Failed out the first semester, looking for advice

[dpmd]

It is a violation of not only Title VII of the Civil Rights Act of 1964, it is also a violation of the EEOC rules under which this has the effect of law. That no one has challenged it in court doesn't mean it's not illegal and/or immoral. Throwing an application in the waste bin simply because it says "IMG" is no different than throwing a job application (which is what this is tantamount to) in the waste bin because it says "foreigner". It is illegal.

You cannot engage in discriminatory screening practices for employment (which is what residency is) based on "national origin". It is clearly against the law. Does it happen? I'm sure it does. But, you shouldn't be so proud to proclaim that it does, nor that it's somehow inherently the right thing to do. At the very least, it makes you sound like a prejudicial bigot and xenophobe. Perhaps in some people's minds even a racist.

In this day and age, be careful where you tread.

-Skip

IMG does not equal foreigner

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Members don't see this ad.

 

[Skip Intro]

IMG does not equal foreigner

You just don't get it, do you? You just want to keep digging yourself in deeper and deeper.

Overview

Unfair treatment because of your race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information.​

If you were born in India, received your medical degree in India, passed all of your U.S. licensure exams, and are qualified to be called "doctor" - and someone throws your application in the waste bin as an automatic employment disqualification solely because you are an IMG - they are BREAKING THE LAW! By extension, any one whose medical degree is not from the United States and is otherwise qualified as above is also included.

You know why they don't administer the TOEFL anymore, right? Because not only was it insulting, it was discriminatory.

-Skip

 

[Skip Intro]

Don't believe me:

Discrimination against international medical graduates in the United States residency program selection process

Evidence of discrimination against international medical graduates applying to family practice... - Abstract - Europe PMC

The unkindest cut of all: Are international medical school graduates subjected to discrimination by general surgery residency programs? - ScienceDirect
​

I'm not inclined at this point to believe that you're disagreeing that this discrimination clearly exists. I am, however, horrified that you appear to not only believe it's acceptable, but that it's perhaps "the right thing to do".

From the last link...

Survey results indicate the perception that IMGs are similar in skill and ability to USMGs, regardless of program size. However, a perception existed among program directors that USMGs were favored in the recruitment process, with more than 70% of respondents indicating that they believed IMGs were discriminated against. Furthermore, nearly 20% reported that they had been pressured to rank a less-qualified USMG higher than a more qualified IMG, and 22% reported that they had ranked a USMG higher than an IMG to avoid a reduced compliment of USMGs.​

Times are changing. Rapidly. Be careful about unabashedly and publicly expressing abhorrent and unsupportable bias. It may come back to bite you.

-Skip

 

[dpmd]

You just don't get it, do you? You just want to keep digging yourself in deeper and deeper.

Overview

Unfair treatment because of your race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information.​

If you were born in India, received your medical degree in India, passed all of your U.S. licensure exams, and are qualified to be called "doctor" - and someone throws your application in the waste bin as an automatic employment disqualification solely because you are an IMG - they are BREAKING THE LAW! By extension, any one whose medical degree is not from the United States and is otherwise qualified as above is also included.

You know why they don't administer the TOEFL anymore, right? Because not only was it insulting, it was discriminatory.

-Skip

You are the one not getting it. The Indian example you gave is an FMG not an IMG. Discrimination on the school an American attended has nothing to do with discrimination based on national origin

 

[deleted480308]

I think it’s important to differentiate selecting based on which training system someone went through as an adult and using their nation of birth

 

[ThoracicGuy]

Despite your overwhelming post count (4.2 posts on average over 12 years says you need professional help) this thread has shown me and everyone else that cares that you provide no value. Welcome to Raney's Ignore List. You're not the greatest, just the most recent.

 

[Raney Schauer]

You were better off just being wrong. And you can throw JLaw at me all day if you want to.

Pay no mind activated.

 

[cresume]

Would you guys consider medical schools that don't accept bachelor degrees from community colleges discriminatory?

 

[Skip Intro]

I think it’s important to differentiate selecting based on which training system someone went through as an adult and using their nation of birth

No it's not. Discrimination is discrimination. If you don't consider someone solely (i.e. you won't even look at let alone consider their application) based on a group classification - whatever that is - it's wrong. Remember, we're talking about residency application. Which is akin to paid apprenticeship and subject to all the rules and regulations of employment.

Would you guys consider medical schools that don't accept bachelor degrees from community colleges discriminatory?

Medical school admission is different. You have to qualify based on specific admission criteria set by the school, including affirmative action legislation, etc. That is not a paid/employment (i.e. "job") situation and would not be covered as such. Something like that might be qualify under Title IX, but I doubt it.

-Skip

 

[deleted480308]

No it's not. Discrimination is discrimination. If you don't consider someone solely (i.e. you won't even look at let alone consider their application) based on a group classification - whatever that is - it's wrong. Remember, we're talking about residency application. Which is akin to paid apprenticeship and subject to all the rules and regulations of employment.



Medical school admission is different. You have to qualify based on specific admission criteria set by the school, including affirmative action legislation, etc. That is not a paid/employment (i.e. "job") situation and would not be covered as such. Something like that might be qualify under Title IX, but I doubt it.

-Skip

Discrimination by group characteristics is not inherently wrong. Particularly if that group designation is one made by decisions as an adult. People who commit felonies are a group, people who fail an mcat or step exam are a group, people who did not attend training with the same accreditation are a group, people who already went through a residency are a group, etc etc etc. Lots of morally fine reasons to discriminate against a group

Racial discrimination is morally wrong and you are trying to inaccurately tuck all the other things in with that

 

[sunshinefl]

Discrimination by group characteristics is not inherently wrong. Particularly if that group designation is one made by decisions as an adult. People who commit felonies are a group, people who fail an mcat or step exam are a group, people who did not attend training with the same accreditation are a group, people who already went through a residency are a group, etc etc etc. Lots of morally fine reasons to discriminate against a group

Racial discrimination is morally wrong and you are trying to inaccurately tuck all the other things in with that

Yeah... am I missing something here? Are people really arguing that making decisions about people based off education, training, credentials, experience, achievement is discriminatory? How are decisions supposed to be made then? Pull names out of a hat?

 

[Skip Intro]

Discrimination by group characteristics is not inherently wrong.

Residency application = job application.

You can accept applications and, after reviewing them, have criteria that eliminate people based on there specific qualifications for the job. "Being an IMG", as I previously linked articles supporting this, is not a defensible one. The Match was set-up to be inherently fair in that regard, with the responsibility that an adequate number of positions exist to ensure that every U.S. graduate has a spot.

Prejudicially disqualifying an applicant because they are part of a group - that is, not even looking at their application - is by definition discriminatory and a violation of Federal employment anti-discrimination laws (as also previously linked). If discovered to be systematic, there is a massive Federal class-action lawsuit waiting to happen.

The Match has been sued before secondary to assertions that it violated anti-trust regulations and it was subsequently dismissed.

This is something entirely different.

Here any "foreigner" is, as was admitted by at least one person on this very thread, having their application "thrown out" simply because it contains in any way, shape, or form the word "IMG". There are Federal laws that protect against this. The Sherman anti-trust regulations were determined not to apply against the NRMP. Don't be so sure in this instance. As an aside, it is equally morally wrong.

Tread lightly.

-Skip

 

[deleted480308]

Residency application = job application.

You can accept applications and, after reviewing them, have criteria that eliminate people based on there specific qualifications for the job. "Being an IMG", as I previously linked articles supporting this, is not a defensible one. The Match was set-up to be inherently fair in that regard, with the responsibility that an adequate number of positions exist to ensure that every U.S. graduate has a spot.

Prejudicially disqualifying an applicant because they are part of a group - that is, not even looking at their application - is by definition discriminatory and a violation of Federal employment anti-discrimination laws (as also previously linked). If discovered to be systematic, there is a massive Federal class-action lawsuit waiting to happen.

The Match has been sued before secondary to assertions that it violated anti-trust regulations and it was subsequently dismissed.

This is something entirely different.

Here any "foreigner" is, as was admitted by at least one person on this very thread, having their application "thrown out" simply because it contains in any way, shape, or form the word "IMG". There are Federal laws that protect against this. The Sherman anti-trust regulations were determined not to apply against the NRMP. Don't be so sure in this instance. As an aside, it is equally morally wrong.

Tread lightly.

-Skip

It's not morally wrong at all because it is about the system they trained in, not where they were born.

And stop with the weird warnings/threats about those with a different opinion than you

 

[dpmd]

Residency application = job application.

You can accept applications and, after reviewing them, have criteria that eliminate people based on there specific qualifications for the job. "Being an IMG", as I previously linked articles supporting this, is not a defensible one. The Match was set-up to be inherently fair in that regard, with the responsibility that an adequate number of positions exist to ensure that every U.S. graduate has a spot.

Prejudicially disqualifying an applicant because they are part of a group - that is, not even looking at their application - is by definition discriminatory and a violation of Federal employment anti-discrimination laws (as also previously linked). If discovered to be systematic, there is a massive Federal class-action lawsuit waiting to happen.

The Match has been sued before secondary to assertions that it violated anti-trust regulations and it was subsequently dismissed.

This is something entirely different.

Here any "foreigner" is, as was admitted by at least one person on this very thread, having their application "thrown out" simply because it contains in any way, shape, or form the word "IMG". There are Federal laws that protect against this. The Sherman anti-trust regulations were determined not to apply against the NRMP. Don't be so sure in this instance. As an aside, it is equally morally wrong.

Tread lightly.

-Skip

For the love of god quit calling them foreigners. They are not.

 

[Raney Schauer]

It's not morally wrong at all because it is about the system they trained in, not where they were born.

And stop with the weird warnings/threats about those with a different opinion than you

Disallowing an entire category of available, willing and qualified people (take the steps and score within the a standard deviation of the mean and no one should question your abilities if that's the yardstick) from addressing a growing physician shortage in this country and around the world is absolutely morally wrong and ethically bankrupt. Just because you don't like someone's school you're willing to sacrifice the health and well-being of the population. Their welfare is secondary to you making sure you win your little game.

Awesome.

Time's up on that crap. There's 7 and a half BILLION people out there need taking care of. Your priorities are out of whack.

 

[quincyfuturemd]

Touched a nerve, did I? "Colored" "female" "Jewish" etc are NOT synonyms for "was unable to get into a US med school, or too lazy or ignorant to fix their deficits"

Don't argue with me, argue with these guys:
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

Quoting the wise gyngyn as to the why:
The pool of US applicants from the Caribbean is viewed differently by Program Directors. The DDx for a Caribbean grad is pretty off-putting: bad judgment, bad advice, egotism, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems, weak research skills, high risk behavior. This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to, or can afford to take risks too! So, some do get interviews.


Bad grades and scores are the least of the deficits from a PD's standpoint. A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!

I'm confused by the last part. The lucky IMGs who get IV and res spots are the ones with higher scores and grades, that's the only way you can prove yourself as an IMG so I wouldn't say it's the least of our worries or makes us look even worse. That makes no sense. When the PDs need to fill spots it will be with higher scoring IMGs. Sure more goes into it than just scores, but they want you to score at a certain level or you're a risk for failing future exams and that's a big worry for programs taking IMGs.

It's a numbers game but it's also straightforward, be the best candidate you can be so when PDs go reaching into the IMG pile your name is considered.

 

[deleted480308]

Disallowing an entire category of available, willing and qualified people (take the steps and score within the a standard deviation of the mean and no one should question your abilities if that's the yardstick) from addressing a growing physician shortage in this country and around the world is absolutely morally wrong and ethically bankrupt. Just because you don't like someone's school you're willing to sacrifice the health and well-being of the population. Their welfare is secondary to you making sure you win your little game.

Awesome.

Time's up on that crap. There's 7 and a half BILLION people out there need taking care of. Your priorities are out of whack.

There’s only a few hundred million here and we have a ton of doctors. You’re getting silly with the irrelevant stats

I’m totally fine with the docs trained in other places competing for spots, I just find it dishonest to call the uphill climb out of the carribean med schools to be morally equivalent to racism.

 

[dpmd]

Disallowing an entire category of available, willing and qualified people (take the steps and score within the a standard deviation of the mean and no one should question your abilities if that's the yardstick) from addressing a growing physician shortage in this country and around the world is absolutely morally wrong and ethically bankrupt. Just because you don't like someone's school you're willing to sacrifice the health and well-being of the population. Their welfare is secondary to you making sure you win your little game.

Awesome.

Time's up on that crap. There's 7 and a half BILLION people out there need taking care of. Your priorities are out of whack.

There isn't a shortage in this country so much as a distribution issue. Even if we took every single caribbean grad and trained them in primary care specialties it doesn't mean they would stay and work in the currently underserved areas.

 

[Goro]

I'm confused by the last part. The lucky IMGs who get IV and res spots are the ones with higher scores and grades, that's the only way you can prove yourself as an IMG so I wouldn't say it's the least of our worries or makes us look even worse. That makes no sense. When the PDs need to fill spots it will be with higher scoring IMGs. Sure more goes into it than just scores, but they want you to score at a certain level or you're a risk for failing future exams and that's a big worry for programs taking IMGs.

It's a numbers game but it's also straightforward, be the best candidate you can be so when PDs go reaching into the IMG pile your name is considered.

Consider those lucky IMGs as you call them. They succeeded, true.

But if they are of calibre, what deficit kept them out of a US medical school?? Why the need to bypass our own system?

 

[quincyfuturemd]

Consider those lucky IMGs as you call them. They succeeded, true.

But if they are of calibre, what deficit kept them out of a US medical school?? Why the need to bypass our own system?

Well for myself I'm not american but I meant more the end of the quote sounded like it was saying it looks worse on an IMGs character if they have good scores and "bad scores and grades are the least of their worries". In my experience the IMGs that do make it are by far and large the ones with higher scores than the IMGs that don't make it. In my experience PDs are very concerned with IMGs not being able to perform in future exams which hurts the accreditation of the program rather than what possible character flaws lead them to the Caribbean/Australia/Ireland etc .

Of course programs want AMGs first when when they go for IMGs to fill spots they are mostly thinking about calibre not why they are IMGs

Also US IMGs are favored over non US IMGs so I honestly don't think why US IMGs didn't make it in the US is a big deal at that point for programs

 

[Goro]

Well for myself I'm not american but I meant more the end of the quote sounded like it was saying it looks worse on an IMGs character if they have good scores and "bad scores and grades are the least of their worries". In my experience the IMGs that do make it are by far and large the ones with higher scores than the IMGs that don't make it. In my experience PDs are very concerned with IMGs not being able to perform in future exams which hurts the accreditation of the program rather than what possible character flaws lead them to the Caribbean/Australia/Ireland etc .

Of course programs want AMGs first when when they go for IMGs to fill spots they are mostly thinking about calibre not why they are IMGs

Also US IMGs are favored over non US IMGs so I honestly don't think why US IMGs didn't make it in the US is a big deal at that point for programs

If you're not an American, then you're an FMG, not IMG...two different things.

If PDs don't like FMGs, it's usually due to visa issues.

Again, it's the mindset of people who are good students at Carib schools that raise concerns for PDs who are leery of IMGs, not academics.

 

[quincyfuturemd]

If you're not an American, then you're an FMG, not IMG...two different things.

If PDs don't like FMGs, it's usually due to visa issues.

Again, it's the mindset of people who are good students at Carib schools that raise concerns for PDs who are leery of IMGs, not academics.

As far as I know US IMG and non US IMG is a thing but either way having a US green card or citizenship helps you in the match over people who don’t have one. When PDs need to select some foreign trained people they prefer US ones. If it’s AMGs vs IMGs then yeah they want an AMG and they could site mindset or whatnot as reasons but in the IMG/FMG world US wins. And of course they want good students over bad ones.

 

[NotAProgDirector]

It's an interesting argument.

Discriminating by national origin is illegal. A fair example of that would be two US grads, one is of Indian descent, the other is not. If their performance is equal and programs specifically avoid the person of indian decent because "their name sounds funny" or "they wouldn't fit in here", that's illegal discrimination.

But the situation with someone who attends an Indian medical school vs US medical school I think is different. Even if their USMLE scores are the same, I don't think you can call the two applicants equivalent. The IMG would likely have far less US clinical experience. IMG's US clinical experience can be very difficult to assess, if they don't do a rotation in a US medical school -- many have community based experiences. I don't see this as national origin discrimination, I see it as US medical school training being "better" than an Indian medical school -- and partially that's because I can't really tell which Indian medical schools are any good.

In my first 2 years of being PD, I reviewed every IMG application I received, because I was worried about missing "a diamond in the rough" -- someone who would be a great pick, but might be excluded because of my filters. I looked at 1000's of apps in those two years, and found zero. I've improved my filters, so that I think it's even less likely that a quality applicant will slip through. But it's simply not worth my time looking through all those apps. But you might be OK with this plan, since I don't discard IMG applications completely.

EDIT: When I said I found zero, what I meant was "I didn't find any IMG applications that would have been filtered out that I was interested in exploring further", not that I didn't find any IMG applications of value at all.

 

[Skip Intro]

And stop with the weird warnings/threats about those with a different opinion than you

Having personal known an employed physician who openly expressed an opinion regarding his feelings about immigrants - and subsequently had his employment contract terminated for cause - my admonition is that you be careful about expressing opinions in mixed company that you otherwise do freely and anonymously here that may be perceived as controversial. We are living in some kind of strange new world order.

-Skip

 

[Raney Schauer]

There’s only a few hundred million here and we have a ton of doctors. You’re getting silly with the irrelevant stats

I’m totally fine with the docs trained in other places competing for spots, I just find it dishonest to call the uphill climb out of the carribean med schools to be morally equivalent to racism.

They're not stats they're broad generalizations. SMH.

And you've got it all twisted. The conversation isn't about racism. It's about considering someone, particularly a U.S. person, who went to a Caribbean med school as unworthy of a residency. That's discrimination.

Too much freakin hyperbole around here.

 

[Skip Intro]

But it's simply not worth my time looking through all those apps. But you might be OK with this plan, since I don't discard IMG applications completely.

I think this belies a deeper question (that may be explored more deeply by a motivated group of attorneys): what exactly are you paying the NRMP for when you submit an application? Is there some inherent agreement that your application will be reviewed? Or, is it simply for the transmittal of the application to the programs?

I'm not sure it's precisely clear what the fiduciary responsibility of the NRMP is, or the receiving institution. I do know that the application fees are graduated based on the number of programs applied to. Why? I have no idea. This is all done electronically and, aside from a little extra electronic confirmation tasking and perhaps server space, is really no more work (or at least should be) for individual humans at the NRMP.

Screening out an application merely because it contains in anyway the word "IMG", which is tantamount to throwing it out, is reprehensible. (And, there is no such thing as "FMG" anymore. Maybe 20 years ago. That is an artificial and outdated term that, if nothing else, only demonstrates that certain people are way behind the times.)

-Skip

 

[NotAProgDirector]

I think this belies a deeper question (that may be explored more deeply by a motivated group of attorneys): what exactly are you paying the NRMP for when you submit an application? Is there some inherent agreement that your application will be reviewed? Or, is it simply for the transmittal of the application to the programs?

I'm not sure it's precisely clear what the fiduciary responsibility of the NRMP is, or the receiving institution. I do know that the application fees are graduated based on the number of programs applied to. Why? I have no idea. This is all done electronically and, aside from a little extra electronic confirmation tasking and perhaps server space, is really no more work (or at least should be) for individual humans at the NRMP.

Screening out an application merely because it contains in anyway the word "IMG", which is tantamount to throwing it out, is reprehensible. (And, there is no such thing as "FMG" anymore. Maybe 20 years ago. That is an artificial and outdated term that, if nothing else, only demonstrates that certain people are way behind the times.)

-Skip

You're confusing the NRMP and ERAS, but otherwise your question is fair.

I assume that all ERAS promises is to send the application to programs. I don't see how they can promise any more than that, they can't make programs review applications. And how do you define "review"? S1 score too low = reject could be considered a review.

ERAS fees increase with the number of applications as an attempt to discourage large numbers of applications, but that really doesn't work and only serves to generate lots of income for AAMC. I agree it's no more work for ERAS to send 1000 applications, vs 10. It is an interesting question as to whether ERAS's pricing scheme is illegal. One could make the argument that although increased costs for larger numbers of applications is implemented to help decrease the number of apps, in reality it serves to increase the costs for IMG's unfairly who must apply to more programs, and that's somehow discriminatory. That argument still seems to falter (to me) as to be illegal it needs to discriminate against a protected class. Graduating from an international medical school is not a protected class, and it's still a stretch (IMHO) to try to hang this on national origin, since lots of IMG's are mainstream kids from the US.

Programs get NONE of applicant fees, although we get to use ERAS at no cost to us.

I think programs can legally decide which medical schools they will consider. If a program decides it's only going to consider medical schools that are east of the Mississippi, or south of the Mason Dixon line, or start with the letter H, or are in the top 30 USNWR list, that's up to them. That might include only US MD schools, or only US MD and DO schools. They should be up front about it, so that people who have no chance won't waste their money. Is that reprehensible? I think it's their loss, because there are some good people they are excluding. But I don't think it's illegal.

 

[Skip Intro]

You're confusing the NRMP and ERAS, but otherwise your question is fair.

Yes, this is correct. Thanks for the clarification, and is the entity that I actually meant. I was wrongly conflating ERAS with NRMP, the former is run by the AAMC and submits the applications to the programs and the later provides the rank list and runs the actual algorithm. They would not be implicated.

And, this is even more interesting, actually, because the AAMC has clear anti-discrimination policies. I wonder what their take on this position would be. Or, even if they know this occurs (and why shouldn't they?).

And how do you define "review"?

The point is, they are not even reviewing applicants head-to-head if they are listed as an IMG. It's like throwing someone's application in the trash bin who is looking to rent an apartment if it says "latino". It's no different.

It is an interesting question as to whether ERAS's pricing scheme is illegal. One could make the argument that although increased costs for larger numbers of applications is implemented to help decrease the number of apps, in reality it serves to increase the costs for IMG's unfairly who must apply to more programs, and that's somehow discriminatory.

Excellent and compelling point.

That argument still seems to falter (to me) as to be illegal it needs to discriminate against a protected class. Graduating from an international medical school is not a protected class, and it's still a stretch (IMHO) to try to hang this on national origin, since lots of IMG's are mainstream kids from the US.

They should be up front about it, so that people who have no chance won't waste their money. Is that reprehensible?

Well, it's certainly discriminatory and if, as you state, there is no chance that the applicant will even be considered at a particular program, this should be disclosed to the applicant so they don't waste their time and money applying... which is reprehensible on part of that program.

-Skip

 

[deleted480308]

Having personal known an employed physician who openly expressed an opinion regarding his feelings about immigrants - and subsequently had his employment contract terminated for cause - my admonition is that you be careful about expressing opinions in mixed company that you otherwise do freely and anonymously here that may be perceived as controversial. We are living in some kind of strange new world order.

-Skip

I’m not at all referencing citizenship status or race as I’ve clearly said before...my comments are about training credentials

 

[dpmd]

Yes, this is correct. Thanks for the clarification, and is the entity that I actually meant. I was wrongly conflating ERAS with NRMP, the former is run by the AAMC and submits the applications to the programs and the later provides the rank list and runs the actual algorithm. They would not be implicated.

And, this is even more interesting, actually, because the AAMC has clear anti-discrimination policies. I wonder what their take on this position would be. Or, even if they know this occurs (and why shouldn't they?).



The point is, they are not even reviewing applicants head-to-head if they are listed as an IMG. It's like throwing someone's application in the trash bin who is looking to rent an apartment if it says "latino". It's no different.

No, it is like throwing an application in the trash bin because it said bankruptcy 6 yrs ago even though maybe their credit is better now.

 

[sg808]

Hello, everyone. I am a long time lurker, I made an account back in the early 10s but forgot it.

Small background:
26 Asian male. Liberal Arts degree and a premed track from a state school in the midwest. After a mediocre undergrad career, I applied solely to DO schools for one cycle while working as a tutor/part-owner at a learning center.

I was a first semester student at a Big 4 Caribbean school. Not going to reveal which, but people can probably guess which by my descriptions. I was academically dismissed due to failing my classes by an extremely small margin. I don't have any excuse, other than the fact that I wasn't ready and I jumped too soon without considering whether the environment of this school was a fit for me. I didn't really do any research into the school other than the fact that this was the only school that accepted me without any caveats (premed program, take more classes, etc). I didn't go out and party (there is literally nothing to do where I am at except drinking which I don't) or even socialize at all. Even those that did do all that have moved on to the next semester, and I haven't. The accelerated curriculum, the bare bones facilities, etc. I am not really blaming anyone but myself, not even the school, especially when there are others who are passing so therefore it is my own deficiencies.

I was diagnosed with depression and anxiety, attributed to late diagnose of ADHD, which I didn't really take seriously due to a bunch of different reasons, a few days before my acceptance, and in my happiness, I thought I could power through it (I know, it was stupid on my part). In hindsight, I should have started therapy and the medication, but health insurance issue were making things hard for me to get good treatment so I just decide to go through it alone.

I have no idea of what to do next. I previously applied to SMP programs, all of whom rejected me, except for one, but I could not accept it due to getting the acceptance only 1 week before orientation and I was given only a few hours to say yes or no, and it was during a very tough time in my family, so I said no, and they did not want to push my acceptance to the next term (meaning I would have to reapply). I wrote out the application for the next year, but never finished it because I got in to the Caribbean medical school. I could probably try SMP programs again, but they will ask me what I have been doing for the last year, and I have no answer. Should I disclose that I attended (and failed out) of this medical school? I am considering other countries (maybe going back to India or the Phillippine in an MBBS program)

I don't know whether I want to pursue an MD/DO (or if it is even possible at this point), but I know I want to be in the health field 100%.

Hey @Trying2Suxede - don’t know if you are still interested in podiatry schools - but if this is a career you interested in pursuing its doable. A close contact of mine was academically dismissed earlier this year from a big 4 Caribbean school and just recently started the fall semester at a top 3 podiatry school and is doing well and very happy. This person applied very late in the cycle and was able to secure 3 interviews and get 2 acceptances and also wrote about/explained the dismissal in the application and interview. So if podiatry is a field you would be interested in it’s def doable.

 

[Skip Intro]

Been a little busy past couple of weeks...

I’m not at all referencing citizenship status or race as I’ve clearly said before...my comments are about training credentials

That's not my point.

My point is that you need to be careful what you're saying/doing publicly these days. If it appears you are publicly discriminating against someone, all it takes is one social media crusade to destroy you. That's essentially what happened to my colleague, although he was terminated in advance by his employer because they thought that would happen. Didn't matter what he'd actually said or had done. All that mattered is what was inferred by the people present. It was enough for him to lose his job. It's all about optics these days.

No, it is like throwing an application in the trash bin because it said bankruptcy 6 yrs ago even though maybe their credit is better now.

This is a separate criteria and different than what we are talking about. In your example, the person has at least had their application considered. Your example is more like someone got a marginal passing score on Step 1, but rocked Step 2. The program director may still be a little leery about that applicant. At least, in your example, the criteria is reviewed and considered.

What I'm talking about is someone not even reviewing the application because of a certain class it is in. It's not even considered. Again, aProgDirector's point is spot-on. There may be a fiduciary responsibility to applicants to disclose what programs will not consider your application if it says "IMG" in any way, shape, or form.

There's no other way to dress this down. It is a clear example of discriminatory practice. You guys can continue to try to feel good about it. You shouldn't. It is unfair, undisclosed, and it is costing individual applicants hundreds, if not thousands, of dollars every year. Programs that covertly engage in this behavior are wasting applicants time and money, and they should be ashamed.

-Skip

 

[sfgiants94]

Furthermore, you do realize that what you two geniuses are openly and gleefully advocating is actually a violation of Federal law, right?

Why don’t you go back and stay in the pre-med forum with the high school students and undergrads where the bar is much lower?

-Skip

You do understand this is the exact foundation that Caribbean medical schools run on... a microcosm (and many would argue macrocosm) of IMG's issues landing residencies in the US. I have a friend I met while working in a hospital that graduated from Ross that is a current resident in the US. He talked about some of his classmates that were accepted, he acknowledges many of them were unfit and understands why it is such an uphill battle for IMGs.

This is the meat and potatoes of your issue that you are unwilling to realize but you seem to be able to cast "where the bar is much lower" at others, hypocritically. You seem to be throwing stones from a glass house, unwilling to acknowledge the bar is much lower at Caribbean medical school themselves. @Goro threw one back and it shattered you (lidocaine applied).

If you can't acknowledge that the bar is lower at Caribbean medical schools and thus when they "level up" from student status to resident status the bar isn't going to be lowered for them again, but they started behind in the race and many were unable to catch up in 4 years. It's very simple and a well known risk that they willingly take, but I can tell you that it is not discrimination. Discrimination is something somebody has no control over (insert your racial, and correct, application for discrimination). Students could have performed better in their undergrad years to earn an acceptance to a US medical school. Students could have reinvented themselves in the US to gain the same exact acceptance. Either way, they had to get over a higher bar. This is desirable and something that was worked toward and earned in the eyes of PD's.

Put into an analogy, think of Caribbean medical schools as city league baseball. If somebody plays 250 baseball games in the minors (earning their way there and being drafted by a team - the higher bar, ie US med school), they may get called up the the show (MLB). Another played 250 games in city league baseball (the lower bar) they aren't entitled to be scouted or called up to the MLB just because they played 250 games (think of this as 4 years of medical school). They aren't being discriminated against.

 

[Skip Intro]

Put into an analogy, think of Caribbean medical schools as city league baseball. <snip>

I don't practice a different level of medicine side-by-side with my U.S.-trained colleagues on the patients who present to my hospital. The rest of your post is assumptions and poppycock.

You forgot the part where the extremely knowledgable premed comes in and gives the most definitive answer, because of out of everyone, they obviously have the experience and expertise to speak the truth.

Oh I apologize, I just read the rest of your post, you didn't forget that part...

Ibid.

-Skip

 

[deleted480308]

This is a horrible, stupid, irrelevant analogy. I don't practice a different level of medicine side-by-side with my U.S.-trained colleagues on the patients who present to my hospital. The rest of your post is assumptions and poppycock.

no one was talking about practicing differently in the US after completing a US residency

The reference was the difference between a US med school and a carribean med school..... and they are different cohorts

 

[sfgiants94]

This is a horrible, stupid, irrelevant analogy. I don't practice a different level of medicine side-by-side with my U.S.-trained colleagues on the patients who present to my hospital. The rest of your post is assumptions and poppycock.

I did not say that nor did I infer it. There is a disadvantage to getting a residency when coming from the Carib, you aren't going to get the looks that US students get. My analogy is hyperbolic, sure, but emphasizes this difference. If someone gets to the MLB from a city league team, they are given the same amenities as all other MLB players. You, as you deserve and have earned, work with the same autonomy and level as your colleagues.

The analogy was to show that it is much easier to get into a Caib med school (city league) compared to US med school (working to get to the minor leagues). I knew somebody with worse stats than I at my undergrad go to the Carib...don't know where they are now. I, with better stats, decided to continue to bolster my application to make it into a medical school in the US, we will be finding out in a bit here. This is exactly why it is not discrimination that PDs prefer US graduates. The aforementioned student I knew made a choice (on this basis alone it is no longer discrimination), I made mine. I made mine knowing I would have to work harder now for more peace of mind later (still not guaranteed a residency spot after medical school, however) - something that is desirable in the eyes of PD's. I jumped the where the bar was higher, not lower.

 

[Skip Intro]

no one was talking about practicing differently in the US after completing a US residency

No, the inherent logic (or lack thereof) is that those participants would ultimately be playing for different teams on different fields. Patently untrue. Now, if you follow the logic (or lack thereof) in that analogy, then that suggests that patient cohorts are somehow different, say, when they present to an Emergency Room. It would follow that the "audience", in this case patients, would be subjected to an inferior doctor if they had the misfortune of attending a single A minor league game when they thought they were going to see the Dodgers.

Either way, irrelevant and stupid analogy.

When you go into training at a bona fide accredited ACGME-endorsed and approved training program, the end result is a qualified board-certified physician. It is an apprenticeship, a job so-to-speak, where people vying for those positions have at least met the minimum criteria to have their applications considered against all other applicants, whatever subsequent fair subjective and objective criteria are utilized to select those applicants for the program.

It's just that simple: not even considering an IMG, whatever flavor they might be, and without considering any other aspect of their application is by definition prejudicial. That program is making assumptions on that individual without considering any other aspect of their story. It would be no different than throwing it in a trash can based on ethnicity, gender, sexual orientation, etc. in my book. (If every program in the U.S. openly did this, you would have a stronger argument.)

Be careful how you publicly fall on this issue, what you say and document publicly, and what your colleagues can trace back to you. People are now losing their jobs over such things for positions they held before popular opinion swayed on the matter. That is my admonishment, and one that I suggest you heed. People are being forced out of jobs ex post facto for what were at the time felt to be the popular and "right side" of an issue, no pun intended.

And, sfgiants94, I didn't read (and am not going to) your follow up post because I really don't care what you think. I've been in private practice over 9 years. I know the game. I know what I'm talking about. When you get here, then maybe I'll care what you have to say.

-Skip

 

[deleted480308]

No, the inherent logic (or lack thereof) is that those participants would ultimately be playing for different teams on different fields. Patently untrue. Now, if you follow the logic (or lack thereof) in that analogy, then that suggests that patient cohorts are somehow different, say, when they present to an Emergency Room. It would follow that the "audience", in this case patients, would be subjected to an inferior doctor if they had the misfortune of attending a single A minor league game when they thought they were going to see the Dodgers.

Either way, irrelevant and stupid analogy.

When you go into training at a bona fide accredited ACGME-endorsed and approved training program, the end result is a qualified board-certified physician. It is an apprenticeship, a job so-to-speak, where people vying for those positions have at least met the minimum criteria to have their applications considered against all other applicants, whatever subsequent fair subjective and objective criteria are utilized to select those applicants for the program.

It's just that simple: not even considering an IMG, whatever flavor they might be, and without considering any other aspect of their application is by definition prejudicial.

Be careful how you publicly fall on this issue, what you say and document publicly, and what your colleagues can trace back to you. People are now losing their jobs over such things for positions they held before popular opinion swayed on the matter. That is my admonishment, and one that I suggest you heed.

And, sfgiants94, I didn't read (and am not going to) your follow up post because I really don't care what you think. I've been in private practice over 9 years. I know the game. I know what I'm talking about. When you get here, then maybe I'll care what you have to say.

-Skip

I think you are too close to this to accurately process what is being said, I wish you well

 

[Shinken]

There's no other way to dress this down. It is a clear example of discriminatory practice. You guys can continue to try to feel good about it. You shouldn't. It is unfair, undisclosed, and it is costing individual applicants hundreds, if not thousands, of dollars every year. Programs that covertly engage in this behavior are wasting applicants time and money, and they should be ashamed.

 

[Skip Intro]

I've been talking about this on this forum for over sixteen years.

MDs are MDs ...or not ????

Keep trying to feel good about it... or "roll your eyes"... or whatever. It doesn't dismiss your prejudice.

-Skip

 

[GypsyHummus]

Op, I can’t tell you what to do, just what I would do in your shoes if I failed out of the carribean.

if you are still there I would recommend looking into either Podiatry school, Optometry school, or Pharmacy school. Podiatry is gonna be the closest thing to an “doctor”, some schools even take the same classes with their DO counterparts. I’ve met one person on the interview trail who failed out of the carribean, I know not what became of him. If he was able to get an interview, there is a chance you could get one and an acceptance too.

 

[Shinken]

This discussion will go on and on and on in this and other threads. The reality is simple: We're humans, and as such, we can never be completely objective. No matter how much this upsets people, the process is never 100% objective. It's simply not possible. If you did something to impair your application, such as attend Caribbean medical school, it's your decision. We cannot over simplify an application by simply looking at USMLE scores, or extracurriculars, or whatever. We have to look at the complete picture. That complete picture includes the decision to attend a Caribbean medical school.

As it has been said before, to most PDs it doesn't matter that a Carib grad did well. The fact that they "had to" or "chose to" attend Caribbean medical school raises a red flag of some sort of personality or academic issue. This has been beaten to death already. Nobody that has the legitimate opportunity to attend med school in the US would choose the Caribbean. There HAS to be some sort of issue. I don't want to find out what that issue was, and have to deal with it for three years in our program.

I'm not being discriminatory, I'm being discerning. Going to the Caribbean for med school is more often than not a red flag we must consider when looking at the complete picture of an application. A decision like that is not a trivial part of a residency application.

People considering applying to the Caribbean need to know how PDs like myself feel, in order to make an informed decision.

 

[Skip Intro]

I'm not being discriminatory, I'm being discerning.

Keep trying to feel good about it... or "roll your eyes"... or whatever. It doesn't dismiss your prejudice.

-Skip

 

[EmeraldDragon]

As it has been said before, to most PDs it doesn't matter that a Carib grad did well. The fact that they "had to" or "chose to" attend Caribbean medical school raises a red flag of some sort of personality or academic issue. This has been beaten to death already. Nobody that has the legitimate opportunity to attend med school in the US would choose the Caribbean. There HAS to be some sort of issue.

You aren't taking into account the people that choose the Caribbean route for the perceived value, as the tuition can be significantly lower. If you feel you have what it takes and would rather pay <$15,000 a semester for a Caribbean school than go into hundred of thousands of dollars of student debt that is 100% a factor in their decision. A lot of second-generation/children of immigrants are guided in this direction by their families. Their line of thinking, why pay more for the same results?

To say something is wrong with every Caribbean grad IS discriminatory, because at the end of the day, they've done exactly what the US students did, but in a tougher environment. I know residency programs that specifically look for IMG's from the Caribbean because they are less entitled than US grads. The problem comes down to guiding the Caribbean students to those residencies, which are usually family and internal medicine, and not necessarily in the most glamorous hospitals.

That being said, to the OP, if you failed out of a Caribbean med school in the first semester, time to move on to something else.

 

[EmeraldDragon]

No one goes down there for "perceived value".

And your logic behind this is...? Because it is a fact that some choose Caribbean schools for the affordable tuition.

 

[dpmd]

You aren't taking into account the people that choose the Caribbean route for the perceived value, as the tuition can be significantly lower. If you feel you have what it takes and would rather pay <$15,000 a semester for a Caribbean school than go into hundred of thousands of dollars of student debt that is 100% a factor in their decision. A lot of second-generation/children of immigrants are guided in this direction by their families. Their line of thinking, why pay more for the same results?

To say something is wrong with every Caribbean grad IS discriminatory, because at the end of the day, they've done exactly what the US students did, but in a tougher environment. I know residency programs that specifically look for IMG's from the Caribbean because they are less entitled than US grads. The problem comes down to guiding the Caribbean students to those residencies, which are usually family and internal medicine, and not necessarily in the most glamorous hospitals.

That being said, to the OP, if you failed out of a Caribbean med school in the first semester, time to move on to something else.

Because they aren't the same results as much as all the Carib folks want to tell themselves that.

 

[EmeraldDragon]

Thats what people say to make themselves feel better after they've been rejected from USMD, USDO, SGU, AUC/ROSS. The only slightly credible schools in the Caribbean are just as expensive as USMD/DO. What school are you talking about in the Caribbean that is cheap, please tell

Students who are qualified for US schools go to the Caribbean. I see a lot of people in these threads who talk A LOT about what Caribbean medical schools are but do not know what they are talking about. They only know their experience or things they've heard from others. Worse yet, they perpetuate misunderstandings or complete falsifications regarding important things like admissions criteria, accreditation, etc.

It would be lovely to have a dialogue about Caribbean medical schools and to be able to answer questions for people who are considering them, but it won't happen here.

 

[EmeraldDragon]

Dude.

What school would anyone ever consider going to besides SGU, AUC, ROSS, SABA (and thats a stretch), the other schools match like 50 people per year. Who in their right mind that is USMD/DO caliber would go to Eastern Barbados Hand-Waving School of Medicine because tuition cost?

Name the specific school you are talking about.

Your lack of common knowledge tells me that not only are you not a student, you also havent done enough leg work/research into these schools.

I know you have no reason to trust that I would, but I absolutely know what I am talking about.

Students of USMD and DO caliber absolutely go to the Caribbean. Don't confuse academic talent with the results of financial and parental pressure on a student. I know for a fact that "mid-tier" schools like Xavier, AUA, MUA, St. James, Trinity, etc regularly enroll students who could get into US med schools or go DO.

Also, side note, anyone who has has any real experience with Caribbean schools is aware that the "Big 4" are on the exact same level as most of the mid-tier schools.

Their admission standards, education quality, and ultimate results are nowhere near as high as they tout them to be, and in a time of declining admissions for them, they are lowering their standards even further. However they have the money to make sure that their accreditation reports don't reflect that and pay trainers to go to their campuses for weeks to teach their professors what to say, word for word, when the accreditation committees come visit.

The Big 4 are designed to suck as many students into their MD1 classes as possible, and spit them back out after collecting 1 or 2 semesters of tuition. Some of the mid-tier schools are run more along the lines of small businesses, and they need student retention to stay successful, they graduate and match a larger percentage of their starting classes, and aren't beholden to shareholders.

Yes there are trash Caribbean schools out there, absolutely, majority of them, probably. But you cannot paint all of them with the same brush. You can give potential applicants good and relevant information however, and prepare them for the very difficult journey they are about to embark on. Everyone here repeating the popular, big four only line is just setting up another class of 200 people now $30,000 in debt who failed a shelf exam by 1 point.

 

[EmeraldDragon]

Ok I'll bite

Out of all those bs schools, I looked up AUA bc I actually rotated with a couple of their students (who were complete idiots, showed up late everyday and were generally rude know it alls to everyone at the hospital). Here is their tuition

View attachment 241156

So tell me how this is cheaper than the state school your penny pincher USMD caliber imaginary friend turned down

You say, "I know you have no reason to trust that I would, but I absolutely know what I am talking about." Are you serious?

I said AUA could be considered mid-tier, I didn't say AUA was affordable.

I'm not going to convince you... I know what I know because this is my career. I have no reason to lie about admission stats because I am not here to promote any school. I'm on my own time. I've read this forum and many others for years and years to see the student perspective, and I thought it was time to share a tiny picture of what happens behind closed doors.

Believe me or don't, but I am as qualified to weigh in on questions posed in this forum as you are.

 

[dpmd]

I said AUA could be considered mid-tier, I didn't say AUA was affordable.

I'm not going to convince you... I know what I know because this is my career. I have no reason to lie about admission stats because I am not here to promote any school. I'm on my own time. I've read this forum and many others for years and years to see the student perspective, and I thought it was time to share a tiny picture of what happens behind closed doors.

Believe me or don't, but I am as qualified to weigh in on questions posed in this forum as you are.

If your career involves telling students to go Carib instead of a us MD or DO school because it is the same end result for less money, then you are no better than a con man or woman and should be ashamed of yourself.