and I'm about as blonde and blue-eyed a white girl as ever there was.

"Brain drain", my arse. You couldn't care less about that. What you and everyone else on this forum who whines about FMGs is worried about is being less qualified and experienced and therefore less attractive for a residency spot than someone from another country.

Clearly, the "race card" wasn't THAT weak in this argument...

 

[Pir8DeacDoc]

it's a know fact that patients respond better to doctors and healthcare workers from a similiar culture of their own. I can't see why you can't imagine that. I know there are many things about other cultures I can't "get", no matter how hard I try.

 

[sophiejane]

it's a know fact that patients respond better to doctors and healthcare workers from a similiar culture of their own. I can't see why you can't imagine that. I know there are many things about other cultures I can't "get", no matter how hard I try.

Great. But unfortunately poor people don't have the choice because apparently docs from their own north American culture aren't interested in caring for them if they don't have insurance!

 

[GoPistons]

agreed that "disrupt" was a poor choice of words...

disagree that I am racist...

anyways, one may think that FMGs are the "brightest" from their countries... but frankly that is not true... although some of them are certainly incredible physicians with an extreme level of knowledge... here are the problem with FMGs as I see it:

1. most have difficulty communicating in the language of this country
2. some fail to recognize social norms
3. most populations in the inner-city are indigent and have trouble relating to a physician from another country
4. FMGs are usually very wealthy in their own countries... how else did they afford step 1, 2, 3, etc.? this further emphasizes their inability to relate to the indigent of the inner-city
5. there is lack of quality control in these countries... FMGs can be bright or absurdly inadequate in the US medical field...
6. medical school admissions in other countries requires only high test scores or bribes... there is usually no interview and definitely little weight on external attributes needed for physicians.
7. FMGs usually did not attend undergrad so they may be less intellectually mature than their USA counterparts... that is why undergrad is required for admission to US medical schools...

contrary to the above, I don't hate FMGs, and I'm not xenophobic. I just state the facts as I see them.

The above 7 points are the reasons why the "competitive" specialties don't even consider FMGs for admission.

Back to the thread... the above 7 points make internal medicine and peds less desirable for USA graduates... people do not want to have to overcome the stereotypes of an internal med/peds physician... that is what I meant by "disrupt"... FMGs have disrupted the traditional concept of what an internist is... to the general population, an internist is a physician from another country that can barely speak english...

 

[BKN]

it's a know fact that patients respond better to doctors and healthcare workers from a similiar culture of their own. I can't see why you can't imagine that. I know there are many things about other cultures I can't "get", no matter how hard I try.

It's time to give up on the USMG vs IMG argument. Nobody is changing their minds.

But one more thing about the original post (best prestige vs less prestige training). Multiple choice:

BKN is excessively proud of his Baylor degree and Hopkins residency. Of the approximately 200,000 patients he's seen in the 27 years since finishing, how many have asked him where he trained?

a. about 50
b. 10
c. 0
d. 1000
e. none of the above



answer: c

 

[sophiejane]

WRONG. Wrong and transparently xenophobic.

The reason many US grads don't want to do IM/Peds/FM is because the hours are long and the pay is lower than the specialties, and managed care is a freaking nightmare.

Maybe this is a regional thing, but I have never heard that argument before.

To say that a high number of FMGs in primary care makes it unattractive to US grads is ridiculous. All of your arguments have to do with race, culture, and xenophobia. None have to do with the real reasons, which are cash and lifestyle.

By the way, in my neck of the woods, finding a nephrologist or cardiologist who's not from east Asia is darn near impossible, but most of the rural primary care docs are good ol' boys from the south and just as white as they can be.

 

[Poety]

It's time to give up on the USMG vs IMG argument. Nobody is changing their minds.

But one more thing about the original post (best prestige vs less prestige training). Multiple choice:

BKN is excessively proud of his Baylor degree and Hopkins residency. Of the approximately 200,000 patients he's seen in the 27 years since finishing, how many have asked him where he trained?

a. about 50
b. 10
c. 0
d. 1000
e. none of the above



answer: c

BKN, they don't even listen to years of experience - see how engrained it is in their brains? scary stuff And MUMPU - GREAT FRICKING POST ONE OF THE FEW WITH TRUE PERSPECTIVE!!!

 

[Eyesore]

BKN is excessively proud of his Baylor degree and Hopkins residency. Of the approximately 200,000 patients he's seen in the 27 years since finishing, how many have asked him where he trained?

a. about 50
b. 10
c. 0
d. 1000
e. none of the above



answer: c

These days, some people just look it up online before seeing you. No need to ask.

 

[f_w]

1. most have difficulty communicating in the language of this country

Some have language issues, but so do US grads.

2. some fail to recognize social norms

Yep, some do have a problem to accept how f###$# up some of their US patients are. Also, the medical culture in other parts of the world has the physician giving a lot firmer direction than it is common here. 'If you remain as fat as you are and keep smoking at this rate, you will die a horrible death within the next 5 years' is something a physician is allowed to say to his patient in most parts of the world. Here you have to treat your patients like elementary school children, everything they do is an 'issue' and an 'opportunity'. But most FMGs manage to dumb down sufficiently to blend in in no time.

3. most populations in the inner-city are indigent and have trouble relating to a physician from another country

Says who ?
(the famous 'inner city patients' also have a problem to relate to physicians of another race. due to the scarcity of minority physicians in this country, no matter what, they will have to deal with cultural barriers.)

4. FMGs are usually very wealthy in their own countries... how else did they afford step 1, 2, 3, etc.? this further emphasizes their inability to relate to the indigent of the inner-city

Sorry to disappoint you there. Have yet to meet a 'very wealthy' FMG. They will rarely come from the lowest layers of society, but how is that different from the US ? Just like here, they are more likely to have educated parents, but thats pretty much it. The 'very wealthy' have little reason to leave their own countries. And if they leave, surely not to work 80+ hours with little recognition in a country far away from home.

5. there is lack of quality control in these countries... FMGs can be bright or absurdly inadequate in the US medical field...

If someone is inadequate in the US medical field, he/she will not survive the first year of a US residency. Residents do get put on probation or terminated, the quality control is up to the residency programs. (not to mention that FMGs have to pass the same exams as US grads before they even start residency).

6. medical school admissions in other countries requires only high test scores or bribes... there is usually no interview and definitely little weight on external attributes needed for physicians.

Thank God !

I'll look past the blanket accusation of corruption in 'other countries'. An admissions process blind to all the fluff on US medschool admissions concentrates on academic achievement. This includes factors such as high school leaving exams, A-levels etc. The people at the top make it into medschool, law or engineering. Yes, you will end up with a good number of egg-heads. At least it doesn't breed this hypocrisy I see here every day with college students 'volunteering' to pad their medschool applications while they give a r#)! _)* about the patients they are dealing with.
(incidentally, my school used to have a separate path for admission that put less emphasis on grades/MCAT and focussed on ECs and a faculty interview. It turned out that the people admitted through this path couldn't hack it and tended to drop out after 2 years. when the school figured this out, they went back to the old grades/MCAT formula. you make the cut or you don't, its that simple)

7. FMGs usually did not attend undergrad so they may be less intellectually mature than their USA counterparts... that is why undergrad is required for admission to US medical schools...

Because you guys seem to need it.
Many countries have multi-tiered school systems. School years are longer and there are more hours during the week. The people attending the level of school leading to university admission, have more education to their credit than even the best US high school graduates.

contrary to the above, I don't hate FMGs, and I'm not xenophobic. I just state the facts as I see them.

Lol
You just bend the facts as you want to see them.

The above 7 points are the reasons why the "competitive" specialties don't even consider FMGs for admission.

The competitive specialties don't consider most FMGs because they don't have to. They have an ample supply of qualified US candidates (US allopathic, DOs). Some of the currently competitive specialties (gas and rads for example) where not above taking FMGs 6-7 years ago. Albeit it a distorted job market, it is a market nonetheless.

 

[Mumpu]

What exactly is a "doctor lifestyle" for you? A Porsche? A million-dollar house? A trophy wife? Lots of bling to make sure no one (heavens forbid) ever doubts that you are freaking wealthy? $500 dress shirts and $1,000 shoes? Are you a physician or some kind of illiterate overpaid athlete or actor?

My parents together make a bit less than what I will (under present system) as an IM attending. They have a very nice house in a great neighborhood and nice cars, they take vacations to Europe, and they put three kids through expensive private colleges. That's pretty good income, isn't it? What else do you want?

As for FMGs vs USMGs, it's a free market. If there was no demand for them, there wouldn't be FMGs, NPs, PAs, etc., would there?

 

[GoPistons]

If FMGs were this holy grail of super duper qualified physicians, then "competitive" residencies would be compelled to take a look at them... wouldn't they??... we live in a society where you take best over better over adequate all the time...

truth is... these programs don't even bother or think twice about it... why is that?... for the reasons I told you... FMGs have a higher probability of coming with a myriad of problems that USA applicants don't... just a fact of life...

the op is somebody who has worked hard and wants to be "rewarded" in some way... it's called piece of mind... and there's no point in grilling him/her about it...

have you met a PhD that works in a dead-end job?? I have met plenty of them... why are some of them miserable??? It's because their overqualified for what they do... the same concept applies here... if you enjoy something equally as much as internal medicine, then it would make sense to pick the more "competitive" specialty... for piece of mind and a sense that you "accomplished" something that was "difficult"...

 

[Mumpu]

It's a free market. If FMGs sucked, we wouldn't have them. We reach abroad because US educational system is unable to produce enough qualified med school applicants (yes, it's competitive... there is a difference between "wants to be a doctor" and "has what it takes to be one" and even with the competition the system lets quite a few of the former through).

All attempts to figure out what OPs professional interests are (returning to his original question) have repeatedly come down to money and lifestyle.

Competitive does not neccessarily equal difficult. In fact, many competitive specialties are in demand specifically because they are relatively easy.

 

[GoPistons]

I meant difficult to accomplish... not difficult to do...

 

[Poety]

Until I came to SDN, I had naively assumed that my counterparts were for the most part very accepting, and non-judgemental individuals. Its scary to realize just how racist the medical community is, as well, they have some of the most seperatist (sp) ideas I've ever seen.

Its unfortunate that this type of mindset is so dominate in the medical field. A profession that is supposed to have noble and honorable individuals in it, a profession geared towards helping others - its amazing what disgusting personalities this field attracts. Nothing I say is going to change it, nothing anyone says is going to change it, I just wanted to state how absolutely shocked and disappointed I am.

To all of you with these ideas about being better than the FMG's, or better than the URM's, or at your "best school in the whole world" I seriously hope that when the time comes - your only option for medical care isn't the very person you've grown to hate and ostracize.

What sad sad lives you must lead, how absolutely painful it must be to live with yourself and the hate that brews in you --- I'm so glad I don't know what its like to feel that, in all honesty I pity you.

One day you're going to learn, one day its going to come back on you - you may think you're invincible now, that all your judgements have no repercussions, etc etc - but just wait.... they do.

 

[penguins]

I have also been shocked by what I have observed, I was niave and thought most people became docs to help people, etc. I am proud to be a physician as well though. People do treat you differently when they find out you are a doc and your grandparents are really proud. I admit I like that part too. I don't think anyone out there really cares what kind you are though. It is your fellow physicians who will put you down or make fun behind your back for what field you go into.
I am going into Neurology and I love it! I can't tell you how many times people (in medicine) have looked at me with open disgust and asked why in the world.... I have gotten some really bad feedback. I don't care though because I will be happy doing what fascinates me.
I learned all this stuff about lots of people in medicine being jerks in my clinical years but on SDN those same people aren't trying to hide it to get a good evaluation or to get the nurses to like them. They can anonymously sound of with no consequences.
For every idiot on here, there are enough people who recognize it to balance out. I remain an optomist and think that the nice-guy-doctors just aren't spending time on the net, they are spending it with their families and at church.

 

[sdnetrocks]

the op is somebody who has worked hard and wants to be "rewarded" in some way... it's called piece of mind... and there's no point in grilling him/her about it...

have you met a PhD that works in a dead-end job?? I have met plenty of them... why are some of them miserable??? It's because their overqualified for what they do... the same concept applies here... if you enjoy something equally as much as internal medicine, then it would make sense to pick the more "competitive" specialty... for piece of mind and a sense that you "accomplished" something that was "difficult"...

Yes, this is the issue exactly. As to FMGs, I never said that I am better than them. However, I do have more opportunities, and that is a fact. Going into a field that admits FMGs would be turning my back on opportunities that I have and others (such as FMGs) don't. It's that simple, and there's no xenophobia here.

As far as being a jerk or not a genuinely nice person or whatever just because of the thought process I'm going through (that I've anonymously but very honestly publicized here), I resent that completely. I really do enjoy medicine and caring for patients immensely (this is why rads and path are ruled out). And being a gunuinely kind and caring person (at least this is how I see myself), I have a huge disgust for jerks and a**holes (this is why all surgery fields and, consequently, gas are ruled out). Is it so incredible that given this, I also want some financial reward commensurate with my sacrifice? And we've all sacrificed a lot to become docs, and this is not even considering our exorbitant tuitions and paltry resident and fellow pay.

 

[DOCTORSAIB]

Until I came to SDN, I had naively assumed that my counterparts were for the most part very accepting, and non-judgemental individuals. Its scary to realize just how racist the medical community is, as well, they have some of the most seperatist (sp) ideas I've ever seen.

Its unfortunate that this type of mindset is so dominate in the medical field. A profession that is supposed to have noble and honorable individuals in it, a profession geared towards helping others - its amazing what disgusting personalities this field attracts. Nothing I say is going to change it, nothing anyone says is going to change it, I just wanted to state how absolutely shocked and disappointed I am.

To all of you with these ideas about being better than the FMG's, or better than the URM's, or at your "best school in the whole world" I seriously hope that when the time comes - your only option for medical care isn't the very person you've grown to hate and ostracize.

What sad sad lives you must lead, how absolutely painful it must be to live with yourself and the hate that brews in you --- I'm so glad I don't know what its like to feel that, in all honesty I pity you.

One day you're going to learn, one day its going to come back on you - you may think you're invincible now, that all your judgements have no repercussions, etc etc - but just wait.... they do.

 

[dynx]

Great. But unfortunately poor people don't have the choice because apparently docs from their own north American culture aren't interested in caring for them if they don't have insurance!

you have GOT to be pre-med. I haven't met a med student yet that could saddle up on a horse so high.

 

[LADoc00]

More news for ya. All doctors make great money. $100,000 a year is a wad of money. .

HUH?! Ummm where are you living, rural Arkansas???

100K isnt crap! That is roughly the starting salary for a kids coming out of college FFS in a ton of fields (IB, CE/EE..even medical device sales is more than that!!!).

After you are paying housing, school loans, etc. You couldnt even raise a family on that. Im single and barely hanging on making 250K! (well okay, Im doing a tad better than the poor house).

 

[penguins]

To the OP,
I don't think your original question is an exhibition of a "bad guy", my comments are addressed to some of the responders on this thread. I sympathize with you original dillema and understand your questions.

Good luck with whatever you decide.

You can rise to the top or sink to the bottom of any field you choose!

 

[Poety]

To the OP,
I don't think your original question is an exhibition of a "bad guy", my comments are addressed to some of the responders on this thread. I sympathize with you original dillema and understand your questions.

Good luck with whatever you decide.

You can rise to the top or sink to the bottom of any field you choose!

ditto

 

[lateness]

Yes, this is the issue exactly. As to FMGs, I never said that I am better than them. However, I do have more opportunities, and that is a fact. Going into a field that admits FMGs would be turning my back on opportunities that I have and others (such as FMGs) don't. It's that simple, and there's no xenophobia here.

As far as being a jerk or not a genuinely nice person or whatever just because of the thought process I'm going through (that I've anonymously but very honestly publicized here), I resent that completely. I really do enjoy medicine and caring for patients immensely (this is why rads and path are ruled out). And being a gunuinely kind and caring person (at least this is how I see myself), I have a huge disgust for jerks and a**holes (this is why all surgery fields and, consequently, gas are ruled out). Is it so incredible that given this, I also want some financial reward commensurate with my sacrifice? And we've all sacrificed a lot to become docs, and this is not even considering our exorbitant tuitions and paltry resident and fellow pay.

i have to agree, its tru, and yes, no matter what, the fact remains, you do have more opp than fmgs. its true also that if fmgs didnt exist, then there would be tons of spaces in certain hospitals. but its true the more opp, and more specialized competitive places, are for AMGs first.

 

[GoofyDoc]

Going into a field that admits FMGs would be turning my back on opportunities that I have and others (such as FMGs) don't.

Can you name one single field that doesn't admit fmg's? They all admit fmg's.

I don't agree with you, and I don't believe you're ever going to be truly happy as long as you continue to care so much about prestige and what snotty people think of you. But don't give up what you love just because you think you're "wasting" your grades. You've been smart enough to get into a top ten med school, smart enough to rock step 1, etc. Continue to do well and you will get to the best places. Good luck, and I hope you eventually learn to be happy for the right reasons.

 

[penguins]

If FMGs didn't exist there would be tons of open spaces in programs. Therefore... no residents.... therefore no doctors.
The US government controls the ratio of US Med students seats and residency slots. It is an artificial creation of a need for 40% to come from outside the US.
If this bothers you then become an activist and write letters to your congressmen about the system. Don't knock an FMG who worked really hard to get here and is usually a great doctor. It isn't their fault!

Come on, almost any program would rather have an AMG because they look the same, speak the same language and there are no worries that they will go on vacation and not get to come back in the country. Hello! There is a very slight chance that FMGs are taking away a spot from an AMG. Lets be real here. In the rare instance that they would be taking a spot away from one of us Americans is when they are legitimately better for the position.

I am not the biggest political fan of immigration, etc. But I am not going to rag on the FMG who got into a residency here through hard work and determination. I think it is a bunch of whining to think that they are taking spots away from the AMG. The arguement could be made that our government is taking away the opportunity for more US citizens to get into medical school at that level, but that is where the supply and demand gets off balance to begin with! That is the fault of our government, not the FMG!

 

[penguins]

Okay, I re-read your post, Bafootchi, and I guess I shouldn't have aimed my comments at you. You did have a follow-up statement there.
Just a little frustrated by the tone of some on this thread. I am just not going to open this one up anymore, it is way off topic anyway.

 

[Poety]

If FMGs didn't exist there would be tons of open spaces in programs. Therefore... no residents.... therefore no doctors.
The US government controls the ratio of US Med students seats and residency slots. It is an artificial creation of a need for 40% to come from outside the US.
If this bothers you then become an activist and write letters to your congressmen about the system. Don't knock an FMG who worked really hard to get here and is usually a great doctor. It isn't their fault!

Come on, almost any program would rather have an AMG because they look the same, speak the same language and there are no worries that they will go on vacation and not get to come back in the country. Hello! There is a very slight chance that FMGs are taking away a spot from an AMG. Lets be real here. In the rare instance that they would be taking a spot away from one of us Americans is when they are legitimately better for the position.

I am not the biggest political fan of immigration, etc. But I am not going to rag on the FMG who got into a residency here through hard work and determination. I think it is a bunch of whining to think that they are taking spots away from the AMG. The arguement could be made that our government is taking away the opportunity for more US citizens to get into medical school at that level, but that is where the supply and demand gets off balance to begin with! That is the fault of our government, not the FMG!

Oh Penguins, don't ya know? if its not the FMG's they're complaining about ... its the DO's, the lower tiers, the mid tiers, the elite, the URM's, the ORM's, the rich, the disadvantaged, the gunners, the slackers, the one who knows more, the one who knows less, the one admitted for their looks, the one admitted for their non-trad status - you name it, you'll find some whiney baby complaining about it on SDN! And when they're not complaining about their colleagues, they're mad at their patients for using drugs, being poor, not excercising regularly, eating fatty foods, watching television, shopping on a Thursday, walking in the park, driving in their car, participating in any sport that risks injury, etc etc...

 

[Smurfette]

HUH?! Ummm where are you living, rural Arkansas???

100K isnt crap! That is roughly the starting salary for a kids coming out of college FFS in a ton of fields (IB, CE/EE..even medical device sales is more than that!!!).

After you are paying housing, school loans, etc. You couldnt even raise a family on that. Im single and barely hanging on making 250K! (well okay, Im doing a tad better than the poor house).

I hope your post was sarcastic, cuz otherwise you need a reality check. Outside of some very large cities with high costs of living, I have NEVER heard of one of my college counterparts graduating and making $100K+ to start. I didn't even make $50K when I got my job after college (I did not go straight into med school). If you are single and barely hanging on making $250K (and if you're pulling in that much, why change careers?) you must have a quite extravagant lifestyle.

 

[Wednesday]

Hi OP,

There are a lot of opinions on this thread. The thing is that this is something you really have to look inside yourself to answer. It sounds like you may be unhappy "settling" for internal medicine. What other people think really shouldn't be that important, but to YOU it sounds like it might be THE most important thing. You gotta figure that out.

Personally I don't understand this (like many people on this thread) because after doing very well in med school, I picked ob/gyn. Of course, many people think I'm crazy. I picked it because it was the one rotation that I came home from excited, even after 14 hour days. I love the problems and the patients and the procedures. I can think they way they think. I have worked in a career that wasn't right for me and I can tell you from experience that it makes life pretty unbearable. The medical specialty you choose will define you. It's not like picking a job. You will be trained to be whatever it is that you choose. You will spend many hours with other people who are also trained that way. You will socialize with them at conferences. Remember that med school and residency will fade into the distance at some point, and all you will have is what you have chosen to become and how accomplished you end up being at it.

You can think about your stats and hard work in another way. If you apply for dermatology you will still be struggling. In fact, you might not even match (especially if you have trouble explaining why you all of a sudden decided to try for derm--can't tell them what you've told us). If you go for internal medicine you can probably go just about anywhere you want. So in this sense your hard work will not have gone to waste. Of course, all that hard work will probably make you a more knowlegable doctor too, which is really the most important thing, isn't it?

Good luck with your decision. I think that this really is the hardest decision you have to make, especially if you let outside forces cloud your true feelings about what you should do.

 

[Doctor Bagel]

I hope your post was sarcastic, cuz otherwise you need a reality check. Outside of some very large cities with high costs of living, I have NEVER heard of one of my college counterparts graduating and making $100K+ to start. I didn't even make $50K when I got my job after college (I did not go straight into med school). If you are single and barely hanging on making $250K (and if you're pulling in that much, why change careers?) you must have a quite extravagant lifestyle.

Ditto. Aside from the go-go 90s, I've never heard of anyone with a BA earning $90k right out of college. Actually, I didn't even hear about it in the 90s. The average family in the US totals about $60k a year. I don't see where someone making $250k a year has room to gripe about barely getting by. Actually, that's exactly the type of thing you don't want to say when you're trying to convince people how bad off doctors are.

 

[GoPistons]

to the op,

Don't get discouraged by others on this thread... many have incredible/optimistic/naive views of medicine...

lifestyle, money, location, feeling of accomplishment, doing what you like, helping others etc. should all be part of your thinking... you are not a bad person for thinking about these things... people in every other profession think about these things without getting bombarded with the "you are not a nice person crap"...

many people feel the need to justify their choices of what specialty they went into... unfortunately, they rationalize their decision my thinking they are such a "great" person for choosing family practice, internal med, etc.

I, for one, can't rationalize undergoing 11-14 years of extra training out of high school and only earning 150k... yes, I mean ONLY... while working 50+ hrs/wk and being called all hours of the night and weekends... no matter how "righteous" my profession is...

to all the doctors that think they made enormous sacrifices and have embraced the "holier than thou" attitude, get over yourself... it is just a profession...

 

[Doctor Bagel]

lifestyle, money, location, feeling of accomplishment, doing what you like, helping others etc. should all be part of your thinking... you are not a bad person for thinking about these things... people in every other profession think about these things without getting bombarded with the "you are not a nice person crap"...

Sure, all these things are valid. However, obsessively worrying about how others think about you or view your choice of residency is, well, silly and immature. The op's primary concern seems to be with how others will view him, not with how happy or how good of a lifestyle he'll have in another field.

However, I disagree that $150k is a low salary considering time and effort. Lots of people go to tons of school, work really hard and accomplish great things and never break $100k. If you know lots of people who tell you they're making $150k who aren't doctors, chances are they're lying.