How do you feel about FMGs???

[brahms]

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i am a US allo senior, and have read many anti-FMG posts with disgust and embarassment that my colleagues were posting on other threads. but i have to agree that when i'm on the interview trail, the programs that have lots of FMGs go lower on my rank list. it's not because i'm racist or elitist, but these programs happen to have many qualities that are undesirable to US seniors such as lack of night float, too many weekends on, unhappy residents, too few graduates going onto fellowship, etc. it has nothing to do with the FMGs themselves - they just happen to be filling the less cush programs because US grads don't want to go there.

 

[mellow yellow]

After having rotated any several hospitals, many with FIMGs, I have to honestly admit that the FMIGs tend to be smarter and more qualified than american medical grads that are in similar years of residency training. Of course there are many exceptions to this rule... But this makes sense if you realize that most FMIGs are required to complete a year or two of internship before they come to the US to practice. Moreover, the average FMIGs that make it to the US, are the best and the brightest. If you want to make an argument for accepting all US trained grads over FMIGs, I guess one could say that since federal $$ go towards paying the salaries of residents and since US citizens pay taxes, then the US grads should have priority. And this is a very valid argument...

But don't just 'blow off' FMIGs with whom you work with. You definitely can learn alot from them as their physical exam skills are far superior to yours. Seriously. They rely on physical examination skills to diagnose far most often than the average US trained grad does...

Btw, i'm an American medical student, white as white can be... 🙂

 

[tom_jones]

They rely on physical examination skills to diagnose far most often than the average US trained grad does...

Btw, i'm an American medical student, white as white can be... 🙂

far most often. Good grasp on the english language. Good luck on OSCE's.

 

[Apollyon]

far most often. Good grasp on the english language. Good luck on OSCE's.

"Good grasp on the english language." Kettle, meet pot.

Grasp "of", and "english" gets a capital "E".

 

[AMIOK]

This subject too tempting to pass up...I have officially been sucked into it. As you will be able to tell I a caucasian All-American boy, born and raised in Southern MN. After an injury I was unable to continue my work so went back to school. I went back to med school in a foreign country for many reasons...one of them was not my ability to get accepted into a US school.

There are so many topics to address but sacrifice seems like a good place...

Sacrifice: How many of the US students sold everything they owned, put your prize dogs up for adoption, travelled across the world so you could only see your family 1 time a year, went to a foreign land, were the only white guy on campus for 4 years and had you life threatened not once but twice by people that want to kidnap or kill you? Is this an exaggeration? NO, this is putting it nicely. Yes, foreign schools are privately owned, therefore they can make up their own rules. Did you know that discrimination is legal in foreign countries? Did you know that sexual harrasment is not even considered an offense? Many of my classmates were sexually harrasssed with no recourse. Did you know that at least in our school the core rotations are performed at 34 hour shifts in hot, stinky, infested hospitals? Then 14 hours off....then 34 hours on again. And no you do not leave for a latte when you want. If you are caught leaving you may get what is called perpetual duty (you work til we tell you...often an addition 24 hours). They have complete control to berate and humiliate you.

Taxes: Somebody justified IMGs not getting residencies cuz the US students pay taxes. Wel, before I went to medical school I paid personal taxes of $73,000 the last year. Does that mean I get to go to Harvard now???? Also, most of you have not really paid any taxes yet at your $5-10/hr jobs. Your parents may have , but not most of you.

I love the one, "We are smarter cuz we got into a US medical school." Well, if your premis is true, let me ask this. Did you get into your first choice? Did all of you go to Mayo, Wash U, Harvard? If that is your criteria for acceptance into residency then you must admit that those people that got into "better" schools than your should without question get 1st picks of the residencies of their choice. You should get whatever is left over, cuz lets face it your school well, just is not ranked. But you might say, "Hey, I am as smart as they are!" Too bad you are not rewarded on merit...only by the rank of US school you went to.

As far as residency directors that accept IMGs. Well, I am hopeful that they see what I do...people. Who are the best candidates for the job? Who will help better their program?

So based on sacrifice...probably tied. I know many US students have worked hard.
Based on taxes...I probably win.
Intelligence...mmm, could go either way. I was salutatorian in class of 275. I have 12 years of college and doctorate degrees and got 227 step I and 245 step II while working and having 3 children (2 of which I homeschool).

Well, my point is that this is a very complicated topic and people cannot be generalized but must be individualized. There are good and bad on both sides of the fence.

This reply was not intended to get so long...and kinda disorganized. I would have worked harder on it but I have to wake the kids, then fly out for an interview.

Good luck to all of you on your future careers. The cream always floats to the top, no matter what country you are from. And remember to love all...and if you cannot love at least try the first step....tolerate.

 

[leorl]

After having rotated any several hospitals, many with FIMGs, I have to honestly admit that the FMIGs tend to be smarter and more qualified than american medical grads that are in similar years of residency training. Of course there are many exceptions to this rule... But this makes sense if you realize that most FMIGs are required to complete a year or two of internship before they come to the US to practice. Moreover, the average FMIGs that make it to the US, are the best and the brightest. If you want to make an argument for accepting all US trained grads over FMIGs, I guess one could say that since federal $$ go towards paying the salaries of residents and since US citizens pay taxes, then the US grads should have priority. And this is a very valid argument...

But don't just 'blow off' FMIGs with whom you work with. You definitely can learn alot from them as their physical exam skills are far superior to yours. Seriously. They rely on physical examination skills to diagnose far most often than the average US trained grad does...

Btw, i'm an American medical student, white as white can be... 🙂

That was nice 🙂. I have to say though, it does all equal out. An FMG can seem a little more advanced during any given year of a residency, but eventually down the line everyone tends to catch up with each other. Obviously, some will be brilliant docs and some just competent, but on average, people will even out.

I attend one of the top 30 European colleges. I have to say, we as Americans tend to think of ourselves as the best all the time. But I'm constantly impressed by their intelligence. You'd think because we have degrees and possibly work experience under our belts, we'd be the wise ones of the classes. While that might be true at first, they soon show us how bright they are. One of my US classmates said "While we have more experience in terms of research, degrees, experiences etc, they are the brightest in their countries. We are definitely not the brightest of the US population." And he's right.

 

[tom_jones]

Sacrifice: How many of the US students sold everything they owned, put your prize dogs up for adoption, travelled across the world so you could only see your family 1 time a year, went to a foreign land, were the only white guy on campus for 4 years and had you life threatened not once but twice by people that want to kidnap or kill you? Is this an exaggeration? NO, this is putting it nicely. Yes, foreign schools are privately owned, therefore they can make up their own rules. Did you know that discrimination is legal in foreign countries? Did you know that sexual harrasment is not even considered an offense? Many of my classmates were sexually harrasssed with no recourse. Did you know that at least in our school the core rotations are performed at 34 hour shifts in hot, stinky, infested hospitals? Then 14 hours off....then 34 hours on again. And no you do not leave for a latte when you want. If you are caught leaving you may get what is called perpetual duty (you work til we tell you...often an addition 24 hours). They have complete control to berate and humiliate you.

Good post. That's the American dream, and the country will be better off if qualified people with that kind of drive make it in. But, given the conditions you describes, why did you choose to go train at a location like that if it wasn't inability to get into a US med school.

 

[AMIOK]

I had no idea it was like that when I went. The Dean was awesome, the people were nice and well as far as hard work, that never stopped me before. Then I learned, but it is over. I have lived abroad (a dream of mine), in my wife's native country and now I understand her better as well.

I was kind of regretful that I responded to this entire thread. I stumbled upon it and just reacted. My ingorance led me to believe that the US doctors and students were very friendly... I had no idea this sentiment was out there. I believe it must only be a few. I probably will not visit this forum in the future cuz there are so many other inspirational forums and positive people that will lift and brighten my day.

I thank you for your comment and wish everybody so much success. Nobody gets through medical school without great personal sacrifice. Good luck to all in your residencies no matter where you are from.

 

[ramblin_med]

Please excuse my ignorance if something I say is incorrect, but its my thought that perception is the most important entity in this discussion.

It is the perception of American MDs that we deserve special treatment, because we are accepted into an American MD school. Acceptance into such a school is the largest hurdle to becoming doctor and the bottleneck to the medical community. After that, school is very difficult, but a vast majority of students will become MDs.

When someone other than an American MD competes, it is assumed that person could not get into an American MD school. It is also assumed that their schooling could not have been more difficult than ours.

IMHO, this is where the feeling of superiority derives.

Now for some reality checks:
Most schools with lax entrance requirements are MORE difficult than American MD schools (esp. European schools). The bottleneck is graduation not admittance. More people get a shot, but only those who earn it graduate.

We all take the same boards. If you think the boards are an accurate representation of medical proficiency, then you can't argue with the results.

Finally, please stop accusing everyone who isn't in love with FMPs of racism. The U.S. has an extremely diverse population. Not every American MD or student is a paranoid white male (even if I am 😉 )

Most medical professionals don't have the time or inclination to evaluate the medical school accredidation boards of every country on Earth. Not to put too fine a point on it, but how much do you know or trust the agencies of Laos or Uzbekistan? We have confidence in the American entity, and are comfortable with their certifications.

I apologize if anything I said was flat out wrong. I still think that in this instance perception is as important as reality.

 

[leorl]

AMIOK, don't take it as a reason to leave. Yes, the sentiment is out there. And it is surprising to more open-minded people and the people who chose to live abroad for a period of time. The stigma of being an FMG is inability to get into US schools, but it definitely isn't representative of how all medical students/professionals feel, and SDN should not be taken as representative of the total medical student population. Quite often, the anonymity offered by these boards lets out feelings people otherwise would try to curb or rationalize. I think it's important to discuss issues like this to try to dispell ignorance and narrow-mindedness. The tide is turning, especially as there are increasing numbers of Americans applying to medical schools abroad in order to gain some sort of life-experience. It's definitely why I chose to go abroad and I have no regrets. I'm actually immensely thankful I chose this path.

 

[mountaindew2006]

As a fourth year applying to residency, I can say I look at the number of DOs and FMGs at a program. The more FMGs and DOs, the more I consider that the program may not be as strong or competitive as I would like. This is not the only thing I look at, but it is absolutely a consideration. To think I am the only one in the country doing this would be ridiculous.

At my med school one of the programs did not fill last year and they sent out a survey to people who had interviewed there. Those who responded said the number of DOs and FMGs in the program was a negative in their decision making process. For that reason, the program is making a concerted effort to recruit American grads with MDs. Most of my friends look at this as well, as do many American grads. It is just a fact.

It is also a fact that the Columbias and Dukies and Hopkins geeks with similar boards as mine are getting more interviews just because of the big name schools. Am I angry about it? Not really, but I know for a fact it is true. Again, "tier" of school is also a factor that is looked at to determine quality of applicant. Right or wrong, it happens.

One program director I know prints out the applications of every American grad who applies- this year, approx 250. The same number of FMGs applied, and only a handful with super-stellar numbers ever got printed out and put on his desk. The rest were rejected without any consideration. There are filters on ERAs for this very reason. Whether they were even offered interviews, I do not know. There are a couple of FMGs in the residency, and I can honestly say many of the attendings give them a hard time. Some of these residents are my good friends. I know for a fact they have fared worse in finding fellowships because-even though the residency is strong- the bias continues.

I rotated with some 4th years from a Caribbean school last year, and they were very well aware of the bias and had to make up for it by applying to larger numbers of programs and programs with records of taking FMGs.

That is just the way it is, right or wrong. Would I prefer to match at a program with all American MDs? Yes, I would, and I'm certainly not alone.

hey there

i agree with the above post. I would certainly want a residency with more US MDs as oppossed to FMGs or DOs. Although the DO thing isnt as much of a matter as FMG and "US" IMG (which is essentially a FMG -foreign med graduate, for which theyve created the adjective "US IMG" to shy away from being grouped into FMGs which they truly are).

It's reasonable that when we US med grads post things like this, that these others seem to moan, complain, and call us 'elitist'. Perhaps there is some validity to this, however, I must admit we are entitled to this given our CONSISTENT effort in academia.

Bottom line, NON US grads are NON US grads. You all are not at the same level as us, given especially the fact that you could not make it into US med schools given whatever reason. DEAL WITH IT!! 👍

 

[cdh86]

Pretty generalist statement. Maybe you're rght in some cases, but there are many people who go abroad for various reasons: Exploring a culture, their roots, maybe just to get out of the US for a bit and see the world, and get a decent education while they're at it...

As stated before, many FMGs coming to the US are the best in their country, and may in fact, be as good, if not better, than their respective US counterparts.

 

[mountaindew2006]

Pretty generalist statement. Maybe you're rght in some cases, but there are many people who go abroad for various reasons: Exploring a culture, their roots, maybe just to get out of the US for a bit and see the world, and get a decent education while they're at it...

As stated before, many FMGs coming to the US are the best in their country, and may in fact, be as good, if not better, than their respective US counterparts.

with all due respect, if someone really wanted to explore and go abroad, it's called going on a vacation to the caribbean, not med school there. the same applies to other foreign countries. I can see that others from different countries might be the best over there, but if u plan to relocate...well deal with the system, no one is taking you by the ear and pulling you to come over to the US. My parents, etc migrated here tooo they had to adjust, etc so should these ppl, its all apart of the migrating process.

 

[cdh86]

with all due respect, if someone really wanted to explore and go abroad, it's called going on a vacation to the caribbean, not med school there. the same applies to other foreign countries. I can see that others from different countries might be the best over there, but if u plan to relocate...well deal with the system, no one is taking you by the ear and pulling you to come over to the US. My parents, etc migrated here tooo they had to adjust, etc so should these ppl, its all apart of the migrating process.

Going on a vacation is one thing. Going and experiencing a culture, learning a new language, is completly different. They can indeed be on the same level (although I do not dispute that there are some countries that may have 'inferior' medical training).

I, for one, have right of abode to Britain. Why shouldn't I do my Medical Education over there (or elsewhere within the EU, where you can travel from country to country and practice with full registration for the most part)? I would think that medicine in the UK is close to medicine in North American (or one would hope). I have an opportunity to gain a medical education while travelling abroad and exploring my heritage.

People do adjust. It's why they write the USLME, and apply for placement, so show that they are on par, if not better.

Your statement that, "You all are not at the same level as us, given especially the fact that you could not make it into US med schools given whatever reason. DEAL WITH IT!!" I think is a bit fatuous, stating that people always go aborad because they couldn't get into a US Medical School. As said many times before, many people have found that FMGs tend to perform fairly well, because chances are, if they're here, they're fairly intelligent.

CH

 

[cdh86]

To add to my above post. I was referencing more those who go to Europe, or to their cultural background, as opposed to the Carib. I can't comment on those who go to the Carib, because I don't know anyone who has selected that path.

CH

 

[novacek88]

I think a lot of the disdain toward FMG's is simply racism that is elaborately disguised by weak rationalization. They are ridiculously maligned for no reason. They work in hospitals that most U.S. grads would avoid. They go into fields that U.S. grads have no desire of entering. Despite all of this, I hear lame comments like they can't speak English or they don't deserve to practice here etc. How many of you can speak a second language fluently? You think you wouldn't have any trouble if you moved half way accross the world and tried to adapt to a foreign system? Because they lack the same mannerisms and accent as you, they are somehow inferior and goofy? Just be glad you were born and raised here because many FMG's have more courage and strength than you could ever imagine.

I love FMG's. They are hardworking and humble. They are some of the most approachable docs in the wards.

I can understand one saying they won't apply to a program occupied by many DO's and FMG's because the program may be less competitive and hence offer drawbacks that other programs lack.

However, it amazes how so many U.S. M.D. grads in competitive residencies like to piss on FMG's. Talk about kicking someone when he or she is down. It would honorable if you could show some humility and compassion and respect the fact that your FMG colleagues are working in many areas that you would avoid both in regards to specialty and location.

Peace

 

[Doc_Thks_JC]

This thread is indicative of life. There have always been those that were the "elite" and those that weren't. Those that feel they are owed something or that they are special. It's sad that we as humans and especially we as future doctors do not have the human nature or ability to look past this barbaristic approach to life. Life is not about bashing the FMG's or the DO's or anyone else. If you have not figured this out, I feel sorry for you in life but more so I feel sorry for your patients.
" Let he who is without sin cast the first stone" : Quote Jesus

 

[novacek88]

This thread is indicative of life. There have always been those that were the "elite" and those that weren't. Those that feel they are owed something or that they are special. It's sad that we as humans and especially we as future doctors do not have the human nature or ability to look past this barbaristic approach to life. Life is not about bashing the FMG's or the DO's or anyone else. If you have not figured this out, I feel sorry for you in life but more so I feel sorry for your patients.
" Let he who is without sin cast the first stone" : Quote Jesus

The only thing bad thing about this thread is it stereotypes all U.S. M.D.'s as being arrogant and racist. The truth is the majority of U.S. M.D.'s are very decent and understanding people.

 

[shivalrous]

Well said novacek88, you'll make an awesome MD. We need more like you who have an open mind and are not afraid of competition from abroad. 😎

 

[ASA HOUSE MD]

In the real world, when you're a resident/attending, you are going to have to deal with all walks-of-life in the medical profession. Whatever negative opinion of FMG's you may overtly/covertly harbor is irrelevant and can only hurt you professionally and/or personally.

No one, especially patients, gives a rat's ass about where you went to school. If you have good clinical acumen it speaks for itself.

If you disingenuously believe you can "skate/hide by" the name of your school alone, then you are in for a rude awakening.

 

[mosche]

Bottom line, NON US grads are NON US grads. You all are not at the same level as us, given especially the fact that you could not make it into US med schools given whatever reason. DEAL WITH IT!! 👍

This post is childish. Mountaindew, I've noticed that on other posts you keep hinting that someone you "know" made a 197 on Step 1. I've indicated that I work for Kaplan as an instructor. One of our students did her medical training in Israel -- she made aliyah there after college to be with her mother who had gone there for the climate/health reasons, her mother passed away in 2003. Before moving to Israel in '01, she graduated with a 4.0 from Vanderbilt and had scored a 39 on the MCAT. This past summer she came back to the states to prepare for the USMLE at our office. She did; she took it; she rocked -- 262/99. BTW, she had been accepted to NYU, Hopkins, Vandy, UT, UAMS, and Emory medical schools.Thus, your above post is not only zenophobic, it's WRONG.

Next, you indicated in the "197" thread that your "friend" is very desireous of a cushy lifestyle with lots of money ( my paraphrase). How many FMG's and IMG's are really vying for those residencies? Not many! Most at our center just want to be able to practice period -- even if it's at the VA! Given your "friend's" criteria as an alternative, give me the FMG/IMG. Given a choice of the Israeli grad and almost anyone else, I would choose her!

Finally, I do not understand what purpose these threads serve. We are, as has been said, medical students; not MD's, not hospital administrators, etc....
Therefore, these threads only serve as a forum for people to voice their vitriol.

 

[erichaj]

I love american medical grads. Like the one who was doing a colonoscope and instead of placing the probe in the anus, he put it in her vagina.

It's amazing how US grads think that human being don't make mistakes.

In fact, there are many malpractice cases where it was a US grad that made a huge mistake. For example:

The guy in NYC who took the wrong leg off during surgery and the guy who did neurosurgery on the wrong side of the brain on his pt. Those were US grads not IMG.

Don't make general statement about people. It makes you look like an idiot.

EH.

I personally love FMGs!! They have done an excellent job of filling out empty Family Med spots at my school, and then consistently copying my pt notes while on their off-service rotations. They're also good for crazy laughs, like the one FMG who was on my OB rotation who 'forgot' to put on gloves for a delivery, then the next day volunteered to first assist on a c-section of twins without ever having seen a c-section. Then there was the one on my cardiology rotation who on the first night of call asked, 'what are cardiac enzymes?' These guys are hilarious!!!

 

[novacek88]

Well said novacek88, you'll make an awesome MD. We need more like you who have an open mind and are not afraid of competition from abroad. 😎

LOL...I'm actually a DO but I hope that love is still there. In all seriousness, I have been treated well by M.D.'s. Maybe some of these guys are talking behind my back but they treat me well in person and that's what I go by.

 

[KWBum]

Ok, so I'm an FMG. Or, more acurately, an US-IMG, as they say these days.

And these past months I've been rotating through US hospitals learning medicine, and trying to figure out what, exactly, I missed by going to school abroad.

I've come to the conclusion that the answer to everything is voodoo.

VooDoo.

Starting at the beginning, take this website, for example:

www.mdapplicants.com

No matter what numbers you put in (well....within reason, of course) you will find people who get in. I put in 25 MCAT and 3.0 GPA....and got a few acceptances.

My advisor at Harvard advised me that it wouldn't even be worth my time and money to apply to med school with an MCAT of less than 30. Besides, with less than that they wouldn't even sponsor my app. Well, I beat that, got the grades, and they sponsored the app, and I still didn't get into to a U.S. school. Explain that to me?

So, there's all types graduating with U.S. M.D. degrees.

Does foreign education lack in some way? In my own school we have a nutty pathology professor lady who essentially make you memorize the big Robbins, and then gives you oral exams lasting hours on ~five chapter blocks.

I met at guy at my recent CSA from a U.S. school who had never done a pelvic exam on a real patient, just on mannequins.

Now, where do the home-grown docs excell? In paperwork, for one. If you are at one hospital for two years, well, then, you know exactly how to buff a chart, and whom to call for that rehab consult. But does that make you a better doctor...once you get to some other hospital...with a totally different system of documentation? And writing a patient note, is that rocket science?

One of my attendings at a NY hospital was an Indian guy. He looked at things once to remember them. He'd politely let you stumble through the patient's lab data, and then take over citing values (from memory) from three weeks ago.

What is the point, after all, of all of us taking Steps 1-3? What is being assued, or implied by a residency director who will take a U.S. grad with a Step of 175, but no foreigners below 200?

I had a resident who came to the U.S. at 12. So, he had grade school here, high school, med school, and now residency. And he had a stronger accent, and more screw-ups with his english (idiomatic, and otherwise), than my other resident, a Romanian, who'd been here a year and half, and had taught himself english in Romania. I had to ask the Romania where he was from because I wasn't sure if he even had an accent.

What's my point to all this? Well, I've had great docs on both sides of the ocean. And I've had crappy ones too. U.S. med students have a lot of advantages. And we foreigners have a lot of problems.

But high scores and a degree from Ivy U doesn't guarantee much other than you have a high score and a degree from a "good school."

If every U.S. student got 230's on the Steps, then the mean wouldn't be 214. Hell, the pass mark is 175. That in itself must be a measure of some competency. If it wasn't it would be higher, one would assume, right?

So, the answer is voodoo. Residency programs accept people for reasons probably not even known to themselves. If a program has a cut-off score, fine. But if it won't even consider me if I don't have 12 months of U.S. hospital experience, in spite of being above the cut-off, what's the point to that? Yet, another program has no minimum, and no experience requirements, and is at a "better" school. Sure, I see their point, they want a minimum level of competency. But in what? Chartwork?

Or what if I went to DO school? What then? I still learn the same stuff, still pass the same boards, still rotate at U.S. hospitals.

Voodoo.

 

[stroke]

wow!!! -- and why did i have to open this thread at 12am? it's 3 am and i feel like someone spit at me after reading most of this stuff. It's upsetting that people that I will call colleagues and supposively represent the "elite" of our nation can be so judgmental and shortsighted. My only hope is that there are few of you and as someone said majority of doctors practicing in America, no matter where did they graduate are good people.

I am a US med school senior, a US Citizen (and usually very proud of that, except for a moments like this) who wasn't born in the US. My parents immigrated to this country for various reasons, in no small part they wanted their son to live in the Land of the Free rather than being "wasted" b/c of wrong religion and nationality: a common problem in the former Soviet states. This brings me to one of the points raised here:
"So you want them to stay in their own country if they're so smart. Why do you think they come here? Just to take spots from US medical students? If everything was rosy at home, do you think they'd be so keen to come to the US?" SOmeobody already tried to explain to some of you some reasons. My mother is a doctor, and she went through hell to become a doctor here again. I think i explained the reasons as to why she came here, although I am not sure it will get through some of your thick skulls.

As to why Residency Programs prefer American grads, there is one very simple explanation to this (it usually explains everything anything at any time and place, but especially in this country and now): MONEY. Residency program is paid for residency position by Medicare. Roughly 120K per spot (so the program make on you 60-70K/year). But there is a catch: 120K is for American grad. The FMG/IMG "worth" less in the eyes of Medicare, almost 30K less a year. So if a competitive residency ends up taking an IMG/FMG (s)he is more than worthy. As someone mentioned here, if Residency program match was like a true job search, a lot more qualified foreigners would have jobs -- b/c of this artificial pricing difference American grads already protected.

I have a lot more to say, but it's late and I have a feeling it's probalby worthless/useless. I won't teach anybody to be more tolerant and/or culturally sensitive. It's too late for that now 🙁 There is a truth that there are bad FMG/IMG's (I personally know someone who got 18 on the MCAT and being a student at one of Carribean schools, and it's scary that this person might practice medicine one day, but I've also seen a US grad stating that why don't we take out the patient's liver b/c the 2nd one will help them live (and it wasn't a joke). BUT THERE ARE GOOD (really good) doctors who are FMG's. it's like with everything in life: there is good and there is bad --> we can't put everybody under the same umbrella. I just hope that there are more future doctors as Amiok. While we are all very different people, we can strive to be more tolerant; I think we can benefit from this trait as a profession and as a society as a whole

 

[b&ierstiefel]

Geezus Christ! Put This Crap To Rest!!! Who The Hell Cares?!?!?!

 

[BellKicker]

Geezus Christ! Put This Crap To Rest!!! Who The Hell Cares?!?!?!

👍 👍

 

[brendang]

As a non-US IMG (yeah, being a Canadian is soooo really f*#king different), I've been amazed by all the passive-aggressiveness I've encounted by some during medical school while rotating with US students... Interestingly enough, on my ophtho interviews throughout the US this season, I've come across no problems or sarcastic jabs by both interviewers and applicants... Even during an interview with the Chairman of an Ophtho program, they really don't give a flying-f*@k that I partied my ass off in college at the tender age of 18-19 but that I stepped up when and where it counted... Those who feel intimidated by people "like us" are the ones who were paying extra attention to Freud's discussion of penis-envy in psych class... Booyah.

 

[shivalrous]

Haha, penis-envy.....let the best man win.

 

[shellfish]

very true. but IMGs also comprised 19% of 2004's dermatology match while 135 US seniors who applied into derm didn't match at all.
i got the numbers from these 2 links:
http://medicine.wustl.edu/~residenc/outside/spec/
http://www.nrmp.org/res_match/data_tables.html

this interpretation of the tables is inaccurate. 80% of dermatology spots were filled by US seniors. that doesn't mean the other 20% was filled by FMGs. rather they were filled by reapplicants, research fellows, interns/residents. i have read on derm ezboard that the percentage of FMGs in derm residencies is actually more like 1%.

 

[Miklos]

this interpretation of the tables is inaccurate. 80% of dermatology spots were filled by US seniors. that doesn't mean the other 20% was filled by FMGs. rather they were filled by reapplicants, research fellows, interns/residents. i have read on derm ezboard that the percentage of FMGs in derm residencies is actually more like 1%.

According to FREIDA http://www.ama-assn.org/vapp/freida/spcstsc/0,1238,080,00.html the average number of IMGs in derm is 3.8%

You can bet that those are highly qualified people with tons of research, completed foreign residencies, PhD's, etc...

 

[Mirror Form]

I agree that there are many excellent FMG's who are great assets to both the US health care system and to the country in general. However, FMG's need to realize that US MD's have many understandable reasons for not instantly accepting every single FMG as an equal. It isn't just b/c of being "elitest" or "racist." Most of the FMG's who are complaining would be acting the exact same way as the US MD's if they were in our shoes.

First of all, getting into an allopathic US school is extremely difficult and stressful. The same can be said for SOME foreign schools, but not all. So after putting in all the hard work and stress of getting through a very tight bottleneck, of course some US grad are going to look a little down on other MD's that didn't have to compete to the same degree. I used to think that while it might be easy to get into some foreign medical schools, then it must be very competitive to graduate. But after meeting many FMG's (and living with one, who will be a very good US doctor someday), I found out that this simply isn't the case. Therefore, FMG's often have to do more in order to earn the respect of a residency selection board. I think this is completely fair.

Also, b/c of the tight bottleneck in getting into a US allopathic school, many US citizens are told "you're not smart enough to be a doctor." Meanwhile, somebody who did just as well in college in a foreign country gets to go to med school there and then come be a doctor in our country. Since all US grads have pretty smart friends still who couldn't do well enough in pre-med to make into US med schools, we can get a little bitter when people who are sometimes no more intelligent then our old friends get to show up later and become doctors in our country due to the fact that they were born somewhere else.

Another reason US grads aren't thrilled about competing with FMG's is b/c often FMG's will do an entire residency in their own country, and then reapply for the same residency in the US. Or they'll do several years of research and whatnot. Whereas, US grads have huge loans and don't have the luxury to do multiple residencies or unpaid research fellowships for 4 years in order to beef up our applications.

 

[Shock]

This view is coming from a USIMG.

I believe that US AMGs must remember that some of their own peers in medical school in the states got accepted from the waiting list. With that said, once these "waiting list" candidates were accepted, no one is ever going to look down upon them when they are doctors for this simple reason.

Knowing this, what would you say about the poor guy/gal who never got accepted from the waiting list(s) and chose to study abroad (whereever that offshore school would be; Carribean, England, Israel, Australia, Europe somewhere, India, etc....) because of this very reason?

Surely, this applicant must have been worthy of a spot in a US medical school if he/she was on their waiting list? And surely sometimes it is either a matter of fortune or connections as to who gets called from the waiting list, right?

Now, I just wanted to point out that at least 20% of my colleagues who decided to go the offshore route had been on waiting lists and the majority of these students ended up doing extremely well in the basic sciences and then on the steps (both of them). If you the reader (especially US AMGs) did not know this, now you do, and you must admit that what these particular US IMGs I am referring to deserve some respect and ought to be commanded for risking and sacrificing so much by going out of the country to one day manage sick patients. If you don't see my point after all of this, then you never will.

More power to those USIMGs who always need to work twice as much harder, sleep half as much, and be significantly more compassionate towards their patients versus AMGs (only those who view FMGs as inferior).

 

[DrIng]

heard an interesting rumour today, just to throw skuttlebutt in the opposite direction for once. Someone told me (total hearsay i admit) that the fail rate for US grads on the Step 2 CS was originally around 20% until the results were 'moderated'. Which is interesting because Step 2 CS is very like the old CSA which none of the grads from my foreign school ever failed in it's years of existence. (And no I don't know what the fail rate for FMG's was) My point is not to start name calling but to emphasise that we have different strengths...

 

[Miklos]

Another reason US grads aren't thrilled about competing with FMG's is b/c often FMG's will do an entire residency in their own country, and then reapply for the same residency in the US. Or they'll do several years of research and whatnot. Whereas, US grads have huge loans and don't have the luxury to do multiple residencies or unpaid research fellowships for 4 years in order to beef up our applications.

I think that you are misinformed. The foreign grads that come to the U.S. with completed residencies, PhDs, research and stellar scores very rarely do so because they solely aim for US residencies.

The reason they come is that opportunities for them as young physicians and researchers are often severly limited in their home countries.

The U.S. is the greatest beneficiary of the worldwide "brain drain".

Why?

Because, Americans value excellence over origin.

This, believe me, is a relatively rare thing. There are very few countries even in the developed world that will acknowledge and reward "foreign" talent, nevermind to the extent that the U.S. does.

If you get the chance, take a look at the birth places of "American" Nobel prize winners in the sciences. This is just the tip of the iceberg when it comes to measuring the contributions of foreign born U.S. citizens to the American commonwealth.

If at some time, the U.S. does turn its back on its highly talented would-be immigrants, you can be sure that the consequences will be dire for all Americans.

Miklos

 

[Mirror Form]

I think that you are misinformed. The foreign grads that come to the U.S. with completed residencies, PhDs, research and stellar scores very rarely do so because they solely aim for US residencies.

The reason they come is that opportunities for them as young physicians and researchers are often severly limited in their home countries.

Well of course they come here b/c the oppurtunities are better. I met several foreign grads on the interview trail this year (ophthalmology), and every single one had already completed an entire residency in ophthalmology in their own countries. I don't blame them in any way for wanting to come to the US for better oppurtunities. However, can't you see why US grads would be annoyed by somebody who's already completed a foreign residency competing with them?

If at some time, the U.S. does turn its back on its highly talented would-be immigrants, you can be sure that the consequences will be dire for all Americans.

Miklos

I definitely agree that having many of the world's best and brightest come to our contry is beneficial for us.

 

[drgirl]

Another reason US grads aren't thrilled about competing with FMG's is b/c often FMG's will do an entire residency in their own country, and then reapply for the same residency in the US. Or they'll do several years of research and whatnot. Whereas, US grads have huge loans and don't have the luxury to do multiple residencies or unpaid research fellowships for 4 years in order to beef up our applications.

Trust me, an IMG doesn't always plan his career by saying "Oh, how about I do a residency in my own country, work like a dog and get paid peanuts so I can beef up my application, just so I can do it all over again in the US."
Yes, US Grads have huge loans. However, in now way does that mean that IMG's are living cush lives with money to spare while we do research, residencies etc. Yes, there are a fortunate few who can afford that. There are many more who just want to do research. Or are doing residencies until they get visas (hey, you gotta eat).
In my country, we pay every cent of our tuition out of our own pockets--no loans etc. It's not cheap either. To top that all off, we end up paying enormous amounts of money just to take the USMLE's and to travel all the way here to take the Step 2 CS. It may not seem like a lot to anyone who is earning in US dollars, but try converting to a currency from a 'third world' country. So, if a doctor feels like he/she could benefit from training in the US and comes here, takes a scuttlebutt monkey research job, lives in a dump, earns no money and basically does whatever they can to get into a residency (those 250+ board scores that many IMG's have isn't enough)--to suggest that that is a 'luxury' is preposterous. Also, US Grads could beef up their application if they needed/wanted to badly enough. What about US Grads who complete residencies in a field only to switch over to something else? Why aren't they resented then?

I refrained from posting until now because it's a never ending debate. I couldn't resist responding to this though.

 

[neuro kid]

I am an IMG and a proud one at that.

i cant speak for everyone who comes from abroad to do a residency in the US, but here's my story.

I am the son of two doctors who are doing very well in practice in my native country (and i knock on wood as I say that). I competed with thousands of students to get into the top medical school in my country (believe me, the ratio of selected to competing students was about 1 in 1100). I did well in med school, both in academics (i published 11 papers during my medical school) and in extra curricular matters (president of my school's student body). I also have very competitive board scores.

I came to the US to pursue a residency immediately after med school ended, not because of the money (I have seen lots of it back home) but because I have gotten into a habit of achieving the best. The US today boasts of the best medical institutions, and I could not resist myself from coming over.

I thought that getting into a residency would be easy, but its not.

First of all, the visa issues kill you. I did not get a single interview from my desired universities (one of the program directors was nice enough to reply that they dont want me because I had "visa problems".).

Secondly, I am proud enough to not accept aid from home. I landed on US soil with $4000, and am living on that for the past 5 months (i had to take greyhound for all my interviews (my rides have ranged from 6 to 42 hrs). I have, till date, had to miss 2 interviews coz my bus dint make it on time).

Third, it is going to be a hell's tale when I do end up in a residency. Most IMGs have a lot of trouble getting the right visa to stay on for long enough to do a suitable fellowship after residency, and have to continually hop from job to job to maintain their visa.

Whats ironic is that USA's medical powerhouses run on FMGs (at least partly) who came over in the past thirty years or so. This is the reason I feel I deserve a residency spot here. In such a scenario I hate the fact that I have to play second fiddle at every step.

I dare say that most IMGs who come over are very good, and often the best from their countries. I dare say that we deserve these spots.

 

[medlaw06]

ladies and gentlemen...why argue over something so pety!

There are FANTASTIC IMGs and HORRENDOUS IMGs

There are FANTASTIC MDs and HORRENDOUS MDs

There are FANTASTIC DOs and HORRENDOUS DOs

It's not anything else than simply this: ARE YOU A GOOD PHYSICIAN!?!

If you are, I could give 2 s***ts less where you are from or what initials you have after your name!

BTW...I worked at Kaplan and there was a guy from Punjab, India who was chief of surgery in the state's largest city. He was a great physician who operated on some of the nations biggest people (or so he claims, but he had pics to prove it). He was in US for 2 years trying to save enough $$$ for himself, the test, Kaplan course, and send the rest to his wife and kids back in India. He worked at the local Dunkin' Donuts cleaning toilets and "having to make the donuts" during the graveyard shift so he could study in the daytime.

He passed all 3 steps on his first shot with really good scores. While I do not know what happened of him, I have to say that I admire his courage and dedication. I guess complaining of other things becomes a little pety, don't you think!?!

 

[CambieMD]

ladies and gentlemen...why argue over something so pety!

There are FANTASTIC IMGs and HORRENDOUS IMGs

There are FANTASTIC MDs and HORRENDOUS MDs

There are FANTASTIC DOs and HORRENDOUS DOs

It's not anything else than simply this: ARE YOU A GOOD PHYSICIAN!?!

If you are, I could give 2 s***ts less where you are from or what initials you have after your name!

BTW...I worked at Kaplan and there was a guy from Punjab, India who was chief of surgery in the state's largest city. He was a great physician who operated on some of the nations biggest people (or so he claims, but he had pics to prove it). He was in US for 2 years trying to save enough $$$ for himself, the test, Kaplan course, and send the rest to his wife and kids back in India. He worked at the local Dunkin' Donuts cleaning toilets and "having to make the donuts" during the graveyard shift so he could study in the daytime.

He passed all 3 steps on his first shot with really good scores. While I do not know what happened of him, I have to say that I admire his courage and dedication. I guess complaining of other things becomes a little pety, don't you think!?!

I am out in the "Real Worl." I agree with the previous poster. The argument as to whether FMGs should be allowed to work here is pointless right now. This country does not train enough physicians to staff all of the patients that need to be seen. I actually consult FMGs over US trained docs in some instances. Some FMGs work harder and provide better service. This is not always the case but I have seen it on several occasions. Abetter topic to discuss would be " how should I prepare for residency" or what should I do to get the most out of residency training." I know, I sound like an old man.

CambieMD

 

[Bella78]

ladies and gentlemen...why argue over something so pety!

There are FANTASTIC IMGs and HORRENDOUS IMGs

There are FANTASTIC MDs and HORRENDOUS MDs

There are FANTASTIC DOs and HORRENDOUS DOs

It's not anything else than simply this: ARE YOU A GOOD PHYSICIAN!?!

If you are, I could give 2 s***ts less where you are from or what initials you have after your name!

BTW...I worked at Kaplan and there was a guy from Punjab, India who was chief of surgery in the state's largest city. He was a great physician who operated on some of the nations biggest people (or so he claims, but he had pics to prove it). He was in US for 2 years trying to save enough $$$ for himself, the test, Kaplan course, and send the rest to his wife and kids back in India. He worked at the local Dunkin' Donuts cleaning toilets and "having to make the donuts" during the graveyard shift so he could study in the daytime.

He passed all 3 steps on his first shot with really good scores. While I do not know what happened of him, I have to say that I admire his courage and dedication. I guess complaining of other things becomes a little pety, don't you think!?!

Could not have said it better myself!!! 👍

 

[b&ierstiefel]

The senior residents with whom I worked during my subinternships were mostly FMGs. They knew their **** down cold! One thing, besides how much they knew, that I really admired about them was their sense of work ethic. They never complained. If they had work to do, they got it done efficiently and effectively. I remember some of them telling me in conversations that they felt privileged to be doing medicine in the US. This made me look back at all the stupid crap I was bitching about as a med student...although I like to bitch about things and sometimes feel justified in doing so, the stuff I bitch about doesn't compare to the crap that they have to deal with. I also remember distincly that these folks were attending level physicians in their own countries! So yes, there are some fantastic FMGs out there!

I'm so seriously...I learned so much from them and personally I don't think I would be as good as they are. So yes, there are some crappy AMGs out there (like myself).

 

[AMG_MD]

The senior residents with whom I worked during my subinternships were mostly FMGs. They knew their **** down cold! One thing, besides how much they knew, that I really admired about them was their sense of work ethic. They never complained. If they had work to do, they got it done efficiently and effectively. I remember some of them telling me in conversations that they felt privileged to be doing medicine in the US. This made me look back at all the stupid crap I was bitching about as a med student...although I like to bitch about things and sometimes feel justified in doing so, the stuff I bitch about doesn't compare to the crap that they have to deal with. I also remember distincly that these folks were attending level physicians in their own countries! So yes, there are some fantastic FMGs out there!

I'm so seriously...I learned so much from them and personally I don't think I would be as good as they are. So yes, there are some crappy AMGs out there (like myself).

Your story is making me cry...... what a classic example of crappy argumentation and gross generalization. Are you implying that every IMG is "fantastic" and every AMG is "crappy"? Jeez - do you even know the meaning of the word patriotism? If things are as bad as you make them out to be, then why do you think that the influx of IMGs is increasing on a yearly basis?

Just think about this - not only are IMGs coming in and taking AMG jobs, but also the total # of jobs is decreasing because of trends like outsourced radiology reads, which are being shipped off to India. You think I'm kidding - go read the Radiology forum, several posts on this.

Your kind is pathetic - trying to kiss-a$$ to the general point of view while refusing to accept facts. You will probably be out of a job soon, at this rate, and you will only have yourself to blame.

 

[cdh86]

No, he's stating that there are really good IMGs and really crappy AMGs...Fact is, that they're all "MG"s, and that's what matters. In the end, they pass the same exam and get the same lisence. I'd rather have a compassionate doc trained in another country than some arrogant one trained in my own. Again, they have the lisence on the wall, so they've met a standard as far as regulations are concerned.

They're not 'taking your jobs'. Maybe providing some competition, but if you're superior, it shouldn't be an issue, right?

CH

 

[neuro kid]

Your kind is pathetic - trying to kiss-a$$ to the general point of view while refusing to accept facts. You will probably be out of a job soon, at this rate, and you will only have yourself to blame.

dear dude,
your insecurity makes me laugh.

 

[b&ierstiefel]

Your story is making me cry...... what a classic example of crappy argumentation and gross generalization. Are you implying that every IMG is "fantastic" and every AMG is "crappy"? Jeez - do you even know the meaning of the word patriotism? If things are as bad as you make them out to be, then why do you think that the influx of IMGs is increasing on a yearly basis?

Just think about this - not only are IMGs coming in and taking AMG jobs, but also the total # of jobs is decreasing because of trends like outsourced radiology reads, which are being shipped off to India. You think I'm kidding - go read the Radiology forum, several posts on this.

Your kind is pathetic - trying to kiss-a$$ to the general point of view while refusing to accept facts. You will probably be out of a job soon, at this rate, and you will only have yourself to blame.

First of all, I was telling a story and after re-reading my post, I can see that I'm not really making much of an argument. I realize that there are some good FMGs out there and there are some pretty horrible ones too. Same goes for AMGs as well.

Look buddy, you're trying to bait me...and I'm not gonna fall for it. I'm not gonna automatically take your position--it is a very simplistic, unilateral, narrow-minded and easy stance to take. I can identify with the FMG issues that are frustrating to you. But, if I do end up being out of a job, I will be the only one left to blame. That's fine with me. I think to blame my job woes on something generalistic such as, "Oh there are things guys called FMG's who are taking my jobs...ooh ooh...aah aah" is cowardly and simplistic. I'm sorry but if you (and I don't mean you personally) suck, you deserve to lose your job because you suck at it.

I don't refuse to accept facts which you mention. I'm well aware of what some of these issues are, especially the whole outsourcing issue in the field of radiology due to the advancement of technology. And your approach to this whole issue is valid. But your opinions are not shared by everybody and those who disagree with you are not pathetic and ignorant.

 

[cdh86]

Actually, I think I'll retract my former statement, and agree with AMG_MD. I mean really, he's right. It's those freakin' foreigners, coming here to steal OUR money. Why should have to compete against someone from another country? They're clearly inferior to me, they aren't even worthy to compete against me.

I couldn't agree more with them stealing out residencies. It's highway robbery! But while I agree with you, I think we need to think BIGGER. While banning them from coming into our country (let's face it -- they just don't deserve it), let's start looking at our own society.

What's this letting women into medicine!? I mean, they are FAR too emotional to be physicians, let alone good ones. And surgeons? Please. Women should stick to nursing, where they can all use their maternal instinct. Leave the manly work to the men -- the ones cut out to be doctors.

While we're cutting women out, let's look at racial groups too! I mean, these freakin' IMG's come from various countries, so we can therefore decide that anyone NOT from the USA (cut off 2nd generation -- they become smart) shouldn't be allowed in Med School -- no -- school, period. They're not smart enough, and they'll just pull the rest of us down.

Stand with me, BROTHERS (or sisters, but only if you're nurses), and say NO to anyone but white males in Medicine (afterall, we're the only ones cut out for it. No, we were never immigrants).

(To anyone who took that seriously, and I hope it was no one, yes, it was sarcasm.)

CH

 

[b&ierstiefel]

Gosh! What was that line about comparing the special olympics to arguing on the internet...brainfart.

 

[cdh86]

I couldn't resist, what can I say? 😉

 

[b&ierstiefel]

This debate will never end. As long as there is a studentdoctor dot net, threads like this will always exist. I try to stay away from these threads because I really don't care one way or another but it is entertaining to see some people get their panties in a bunch over an issue in an internet "chatroom".
Aight, I need to get my panties unbunched now