Ihear its getting much harder to come back to US for IMGs???

[Dung]

Hello,
I am going to be starting IMG medical student at the carribean and I am told that its getting INCREASINGLY difficult for us to come back to the US for ANY RESIDENCIES. Is these true??? I thought as a Ross graduate student (one of most prestigeious carrbean institustions), I will have about equal chance, almost, as the US students?

I am hoping to become a vascular surgeon or cardiac surgeon. I think its great to fulfill by life dreams. Please tell me the truth. Is it true that US policy will eventually make american medical graduate to residency spots 1:1? I don't want to have my dreams shatter.

Also, I am a green card holder, so I have all priveleges of US citizen. I am assured I will get first shots over those IMG's without green card, like people who only have visa.

Thank you so much for your help!

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[Besyonek]

If someone has told you that you'll be able to become a CT surgeon after going to Ross, they were either deceiving you or don't know what they're talking about. Those few people who make it through a beach school end up largely in the unfilled residency spots that US med school grads didn't want to fill; i.e., family medicine in Arkansas. Now before anyone sends me hatemail in rsponse to that last comment, I'll note that I may very likely go into FM myself, and have actually been to Arkansas, a beautiful state. It's just not a mecca for graduate med education.

Anyhow, you get the idea. Sure, there is that rare beach school grad who gets a competitive residency. There are also a handful of people who've won the lottery after buying a ticket at the 7-11.

If you want to achieve your very lofty (and admirable) goals, STAY IN THE US!!!! If your stats are weak, retake the MCAT or take some more science classes. Or do some research or get some clinical experience. Don't go to the Carib unless you have $$$ to waste and like to be disappointed.

By the way, don't use the words "prestigious" and "Ross" in the same sentence. It's an oxymoron.

Yes, it is true that it is getting more difficult for IMGs (including those from beach schools) to get back into the US. Please do some more research before you throw your future away on this venture.

On edit: having a green card will not put you at the head of the line in front of other FMGs. Rather, the fact that you went to a Carib school will put you at the end of the line behind ALL US med school grads, whether or not they are citizens, green-card holders, or foreign citizens.


[This message has been edited by Besyonek (edited March 31, 2001).]

 

[ElainePirrone]

For a list of the residency positions received by Ross University graduates, including residencies in surgery, you can contact the Office of Graduate Affairs at:

[email protected]
(212) 279-5500 x 621

 

[Stephen Ewen]

I have been hearing this too.

And hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it and hearing it....

 

[kimberlicox]

<font face="Verdana, Arial, Helvetica" size="2">Originally posted by Stephen Ewen:
I have been hearing this too.

And hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it, and hearing it and hearing it....•

Yep as I believe I posted in the other thread by this poster, I have been around the medical field for nearly 15 years. And in that entire time I have heard "spots will be cut back to 110% VERY SOON" and "You will NEVER work in the US again" and "You will ONLY get residencies no one else wants". Blah blah blah.

While I don't doubt that change will eventually take place, given the past history, I doubt it will be any time soon.

 

[DrPeace]

hmmm

 

[DrPeace]

I think sometimes peope just like to spread negative rumors because to some people it's more fun talking about others' misfortune and impending dome than giving realistic hope. It's also fun to these same people because it makes them look like a mentor full of "wisdom". I used to call them "confucius-wanna-be". Just like there are more bad news about the economy than good ones

, but then in the end, nothing ever really resembles the '29 depression.

I was told by the whole world that I would be lucky enough to do residency in rural places, but then I ended up in California(Stanford), even got a pre-matched offer at Bayview Hopkins(not the main one, I wish!)and 4 other prematched offers from university-based hospitals only. HMMMMM????? Hard to come to the states??? Still a very difficult proposition to accept for me. Or I can be totally wrong because some people might have had a difficult time securing a spot...god knows why!

Kato

 

[jenavari]

If you look at the statistics from the NBME for this years match, the number of US citizen-IMGs and non-US citizen-IMGs that got residency postions increased by approx. 4 percentage points each. Your best bet is to contact the school you are interested in and get a list of this years residencies positions. (You can also ask for the past few years if you would like.)

 

[DDOg]

Dont listen to that fool about who said that crap about foreign medical schools. I ask everyone why do these people feel that they have to put down the FMG graduate. I talked to both my brothers (one an MD in Emergency mdicine) the other A D.O. in orthopedic surgery, and asked them why these schools are being shot down. Is it becuase it is easy to get in? If so explain to me please about minorities who get in well below the GPA requirements in US medical schools? No one can talk now. I encourage your decision to go and fulfill your dream. DOn't give room for anyone to shoot it down especially someone who hasn't even applied themselves.
All the best to you. I am sory to sound rude but I am getting so sick of the same crap being told by people who have no idea of what they are talking about.
However, the policies will change for foreghn graduate students but also keep in mind that 35% of current residents are foreign. Peopl like to depict them as beach schools becuase the honest tuth is that the FMG is a threat to the MD. Otherwise why all the anger and need to put FMGs down.

 

[Josep]

In my opinion is not becoming harder being IMG and get a good residency position, maybe is harder every time the requirements to be able to do it ( Visas, CSA...) but once you have it I think is becoming easier, if you look statistics every year there are less IMG applying and the match rate has increased from 30% a few years ago to 45% this year.
Also I think for residency directors is very important where an IMG has gotten the MD, because in my opinion an IMG from the caribbean is someone that has not been accepted in the US and otherwise an IMG from an Western European country can come from a prestigious university with the same quality as a US med school or even more.
Also going to an European med school( is the sistem I know ) is extremely difficult and only the people with great scores can accede because in Europe almost all the med universities are public so it means that only you can accede for you intelligence not for your bank account.

 

[Dreamer]

From what I have heard and from my own experience it is reality that IMG have hard time to get residency. I do not know about Caribbean schools though heard different opinions but if you are from Europe especially Eastern Europe its tough. They DID CUT residency slots to almost 1:1, I was told it by one of the program directors. Now the programs are choosing basically only cream of the crop from IMG. The rest of us have hard time. Green Card, US Passport or Visa don't matter. If I am not mistaken they reduced available slots in 1996. Until 1998 it ws almost impossible to hear about unemployed IMG who has ECFMG Cerificate. Now I know quite few, including myself. I do not complain that I couldn't get into residency, may be I dumb though its doubtful for I am attending teh Law School now to be MD/JD and it isn't easy to outdo half of class of native English speakers. What pisses me off is that few years ago the guy put up web page and started to line up signatures to sue NBME, ECFMG and so on for the fact that they concealed the fact of reducing residency slots and encouraged people to spend money and time. In few days he posted notice "I am not going to maintain the page any more". I know its speculation but I think he was offered the residency just to shut him up. I also know for the fact that nepotism works and if you know somebody you have the residency, works well on East Coast. It means that all attempts by NRMP to have unbiased system are useless. Also do not forget the CSA, what is designed SPECIFICALLY for IMG, I consider it to be discrimination, CSA is on eof the reasons that less IMGs are applying for the residency. If you are unlucky one you are not allowed to apply for the US MEdical School, you have to go and do premed, nobody cares about your Diploma, checked it out myself. But at the same time we hear about shortage of physicians, especially in underserved areas and recently I read in the paper that some guys are going to study medicine on Cuba and then they will practice in the underserved areas. BS, the paper said nothing to the public about ECFMG and residency, it will take about 10-12 years for these guys to be able to practice (Cuban med. school is 6 years, premed is included). What I do not get why can't goverment offer residency to desperate IMGs on a condition taht after residency they go to these areas and work there specified amount of years. But it looks to me politically beneficiary to talk about shortage and reduce residency slots. I personally couldn't get anything 2 years in a row, even on scrumble day. My analysis of offered and matched positins for the last 4 years show that amount of slots slowly decreasing but amount of matched positions dramatically increased. However if you look at the amoun of offered positions before 19956/96 you'll see the difference. I personally went to the Law School and feeling great, but I do and will follow the news concerning IMG and my dream today is to bring a suit in few years if the official fairytails about shortage of physcians and ECFMG ripoff continue.
Sorry for the long response.

 

[Bartas]

Hi Dreamer!

Could I ask you a few Qs about MD/JD?

[email protected]

 

[Cogito]

Ladies and gents,
I am an USFMG. I attend Ross U. After doing our basic science portion of medicine, we do a semester in Miami. Then we must pass Step 1 before we do rotations in US hospitals. We can set up our own clerkships as well. Some of the hospitals are top notch, others are average. I guess the point is, I feel that after I have made it through the basic sciences, done well on Step 1 and have been trained in US teaching hospitals, what truly (qualitatively) seperates me from a US grad. Sure I am a realist and I understand that Family Medicine is much more a reality than Neurosurgery. No matter where we are in life, we seem to want to protect the fragile ego. If we graduated from a US school, we may have that little voice telling us that we are lower than those from the IVY's. Some MD's value their MD status over a DO etc. etc. (I wish I were a Harvard grad making this point, then some of the die hard egomaniacs would add more credence to the truth). I think at the end of the day what will matter is the level of care we will provide. Is it possible that someone who so passionately thinks themself "better" because of where they attended has a serious ego problem, and someone who is willing to go through anything to make it to their goal will do the same for a patient?
Getting into Ross was not very difficult. Getting through the program is a serious accomplishment.
I honestly believe that anyone who is so impassioned about dissing DO's, FMG's has major insecurities. Why do you care so much to be so zealous in your views? Were you abused by an FMG? DO you feel that your US MD degree will make you a better physician? I truly hope that an attending in your residency will slap the self-gratified smile off your face. This will be for your benefit and your future patients as well.
Later,

 

[ceg123]

This is in response to the individual who critized "beach" schools.
Do you have information to back up you statements or are you talking here-say. I just don't think you are an expert in this area.

 

[R. Dale Jackson]

Originally posted by kimberlicox:
• Yep as I believe I posted in the other thread by this poster, I have been around the medical field for nearly 15 years. And in that entire time I have heard "spots will be cut back to 110% VERY SOON" and "You will NEVER work in the US again" and "You will ONLY get residencies no one else wants". Blah blah blah.

While I don't doubt that change will eventually take place, given the past history, I doubt it will be any time soon.

•

I thought it already happened? I believe it was called the "Balanced Budget Act of 1997," which wreaked all kinds of havoc on GME.

 

[joseph-arveson]

Originally posted by DrPeace:
•I think sometimes peope just like to spread negative rumors because to some people it's more fun talking about others' misfortune and impending dome than giving realistic hope. It's also fun to these same people because it makes them look like a mentor full of "wisdom". I used to call them "confucius-wanna-be". Just like there are more bad news about the economy than good ones

, but then in the end, nothing ever really resembles the '29 depression.

I was told by the whole world that I would be lucky enough to do residency in rural places, but then I ended up in California(Stanford), even got a pre-matched offer at Bayview Hopkins(not the main one, I wish!)and 4 other prematched offers from university-based hospitals only. HMMMMM????? Hard to come to the states??? Still a very difficult proposition to accept for me. Or I can be totally wrong because some people might have had a difficult time securing a spot...god knows why!

Kato•

Again, Thousand Year old universities in England still using the collegiate and honor school system are not what these people mean by "foreign."

You may have answered these before, or not want to, and I would understand in either case...but, may I ask..

What do you have against Oxford? Many people in here are right..the basic principles of medicine are the same where-ever you study them--did you think there would be a whole different body of knowledge there?

Did you attend Oxford as a school leaver or as a senior student after going elsewhere? Do you think that just the environment of being there affected you for the better regardless of the specific quality of the eduction? (Watch a movie from the '80s called "Educating Rita")...I read a thing a while back from one of the best computer science schools in England (Imerial College London I think, but wouldn't bet on it...) and the guy who does recruiting or admissions there was saying they can have a highest quality prospective student on the "hook" until the kid gets into Oxford or Cambridge and then he/she is gone even though those are weaker programs..and he said he would make the same choice... Don't you think you got something from just being there?

May I ask which college you went to? While I know most of the medical instruction takes place at the university level, I imagine someone might see the whole process dfferently if he were at St. Edmund Hall vs., say, Green...

Do you feel the honor school system is a good thing?..I know this year they began a provision for a few people to enter as sr. students and proceed to MB BCh without the BA first...how do you feel about it? Do you think students there would benefit from a 1 year liberal arts core before proceeding to an honor school?

I am very interested in any thoughts you have on this..and regardless if you choose to answer or not, I think you for all the posts you have written and for your time and consideration on this...

Joseph Arveson
[email protected] real email is broken AGAIN!!!...

 

[Winged Scapula]

Originally posted by RDJ:
•I thought it already happened? I believe it was called the "Balanced Budget Act of 1997," which wreaked all kinds of havoc on GME.•

Positions were cut back, but NOT to 110% of the current US allopathic grads - which is what the proposal was years ago that gets everyone frightened.

 

[Rusty]

Originally posted by Kimberli Cox:
•Positions were cut back, but NOT to 110% of the current US allopathic grads - which is what the proposal was years ago that gets everyone frightened.•

I believe you are referring to the 1995 report by the Pew Health Professions Commission entitled, "Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century." In that report, a number of sweeping recommendations were made including the reduction of medical school enrollments (both allopathic and osteopathic) by 20-25%. Also, the commission recommended that the number of medicare-funded residency positions be reduced to 110% of all US medical school graduates (both allopathic and osteopathic). This report was highly controversial as it was primarily based upon the research of Weiner et al and their questionable conclusions regarding physician workforce estimates which have not yet proven correct in the present health economic climate. This is a fascinating report and worth reading. I am not certain if it is available online.

 

[Winged Scapula]

Yep - that was it Rusty. Thanks - I couldn't remember the name of it and am not working on my home computer with its files containing such stuff.

People bandy about the 110% "solution" as if it were fact which is what irritates me. Obviously positions have been cut, entire programs eliminated, but for those who are flexible in their career and geographical choices there are still positions to be had for the qualified.

 

[Dreamer]

I am not sure that qualifications should depend upon your status as IMG. I still have in my files response from one big program saying "We do not accept Foreign Medical Graduates", at the bottom of the page was "Equal Opportunity Employer". The same I was told orally by a lot of programs when I was calling them to inquire about them and during the scrumble. Do not know about EOE there, they did not say it to me. But the fact is that even if slots are not cut to 110% they are cut. The loosers are IMG and patients, since it turned out there is lack of physicians in the country.

 

[Winged Scapula]

Dreamer -

In an ideal world you would be right - there would be no preference based on IMG status or citizenship. It would be based on academic, technical and personal qualifications.

I have seen the very same as well - programs which claim to be EOE but outwardly state they don't take IMGs, or programs and entire states which make it extremely difficult based on this status - regardless of your education, citizenship, etc.

However, that being said, I DO think it fair to prefer US citizen IMGs over non-citizens; its simply good politics and human nature to prefer your "own". The situation was much the same in Australia - had I wanted to stay I would have had a difficult time at best. 5 months into the new year, one of my classmates is still fighting with immigration to extend his visa so that he can work at the intern job he's been offered.

There is less bias (here and in Australia) in less favored parts of the country - you only have to look at more remote or inner city programs to see that they take a preponderance of IMGs; becomes a viscious cycle as programs which can't compete for US grads take IMGs which then pushes away US grads who don't want to be in a program known for being IMG heavy.

 

[Dreamer]

Kimberli-

I totally agree that its understandable that programs prefer US Citizens IMG over non-citizens. But here is a problem, you see many people who came here from Eastern Europe as myself or from other "Unknown" countries have heard about equality and democracy in the US, and after hearing about ECFMG assume that it works fair and then find opposite tough way. I admit I might blundled myself on the USMLE I, because I was not acquainted to multipe choice questions in three hours. However there are much more people who did better than I did and who are trying to get in year after year. Iwould prefer ECFMG gives some warning in their booklet that it takes more than USMLE and now CSA. Avbout programs in the underserved areas, I personally tried, no luck for some of them are not shure that foreigner can go along with teir patients who might not have seen immigrants in their entire life.

 

[Hopkins2010]

I think the solution would be to eliminate some residency positions from the urban doctor-overpopulated areas and move these positions to more rural/underserved areas.

That way, more American grads would be forced to initially practice medicine in rural/underserved areas without the govt spending lots of money on incentive plans to accomplish the same result.

Maybe the total number of residency slots should not be cut, but they should be redistributed to more underserved areas.

I do think American grads/US citizens should be favored over IMGs and noncitizens. Alot of these med schools are publicly supported, so the American applicants and their families have been pumping money into the system the whole time. I think its only fair to honor this over someone who has not contributed to the system in the past.

IMGs are just as qualified as American grads for the most part, so its not an issue of who are the better doctors. But every country on Earth favors their own citizens to some degree, and I dont think the U.S. is obligated to be an exception to this.

By the way, what is the current % of residency slots relative to American grads? People keep mentioning 110% as a future goal, but does anybody know what the current percentage is?

 

[spyyder31]

Cogito,
Could I email you in regards to your time at Ross U.?
Thanks

[email protected]

 

[kundun]

I agree wholeheartedly with baylor21. There is no question that each and every year many individuals are disallowed entry into medical school for whatever reasons those may be. However, I believe those who do get in, should not have to compete with IMGs both noncitizens and US citizens alike for postgraduate medical education. The UNITED STATES government funds graduate medical education...I believe a UNITED STATES citizen that attended a UNITED STATES medical school is entitle to that position.

 

[DrPeace]

I think if the "110%" cut is centrally controlled, then it can be accomplished instantly. And I don't reckon it will be accomplished within the next two decades or so. However, it is not that simple. It is an artificial systems created by human but can be as complicated as human physiology. But basically, it is extremely difficult to cut down training positions when there is a DEMAND. The residents here are already working themselves to death with the number of staffs available, we can't afford to lose even one. In fact, I wish there can be 10 more residenst so I can work in decent hours. I am working like 85 hours per week and I can't imagine who would take my shift if I were to leave the program. You have to understand that it is the "practicing" physicians who wanted to cut down so there will be less graduates to compete for patients later. They pretty much cover their ears and ignore everything else as long as their job security and income are possibly at stakes. In fact, my teaching hospital had been receiving messages from AMA and other relevent interest groups that tried to encourage us to cut down positions. But the hospital sees that as ludicrous and an almost impossibility. One of them even replied with a simple message, "Lovely statistics on the issues of physicians surplus. BUT who the hell is gonna cover the shifts?" But strangely enough, these interest groups DON'T listen to this BASIC fact. Doesn't matter you have the greatest theory on physician surplus and funding problems and legislative push and blah blah blah, the FACT is that I need THIS MANY residents to cover this many shifts, any less would require the residents to work A LOT more than a natural person can bear. And the paradox is that at the same time, they are trying to push more decent hours for the residents to optimise their stamina to ensure "quality care". Seems like these interest groups have no ideas what they are talking about. Even in bigger city like SF, the residents are still working like dogs. So how on earth is it possible to cut down positions even in this big city without affecting the number on a national level? Any ingenious ideas would be appreciated. This is a practical, LOCAL matter, not national statistics. Maybe it implicates that there IS a shortage of physicians. And of course in the interest of practicing physicians, they wouldn't want any studies to prove this. I am old enough to realise that JOB SECURITY and MONEY is most often the prime motivator in all sorts of agenda against training more doctors. And virtually ALL policies are stemmed from these two issues. And it is sometimes fortunate to have academic centers to train physicians rather than private doctors because the private physicians I have seen so far ARE so FREAKING greedy and selfish with regards to their practice that they wish they are the only physicians in town and patients wait for months on the waiting list to see them, and one of them even wish they should stop enrolling medical students for ten years so they can "ensure their bookings are full." On the other hand, they talk about all their noble acts and supreme service to humanity. IT MAKES ME SICK TO SEE SUCH HYPOCRISY.


Kato

 

[Hopkins2010]

My comments were based on the assumption (I dont know this to be true) that there is indeed an oversupply of residents/physicians.

If that is not the case, then my comments don't apply. Clearly we need to find out if, where, and how much of an oversupply there really is.

Kato, it sounds as if you are saying there is actually an undersupply. If that is the case, then of course they should not cut back on residency positions.

I have heard that the AAMC and AMA have stated that physician growth has been disproportionately large (even when adjusted to patient population growth) over the last 10 years or so. Maybe their findings are flawed, I dont know.

To some degree, these dynamics are market-controlled. If there really is a surplus of doctors in urban areas, then simple economics dictates that these doctors will find decreased opportunities for getting patients. I guess at this point most docs would STILL rather stay in an oversupplied market in an urban area instead of moving to a undersupplied rural area. Until the consequences of oversupply in urban areas become so great that its better for these doctors to move to rural areas, nothing will change. Of course, alot of people think that waiting that long for the market forces to drive the distribution of doctors is not in the best interest of our health care infrastructure.

Perhaps the govt agencies are jumping the gun on this issue and there is really not that much of an oversupply like they have stated. They need to do their homework and get their story straight. If there is not an oversupply, then I think that IMGs should not be inhibited; ONLY if there is an oversupply should we be cutting/redistributing residency positions, and in that case the US grad should be given SOME (not total) deference in comparison to the IMG.

 

[DrPeace]

You are right Baylor. I agree with you. I think they should OBJECTIVELY analyse the problem and come up with a solution without any biases. And yes I do agree with you that US grads should have some sort of priority because, hey, it's their country, simple as that!! Hahahahaha. Just like I would only leave all my money and real estates to my screwed up kids rather than my loyal butler!Hahahahah. And I think some people might misinterpret the concept of equal opportunities. I think it applies to underrepresented minorities who are citizens of United States under law. And you are right, the U.S. shouldn't have any obligation in executing this right to everyone in the world. If it does, it sort of defeats the purpose of being a US citizen.

Kato