Don't like SOAP? Write your congressman.

[xrevision]

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Members don't see this ad.

I've posted this in another thread, but to garner more attention I wanted to put it in a separate thread.

Instead of just circlejerking/beating a dead horse on an internet forum I've already written to my congressman to investigate if there are better ways to ensure that more US citizens (AMG and US-IMG alike) match. Such as limiting the amount of FMG's applying to the main match, and have 2 different matches. I suggest you other AMGs/US-IMG's do the same. This is in light of tying SGR to residency positions. If that were untied and more residency positions were created, I don't think special protections would be needed. I do like working with IMG's, but this is about protecting the interests of our citizens.

And to make sure international schools don't pop-up all over the place to try and take advantage of US IMG's there should be a quota based on all of the graduates currently enrolled abroad this past year, and do not let it increase as schools will likely want to increase class sizes/start new schools to take advantage of this protection in the first round.

 

[HIJay]

I've posted this in another thread, but to garner more attention I wanted to put it in a separate thread.

Instead of just circlejerking/beating a dead horse on an internet forum I've already written to my congressman to investigate if there are better ways to ensure that more US citizens (AMG and US-IMG alike) match. Such as limiting the amount of FMG's applying to the main match, and have 2 different matches. I suggest you other AMGs/US-IMG's do the same. This is in light of tying SGR to residency positions. If that were untied and more residency positions were created, I don't think special protections would be needed. I do like working with IMG's, but this is about protecting the interests of our citizens.

And to make sure international schools don't pop-up all over the place to try and take advantage of US IMG's there should be a quota based on all of the graduates currently enrolled abroad this past year, and do not let it increase as schools will likely want to increase class sizes/start new schools to take advantage of this protection in the first round.

done. wrote to ny senator schumer re: lack of residency spots in general and possible burst of medical school loans if students can find residency spots

 

[gutonc]

done. wrote to ny senator schumer re: lack of residency spots in general and possible burst of medical school loans if students can find residency spots

I'm sure Chuck will get back to you first thing Monday.

 

[45408]

Anyone feel like posting a generic letter? I'd send one to my congressman.

 

[HIJay]

I'm sure Chuck will get back to you first thing Monday.

ha i highly doubt it, but at least i tried. we live in a democratic country, might as well exercise it and give it a shot.
tho i did get a nice generic email response that he received it. haha🙄

 

[081479058]

Anyone feel like posting a generic letter? I'd send one to my congressman.

I second this.

 

[Law2Doc]

With the increase in US med school enrollees on pace to eclipse the number of residency slots in five (?) years, isn't this a problem that's going to work itself out naturally?

 

[scott1981]

With the increase in US med school enrollees on pace to eclipse the number of residency slots in five (?) years, isn't this a problem that's going to work itself out naturally?

in theory

 

[jackets5]

in theory

Of course it will. Virtually every program will jump at the chance to take a AMG over an IMG. Big problems is AMG's simply do not apply to the caliber of programs that are VERY IMG heavy. All these programs have to choose from are IMG's a lot of the time. Either way the AMG match rate after SOAP will be close to 98% in all likely hood. If AMG's applied more broadly the match rate would be close to 100%

 

[sazerac]

Of course it will. Virtually every program will jump at the chance to take a AMG over an IMG. Big problems is AMG's simply do not apply to the caliber of programs that are VERY IMG heavy. All these programs have to choose from are IMG's a lot of the time. Either way the AMG match rate after SOAP will be close to 98% in all likely hood. If AMG's applied more broadly the match rate would be close to 100%

If the PD is an IMG and has been working with IMGs a lot and knows which schools produce quality IMGs, etc., isn't it conceivable that a program would deliberately choose IMGs over less familiar AMGs?

That might be the real long term source of power for the IMGs in the future - become PDs themselves and then give preferential treatment to the next generation of IMGs.

 

[Noegrus]

If the PD is an IMG and has been working with IMGs a lot and knows which schools produce quality IMGs, etc., isn't it conceivable that a program would deliberately choose IMGs over less familiar AMGs?

That might be the real long term source of power for the IMGs in the future - become PDs themselves and then give preferential treatment to the next generation of IMGs.

Yes. Everyone not from our country, better still, from our state, is our enemy and is trying to undermine us. Their purpose in life is to see us fail. These IMG PDs all giggle with glee when they see how many half-literate IMG-minions they have introduced to the system, at the expense of us hard working, tax paying, AMGs.

 

[Law2Doc]

If the PD is an IMG and has been working with IMGs a lot and knows which schools produce quality IMGs, etc., isn't it conceivable that a program would deliberately choose IMGs over less familiar AMGs?

That might be the real long term source of power for the IMGs in the future - become PDs themselves and then give preferential treatment to the next generation of IMGs.

This assumes PDs don't answer to anyone, and that's really not the case. Its easy to favor IMGs when that's the bulk of who is applying. Much harder to justify to your bosses when you start getting more prestigious local options.

 

[jackets5]

If the PD is an IMG and has been working with IMGs a lot and knows which schools produce quality IMGs, etc., isn't it conceivable that a program would deliberately choose IMGs over less familiar AMGs?

That might be the real long term source of power for the IMGs in the future - become PDs themselves and then give preferential treatment to the next generation of IMGs.

Are you serious? Look at the programs in IM, FM, Peds etc. Lets not even talk about things like Ortho, Derm, Uro, Optho etc. The University programs, the programs in real nice areas, high end community programs (Hopkins-Bayview, U-Chicago Evanston etc). Have pretty much all AMG's. The programs the vast majority of IMG's match at are in programs and in specialties that AMG's dont even consider applying to.

The game is rigged toward AMG's big time, as it should be. Lets not pretend that there isnt a pre-SOAP AMG match rate of like 95%, post SOAP probably like 98%+

 

[HealWithSteel86]

I've posted this in another thread, but to garner more attention I wanted to put it in a separate thread.

Instead of just circlejerking/beating a dead horse on an internet forum I've already written to my congressman to investigate if there are better ways to ensure that more US citizens (AMG and US-IMG alike) match. Such as limiting the amount of FMG's applying to the main match, and have 2 different matches. I suggest you other AMGs/US-IMG's do the same. This is in light of tying SGR to residency positions. If that were untied and more residency positions were created, I don't think special protections would be needed. I do like working with IMG's, but this is about protecting the interests of our citizens.

And to make sure international schools don't pop-up all over the place to try and take advantage of US IMG's there should be a quota based on all of the graduates currently enrolled abroad this past year, and do not let it increase as schools will likely want to increase class sizes/start new schools to take advantage of this protection in the first round.

Someone with your type of decision-making (blinded by self-preservation) a decade ago would have written his congressman to make sure your crappy Caribbean school wasn't allowed to exist. I know I'm making an assumption that you are an IMG... But I'm almost assuredly correct.

It should be based on merit. You being born in the US doesn't make you a doctor. It shouldn't. And that's why we have the MCAT. I wish you luck - I truly do. But I don't think the system should be base on anything but merit. And its not the governments responsibility to protect you. Nobody is being forced to drop 50k per year abroad.

 

[NotAProgDirector]

There are more people applying for training than total spots. Thus, all spots will be filled and some people will not get a spot.

If we change anything about the process (other than increasing the number of spots), all we change is the people who get spots -- one group may get more spots, and another group may get less. It's just a matter of deciding whom should get the spots.

US allo grads already have a very high match rate. Although changes might increase this further, the absolute change will be very small. Thus, this whole debate is all about how slots are allocated to DO's, US IMG's, and non-US IMG's

This is an ongoing debate every year -- should it be purely "merit" based where the people with the best applications get spots, or should it be "citizenship" driven where US citizens (including US-IMG's) get a preference. There isn't a right answer -- it depends on which of these you think is more important.

Now, anyone is welcome to write their senator to try to influence the process. But let's be realistic of what's likely to happen. Congress trying to legislate how the match works is not likely -- the match is a private institution and it's not even clear that Congress can force the match to change in any way. They could change GME funding -- but that's really complicated and is certain to upset key people, unlikely to happen.

What Congress clearly could do is adjust visa policy. It would be "easy" for Congress to end or limit H visas for IMG's. H visas are given to foreign workers where a US citizen can't be found to work in the job. US IMG's could very effectively argue that they are willing to work these jobs and are completely qualified, and that H visas should only be given out after all US IMG's (and AMG's) have positions. J visas are unlimited, and perhaps programs would just switch to J's -- although Congress could amend the J visa rules to limit the number.

Honestly, if anyone wants Congress to "fix" the problem (again, not clear that anything needs to be fixed), this is likely to be a much more likely solution.

That said, getting Congress to do anything is difficult.

 

[IMvrach]

It's hard to see what is so special in H1b for physicians from the Congress' point of view. Using the same argument, American software engineers could demand restricting H1B until there are unemployed American programmers.

Another issue is that the programs, like software companies, want flexibility to decide who they consider qualified and don't want the Congress to pass laws telling them who is qualified for Derm and who is just for Psychiatry.

 

[deathmerchant]

Lets imagine from next year, FMGs are not allowed to apply, every AMG gets matched. and the FMGs who mid way in the process get screwed.. dont care..!! 5yrs from now the compalcency increases and now people who are applying to community programs are the ones who have barely passed and never put any effort . Be sure of this. Ever wondered why the bar is getting raised every year and its getting more and more competitive to get residencies. Its the uncertainity.
Anyone who argues that increasing the bar and competition and hence health care and research quality,is not a good thing is a FOOL, and that too at the expense of 1-2 % people not matching who were probably not meant for this profession in the first place or were simply unlucky or poor planners and will get a spot next year.
you think the congress people are stupid with their advisors and so much experience. they know this is for the good.
And when in 10yrs there wud be no one to go to areas in the middle of nowhere, and government will have to pay 4 times the money to even make sumone think abt working there, there goes ur taxes to waste- theory.

Some one would say, dont deny them , just give them second priority..well as u might have seen this is actually what happens . they ARE given last priority.. at the expense of a rare stellar candidate getting into a good program ..and thats hardly 5 %...!!( if its made official that say we will only select say 2000 IMGs or just take them if and when spots are unfilled, I doubt any decent applicant will take the chance of applying here for an official third class priority...So basically , rest assured nothing can be done or should be done if there is a single wise person in the Congress.
Though all this discussion would be null once the AMG no rises over next few yrs.
PEACE.

 

[molten]

^I had trouble understanding why the above was not obvious to apparently many people on the forum and was therefore interested in knowing whether they knew full well that all the clamour against IMGs was to favour only 4-5% of AMGs. I thought the clamour was unpatriotic. And also un-American. I'm not sure in how many other countries just an exit from medical school guarantees specialty/residency training.

 

[LovelyBRass]

It should be based on merit. You being born in the US doesn't make you a doctor. It shouldn't. And that's why we have the MCAT. I wish you luck - I truly do. But I don't think the system should be base on anything but merit. And its not the governments responsibility to protect you. Nobody is being forced to drop 50k per year abroad.

Why does every other country in the world make it so difficult for US grads to get a residency but it's unpatriotic to limit FMGs here? There's be no way in hell Australia would let me take a residency spot away from a native, even if I somehow managed to know more about Australian medicine than that person. It just doesn't happen in other countries; you train your own first.

Sent from my DROID Pro using Tapatalk

 

[xrevision]

Someone with your type of decision-making (blinded by self-preservation) a decade ago would have written his congressman to make sure your crappy Caribbean school wasn't allowed to exist. I know I'm making an assumption that you are an IMG... But I'm almost assuredly correct.

It should be based on merit. You being born in the US doesn't make you a doctor. It shouldn't. And that's why we have the MCAT. I wish you luck - I truly do. But I don't think the system should be base on anything but merit. And its not the governments responsibility to protect you. Nobody is being forced to drop 50k per year abroad.

Scored 35 on the MCAT with a 3.9 undergrad GPA in chemical engineering. Got interviews to numerous top 20 schools like UCLA, Pitt, Vandy, currently attending one of them. Matched into a top tier radiology residency. You are most assuredly WRONG.

 

[IMvrach]

Unlike most countries, residents stay in the States after their residency. They don't come here just to get better training and go home. And due to its image as an open-minded country with the most advanced research opportunities, US attracts higher caliber of candidates then any other country.

The whole argument rotates around US-IMGs versus foreign IMGs, as AMGs match nearly 100%. Foreign IMGs are at clear initial disadvantage, compared to the US-IMGs: they often have initial language difficulty, visa issues, have much less or not at all US clinical experience/connections. Understandably, uncertainty in assessment of non-US IMGs makes programs have higher threshold of entry for them, compared to the US-IMGs. This is probably why some studies(see below) find that patients of foreign IMGs have better outcomes, compared to that of US-IMGs. And as for the Congress well-being of Americans is much more important than fundamental right of a citizen to become a doctor after going to a Carib school, I highly doubt they will take away freedom of a program to select the best candidate, whoever it be, Caribbean grad or not.
--------------------------------------------------------------------------------------------------------------------------------------------------
http://en.wikipedia.org/wiki/International_medical_graduate
Quality of care

An analysis among patients with congestive heart failure or acute heart attack in Pennsylvania, United States, found that patients of international medical graduates that entered medical school as non-U.S. citizens had the lowest death rates. There was not statistically significant difference in mortality between patients of all international medical graduates and U.S. medical graduates. There was a statistically significant lowering of mortality by U.S. medical graduates when compared to U.S.-citizen international medical graduates alone, but the odds ratio failed to show the difference was not due to factors outside of the study parameters.[10] When U.S. citizen international medical graduates were compared to non-U.S. citizen international medical graduates, the difference was "striking" — consistent with previous research which found U.S. citizens who graduated from foreign medical schools, particularly from Caribbean medical schools,[11] were associated with lower scores in other types of evaluations (e.g., specialty board scores) than other graduates.[12]

Why does every other country in the world make it so difficult for US grads to get a residency but it's unpatriotic to limit FMGs here? There's be no way in hell Australia would let me take a residency spot away from a native, even if I somehow managed to know more about Australian medicine than that person. It just doesn't happen in other countries; you train your own first.

Sent from my DROID Pro using Tapatalk

 

[septoplasty]

Unlike most countries, residents stay in the States after their residency. They don't come here just to get better training and go home. And due to its image as an open-minded country with the most advanced research opportunities, US attracts higher caliber of candidates then any other country.

The whole argument rotates around US-IMGs versus foreign IMGs, as AMGs match nearly 100%. Foreign IMGs are at clear initial disadvantage, compared to the US-IMGs: they often have initial language difficulty, visa issues, have much less or not at all US clinical experience/connections. Understandably, uncertainty in assessment of non-US IMGs makes programs have higher threshold of entry for them, compared to the US-IMGs. This is probably why some studies(see below) find that patients of foreign IMGs have better outcomes, compared to that of US-IMGs. And as for the Congress well-being of Americans is much more important than fundamental right of a citizen to become a doctor after going to a Carib school, I highly doubt they will take away freedom of a program to select the best candidate, whoever it be, Caribbean grad or not.
--------------------------------------------------------------------------------------------------------------------------------------------------
http://en.wikipedia.org/wiki/International_medical_graduate
Quality of care

An analysis among patients with congestive heart failure or acute heart attack in Pennsylvania, United States, found that patients of international medical graduates that entered medical school as non-U.S. citizens had the lowest death rates. There was not statistically significant difference in mortality between patients of all international medical graduates and U.S. medical graduates. There was a statistically significant lowering of mortality by U.S. medical graduates when compared to U.S.-citizen international medical graduates alone, but the odds ratio failed to show the difference was not due to factors outside of the study parameters.[10] When U.S. citizen international medical graduates were compared to non-U.S. citizen international medical graduates, the difference was "striking" — consistent with previous research which found U.S. citizens who graduated from foreign medical schools, particularly from Caribbean medical schools,[11] were associated with lower scores in other types of evaluations (e.g., specialty board scores) than other graduates.[12]

The study you quoted also stated the US-IMG's had similiar outcomes as AMG's (the particular study was ALSO used by another AMG in the other thread, but "CDI" or someone dismantled them).

Would you agree that then, US-IMG = AMG? Hells No.

 

[IMvrach]

I do not see a contradiction. There was a difference between outcomes AMGs and US-IMGs, with advantage to the former, though not statistically significant. Recall that residency admission process cuts quite a significant number of lower performing US-IMGs, so similar performance of those who make it in makes sense to me.

---------------------------------------------------------------------------------------------------------------------
http://www.ama-assn.org/ama1/pub/upload/mm/18/0810-health-affairs-imgs.pdf
The differences in mortality of patients cared for by all international graduates and U.S. graduates (adjusted odds ratio: 0.99; 95 percent confidence interval: 0.94 to 1.04) were not statistically significant, nor were the differences between U.S.-citizen international graduates and U.S. graduates (adjusted odds ratio: 1.07; 95 percent CI: 0.99 to 1.16). However, the patients of non-U.S.-citizen international graduates had significantly lower mortality than U.S. graduates (adjusted odds ratio: 0.91; 95 percent CI: 0.86 to 0.97). Likewise, their patients had significantly lower mortality than the patients of U.S.-citizen international graduates (adjusted odds ratio: 0.85; 95 percent CI: 0.78 to 0.93).

Among international graduates, the apparent superior performance of non U.S. citizens suggests that policies that affect the size of this group might have implications for quality. Our data also address some of the negative perceptions about the care provided by these physicians.

In contrast, the apparent performance of U.S. citizens who graduate from international medical schools suggests the importance of further research to clarify whether their performance is a result of their medical education experiences or their ability.To the degree that it is the former, U.S. citizens will need information about international medical schools on which to base their application decisions. To the degree that it is the latter, and as additional training opportunities become available for U.S. citizens, medical schools and residency programs will need to be more vigilant in their selection procedures and not accept students who lack the ability to perform as physicians.

The study you quoted also stated the US-IMG's had similiar outcomes as AMG's (the particular study was ALSO used by another AMG in the other thread, but "CDI" or someone dismantled them).

Would you agree that then, US-IMG = AMG? Hells No.

 

[hereiam12]

Unlike most countries, residents stay in the States after their residency. They don't come here just to get better training and go home. And due to its image as an open-minded country with the most advanced research opportunities, US attracts higher caliber of candidates then any other country.


I dont know where you get your information, but there is a significant number of IMGs who end up going back to their home country. Most of the Canadian IMGs, almost always end up going to Canada.
I actually want you to lookup medical staff list in Dubai hospitals and u'll be suprised to see all of their medical staff will be U.S. trained. I can even post actually web links to some of the hospitals in Pakistan and Indian where it'll show you clearly that medical staff of their hospital is US trained.
It sucks because in US we give jobs to others, we pay for their training, and we LOSE a doctor.

 

[IMvrach]

I can understand this argument. I don't have the numbers of those who return after training, but I do agree that the Congress might consider some kind of "return of service" by those who train in the United States. It does not matter how great foreign IMGs are, if they leave after training.

Obviously, it's not a trivial issue as the Congress-passed terms of the J1 visa on which many(most?) of the non-citizen residents come, requires to pass through complex immigration process in order to stay in the US. I frankly think that while the requirement for J1 holders to leave the US (unless they get a rather restrictive waiver) made sense during the Cold War, it is obsolete now. Similarly, for H1B visa on which the rest of FMGs comes, if one's residency + fellowship takes 6 years, you are REQUIRED to leave. Still, I believe, the vast majority of them find ways to stay in the US.

I dont know where you get your information, but there is a significant number of IMGs who end up going back to their home country. Most of the Canadian IMGs, almost always end up going to Canada.
I actually want you to lookup medical staff list in Dubai hospitals and u'll be suprised to see all of their medical staff will be U.S. trained. I can even post actually web links to some of the hospitals in Pakistan and Indian where it'll show you clearly that medical staff of their hospital is US trained.
It sucks because in US we give jobs to others, we pay for their training, and we LOSE a doctor.

 

[Textbookversion]

The problem isn't SOAP. The problem is that IMG's exist. If you are an American citizen go to med school in the US, or don't go at all IMO.

 

[ActionFigure]

Unlike most countries, residents stay in the States after their residency. They don't come here just to get better training and go home. And due to its image as an open-minded country with the most advanced research opportunities, US attracts higher caliber of candidates then any other country.

The whole argument rotates around US-IMGs versus foreign IMGs, as AMGs match nearly 100%. Foreign IMGs are at clear initial disadvantage, compared to the US-IMGs: they often have initial language difficulty, visa issues, have much less or not at all US clinical experience/connections. Understandably, uncertainty in assessment of non-US IMGs makes programs have higher threshold of entry for them, compared to the US-IMGs. This is probably why some studies(see below) find that patients of foreign IMGs have better outcomes, compared to that of US-IMGs. And as for the Congress well-being of Americans is much more important than fundamental right of a citizen to become a doctor after going to a Carib school, I highly doubt they will take away freedom of a program to select the best candidate, whoever it be, Caribbean grad or not.
--------------------------------------------------------------------------------------------------------------------------------------------------
http://en.wikipedia.org/wiki/International_medical_graduate
Quality of care

An analysis among patients with congestive heart failure or acute heart attack in Pennsylvania, United States, found that patients of international medical graduates that entered medical school as non-U.S. citizens had the lowest death rates. There was not statistically significant difference in mortality between patients of all international medical graduates and U.S. medical graduates. There was a statistically significant lowering of mortality by U.S. medical graduates when compared to U.S.-citizen international medical graduates alone, but the odds ratio failed to show the difference was not due to factors outside of the study parameters.[10] When U.S. citizen international medical graduates were compared to non-U.S. citizen international medical graduates, the difference was "striking" — consistent with previous research which found U.S. citizens who graduated from foreign medical schools, particularly from Caribbean medical schools,[11] were associated with lower scores in other types of evaluations (e.g., specialty board scores) than other graduates.[12]

the reason many non-us IMG physicians report lower mortality rates in their patients is because they were trained Attendings in their former country. They are going through residency in the USA only to become licensed and an attending in this country; not because they are in 'training' like fresh grads (US-IMGs and AMGs)

 

[IMvrach]

Non-US IMGs were 21 years after graduation, 2-3 years more than other groups of physicians. But this is not an explanation of 16% decrease in mortality over US-IMGs and 9% over AMGs as the number of years after graduation was associated with INCREASE (see below) in mortality. Besides, it's really difficult for an attending in home country to get residency spot in the US as most programs have cutoffs of 3-5 years since graduation.


Each additional year since graduation was associated with a 0.58 percent (95 percent CI: 0.34 percent to 0.81 percent) increase in the mortality of a physician’s patients.

the reason many non-us IMG physicians report lower mortality rates in their patients is because they were trained Attendings in their former country. They are going through residency in the USA only to become licensed and an attending in this country; not because they are in 'training' like fresh grads (US-IMGs and AMGs)

 

[septoplasty]

I do not see a contradiction. There was a difference between outcomes AMGs and US-IMGs, with advantage to the former, though not statistically significant. Recall that residency admission process cuts quite a significant number of lower performing US-IMGs, so similar performance of those who make it in makes sense to me.

So you are saying the residency selection process is flawed? 🙄

 

[IMvrach]

What? I was saying that while students accepted to the US med schools are stronger than in the Caribbean, much much smaller fraction of the later survives the med school and filtering by the match. So the difference is much less between AMGs and US-IMGs, after they complete residency, than it was between accepted students as many of the lower performing Caribbean students were filtered out..

So you are saying the residency selection process is flawed? 🙄

 

[IMvrach]

Current version of STEM bill makes no sense: M.Sc. in software engineering will have a "Green Card attached to the diploma", while residency + fellow won't. The later represents much higher investment than the former.

https://www.aamc.org/advocacy/washhigh/highlights2013/331608/032213senatorsintroducephysicianimmigrationreformbill.html

AAMC, American Medical Association (AMA), and American Hospital Association (AHA) are listed among the supporters of the measure.

 

[neuro critical]

This post is completely flawed
If some AMGs are not getting residency spots, it means that he/she is completely stupid. There are plenty of positions everywhere, even more in primary care. You have to set your expectations to your previous training, meaning that if you are a Caribbean graduate or a DO from an obscure school in Maine your are NOT going to match at MGH or JHU for Derm! Accept that! People from better schools worked a lot harder than you to study in those schools...
Also, I am an IMG. I came to the US for residency and fellowship and matched in top tier programs. My CV had 15 papers in international journals, 4 book chapters and a PhD, besides previous training in my home country. Do you think a PD from a highly academic place would prefer having me or some fresh graduate from a crappy american school?
Wake up, start working, and people will recognize your merit. Dont wait for things happen for you. Also, entitlement is one of the worse things, you should not have a residency position just because you were born in this country. My daughter was born here, so that means that she will already have her position secured in 20 years?

 

[benjee]

This post is completely flawed
If some AMGs are not getting residency spots, it means that he/she is completely stupid. There are plenty of positions everywhere, even more in primary care. You have to set your expectations to your previous training, meaning that if you are a Caribbean graduate or a DO from an obscure school in Maine your are NOT going to match at MGH or JHU for Derm! Accept that! People from better schools worked a lot harder than you to study in those schools...
Also, I am an IMG. I came to the US for residency and fellowship and matched in top tier programs. My CV had 15 papers in international journals, 4 book chapters and a PhD, besides previous training in my home country. Do you think a PD from a highly academic place would prefer having me or some fresh graduate from a crappy american school?
Wake up, start working, and people will recognize your merit. Dont wait for things happen for you. Also, entitlement is one of the worse things, you should not have a residency position just because you were born in this country. My daughter was born here, so that means that she will already have her position secured in 20 years?

So, your qualification is even better than some of program director and you are competing with those freshly newly graduates for training spot again?? why?

 

[neuro critical]

So, your qualification is even better than some of program director and you are competing with those freshly newly graduates for training spot again?? why?

I do research in a very specific niche that I would have better opportunities here. I ended up training again to not restrict my options in the future

 

[iloveeyes]

It's tragic that this thread has degenerated to the bashing of foreigners. The unfortunate truth is even if you wanted to stay in the US after training, it is going to be difficult, if not impossible. With the J-1 visa, you HAVE to return to your home country for two years to practice before you are allowed back on US soil. I'm not sure how easy it will be to get an attending job back in the US after all that time away.

The H-1B is difficult to get for residency. You need to have graduated from med school, completed all three board exams and some programs don't even sponsor it. So essentially, what the State Department is doing is forcing everyone on the J1 visa who's been trained in the US to leave. This is an odd policy since almost all countries I know like skilled immigrants, especially one who will become an attending upon completion of all his/her training on US soil.

Australia, for one, is advertising heavily for skilled immigrants. As an attending from the US, you could go, take a few exams, and under their point system, qualify for permanent residency and be able to practice. Could this progressive policy attracting skilled migrants be responsible for the fact the Ozzies are doing so well for themselves (even though Europe and the US are currently struggling)?

You could argue the US is trying not to contribute to the global brain drain of physicians away from resource poor countries. However, people have free choice and should be allowed to make those decisions themselves. And it's so much easier advocating for that when you're not the one struggling to give your child a decent education since you don't make enough as a doctor in some places. I have a friend from Zimbabwe who is trying to come to the US. What the J1 will do is send her back to Zimbabwe where she probably won't be paid and won't even have the resources to do her job effectively.

 

[benjee]

I do research in a very specific niche that I would have better opportunities here. I ended up training again to not restrict my options in the future

That's where I see the flaw or wasting resources of this training system because applicants with extensive experience and research should have different types of opportunities available to further their training instead of having these candidates redo the training that they have already in the past. anyway, no system is perfect.

 

[LovelyBRass]

That's where I see the flaw or wasting resources of this training system because applicants with extensive experience and research should have different types of opportunities available to further their training instead of having these candidates redo the training that they have already in the past, at the expense of training US citizens in their home country. anyway, no system is perfect.

fixed that for you

 

[IMvrach]

This argument completely lost sense. It's not the same issue as shipping jobs overseas, where one can argue that it's bad for America as a nation and have Congress intervene. Trying to block foreign-born IMGs altogether, you don't care what is best for America, you care what is best for you personally or your friends, even though what you want will make life worse for many others.

I suggest that you go and poll Americans, what they would prefer, a foreign born physician with better patient outcomes or a physician born in the USA, but that their chance of survival would be lower. If they answer the later, you can try to petition the Congress to make merit-based residency selection process illegal. Otherwise good luck making Congress force programs to accept the bottom half of the Caribbean grads at the cost of the top 40% of non US IMGs.

fixed that for you

 

[dozitgetchahi]

This post is completely flawed
If some AMGs are not getting residency spots, it means that he/she is completely stupid. There are plenty of positions everywhere, even more in primary care. You have to set your expectations to your previous training, meaning that if you are a Caribbean graduate or a DO from an obscure school in Maine your are NOT going to match at MGH or JHU for Derm! Accept that! People from better schools worked a lot harder than you to study in those schools...
Also, I am an IMG. I came to the US for residency and fellowship and matched in top tier programs. My CV had 15 papers in international journals, 4 book chapters and a PhD, besides previous training in my home country. Do you think a PD from a highly academic place would prefer having me or some fresh graduate from a crappy american school?
Wake up, start working, and people will recognize your merit. Dont wait for things happen for you. Also, entitlement is one of the worse things, you should not have a residency position just because you were born in this country. My daughter was born here, so that means that she will already have her position secured in 20 years?

Excuse me? You're one to talk about 'entitlement'. The attitude of some FMGs is just simply astonishing, and we've been seeing a lot of it around here ever since the whining about SOAP started. And the notion that US graduates 'dont work hard' or automatically aren't as qualified as foreign graduates is patently offensive and often incorrect.

I'm sorry, but carrying an attitude like this in a country that did you a favor by letting you come in (and paying for your training) is just the height of arrogance.

 

[umean2tellme]

Did anyone get a reply from their Congressman yet?

 

[IMvrach]

Hot off the press:

The bill seeks to improve the pathway for physician immigration to the U.S. with changes to the Conrad State 30 J-1 visa waiver program, H-1b visas, and national interest waiver green cards requirements. AAMC, American Medical Association (AMA), and American Hospital Association (AHA) are listed among the supporters of the measure.

https://www.aamc.org/advocacy/washh...sintroducephysicianimmigrationreformbill.html

Did anyone get a reply from their Congressman yet?

 

[CDI]

The study you quoted also stated the US-IMG's had similiar outcomes as AMG's (the particular study was ALSO used by another AMG in the other thread, but "CDI" or someone dismantled them).

Would you agree that then, US-IMG = AMG? Hells No.

Wait, what did I do?

I just know IMG PDs of IMG heavy programs wont choose crappy AMGs over solid IMG options. That wont change anytime soon.

 

[CDI]

Excuse me? You're one to talk about 'entitlement'. The attitude of some FMGs is just simply astonishing, and we've been seeing a lot of it around here ever since the whining about SOAP started. And the notion that US graduates 'dont work hard' or automatically aren't as qualified as foreign graduates is patently offensive and often incorrect.

I'm sorry, but carrying an attitude like this in a country that did you a favor by letting you come in (and paying for your training) is just the height of arrogance.

Looks like you completely missed the point of his post.

"Letting " a hard working physician scientist in...what a joke. Showing your height of ignorance.

If you knew what was good for you, you'd be begging for people like this to come over and enhance our nations production. Swing by NIH when you're free sometime. Thankfully the leaders in the field aren't as short-sighted as you seem to be and actually understand that the US is where it is today because of its ability to attract the top talent from other nations, and will continue to do so whether you like it or not.

He just stated his daughter will have to earn her keep as well and shes a US citizen. Don't know why that seems to have skipped by you.

 

[NotAProgDirector]

Hot off the press:

The bill seeks to improve the pathway for physician immigration to the U.S. with changes to the Conrad State 30 J-1 visa waiver program, H-1b visas, and national interest waiver green cards requirements. AAMC, American Medical Association (AMA), and American Hospital Association (AHA) are listed among the supporters of the measure.

https://www.aamc.org/advocacy/washh...sintroducephysicianimmigrationreformbill.html

I am amazed that, given a quick read of the text of the bill, it's a completely reasonable, pork free, focused piece of legislation. It allows the Conrad 30 program to increase year-to-year if >90% of the waivers fill, a similar mechanism to decrease the cap if they don't fill, protections for J waiver physicians that are sorely needed, a way for J waiver physicians to change positions (at a cost of an additional year), and a grace period until Oct 1 to start their jobs.

I don't quite understand the "more than 5" language. I think they are saying that if all states that give more than 5 waivers have used >90% of their waivers, then the number of waivers increases. This means that some states that have no waivers used "wouldn't count". I'm OK with that if it's because those states have simply decided not to participate. If it's because no one wants to go work in those states, all this does is open more spots in popular states, draining more people from the unpopular ones.

 

[IMvrach]

It seem that the second part of Section 5.ii will make going over 45 wavers very unlikely, if only in case of dire nationwide need. If even a single person goes to an unpopular state, 45 "available wavers" are added to the count. And if some states are full, triggering an increase in the number of wavers and forcing people to go elsewhere, they will go to a state with zero wavers, unless that state does not accept IMGs.🙂

`(ii) When an allocation has occurred under clause (i), all States shall be allotted an additional 5 waivers under paragraph (1)(B) for each subsequent fiscal year if 90 percent of the waivers available to the States receiving at least 5 waivers were used in the previous fiscal year. If the States are allotted 45 or more waivers for a fiscal year, the States will only receive an additional increase of 5 waivers the following fiscal year if 95 percent of the waivers available to the States receiving at least 1 waiver were used in the previous fiscal year.

I am amazed that, given a quick read of the text of the bill, it's a completely reasonable, pork free, focused piece of legislation. It allows the Conrad 30 program to increase year-to-year if >90% of the waivers fill, a similar mechanism to decrease the cap if they don't fill, protections for J waiver physicians that are sorely needed, a way for J waiver physicians to change positions (at a cost of an additional year), and a grace period until Oct 1 to start their jobs.

I don't quite understand the "more than 5" language. I think they are saying that if all states that give more than 5 waivers have used >90% of their waivers, then the number of waivers increases. This means that some states that have no waivers used "wouldn't count". I'm OK with that if it's because those states have simply decided not to participate. If it's because no one wants to go work in those states, all this does is open more spots in popular states, draining more people from the unpopular ones.