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My compliments to you sir for a reasoned, well constructed argument. I confess that I have not followed this thread from the beginning, but came in at a point somewhat later. Nevertheless, I am sticking to my guns and disagree with you on several points. I will outline them briefly here:
1) I do not as a rule believe that Caribbean training is on the same level as American medical training. If it were it would be both more popular and compelling for more US students. Secondly, if the preliminary training (i.e. years 1 and 2) were really as good as they are in the US, then there would be no purpose or rationale for a fifth semester to shore up basic sciences in order to pass the USMLE. I agree with you that in the long run that medical fact memorization has little to do with medical training, we must nevertheless consider that our standard is board passage. And for extra time necessary to pass the boards, it is an indication of weaker preclinical training.
I admit that I know little about foreign non-Caribbean medical training. I state here and now that I have nothing against foreign doctors, but there is a reason why so many physicians want to come to the states. Is there any similarity in number of American physicians wishing to go overseas and train after a US medical education?? I dont see it in my limited experience. If I am mistaken, please fill me in.
2) It is true that some physicians are well trained, others are not regardless of location of training. However, I believe that there is a much larger discrepancy with "foreign" school than those in the US. I have recently interviewed for residency positions in the US, and have even posed the question to residency coordinators that accept foreign student applicants. Their rationale given was that there are SOME superbly trained foreign students, but there are some exceptionally poorly trained ones as well. They state a reluctance with foreign grads because of what they perceive as an extremely wide level of variability surpassing by a large margin that of American grads. My point is that American grads (some with good and some with poor training, DO and MD) have less variability in training and are thus more standardized in the finished product. Therefore, we are PERCEIVED as less of a risk. And in this thread, that ultimatley was the question posed.
3) I am not certain if "most DOs going into DO school" because couldnt get into MD school argument. I am a soon to be DO who chose DO school purely out of practicality. My stats were competitive either way but the time frame was sneaky in my case. I had submitted the AACOMAS (DO app), had been offered interviews and had been accepted to school a full month before the AMCAS (MD app) was even due. In that I am not independently wealthy to put in deposits everywhere and the fact I could not justify the logic behind turning down an acceptance to medical school in the "hope" of landing an MD interview. Now, my case is unique, I know many others who have just as unique of a story. I do not deny that there is a subset of the DO population who went DO after not getting into MD, I do not believe it to be as large as is rumored. I certainly do not feel it is the majority of us. But i do agree with you when you say "Who cares".
4) I do not claim superiority over European institutions or students, or anyone for that matter. However, I stick to my point that there has to be a reason that worldwide, physicians flock to the US for medical training opportunities. I do believe that the opportunities and strength of training are superb here but can not directly compare due to my inherent lack of foreign training experience.
5) I cannot comment on your choice for not applying to US schools in this last round of application. Perhaps, let me say it again PERHAPS you felt that lack of acceptances last time may translate to the same result this time. I must concede that it is equally possible that you decided to go to a foreign school because you wanted to do so. I tend to doubt the latter due to your admission that you do not deny having preffered to go to a US school. However, I do understand your frustration with affirmative action and difficulty landing a slot. I fully agree with you on that point.
6) I had no hidden agenda by stating that "People make decisions for whatever reasons". It simply was a filler to move on in my argument and in hindsight was not the best manner to phrase my thoughts. I meant no offense.
7) I applaud you and your argument for overcoming obstacles. I believe that to be a quality vital to a GOOD physician. Note that I say good. Many trained here and abroad have much given to them and I believe that adversity breeds success and ultimately a perspective vital to medicine. I do however feel that ultimately the American model and opportunity is superior to that in the Caribbean despite devoted instructors, plenty of extra hours etc.. By that argument, you make the assertion that American schools do not have the same or better faclities, caring instructors and hours of training. Plus, on the whole, I would guess that American students by an large do better on average on boards. This unfortunately is the standard by which we judge, albeit a questionable one.
8) Lastly, by encouraging people who "cannot take the fire" to "leave the kitchen", you leave the impression that the only way in this thread to have a disagreement is to lash out. It is unfortunate that you feel this way (if you truly do) becuase when we attack each other, we bring what we are trying to bring to attention down in repute. We can accomplish more in a more appropriate way if we disagree but do so intelligently. You have done so and for that you are to be commended.
BTW, I agree in hindsight that the "kid" was totally out of line and has no place in spouting off in the way he has done so.
8)
My compliments to you sir for a reasoned, well constructed argument. I confess that I have not followed this thread from the beginning, but came in at a point somewhat later. Nevertheless, I am sticking to my guns and disagree with you on several points. I will outline them briefly here:
1) I do not as a rule believe that Caribbean training is on the same level as American medical training. If it were it would be both more popular and compelling for more US students. Secondly, if the preliminary training (i.e. years 1 and 2) were really as good as they are in the US, then there would be no purpose or rationale for a fifth semester to shore up basic sciences in order to pass the USMLE. I agree with you that in the long run that medical fact memorization has little to do with medical training, we must nevertheless consider that our standard is board passage. And for extra time necessary to pass the boards, it is an indication of weaker preclinical training.
I admit that I know little about foreign non-Caribbean medical training. I state here and now that I have nothing against foreign doctors, but there is a reason why so many physicians want to come to the states. Is there any similarity in number of American physicians wishing to go overseas and train after a US medical education?? I dont see it in my limited experience. If I am mistaken, please fill me in.
2) It is true that some physicians are well trained, others are not regardless of location of training. However, I believe that there is a much larger discrepancy with "foreign" school than those in the US. I have recently interviewed for residency positions in the US, and have even posed the question to residency coordinators that accept foreign student applicants. Their rationale given was that there are SOME superbly trained foreign students, but there are some exceptionally poorly trained ones as well. They state a reluctance with foreign grads because of what they perceive as an extremely wide level of variability surpassing by a large margin that of American grads. My point is that American grads (some with good and some with poor training, DO and MD) have less variability in training and are thus more standardized in the finished product. Therefore, we are PERCEIVED as less of a risk. And in this thread, that ultimatley was the question posed.
3) I am not certain if "most DOs going into DO school" because couldnt get into MD school argument. I am a soon to be DO who chose DO school purely out of practicality. My stats were competitive either way but the time frame was sneaky in my case. I had submitted the AACOMAS (DO app), had been offered interviews and had been accepted to school a full month before the AMCAS (MD app) was even due. In that I am not independently wealthy to put in deposits everywhere and the fact I could not justify the logic behind turning down an acceptance to medical school in the "hope" of landing an MD interview. Now, my case is unique, I know many others who have just as unique of a story. I do not deny that there is a subset of the DO population who went DO after not getting into MD, I do not believe it to be as large as is rumored. I certainly do not feel it is the majority of us. But i do agree with you when you say "Who cares".
4) I do not claim superiority over European institutions or students, or anyone for that matter. However, I stick to my point that there has to be a reason that worldwide, physicians flock to the US for medical training opportunities. I do believe that the opportunities and strength of training are superb here but can not directly compare due to my inherent lack of foreign training experience.
5) I cannot comment on your choice for not applying to US schools in this last round of application. Perhaps, let me say it again PERHAPS you felt that lack of acceptances last time may translate to the same result this time. I must concede that it is equally possible that you decided to go to a foreign school because you wanted to do so. I tend to doubt the latter due to your admission that you do not deny having preffered to go to a US school. However, I do understand your frustration with affirmative action and difficulty landing a slot. I fully agree with you on that point.
6) I had no hidden agenda by stating that "People make decisions for whatever reasons". It simply was a filler to move on in my argument and in hindsight was not the best manner to phrase my thoughts. I meant no offense.
7) I applaud you and your argument for overcoming obstacles. I believe that to be a quality vital to a GOOD physician. Note that I say good. Many trained here and abroad have much given to them and I believe that adversity breeds success and ultimately a perspective vital to medicine. I do however feel that ultimately the American model and opportunity is superior to that in the Caribbean despite devoted instructors, plenty of extra hours etc.. By that argument, you make the assertion that American schools do not have the same or better faclities, caring instructors and hours of training. Plus, on the whole, I would guess that American students by an large do better on average on boards. This unfortunately is the standard by which we judge, albeit a questionable one.
8) Lastly, by encouraging people who "cannot take the fire" to "leave the kitchen", you leave the impression that the only way in this thread to have a disagreement is to lash out. It is unfortunate that you feel this way (if you truly do) becuase when we attack each other, we bring what we are trying to bring to attention down in repute. We can accomplish more in a more appropriate way if we disagree but do so intelligently. You have done so and for that you are to be commended.
BTW, I agree in hindsight that the "kid" was totally out of line and has no place in spouting off in the way he has done so.
8)
