Would you return to your country after residency/fellowship in the US ?

  • yes i would return

    Votes: 8 34.8%
  • no i will not

    Votes: 6 26.1%
  • i have an open mind and will consider both options

    Votes: 9 39.1%

  • Total voters
    23

IMGforNeuro

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hi guys,
i just wanted to know the opinion of the foreign citizen med grads. Would you prefer to return to your respective countries after residency and / or fellowship ?
I am also particularly interested in FMGs from south asian countries india , pakistan , sri lanka etc.
What is your opinion about career opportunities in your repective countries after doing residencies and fellowships in the US?
 

IMGforNeuro

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oh come on guys . 18 views and still no replies.
I was hoping the IMGs from asia would be interested in this poll.
 

1500sr

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hi IMG neuro,

I am from India and preparing for USMLE,If i get my MD here I would love to work here gather The most knowledge about the recent medical technology,Since I am from rural part of my state in India where there isn't enough basic medical facilities available for the people . I would like to build a much sophisticated hospital there with the money I earn here,Ofcourse If there is GOD's will.I think its the least I can do for my country.:idea:
 
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IMGforNeuro

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hi 1500sr,
i am also from India and i respect your feelings. I also have similar plans .
 

Energon

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What do you guys think about getting jobs at institutions like Apollo or some of the other biggies in mumbai or delhi? I read an india today article that had an in depth analysis on these facilities. It sounds like a great option... top of the line equipment, great pay (in indian scale) and best of all no managed care. Although I am an american, I might consider going this route after I have paid of my loans (depending on how the situation is here).
2nd of all any thoughts on the upcoming india pak series?
 

IMGforNeuro

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hi AMMD,
i personally feel that life in delhi , mumbai , bangalore or other big cities is fantastic. I have spent a large part of my life in delhi.
I am from a family of doctors with many family friends and acquaintances working in good hospitals.
There are numerous high paying hospitals in delhi of which Apollo , Escorts , Batra , Gangaram , PSRI , Metro etc. are a few . Every metropolitan city has such hospitals.
Regarding the physicians they are trained in the best institutes in India as AIIMS , PGI etc. Many do fellowships abroad as in US , UK , Japan, etc.
I spoke to many physicians regarding recruitments to such hospitals. There are some who have american residencies and fellowships and indeed all have great careers. But all of them have trained in university based programs with fellowship training too. To be honest , residency in a community based program and without a decent fellowship will not be sufficient to get in these places.
In fact I know of some doctors in different specialities there about where they did residencies. To be honest they have great practices in the most sought after places , live in great areas with fame and glamor. But that is after residencies and fellowships in good academic programs . I am not saying they went to cornell or hopkins , but yes they have been trained in decent academic univ programs as wayne state , umdnj , suny , univ of illinois etc. Once this kind of residency is achieved , we have a good shot at good fellowships . It is only after this that we can achieve careers like them.
Honestly, most community based programs in the US thrive on FMGs , but that kind of training will not get anyone in these hospitals.
BEST PART , NO or very less medical malpractice liability and more respect.
I am very excited about the India Pak series. It is always a hard fought series with lot of fanfare. Hopefully peace prevails .
 

Energon

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IMGNeuro:
Dont limit yourself by that sort of negative thinking. One of my school friends (from the middle east where I was) did his MBBS through Bombay University internal med in a community program in Brooklyn, fellowship in pulmonology crit care at the same place is now headed back to Pune with the Apollo group.
Say if you did get into a good fellowship position even after a community based program and were offered a job in one of these institutions, would you think about it?
I know that life here in many ways is more convinient, however, back home you would be in a much higher social/ income bracket than as a physician in the US... difficult decision i must say.


On a side note,
My 83yr old grand mother recently underwent a quad bypass @ Lilavati in mumbai... it was an incredible facility, the competency of the surgical staff, medical staff, diagnostic staff; the equipment, recovery facilities etc were way beyond my expectations. I was very happy with the services rendered to our family. However, I dont know if these sort of services are probably only provided to NRI's or well off Indians (which seem to be growing at an exponential rate). Nonetheless, these hospital systems are proving to be a great career opportunity for you guys.
 

Energon

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p.s. I am really psyched about the indo/ pak series... always produces good cricket.
Funniest thing is, I haven't touched a bat or a ball in 10 years... and although I am a fan of american sports,baseball mostly, I still love my cricket.
 

IMGforNeuro

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I must say your friend is having the best possible career.
I do have certain aims regarding residency and fellowship after which if i had the opportunity to work in such hospitals i would actually grab it with both hands.
I have always believed that if a person is successful in his/her own country among his people , then that is the best thing.
REASONS: Everything you need or will ever need is available in India. There are many requirements of every person which include family, culture , music , environment and hundreds of social and lifestyle issues. I can enumerate many things which i need and miss. I can understand people from financially weak families going through struggle in america and compromising on many other things for financial reasons. But someone from a stable family with the possible education and job in these hospitals has the best life.
For a successful person ,India is the best for an indian , america is best for an american , japan is best for a japanese, korea is best for a korean and so on.
Life is very easy in India , you can have servants and drivers , can employ people. So life can be very comfortable in a different way. There is nothing more pleasurable than being successful and well placed among your own people.
I have noticed and compared life of doctors in the US and in India (my parents and late grandfather are doctors). In India there is a greater patient load , but in the US life is more stressful.
You mentioned Lilavati in Mumbai, I have seen and heard about several hospitals in big cities which are great.
You must have heard about a hospital in bangalore providing free cardiac surgery to poor pakistani children as a part of indo-pak peace process. Recently Dr Cherian in Chennai (Madras) is operating on 20 Iraqi children with cong heart disease. Escorts Heart Institute has a robotic cardiac surgery center (among the very few centers in the world). The chief of Escorts , Dr Trehan did residency from NYU.
The money these doctors ( and others working in big cities)earn in India has greater buying power in India than an average FMG earning in america and spending in america.
The expertise of these doctors is great also because of the volume of clinical load.
 
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Energon

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Very true. But what about US citizens/grads who want to work there on a consulting basis? Do you have any info?
I might apply for dual citizenship when it comes through... just trying to keep my options open.
 
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IMGforNeuro

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i have heard about foreign doctors coming to india in CMEs and conferences. Regarding full time consultation i think with dual citizenship it should be fine.
I am not very sure of doctors working in these hospitals part time though. Most of these are full time clinical consultants , but many also work as part time consultants in other hospitals. Like most of their medical practice is in these hospitals but they also do a few hours of consultation in other hospitals.
 

Energon

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The only reason I asked is because my parents are nearing their retirement age and are currently in a house hunting process in Bombay. When this happens it will be really convinient for me to visit/work for a few months and come back to do the same here. Change of scenario always helps me stay motivated.
 

IMGforNeuro

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Bombay is a great city. Has lots of good hospitals. Most of my parents social circle is among doctors in delhi , but what i have heard is that with US residency/fellowship you can get attachments in good hosps in big cities. To be honest incomes of doctors is greater in mombay compared to delhi. You will find doctors even having mercs in bombay and many of them ( of course with some seniority) . But that is not the point , their patient base is from the rich corporate class , film industry , bureaucrats and politicians. So the overall quality of life and fame is fantastic.
I know from personal experience that a lot of money can be made in these cities with very good quality of life. Just to inform you that the consultation fee in bombay is 750 rupees for a single patient visit. Imagine if you can make this amount in a few miutes. Incomes of many doctors range in lakhs of rupees a month. So you can imagine they have a lot of buying power in india. In delhi consultation fee ranges from 500 to 650 rupees. I am very confident and have seen many cases in which people with good residencies and fellowships have made it to this level. I think it takes some time and patience. The output of learning some advanced technique or procedure is much more there. I know of some surgeons who learnt joint replacements , keyhole spine surgeries and making a killing in delhi. Such opportunities exist in non surgical fields too. Learn some good tech in cardio , GI etc and there will be people to take you. I have done some ground work in neuro which is my field of interest. Infact i was a neurosurg resident in delhi so i studied this very carefully.
Personally , i think these people are very practical , they do the best of everything , learnt new things from a good set up and then work in a place which has a lot of potential (good market).
You have been in the US long enough to realise that medical technology advances fast. In india there are great training centers , but insufficient to supplement the needs of one billion people. It is something like introducing a new product in a market and making good money and earn respect because it is in the field of medicine.
I have seen a lot of big hosps coming up in delhi in the last few yrs. Ranbaxy is also planning to make a big corporate hosp. I am sure bombay is also expanding on the same lines with navi mumbai and other suburbs developing. One physician was telling me that it is important to see opportunity where others don't see.
However many physicians trained in india , of couse they are not subspecialised feel the stress. This is where US residency and most importantly fellowships just pushes us above the rest.
I know in my city one guy did DM nephrology and did another nephro fellowships in US and is now working in apollo. Another guy did epilepsy fellowship from cleveland clinic and working in a good hosp too.
I am sure you will come across people in bombay too.
 

Energon

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Thanx for the valuable info IMG

If you dont mind me asking, why did you decide to leave a neurosurgery residency from delhi? You could have finished that and done 1-2yr visiting fellowships in the states to subspecialize. That is what several of my dad's classmates from KEM (bom) did. Two of them who are orthopods and in a conjoint private practice; did fellowships in NYC (Hosp of special diseases). One guy did it in scope/ minimally invasive joint surgery, the other guy did spine. They are doing really well in private practice. They still come over every year to do lectures and buy equipment... but none of them are considering migration.
 

IMGforNeuro

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well , what should i say. I was adviced the same thing by my colleagues. It is just that ' the grass is greener on the other side' and sometimes you don't see reason untill you experience reality.
The temptation and ' virtual ' image of america. Now i know the pros and cons . Honestly now i have seen and compared so i feel i made this decision in haste. But still i can look forward to something good back home, provided i work hard and be practical.
I have realised that to making it good back home , EM and Family practise should not be chosen because they do not exist there , infact in no other country. I know of someone who did ER but could not find attachment there because all emergencies are dealt by gen med , gen surg and other specialities. All FP work is done by gen med.
I assume AMMD that your dad is also a doctor. Just for my info , how good are medical jobs in the middle east for US trained doctors? If you don't mind me asking , which specialities are you interested in?
 

Energon

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As a US trained doc, you are a paid higher than an Indian trained doc. Its wierd that they have 2 pay scales... I think its based on which country you come from. The ones who had done residency in US or UK were getting paid a lot and had the best of both worlds.
My old man was a pediatrician. He worked for the government medical system as a ped for about 10 years. He really didn't fancy clinical too much and thus took up a really great job with UNICEF/WHO doing disease control, his specialty being polio. We have left the middle east since then, but my dad still works for the UN and is currently stationed in Ethiopia. He is planing to retire from the UN in 2 years and move back to Bombay instead of living in the states although both him and my mom are US citizens.

However, if you are thinking about middle east, UAE is the only place I would go to. They are very liberal and the standard of living is very high. Oman, the place we were, was also a very liberal country with an extremely high standard of living, however in the recent years they have been trying their best to eliminate all expatriates from the work force and replace them with locals. So even if you go, there aren't as many desis there like before. YOu may find yourself isolated
pm me for more details.
 

Energon

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yes. EM and FM bad idea. Like you said Gen Med does most of this stuff there and they might actually be more proficient considering the volume they see. More so, for EM as a specialty, you need EMS in the area. By the looks of the traffic situation in Indian cities, the idea of any sort of EMS is virtually impossible if not ineffective.
Your best bet,
1. do something procedure based pulmonology, GI, Cards, Rads etc. which will make you an extremely hot comodity back home
2. stay in the US,
and if you really want to have an excellent career at home:
3. do some sort of a research fellowship in neurosurgery and then beg for your old spot or try get another neurosurgery back home (as someone with US experience).

It seems to me that neurosurgery is really picking up there... look up that India today article from one of the Nov issues which will give you more insight.
 

IMGforNeuro

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well you do have some good emergency services developing in delhi with a society supplying mobile emergency vans for services.
But the field of EM exists only in the US because of the system. Some of my friends in UK also feel the same way. It is just that people from different specialities deal with emergencies so they do not want to lose a part of their practice.
There is a lot of scope in medical practice in India in every field, now with health insurance sector expanding.
People in non surgical fields are also very successful.
Having experienced neurosurg residency , i have realised that there are many things which neurologists do which are not done by neurosurgeons. Every field is irreplacable.
 

Energon

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IMG, did you participate in the match? If so I hope you got your neuro spot.
 

IMGforNeuro

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I received my ecfmg certificate late so i will try the next yrs match .I am pursuing research now which is useful for a good neuro spot.
 
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Energon

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excellent. best of luck in the future man.

are you still thinking about the middle east as an option?
 

IMGforNeuro

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don't know . was just contemplating. It is just a few hours flight to india , so can think of visiting frequently untill i find placement in a nice hospital.
 

Energon

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I know 2 kids from bombay (I played with as a kid when I visited my grandma for the summer) who are now in the Middle east. One guy I know really well is an opthalmologist. He was freakin brilliant, did KEM medical school and then did an optho residency and a retina fellowship in some big name institution in hydrabad. He worked in Kuwait for 5 years (just resigned this year), saved up enough money and is in the process of starting up his own practice in bombay. worked out really well for him.
 

IMGforNeuro

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Honestly, i am thinking on similar lines.
I also know of some people who did this way. Plus middle east is closer to home, so easier and less expensive to visit . Infact can visit frequently from there.
 

Energon

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if you live in the middle east, the travel to home and back is free!!! it is the employers responsibility to an expatriate employee.
 

ericdamiansean

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  1. Resident [Any Field]
I'm currently studying for my step 1, taking it after i finish my pre-clinical years. Hope to do internal medicine and later on specializing in geriatrics.

I would like to go to US because I feel that's a great place for me to learn

Asia's a good place for clinical training, and the US would complement it
 

drdoc

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I m a doc from Mumbai passed 1993 followed by GP. M now prepariing for USMLE 1.
Would like to know what job options or other options one has to keep oneself engaged in similar fields until u reach the match stage while preparing for thses exams .
 

IMGforNeuro

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I would honestly say that before coming to US , clear usmle because it will be difficult to study and work here. I assume you would be out of touch with basic sciences for many yrs so it will take more effort to be done with step1. I have seen people many yrs out of med school try to take usmle. The best thing would be to take KAPLAN classes in mumbai. This will be of tremendous help. I have heard of many practising doctors taking kaplan.
In the US you should search for residencies which will take old grads. Try to do observership or research here and get letters of recommendation.
 

drdoc

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hi tx for ur reply..
I m currently in uSA on a dependent visa. N just started reading for the USMLE.
Hmmmm so is it possiblle to get observership or soemthing related while m studying..so i cud be inntuch with feild whiel preparing..
n me being an old grad, will it concern my residency application

tx
 
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Premedtomed

IMGforNeuro said:
Honestly, i am thinking on similar lines.
I also know of some people who did this way. Plus middle east is closer to home, so easier and less expensive to visit . Infact can visit frequently from there.



Good luck to you dude. I am a US resident and will be going to medical school here and also practice medicine here.
I feel that you are luckier cause you will be staying close to India. Have fun. :thumbup:
 

IMGforNeuro

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drdoc said:
hi tx for ur reply..
I m currently in uSA on a dependent visa. N just started reading for the USMLE.
Hmmmm so is it possiblle to get observership or soemthing related while m studying..so i cud be inntuch with feild whiel preparing..
n me being an old grad, will it concern my residency application

tx
It is possible, but you will have to search for places that allow observerships. The other advantage is that you will get a US lor. If you have time , try to do a phd, but i think it would postpone your residency by a few more years.
Don't mind it, but try for primary care residencies (because of so many yrs from med school). A US LOR would make your chances better for primary care residencies (int med, FP, PEDS)
good luck
 
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