Grim Picture for IMGs in 2016 Charting Outcome

[psycharmed]

---

Members do not see this ad.

I am a final year medical student from India interested in a Psychiatry residency in the US.

The charting outcomes in the match (2016) for IMGs ( http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-IMGs-2016.pdf ) paints a very bleak picture.

Only 29% Non US IMGs matched in Psychiatry. What I found more surprising was that there was no factor with a high predictive value. Factors like scores and number of research experiences were almost same for people who matched and didn't. In fact, among the people who scored between 230 and 240 in Step 1, 13 matched and 28 didn't, which comes out to a match rate of 31% even if you have a good step 1 score.

This has got me really worried. What criteria are the program directors using to hire people? The variables put forward by NRMP work well for residencies like IM and Peds where high scores is directly proportional to a higher chance of matching, but they don't say much about Psych.

 

[splik]

For IMGs the more important things are:
1. is this person actually interested in psychiatry? (most of the Indians applying for psych are not)
2. can this person speak English fluently and navigate cultural differences?
3. has this person done electives in the US as a medical student and obtained strong letters of recommendation? If not, have they received clinical training in another country (for example obtained the MRCPsych or done electives in psychiatry in the UK or Canada etc)

 

[psycharmed]

For IMGs the more important things are:
1. is this person actually interested in psychiatry? (most of the Indians applying for psych are not)
2. can this person speak English fluently and navigate cultural differences?
3. has this person done electives in the US as a medical student and obtained strong letters of recommendation? If not, have they received clinical training in another country (for example obtained the MRCPsych or done electives in psychiatry in the UK or Canada etc)

Thanks Dr. Splik.

Aren't match outcomes with respect to the applicant's first choice specialty? So, if an applicant, say an Indian (who you've generalized as being not interested in Psych) was ranking programs he got interviews in, why would he rank a Psych program first without genuine interest? If it were a backup /"easy catch" , wouldn't it be ranked lower?

 

[Merovinge]

Thanks Dr. Splik.

Aren't match outcomes with respect to the applicant's first choice specialty? So, if an applicant, say an Indian (who you've generalized as being not interested in Psych) was ranking programs he got interviews in, why would he rank a Psych program first without genuine interest? If it were a backup /"easy catch" , wouldn't it be ranked lower?

There has been a long history of Indian doctors coming to the states for the "easy" $$ of psychiatry. Many folks experience when encountering them is that they don't care at all about the field and choose it because it was relatively easy to get into, less work than IM/FM, and they could get away with less medical knowledge.

Mind you I am marrying an IMG and splik is probably the best poster on this board, so the above are not my thoughts but certainly sentiments I have experienced and heard from others.

 

[deleted736562]

There has been a long history of Indian doctors coming to the states for the "easy" $$ of psychiatry. Many folks experience when encountering them is that they don't care at all about the field and choose it because it was relatively easy to get into, less work than IM/FM, and they could get away with less medical knowledge.

Mind you I am marrying an IMG and splik is probably the best poster on this board, so the above are not my thoughts but certainly sentiments I have experienced and heard from others.

Yes, but to be also fair, that probably also applies to hundreds of weak US MD's, DO's or IMGs who pick psychiatry for these same reasons. From my (short) experience, I think IMGs tend to be more motivated than the former.

 

[Merovinge]

Yes, but to be also fair, that probably also applies to hundreds of weak US MD's, DO's or IMGs who pick psychiatry for these same reasons. From my (short) experience, I think IMGs tend to be more motivated than the former.

Absolutely true. It's sadly just easier to sterotype folks who look a bit different and have accents. There is also something to be said about needing to understand a pts culture more in psychiatry than other fields of medicine. Tends to be like many things where it's a combination of unfair stereotypes mixed with reasonable concerns.

 

[psycharmed]

Absolutely true. It's sadly just easier to sterotype folks who look a bit different and have accents. There is also something to be said about needing to understand a pts culture more in psychiatry than other fields of medicine. Tends to be like many things where it's a combination of unfair stereotypes mixed with reasonable concerns.

That just makes me feel like I'm entering a system that's pitted against me from the get-go. Even though I have a genuine passion for Psych, I'm now in an unsure place about residency in the US. I would rather focus my efforts into being a Psychiatrist in India than be an unhappy IM resident in the US.

 

[Merovinge]

That just makes me feel like I'm entering a system that's pitted against me from the get-go. Even though I have a genuine passion for Psych, I'm now in an unsure place about residency in the US. I would rather focus my efforts into being a Psychiatrist in India than be an unhappy IM resident in the US.

I would just examine your reasons for wanting to come here for residency and see if the potential benefits are worth the risks. If, for example, your family is all moving here or you really disagree with the state of politics in your area or something very powerful that motivates you than it absolutely can be worth it. Two of my top 4 mentors were born in India, although they came over to the US pre-residency, and are a big reason I am even in this field. Basically, if you are extremely driven and dedicated for the right reasons I think it can be worth it.

 

[psycharmed]

I would just examine your reasons for wanting to come here for residency and see if the potential benefits are worth the risks. If, for example, your family is all moving here or you really disagree with the state of politics in your area or something very powerful that motivates you than it absolutely can be worth it. Two of my top 4 mentors were born in India, although they came over to the US pre-residency, and are a big reason I am even in this field. Basically, if you are extremely driven and dedicated for the right reasons I think it can be worth it.

Psych is like an orphaned child in India. No funding, no attention, all stigma and no respect. In spite of this, I really enjoyed my clerkship in Psych because I find it so awe-inspiring. I got into med school because I wanted to be a Psychiatrist and the reason I want it in the US is because of the superiority of the training there. Moreover, my elder sister, a US citizen, can't stop gushing about how great it is in the US and I agree! I'm second guessing since I only have a 30% chance for success (according to the stats) and even high scores can't guarantee I land a spot.

 

[MacDonaldTriad]

It is tough for IMGs, and scores alone don't differentiate you all that much from the rest of the aspiring psychiatrists in the world. Working with a mentor on a research project, or helping someone with the heavy lifting on a review paper are some of the ways IMGs can get their foot in the door. Best of luck everyone.

 

[splik]

The system is not stacked against you. The US is the only country that provides the kind of opportunity for those from other countries to do their postgraduate medical training here and IMGs are frequently selected over US citizens even at the very best programs. Those who cannot speak English, who cannot demonstrate a proficiency or aptitude for the profession, cannot pass the USMLEs, have not been in clinical practice for many years, have no US clinical experience (ideally in the form of electives completed as medical students) and who do not have strong letters of recommendation written in the American hyperbolic style (ideally from US physicians) should not be surprised about not matching.

 

[masterofmonkeys]

As an Indian-American, (born/raised here), the stereotypes about Indian psychiatrists are quite fair. My experience of 1st and 2nd generation Indian physicians is not particularly positive Of the many, many Indian psychiatrists I've known over the years, just a handful had a genuine motivation to do psych starting out, although admittedly quite a few more seem to have developed a love and passion of psych after starting psychiatry residency; Nevertheless, the percentage is abysmal.

The concern with any FMG, especially in psychiatry, as noted above, is that their interest in psychiatry is not genuine. I think that's the real determining factor. Having been a part of the ranking process for 3 years in two different institutions at FMG-friendly locations, we will absolutely rank FMGs with worse objective stats who seem genuinely interested above FMGs who seem to be looking for an easy career and/or green card. 'Ticking the boxes' isn't enough. Research, USCE, scores, etc don't necessarily count for all that much because at this point most programs are familiar with IMGs who do all those things only to turn into slackers or disinterested individuals once they get here. Genuine interest is consistently the key.

If you are as passionate about psych as you seem to be (and I have no reason to doubt you), then you'll do fine. Maybe not this year, but the next or the next. Don't get discouraged, and don't look negatively upon US residencies for responding to the behavior of your own nationality. (The latter was a bitter pill for me to swallow, but y life's been a lot better since I stopped blaming people for comparing me against a largely true stereotype).

 

[psycharmed]

Thank you MacDonaldTriad, splik and masterofmonkeys for the insight.

It is tough for IMGs, and scores alone don't differentiate you all that much from the rest of the aspiring psychiatrists in the world. Working with a mentor on a research project, or helping someone with the heavy lifting on a review paper are some of the ways IMGs can get their foot in the door. Best of luck everyone.

The system is not stacked against you. The US is the only country that provides the kind of opportunity for those from other countries to do their postgraduate medical training here and IMGs are frequently selected over US citizens even at the very best programs. Those who cannot speak English, who cannot demonstrate a proficiency or aptitude for the profession, cannot pass the USMLEs, have not been in clinical practice for many years, have no US clinical experience (ideally in the form of electives completed as medical students) and who do not have strong letters of recommendation written in the American hyperbolic style (ideally from US physicians) should not be surprised about not matching.

These are great pointers. So basically you have to do enough for them to be convinced that you are committed to a career in Psychiatry. Fair enough, considering the kind of experiences y'all are sharing with respect to IMGs.

As an Indian-American, (born/raised here), the stereotypes about Indian psychiatrists are quite fair. My experience of 1st and 2nd generation Indian physicians is not particularly positive Of the many, many Indian psychiatrists I've known over the years, just a handful had a genuine motivation to do psych starting out, although admittedly quite a few more seem to have developed a love and passion of psych after starting psychiatry residency; Nevertheless, the percentage is abysmal.

The concern with any FMG, especially in psychiatry, as noted above, is that their interest in psychiatry is not genuine. I think that's the real determining factor. Having been a part of the ranking process for 3 years in two different institutions at FMG-friendly locations, we will absolutely rank FMGs with worse objective stats who seem genuinely interested above FMGs who seem to be looking for an easy career and/or green card. 'Ticking the boxes' isn't enough. Research, USCE, scores, etc don't necessarily count for all that much because at this point most programs are familiar with IMGs who do all those things only to turn into slackers or disinterested individuals once they get here. Genuine interest is consistently the key.

If you are as passionate about psych as you seem to be (and I have no reason to doubt you), then you'll do fine. Maybe not this year, but the next or the next. Don't get discouraged, and don't look negatively upon US residencies for responding to the behavior of your own nationality. (The latter was a bitter pill for me to swallow, but y life's been a lot better since I stopped blaming people for comparing me against a largely true stereotype).

Thanks a lot for sharing your experience! This begs the question "What do I have to say that will set me apart?". If everyone has the same embellishments on their CV (like research and USCE), how do you identify the "genuine interest" that you mentioned? What are the things that interviewees say which instantly raises a red flag and on the other hand, what are the things which can convince you to hire them?

 

[HarryMTieboutMD]

I am half Indian (b/r here), and I agree 100% with MofM's post above

At my program we have had 2 recent graduates who were from and went to medical school in India, but both did a lot of work demonstrating commitment prior to entering the match. One was an ICU doctor/laparoscopic surgeon and then came here and did an MPH at our medical school focusing on global health with an emphasis for psychiatry. The other did a PhD, also at our medical, in genetics or molecular biology (I forget) but his focus was neuroscience related. Both demonstrated through substantial, extra training that they had a commitment to psychiatry and were actually the best residents in their respective classes.

That said, we have had sub par IMGs (from India and other places) do external rotations and perform so marginally that they ruined any slim chance they had of matching. Likewise for some US MD grads as well.

Usually with Indians, English is not an issue (thank you, colonialism), though the accent may very well be (my dad actually took an accent reduction course a while ago...)

 

[psycharmed]

I am half Indian (b/r here), and I agree 100% with MofM's post above

At my program we have had 2 recent graduates who were from and went to medical school in India, but both did a lot of work demonstrating commitment prior to entering the match. One was an ICU doctor/laparoscopic surgeon and then came here and did an MPH at our medical school focusing on global health with an emphasis for psychiatry. The other did a PhD, also at our medical, in genetics or molecular biology (I forget) but his focus was neuroscience related. Both demonstrated through substantial, extra training that they had a commitment to psychiatry and were actually the best residents in their respective classes.

That said, we have had sub par IMGs (from India and other places) do external rotations and perform so marginally that they ruined any slim chance they had of matching. Likewise for some US MD grads as well.

Usually with Indians, English is not an issue (thank you, colonialism), though the accent may very well be (my dad actually took an accent reduction course a while ago...)

Interesting. So it seems like an MPH with a Psych track could prove beneficial. That's something I could really consider in spite of the extra money it would involve but if it significantly increases my chances, I guess it'll be worth it.

 

[Blitz2006]

Yeah , I have to agree with the others above.

While psych is indeed becoming more competitives, its not like its Derm/ENT, etc. You should definitely apply, and as long as you have strong LORs and psych experience, I don't think you'll have an issue matching. You may not get into a solid university program, but I'm sure you'll match somewhere.

 

[splik]

Interesting. So it seems like an MPH with a Psych track could prove beneficial. That's something I could really consider in spite of the extra money it would involve but if it significantly increases my chances, I guess it'll be worth it.

No. Please see my FAQs for IMGs thread and what I have written above. Doing an MPH is not going to help you match into psychiatry in itself. Presumably doing an MPH at a particular institution where you get to network with and do research with people in the psychiatry department there might help at that particular institution, but an MPH in itself (or any other masters degree for that matter) is not going to help you. As you are a medical student you already have a leg up over IMGs who have missed the boat and unlike the case discussed above are not coming from a different specialty where you have to prove that psych is not a back up. You have the opportunity to do 1-2 psychiatry electives in the US as a medical student and that is, by far and away the most important thing you can do to help you match and match well (presuming you do well and get strong letters of recommendation). This coupled with doing well on the USMLEs should be your main focus.

 

[psycharmed]

No. Please see my FAQs for IMGs thread and what I have written above. Doing an MPH is not going to help you match into psychiatry in itself. Presumably doing an MPH at a particular institution where you get to network with and do research with people in the psychiatry department there might help at that particular institution, but an MPH in itself (or any other masters degree for that matter) is not going to help you. As you are a medical student you already have a leg up over IMGs who have missed the boat and unlike the case discussed above are not coming from a different specialty where you have to prove that psych is not a back up. You have the opportunity to do 1-2 psychiatry electives in the US as a medical student and that is, by far and away the most important thing you can do to help you match and match well (presuming you do well and get strong letters of recommendation). This coupled with doing well on the USMLEs should be your main focus.

I've been researching some public health programs. John Hopkins offers a one year MHS (Master of Health Sciences) in Mental Health specifically and Boston University offers an MPH wherein you can structure your curriculum around mental health. If these programs allow you to work closely with the Department of Psychiatry and maybe do some research, would it be a good opportunity to show commitment to the specialty and maybe get some LORs from Psychiatrists as well?

As for elective rotations, I'm rotating in the Addiction Institute at Mount Sinai in Feb. I was supposed to rotate in the Personality Disorders Clinic there in March, but the attending who was in charge of the clinic is transitioning to another position. Left in the lurch, I emailed other Psych programs as well but all of them were filled up. I broadened my net a bit and was able to secure a rotation at the Department of Pediatric Neurology. I am interested in Child Psychiatry and they get kids with ADHD/ Autism too so I am looking forward to it. I hope its not a waste since I won't be getting an LOR from a Psychiatrist per se, but I guess something is better than nothing?

 

[splik]

you're not listening I give up. really electives should be in inpatient, consultation-liaison or emergency psychiatry otherwise you are unlikely to be able to show off your clinical skills or work closely with any individual in order to get a decent letter

 

[psycharmed]

you're not listening I give up. really electives should be in inpatient, consultation-liaison or emergency psychiatry otherwise you are unlikely to be able to show off your clinical skills or work closely with any individual in order to get a decent letter

I'm listening and I appreciate the help but since I haven't given my Step 1 yet and am about to graduate, I can't pick and choose electives.
There were around 5 universities where I could apply without Step 1 scores and if one of them is going to give me addiction psych I will take it.

 

[Psyxh1]

As an Indian-American, (born/raised here), the stereotypes about Indian psychiatrists are quite fair. My experience of 1st and 2nd generation Indian physicians is not particularly positive Of the many, many Indian psychiatrists I've known over the years, just a handful had a genuine motivation to do psych starting out, although admittedly quite a few more seem to have developed a love and passion of psych after starting psychiatry residency; Nevertheless, the percentage is abysmal.

The concern with any FMG, especially in psychiatry, as noted above, is that their interest in psychiatry is not genuine. I think that's the real determining factor. Having been a part of the ranking process for 3 years in two different institutions at FMG-friendly locations, we will absolutely rank FMGs with worse objective stats who seem genuinely interested above FMGs who seem to be looking for an easy career and/or green card. 'Ticking the boxes' isn't enough. Research, USCE, scores, etc don't necessarily count for all that much because at this point most programs are familiar with IMGs who do all those things only to turn into slackers or disinterested individuals once they get here. Genuine interest is consistently the key.

If you are as passionate about psych as you seem to be (and I have no reason to doubt you), then you'll do fine. Maybe not this year, but the next or the next. Don't get discouraged, and don't look negatively upon US residencies for responding to the behavior of your own nationality. (The latter was a bitter pill for me to swallow, but y life's been a lot better since I stopped blaming people for comparing me against a largely true stereotype).

Generally I agree with all of your comments, MOM, but this post left me with an unpleasant feeling. I would venture to say as much as 95% of psychiatry residents chose the field with some consideration of lifestyle. It wouldn't be surprising if even 50% or more have no real passion whatsoever in psychiatry or mental health. A good number of my co-residents(mostly white non-FMG Americans) routinely make comments and even "gloat" over how "psych residents don't know medicine" or "psych residents are lazy". Why single out a particular ethnicity when choosing to discriminate? Even if it were true that Indians are more likely to choose psychiatry due to the easy lifestyle and not due to any real motivation for the field, is it morally appropriate to discriminate against any one particular individual because of their ethnic background? If you already go in having prejudices against someone, you're more likely to scrutinize them and somehow justify to yourself that your prejudices were correct. IMO, ethnicity should not be a factor in the evaluation process for residency.

I apologize for making this incendiary comment but everyone would be in an uproar if you remarked how certain ethnicities are more likely to commit crime on a statistical basis, so anyone of that particular background should "stop blaming people" for thinking lowly of them, stereotyping them as untrustworthy, "gangbangers", etc. or that they should happily put up with being detained by police on a more frequent basis than the general population just because of their appearance and ethnic background(something that CANNOT be changed).

 

[splik]

Generally I agree with all of your comments, MOM, but this post left me with an unpleasant feeling. I would venture to say as much as 95% of psychiatry residents chose the field with some consideration of lifestyle. It wouldn't be surprising if even 50% or more have no real passion whatsoever in psychiatry or mental health. A good number of my co-residents(mostly white non-FMG Americans) routinely make comments and even "gloat" over how "psych residents don't know medicine" or "psych residents are lazy". Why single out a particular ethnicity when choosing to discriminate? Even if it were true that Indians are more likely to choose psychiatry due to the easy lifestyle and not due to any real motivation for the field, is it morally appropriate to discriminate against any one particular individual because of their ethnic background? If you already go in having prejudices against someone, you're more likely to scrutinize them and somehow justify to yourself that your prejudices were correct. IMO, ethnicity should not be a factor in the evaluation process for residency.

I apologize for making this incendiary comment but everyone would be in an uproar if you remarked how certain ethnicities are more likely to commit crime on a statistical basis, so anyone of that particular background should "stop blaming people" for thinking lowly of them, stereotyping them as untrustworthy, "gangbangers", etc. or that they should happily put up with being detained by police on a more frequent basis than the general population just because of their appearance and ethnic background(something that CANNOT be changed).

I agree with you about most people in psych not having any particular passion for it, but I think you have missed the point. MoM didn't say that IMG Indians are choosing psych for lifestyle reasons (which is not the case), but because they see it as "low hanging fruit" and an easier match, which is actually not the case, but is the perception. If anything, I would hazard that many IMG Indians are very hardworking and nobody comes to the US for nice hours (or if they do they are in for a rude awakening).

 

[Psyxh1]

I agree with you about most people in psych not having any particular passion for it, but I think you have missed the point. MoM didn't say that IMG Indians are choosing psych for lifestyle reasons (which is not the case), but because they see it as "low hanging fruit" and an easier match, which is actually not the case, but is the perception. If anything, I would hazard that many IMG Indians are very hardworking and nobody comes to the US for nice hours (or if they do they are in for a rude awakening).

You're right. I made a poor choice in word selection. Instead of lifestyle I think MOM was saying that Indian psychiatrists(the post also conflates foreign nationals and Americans of Indian ethnicity at different points) don't typically have a passion or love for psychiatry but as I mentioned in my original post, this general lack of passion is characteristic of many psych residents. Many AMGs also view psychiatry as "low hanging fruit" and use it as a backup when applying to residencies. There was a thread on sdn that detailed how someone applying to derm with psych as backup had received interview invites to every psych program they had applied to even with a lackluster psych LOR.

My objection to MOM's characterization is because he/she is essentially saying most psychiatrists with an Indian ethnic background lack motivation or interest in psychiatry(a percentage higher than the general population of psychiatrists). This tacitly can imply that it is perfectly fine and dandy for the general public, residency programs, etc. to continue to more closely scrutinize and prejudge any one individual of that background when he is applying for residencies, advertising services, etc.

 

[masterofmonkeys]

Generally I agree with all of your comments, MOM, but this post left me with an unpleasant feeling. I would venture to say as much as 95% of psychiatry residents chose the field with some consideration of lifestyle. It wouldn't be surprising if even 50% or more have no real passion whatsoever in psychiatry or mental health. A good number of my co-residents(mostly white non-FMG Americans) routinely make comments and even "gloat" over how "psych residents don't know medicine" or "psych residents are lazy".

Some consideration of lifestyle is fine. None of us are saints. But when Lifestyle is your number 1 criterion, I take issue with it. As is the idea that this field is easy. You're correct. Psych is abysmal. I comment on that frequently. But even if 50% of our field have a dubious dedication to it, the percentage is much higher in my experience, from Indians.

Why single out a particular ethnicity when choosing to discriminate? Even if it were true that Indians are more likely to choose psychiatry due to the easy lifestyle and not due to any real motivation for the field, is it morally appropriate to discriminate against any one particular individual because of their ethnic background? If you already go in having prejudices against someone, you're more likely to scrutinize them and somehow justify to yourself that your prejudices were correct. IMO, ethnicity should not be a factor in the evaluation process for residency.

There is a big difference between noting a statistical trend, making fitting observations about a group, and judging individuals. What you're basically arguing is that we pretend that group and population trends don't exist to prevent discrimination. In other words, because people can be emotionally stupid, we should pretend objective trends don't exist. THat's dumb. I'm a trained psychiatrist and psychotherapy makes up about 30% of my case load. I'm not perfect, but I understand about countertransference and bias. Over the last three years, Indians, Indian-Amercans, and other ethnicities with similar trends have appeared very high in my rank list. As in 'ranked to match', as in top 10 ranks. So I'm probably doing ok.

I apologize for making this incendiary comment but everyone would be in an uproar if you remarked how certain ethnicities are more likely to commit crime on a statistical basis, so anyone of that particular background should "stop blaming people" for thinking lowly of them, stereotyping them as untrustworthy, "gangbangers", etc. or that they should happily put up with being detained by police on a more frequent basis than the general population just because of their appearance and ethnic background(something that CANNOT be changed).

I can see why you were bothered by my last comment, I wonder if that's what made you view the whole thing in a negative light. What I was trying to get at was that the angst wasn't doing me any good. I used to have a giant chip on my shoulder about the ways people pre-judged me in medicine and in real life. For being Indian (and all that entailed). For not going into a more competitive field when my scores supported it. For being a large male (and yeah, I get a LOT of crap for that in psych and especially in therapy and pediatric settings). For being a brown dude in a hoodie in an upper class neighborhood. The chip on my shoulder made me irritable and defensive and quite probably made me look like I was overcompensating. It didn't do me any good. All I can do is worry about myself, as an individual, and be the truest to MOM I can be.

 

[Merovinge]

All I can do is worry about myself, as an individual, and be the truest to MOM I can be.

Thought for a few seconds there you must have one heck of a mom

 

[Dr. Hip]

Hi All, I was born and raised in California and my parents came from India. After completing undergrad in Cali I went to the Caribbean for Med school. I achieved high scores on my step exams and am applying to psychiatry for this years match. I have plenty of friends who keep telling me that my scores are too high and that I should be applying to radiology or anesthesiology. Every time I receive this judgmental remark I am again forced to explain my love for the field of psychiatry, how it all began when I added psychology as a second major in college etc etc.... Anyway with all of that being said I want to go back to the original posters curiosity of why NON-US-IMG's may be having difficulty matching into psychiatry. Now I can't be for certain but this is my experience after doing two years of rotation in America and many of those being psychiatry rotations. I would guess that It has to do with english likely not being your first language as a NON-US-IMG. As a US IMG I don't feel it is skewed against us so much because english is our first language. Too many times in my career as a medical student did I have to assist my Persian attending in communicating with his patients. Mind you he had 270's on his step exams but was a psychiatrist back home and wanted to be a psychiatrist in America. The man is undoubtedly intelligent at a freakish level but psychiatry is about communication and rapport more than any other field of medicine, in my own humble opinion. An IM doc that struggles with english can be much more effective in his patients health than could the same doc who is a psychiatrist. Whether that attending or some of the Nigerian residents or even Indian docs as you all have been so easy to point out, the point is , that I believe that they may be doubting your ability to communicate effectively with your patients in a field in which communication is everything.

 

[Saga1]

It has definitely gotten more competitive over the last few years

 

[J ROD]

Yeah, the secret is getting out........get in while you can!

 

[DetectiveAlonzo]

More love for the DOs! LESSGOOOOO!