Thanks for the clarification, anbuitachi. I think the takeaway from what you say is there are important distinctions to be made among various IMGs. (I don't know if American PDs make these distinctions among IMGs. But not suggesting they should or anything like that since it's obviously their prerogative to accept/reject whoever they like.)
Australian anesthesiologists/anaesthetists do quite well in terms of salary (assuming they find a boss job). $400K+ I've been told. And from the sounds of it better hours/lifestyle too. Plus no CRNA threat at all. Although training is longer. But point being there's currently no financial incentive for these IMGs to move to the US. But some people do so for family or other reasons.
By the way I don't think all IMGs necessarily have "months" to study for the Steps. For example I only have a month of dedicated time over the summer. But I've been trying to study ("trying" haha) while in the hospital 40+ hrs per week. Also I'm guessing some IMGs may need longer to study at least for Step 1 because their med school focuses more on the clinical sciences than the basic sciences. So it could arguably even out, I don't know.
Definitely. Not all IMGs necessarily have months to study, but on average they have a lot more dedicated studying time (or have more control over it at least). I personally worked with a bunch of FMG applicants during my rotations and talked to them a great deal. What I came to understand is most of them study as much as they can until they feel like they can get a good score (b/c they understand they need a high score to get in to residency), vs in American schools, they give you about 5-8 weeks of dedicated studying time, and you have to take the test within that time before you can move on third year, as a result, MANY students are not as well prepared (eg not finishing uworld, barely finishing first aid, etc. yea this might be a shock to ppl on SDN since the avg score here is like a 255 hahaha)
Please stop mixing Caribbean school graduates, who chose that route because they were not good enough for the American medical schools, with foreign "best and brightest" who did a medical school in their home countries.
Btw, this (above) is the answer I got from one of the professors in my program, when I asked whether I had any chances to be accepted as a FMG, years ago.
P.S.
The USMLE Step scores evaluate theoretical medical knowledge. You can bet that a candidate with 270 has more medical knowledge than a candidate with 220, even if the former might be lacking from other points of view (e.g. clinical). The reason a low-scoring AMG can beat a higher scoring FMG is exactly that: the AMG has already proven that s/he can function (well) in the system.
And money is not everything, guys. To be honest, I get pissed when I hear doctors who look down on $150-250 jobs/specialties, when 95+% of this country is making less. Debt is not an excuse, unless in the 300+K range (which is another sign of financial illiteracy - why isn't a state school good enough for college, or even medical school?).
I hope you are not taking this personally. You could very well be a nobel prize winning caliber FMG doctor. Unfortunately, the thing is, the quality of FMGs vary a LOT. From working with FMG applicants and FMG/IMG attendings, some are excellent, but there are more who aren't (compared to AMG). For example, I noticed on average, that the Royal college of physcians graduates tend to be better than many other FMGs that I've worked with.
I agree with you on Step part.
Regarding money, some would agree with you, some may not. This is purely personal opinion. You can't seriously tell someone that 200k debt at 6% interest rate isnt an excuse. It might not be to YOU, but we all have different circumstances. [I'm not sure what you mean about state schools. We have a TON of state school graduates at my medical school]
Too long to quote, but yea I know some schools dont give out MDs at bachelor lvl but some countries do. I wasn't referring to every country outside of US.
Australia like you said its one example. Another huge example is China. It's WAYYYYYYYYYYYYYYYY easier to get into medical school from China, b/c theres no real limit unlike the US. And for many of those schools, you go straight from HS. Tuition is also farrr cheaper, and because of that, many MDs can't even fight jobs in China. But US accepts their MD as equivalent to US MD.
Regarding step, it's like what FFP said. Also it's not like my own preference or something. I was just quoting what a PD told me. It's great that they did well on Step 1 but in the end it's just a test. They want to see students who got into their own system and were able to do well in it vs some outside system they dont have much control over.