1. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice
Dismiss Notice
Hey Texans—join us for a DFW meetup! Click here to learn more.

FMGs and the great U.S. residency spot...

Discussion in 'General Residency Issues' started by Celiac Plexus, Nov 24, 2002.

  1. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    I'm curious... The last time I checked, countries like India, Pakistan, and other developing nations had millions of sick people needing doctors.... Why is it then that so many FMGs from these countries swarm to the U.S. to obtain residency training, and get jobs?

    Is it just all about the ca$h?
     
  2. Note: SDN Members do not see this ad.

  3. Annette

    Annette gainfully employed
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Aug 24, 1999
    Messages:
    1,446
    Likes Received:
    3
    Status:
    Attending Physician
    Maybe because America has set itself up as a great place to train, and encourages foreign physicians to train here and to take that training back to their home countries? Maybe because America is made of immigrants?

    Why are you so worried about foreign MDs? Are you not good enough to get the spot you want, and want some one to blame for your failure?
     
  4. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    I am just asking a question.

    Why is this such an emotional topic? Why do people get so freakin' defensive when questions like this are posed? I just wanted to hear from FMGs as to what their motivation is.

    Please, no more ad hominem attacks... Just answer the question please.....
     
  5. Annette

    Annette gainfully employed
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Aug 24, 1999
    Messages:
    1,446
    Likes Received:
    3
    Status:
    Attending Physician
    Read the first part of my post. How about answering my question?
     
  6. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    Well, if you want YOUR questions answered, then I suggest that you start your own thread.

    To everyone else out there, please read my first post, and answer away! :clap:
     
  7. neilc

    neilc 1K Member
    7+ Year Member

    Joined:
    Jun 1, 2001
    Messages:
    1,289
    Likes Received:
    3
    i gotta sei-agree with anette here...the way you word your question is a bit confrontational...and it is a touchy subject!

    as for the answer, i assume it is prob the same for all immigrants. they come here for the opportunity. the USA is a great place, and lots of people want to become americans. if you ask me, that opportunity for everyone is what makes america so great!

    i am not sure what the need for doctors in india, or pakistan, or wherever has anything to do with it. in america, we have a hard time staffing rural areas with docs too...that need for docs somewhere else will always be there. individuals have the right to decide what is best for them. if you want to care for those underserved areas, you are also qualified to do it....

    sure, we americans are lucky...but, remember that all of us are immigrants, somewhere along the line. it is not cool to just want to shut the door behind us!
     
  8. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    Thanks for the response Neil.

    So besides "opportunity" aka ca$h.... what other reasons might there be?


    P.S.- I never suggested "closing the door"... Just curious as to why FMGs try in such huge numbers to come to America when their own countries are chock-full of sick people in what you might call "underserved" areas...
     
  9. neilc

    neilc 1K Member
    7+ Year Member

    Joined:
    Jun 1, 2001
    Messages:
    1,289
    Likes Received:
    3
    i think "opportunity" may mean things like better options for family and children, perhaps chasing more personal freedoms, better education, and of course, cash...

    i think that few docs are out there to take care of the underserved no matter what country you look at...i mean, we all want to live where we want to live, want to afford the nice stuff, etc. taking care of those who need it is great, but most docs out there do not revolve their practice around that. so, i see no real problem with someone leaving their country, which may need them badly, to come here. if we were all in it to help the underserved, there would be a lot more of us in africa! not to imply that docs are all money grubbing slobs, but to recognize that we also desire certain things....i think you get my point!

    but, who knows...are there any non-americans that have anything to add? i can only speculate, it would be nice to hear some reasons for coming to the US.
     
  10. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    ... the generally passive-aggressive tone of your question, but will answer anyhow. :laugh:

    I do not think that it is always a matter of $, and I think it is superficial to paint the issue in black and white like this. That said, I am also not going into an area/specialty that is money-driven (peds), and my status/prestige/training would likely be similar whether I completed my training in the U.S. or in Austria.

    That said, there are a number of reasons for me to come to the U.S. :

    1) Austrian wait-list for residency slots: to get a slot in Austria, the wait-list right now is ca. 1.5-2 years, and to move up in the wait-list, you either have connections (i.e. your daddy/other relative/whoever knows someone) or you have to do a thesis (i.e. work your ass off, unpaid, for one year, on research project you could care less about so you can get in good with some professor), or you can go do your residency in the boondocks hospital. And that's just to do the general residency, b/c

    2) peds is a specialty in Austria and so in addition to the initial medicine residency you have to do a peds residency, adding more time for training that you could either have spent practicing or pursuing a pediatric specialty if you felt so inclined...

    3) a U.S. residency is recognized in the E.U. if I ever chose to go back, allowing me to leave my options open re: where I want to live. I could not switch from one country within the E.U. to another before residency but can leave, go to the U.S., do residency, and go back, having gotten a good experience/training in the process, and having lived new and exciting places, more easily than moving around within the E.U.

    4) I have family in the U.S. and would be happy to spend some time living close to them.

    So you see, there are plenty of reasons that someone could choose to do a residency in the U.S. that are not solely $-driven.

    Indeed, perusing these boards it has been my impression that unfortunately many people appear to focus on $ too much when choosing their specialty. I understand the immense pressure that must go along with the huge mounds of debt that many graduating AMGs seem to have and their desire to make a dent into them quickly.

    However, I believe that more multi-dimensional approach to choosing a specialty should replace this singular focus on the $/lifestyle-ratio that seems to be at the center of the decision made by some of the posters here. Call me idealistic (and, agreed, thanks to the Austrian tax payer, who funded my education, debt-free), but I think that a pure money-driven decision that disregards your aptitudes, interests, and likes will more often than not end up making you unhappy down the road--and by then, having put all that time and training into it, it may be too late to switch.
     
  11. foreignmd

    foreignmd Junior Member
    7+ Year Member

    Joined:
    Nov 25, 2002
    Messages:
    19
    Likes Received:
    0
    (I wrote my reply before reading the post of nychick, completely agree, not much to add...)

    OK, I am European graduate, non-US citizen seeking residency in the US. The main reason? It's opportunity - but I am not talking about money. I am talking about opportunity for superior clinical training, opportunity to prove myself and achieve professional recognition based on my abilities and hard work (believe me or not, these thing are not granted in all the countries in the world). It makes me sad when I encounter this misperception that all IMGs are greedy selfish individuals coming to the US only for financial reasons. If I complete my residency in the US, I will return to my country much better prepared clinically, and will be able to contribute better to our healthcare system.
    BTW, if it was about life-style, I would have stayed at home and enjoy a our 40hrs/wk work, 3 years of paid maternity leave system...
     
  12. deedee2

    deedee2 Junior Member

    Joined:
    Oct 31, 2002
    Messages:
    6
    Likes Received:
    0
    The following is an opinion of someone who is an immigrant, though a U.S. citizen (spent 1st 12 years of my life in a 3rd world country) and not from an FMG, but has lived and worked in 3rd world countries, including having done a med rotation in a 3rd world country. I can think of several reasons why doctors from 3rd world countries choose to come to 1st world countries like the U.S. to train/live. Yes, the money is decent, however, note that most doctors in 3rd world countries are quite affluent compared to their country's standard of living also so is not that great of a reason. It is a matter of overall quality of life. THere are a lot of things that are quite inefficient in a 3rd world country (e.g. to get a phone hookup, one can expect to spend weeks to months, waiting in long lines and bribing various sources. Or to get from point a to point b can take a long time. Or can't necessarily expect to have water coming from your faucet or electricity 24/7 if your municipality decides it needs extra cash - again- need to bribe no matter how wealthy you are). Furthermore, there are a lot of doctors who are frustrated with not being able to practice the medicine they have learned because of limited resources. They feel that intellectually it might be more satisfying to be in a system where if needed a certain treatment, they have the means to provide it for someone (although we know that that's not always true in our managed care health system either). Of course, there is hollywood image everywhere and the land of milk and honey is definitely enticing for anyone who thinks that they can offer better opportunities - job/education to their children. So when opportunity to leave a place they still hold dear to their hearts arises, they give it a very serious thought. Some even feel that they might be able to serve their country better with some 1st world financial security. I can think of other reasons as well, but I think it really does come down to overall quality of life - both physical and intellectual, regardless of dedication.
     
  13. Raf

    Raf Junior Member
    7+ Year Member

    Joined:
    Sep 1, 2002
    Messages:
    19
    Likes Received:
    0
    I was born and raised here, but am of dominican descent...i have aunts and uncles who are physicinas there and i went to med school there too...i witnessed first hand what doctors go through to make a living, and it's not easy...to begin with just getting the training is often difficult...my aunt took nine years to graduate med school because of the political turmoil and protests of the seventies...they'd close her university down for months because of instability...it is often necessary for physicians to hold down multiple jobs to make a living wage...then they have to deal with a patient population where the majority are poor and of limited education, and who often cannot afford treatment...everyday is a challenge to balance treatment with what the patient can afford and comply with and what the government can or cannot contribute...that can be very frustrating, but i think the vast majority would choose to stay in their own country if only basic things were improved...most of the people i have talked to would never want to come to the US...they are afraid that they would be discrimminated against, and they don't want to leave the culture that they love and a country they consider "home"...
    however, the US has its appeal to a great many as the land of opportunity and there are those that dream of something better, an opportunity to be compensated for talent and intelligence and hard work, to live comfortably, to have a chance to have basic rights and security and stability...physicians specifically look forward to working in better conditions and with more technology and resources in the practice of medicine...although many people outside of the u.s. consider it to be perhaps overbearing on other countries, they do respect the opportunities and the philosophy of the united states regarding freedom and equality and want to be a part of that...overall, then, i agree that the main reasons for people coming to the u.s. to practice medicine is for a better quality of life...that can be interpreted in many ways, not solely in monetary terms
    my personal experience of living in the dom. rep. is that everyday seems to be a struggle in one way or another, over basic things like electricity, phone service, water, dealing with the government agencies and officials when necessary, etc, and i for one, knowing that it doesn't have to be that way, would choose not to live that way if i had a choice
     
  14. Jani

    Jani Senior Member
    7+ Year Member

    Joined:
    Aug 25, 2002
    Messages:
    117
    Likes Received:
    0
    Isn't it because US government knows they are better off that way... without having to spend on training competent doctors and still have them all here... let's face it, it's not because USA wants to give life to these poor souls, its because it simply works better for them- So it works both ways.
     
  15. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    THese are all interesting responses. Thank you all!

    For all of you knee-jerk defensive types out there... I'm all for immigration. I happen to believe that the strength of this country depends on a constant influx of immigrants. It keeps the country vital, and strong. It allows America to have many different perspectives, and benefit from the strengths of many different cultures. Having said that...

    It seems like quality of life, political stability, opportunity, technology, excellent education, and even cheap food motivate FMGs... Interestingly, most of you downplayed the monetary aspect.

    It's curious though because there ARE other countries that meet most of these desires. Western European countries are all equivalent to the U.S. in terms of most, if not all of the above cited desires. Some would even argue that the medical setups are even better in Europe. Of course, you won't make as much ca$h there... Might that have something to do with the relative handful of people trying to emigrate to France, or Spain, or Sweden as compared to America...? Hmmmm..... Just a thought.
     
  16. neilc

    neilc 1K Member
    7+ Year Member

    Joined:
    Jun 1, 2001
    Messages:
    1,289
    Likes Received:
    3
    actually, i think in terms of accepting immigrants on a per capita basis the gool old usa is not the leader...i seem to recall the UK having the most immigrants per capita or square mile or something like that...

    there are lots of immigrants all over, especially to western countries. i have no idea where to begin to look, but those stats would be interesting to see. i may be wrong, but i do vaguely recall that the US was not as prominent as i thought in accepting immigrants.

    one other thing...i study here in prague. docs really make no money, just below the national average. lots do have other jobs, such as taxi drivers, etc...but they tend to stay here, even without the cash, at least for now. eu membership may change that, but wages are on the rise, so that should help. so, i do think money is important, but you really have to have other reasons to leave your home behind...money as a motivation is a big american trait, and it may not be such a motivator for other cultures....but i sure do love the greenbacks myself!!
     
  17. Raf

    Raf Junior Member
    7+ Year Member

    Joined:
    Sep 1, 2002
    Messages:
    19
    Likes Received:
    0
    i cannot speak for everyone, but will say what i have personally observed during my time in the dom. rep., and that is that many, many docs go to places other than the U.S. for training including spain, and other latin american countries such as argentina and brazil, presumably because they have good programs there that are more advanced than those in the dom. rep and in addition they are still within a hispanic culture where they feel comfortable....you just don't hear about it as much, but this does occur frequently. we in the U.S. are simply more aware of the issue concerning international docs in the U.S...
    my intention is not to downplay the money issue...it is a factor in just about any carreer move and nobody should have to be on the defensive for that...there is no reason why anyone who is talented and intelligent should not be compensated for it...unfortunately what is taken for granted in our society, i.e. that if you work enough and are intelligent about your carreer decisions, you will be compensated for it, does not necessarily apply in places where the social and political dynamics are different...the ideal for a physician, i think, is to do work which is important and humane and be compensated in a way commesurate to the work and talent necessary to do so...i think this applies to all docs regardless of country of origin, would you agree?
    are there docs out there who are all about the money? absolutely, but i wouldn't say international docs who come here are any more or less ambitious than american docs...we have simply focused our attention on foreigners, as many people have in different lines of work; why should this even be an issue in medicine, i wonder?
     
  18. Annette

    Annette gainfully employed
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Aug 24, 1999
    Messages:
    1,446
    Likes Received:
    3
    Status:
    Attending Physician
    Training spots beyond a certain level are difficult to obtain in the UK for immigrants. If you are not English, Scottish, Welsh, or Irish, forget trying to become a consultant (attending level in the US).
     
  19. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    This website (http://www.emz-berlin.de/Statistik/indexweu.htm) has some interesting data with respect to migration flows in and out of OECD countries. However, the raw data I think is somewhat misleading as the absorption rate of migrants into a society should really be looked at on a per capita basis, in my view. It is hard to compare 49,200 immigrants into Belgium with 798,400 into the US in 1997, for example, given the huge disparity in the two countries' size.

    This data, however, does suggest that Germany (certainly a smaller country in terms of population than the US) takes in a large number of immigrants relative to the size of its population (although it appears that the German number includes asylum seekers (making it appear larger than in reality) and the US only permanent residents (making it appear smaller than in reality), so it is not evident to me how distorted the figures really are).

    There may be more recent data on this stuff out there, and the Economist did a Survey in their Nov 2 issue on Immigration worldwide that may shed some light. Unfortunately, I think I recycled it....
     
  20. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    In the United States, the annual rate of immigration has been about three per thousand US population in the last 15 years (Note that the annual rate of immigration was apparently as high as eight per thousand U.S. population between 1871 and 1920).

    This compares to 2000 EU data (which includes intra EU- flows) of 1.8 people per 1000, although intra-EU figures vary widely, from 5.3 per 1000 in Ireland to 0.5 per thousand in Finland. For the large European countries, the numbers are 2.3/1000 for the UK, 1.3/1000 for Germany, 3.1/1000 for Italy, 0.9/1000 for France. For Austria, where I live, the number is 2.1/1000. You can find the data at http://www.eu-datashop.de/download/EN/sta_kurz/thema3/nk_02_07.pdf

    There is another difference between the US and many European countries that I think is worthwhile to point out, and that is the different philosphy re: citizenship. I find that Americans are often surprised to hear that being born in Austria doesn't make you Austrian; your citizenship is determined based on the citizenship of your parents, and naturalization to attain the host countries' citizenship is often much more difficult. Hence, there is a whole generations of children of "guest workers" that have lived in Austria/Germany their entire lives but are still Turkish or Italian or whatever. This philosophically different approach to migration is clearly a result of US and European history, but I think it may be another reason that people may feel attracted to the US -- there is this idea that even if the first generation doesn't, generations down the line will be mainstreamed versus marginalized (this may sound really crass but isn't meant to be).
     
  21. BellKicker

    BellKicker Twisted Miler
    7+ Year Member

    Joined:
    Jan 23, 2002
    Messages:
    1,333
    Likes Received:
    1
    nychick, I thought your posts were very interesting!

    Celiac Plexus, my friend. I know the answer to why more Indians and Pakistanis come to the US and England compared to (what was it?) Germany, France or Sweden. I can tell you right now that residency salaries are equal to or greater than US salaries in these countries so it's not the money. The answer is obvious. Can't you figure it out?

    I'll give you a hint: For most IMGs it's at least a 5 year set back and something they'll never quite master.

    Take care, all.
     
  22. WonderBoy

    Physician 10+ Year Member

    Joined:
    Jan 16, 2001
    Messages:
    756
    Likes Received:
    41
    Status:
    Attending Physician
    To answer OP's orginal question:

    Being Indian and knowing many FMG's that have trained in India I believe can add something here.

    The number one reason is $$$. Even if FMG's only can get an IM residency (not that I am knocking IM's) they will take it. You can't earn a whole lot of money in Inida. Doctors do have much more respect there however what are you going to do with respect if you can earn a better living somewhere else.

    Although I can really blame them for coming over, you can't knock someone for wanting a better life.

    However, sometimes I get upset at the fact that some of these people are US citizens who after graduating from High School here (many of my classmates) just go straight to India rather than try to get into medical school here. There are some who were in freshman Gchem with me and after the first year went to India cause they were getting C's.

    Admissions for these kids isn't hard. Just need a high school diploma and $75,000 for the five years. They just have mommy and daddy pay their way in. So they come back here when they are around 23-24 full fledged doctors, maybe just barely passing the Steps. However, I am sure there are some that competent.


    Anyhow getting back to the question, its is money driven, everything is money driven just the nature of life. If you deny this you haven't seen the real world.
     
  23. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    ... sounds like the people that should be mad are the people trying to get into med school in India that these U.S. Indian kids are taking the med school spot away from....presumably there, as everywhere, there are more people wanting to study medicine than spots available at the university....of course I don't know for sure because I don't know anything about the Indian school system but it maybe wonderboy can speak to this issue....

    Nonetheless, I think there are two different issues that are being commingled and maybe muddled here, and that is

    1) U.S. persons going abroad for whatever reason to study medicine and then returning to the U.S. for residency and presumably, to practice and live there

    and

    2) foreign persons that have completed their med school education abroad trying to immigrate and complete residencies here and either
    a) returning to their home countries or
    b) staying in the U.S.

    I would like to point out that unlike the U.S. citizens, this second group of people has the additional hurdles of visa and immigration issues to deal with, and it is not so easy as some might think to obtain them, and presumably has gotten harder since 9/11 if we are to believe Ashcroft et al. - I don't think you just pass GO and collect your visa, and the places that sponsor people are a subset of the programs out there ...

    So really there's no reason to be so bitter...
     
  24. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,277
    Likes Received:
    3,690
    I'm an FMG (or "USIMG", as the PC way goes) from a Caribbean school. When I was an MSIII, at the hospital I was at in Brooklyn, I asked around to people why they came here (a signifigant number of the Indians had been attendings in India, or "Senior Registrars" in the UK (in that hardcore medically racist society, where, if you're not white, you don't move)), and, also, about the seemingly huge numbers of foreign docs here.

    Why? Either to train and go home, or train and stay - it seemed slightly like more of the former.

    Who? I wondered if this was draining these nations of doctors (CP's original thesis) - no so. Every state in India has a medical school, and there are more than 100K new doctors EVERY YEAR - even in the nation of 1.5X10^9 people, they're still pouring out docs to help the poor, and the amount siphoned off to the US isn't even barely a trickle.

    So, it's not difficult to figure how John Q. Public, who grew up in the midwest, but then went to Amherst for college, and to the NYMC for med school, but would NEVER consider working in his hometown (because it's too rural/cold/out of the way/no life/cheap/expensive), but will go visit his folks, and complain about the FMG's - because they choose to live their professional lives where many USMG's live their personal lives.

    Lest you think I'm overgeneralizing, research which areas are medically underserved, and where there are an overabundance of MD's - the irony is that everyone wants to live in the Bay, or NYC, but not train there - that's why, at your "not so good" hospitals, you have so many American-born attendings, and all-FMG residents.
     
  25. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    Wonderboy,

    Your honesty is a welcome breath of fresh air.

    Peace.
     
  26. Thewonderer

    Thewonderer Senior Member
    10+ Year Member

    Joined:
    Oct 20, 2001
    Messages:
    853
    Likes Received:
    20
    I don't have time to read all the posts here. Here are what I think

    1) $$$ Doctors in the US make lots of $$$ compared to those from 3rd world country. Furthermore, doctors here make more $$$ than other DEVELOPED countries that practice socialized medicine where there is often a cap on how much a doctor can make and bill the government.

    2) low tax. US has lower income tax than Canada and most if not all European countries (Germany and Scandinavian countries are notorious for high tax). Some could argue that the difference is not significant though.

    3) freedom in terms of where and how to practice. Yes, American docs have to deal with HMO's. However, in other countries, they have to deal with the BIG government! Government often dictates how many residency spots are available in each specialty (i.e. Canada). Some governments can also dictate who can practice in what region (or at least there is some pressure to position some docs at underserved areas). Government regulation can also dictate who your patients are.

    4) political stability. No war on mainland US.

    5) technology. Hospitals in the US do have and use the most technologically advanced equipments. There is absolutely no argument over that. In some way, it makes a doc's life easier to know if he wants to order an MRI, it can be done within the next 12 hours (if you are in an American VA hospital, that's a different story).

    6) environment for kids and family. I.e. elementary education, nice neighborhood (i.e. if you have $$$, you can have very very high standard of living in the US. If you don't have $$$, that's a different story).


    And what is a best way to become a doc in the US? By first being a resident in the US......
     
  27. garcez

    garcez Junior Member

    Joined:
    Nov 26, 2002
    Messages:
    7
    Likes Received:
    0
    1. Money
    2. Nice safe place to live
    3. Opportunity for their future children
    4. Have you ever tried living in a 'poor' country?
     
  28. Annette

    Annette gainfully employed
    Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Aug 24, 1999
    Messages:
    1,446
    Likes Received:
    3
    Status:
    Attending Physician
    1. It is my home.
    2. I've lived in both 2nd and 3rd world countries. I don't want to stay in them.
    3. I want to earn enough to pay off student loans. (CP, here are your dollar signs. Truely a driving force.:rolleyes: )
    4. I like practicing medicine, but this is why I want to complete a residency. Hmm, maybe that doesn't count.
     
  29. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    Ahem, being a resident in the U.S. first is the ONLY way of becoming a doc in the U.S permanently. :D

    And...newsflash...last time I checked there were limits on how many residencies where available in the US in certain specialties despite arguable shortages of trained people (can you say Neurosurgery?) and some people may not get to pursue a specialty they might have been interested in because it's too competitive. So while it may not be the government deciding, someone out there is...and not everyone gets to choose whatever they want.
     
  30. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    OBGYN.net Conference Coverage
    From American Association of Gynecological Laparoscopists
    San Francisco, California - November 2001
    Foreign Residency Experience
    OBGYN.net Editorial Advisor, Larry Demco, MD with Jon Einarsson, MD

    Larry Demco, MD: "I'm Dr. Demco from Calgary, Canada here at the AAGL Conference in San Francisco, and we have a unique opportunity to talk to a resident, Dr. Einarsson, who is originally from Iceland and who's here in the United States training at Baylor College. It's a dichotomy that a lot of us are in that you're from one country and you're trying to learn medicine in another country. Tell me some of the concerns and problems you've experienced."

    Jon Einarsson, MD: "First of all, I come from a very small country; only 270,000 people live there so most doctors that graduate from there want to go abroad to get a little bit more of a broader experience for their training so most of Iceland's doctors go either to the United States or to Europe for their training. When you're going to the United States there is a big difference between the way medicine is practiced here and the way it's practiced in Europe. It's a socialist system and the residency training programs there are really not training programs, you're basically hired to work and as you work you get experience and eventually feel competent attending so that appealed to me. I think the most surprising thing or the most different thing that I encountered here was the amount of paperwork and red tape that you have to go through to take care of your patients. It's more here than in Europe, and I thought it was a lot there but it's actually more here."

    Larry Demco, MD: "Tell us a little bit about the paperwork that you actually had to go through."

    Jon Einarsson, MD: "There's paperwork as far as just to start your residency then paperwork while you're doing your residency, i.e. in hospitals. But for foreign medical graduates, obviously, it's difficult for American programs to know the quality of medical school that you came from. They don't know what it means to graduate from Iceland or from many other countries in the world so everybody has to take these standardized tests that they have to pass. I think some programs in the United States are hesitant in hiring foreign medical graduates because some of them feel that it reflects poorly upon their program if they have a lot of foreign medical graduates. I'm fortunate, at Baylor they take a different approach and they feel that foreign medical graduates actually compliment their program so they usually take on at least one or two a year there in the OB-GYN department."

    Larry Demco, MD: "With the number of people that are foreign graduates that come to be trained here in the United States, what percentage do you think stay and what percentage go back home and bring the technology of America back to their homeland, like Iceland?"

    Jon Einarsson, MD: "I know for a fact that probably over 90% of Icelandic doctors will return back to Iceland for a variety of reasons. Part of it is you have strong roots there; it's a very close-knit society because it's so small, and people just they want to go back. The working environment in Iceland is pretty good even though it's socialized medicine, and you do have all the resources that you need there. The pay obviously is not as good as it is here in the states but there are other benefits to it so I think most of them will go back but there are obviously other people that don't have the same living conditions where they come from so they have a higher incentive to try to stay."

    Larry Demco, MD: "One of the difficulties even I have from Canada is that you train here with the various instruments and they may not be available in your own country to operate with. Would you like to comment on that?"

    Jon Einarsson, MD: "I definitely think the resources here are greater especially in the larger medical centers that have all the toys that you want and more. That's definitely one of the reasons why I wanted to come here because you're kind of at the cutting edge; you're seeing the latest things and you're working with very, very experienced people and that's very valuable experience."

    Larry Demco, MD: "Do you think the level of care for the people in Iceland will go up with you returning, and do you think you'll share the expertise that you've learned here with the other colleagues?"

    Jon Einarsson, MD: "Yes, definitely, most of the departments in Iceland have people that have trained in different countries. Some of them are trained here, and some of them trained in Scandinavia, England, or other countries in Europe so you get a lot of different kinds of ideas and approaches to things. There is a lot of interaction, a lot of sharing of ideas, and you see a lot of different approaches too."

    Larry Demco, MD: "What advice would you have for the residents who might be looking in on this interview to help or guide them in their pursuit in trying to come to the United States for their training?"

    Jon Einarsson, MD: "I've actually been helping, I'm now a senior resident at Baylor, and I've been kind of looking at the applications with the faculty trying to determine who to invite and who not to invite for an interview. I was surprised that the scores from the USMLE tests are actually quite important, I guess they're not the only thing, obviously, but they are important because that's like a standardized way of seeing where you're at in your knowledge. So I think that would be one thing and another thing would be to try to come to the United States maybe for a month or two and work with faculty that are known in that field, do well, and get a letter of recommendation from them. I think those two things are probably the most important things in your application that most people look at but obviously it's the overall thing and if you have a lot of research background, for example publications, that definitely can help you too."

    Larry Demco, MD: "That's true, I brought one of my residents from Canada here to a meeting and introduced him to a number of the faculty so when his name came up they would have a face with the name. With things like this you benefit and I think this is a reason that residents should come to the annual meeting, meet the people here, and get their names. A face with the name really comes to play big time when they're looking over a list of people to say who they should accept for interviews. I think with my residents we found it very successful, and I think we should encourage our residents and give them support to come to these meetings for that purpose. I'd like to thank you very much for your interview and best of luck in your continued residency. I hope to come to Iceland someday."

    Jon Einarsson, MD: "Thank you very much."
     
  31. Celiac Plexus

    Celiac Plexus Senior Member
    10+ Year Member

    Joined:
    Oct 9, 2002
    Messages:
    1,128
    Likes Received:
    7
    Status:
    Fellow [Any Field]
    Certainly you're not comparing Iceland to India?
     
  32. nychick

    nychick Senior Member
    7+ Year Member

    Joined:
    Oct 24, 2002
    Messages:
    130
    Likes Received:
    0
    about the fact that some people may choose to train here but then go back to their home countries, which everyone here seems to be so convinced is an impossibility.

    Iceland is not India, and Austria is not Pakistan, either...

    I can't speak as to motivations from people in India or Pakistan, as I'm not from there. Maybe the link was off-topic, sorry if it was.
     

Share This Page