I will but yes I also see this conversation is going no where. Have a nice day. I hope you can change your stance and learn to be more supportive of your colleagues. If they pass Medschool and USMLE's they deserve a chance at residency. That is my view.
It was about the ability to practice law. I think you missed the point.
It’s your fault. The school has no obligation to tell you. And besides it’s not part of their business plan.
1) No one is persecuting you, just as no one is forced to go to the Caribbean for medical school. Again, the outcomes data for Caribbean medical schools are widely available to anyone who does their research. If you went to the Caribbean expecting to get a residency position just because you passed some tests, well, that's on you for having unrealistic expectations and for not having done your due diligence prior to making one of the most consequential (and expensive) decisions that a 20-something year-old can make.
I did not see @RJ McReady as playing "judge, jury and executioner". I would recommend that you stop being so defensive, and to rein in your emotions. If this is the way you behave in real life, this type of emotional instability can get you in real trouble especially as a resident who is often at the mercy of their program. Best of luck.
There is certainly a way to make a case for expanding GME in the United States. Unfortunately it has not been demonstrated in this thread.
The match rate for IMGs has drastically improved in recent years. A lot of this has to do with spot expansion and osteopathic GME spots being converted to ACGME
We should be hiring the best and brightest, period. This isn't Europe, people earn what they're qualified for and don't get handouts. I want to be working alongside the best doctors, not the ones that happen to be Americans
American Medical Graduate (AMG) - US citizen or PR, graduated from a LCME or AOA-accreditted school
The fact that you believe this just kills your argument.
>98% of IMGs remain in the US to practice. And you're right, a MD is a MD. That's why I don't advocate taking one over another based upon where they happen to be citizens of. Taking US citizens that barely scraped by or have big red flags over highly qualified international graduates would be a disservice to the taxpayers of this nation. We owe them the best care, not care provided by people who happen to be locals
Higher test scores don't mean you will give better care. You have no evidence of that. Another myth being propagated. Please enlighten me if you have a paper that goes into how to determine who will give the best care. Where did you get your 98% stat? Locals who have higher culture competence, close ties to their patients and better communication ability I think would give better care. This is an opinion.
I am an American Medical Graduate. I am an American and I am a medical graduate. I refuse to use this outdated terminology. I think NRMP and AAMC should revise this to better categorize their statistics and stop lumping in U.S. citizens into the IMG category since we are not international. My opinion.
I respect your Mom for her efforts and that is unfortunate that she could not practice clinically if that is what she wanted to do. I am not trying to displace FMGs. I just think the U.S. needs to take care of its own first. Remaining slots I am very happy to provide to FMGs.
Perhaps you are unaware that many FMGs come from places like Cambridge or Aga Khan to name but two, some of the best medical schools in the world?
Great Point! There are almost no alternative pathways for unmatched U.S. citizens and LPRs. You have to go back to school in order to utilize your medical knowledge. Such a waste of good talent that could easily fill in as a PA or LPN. There is Assistant Physicians in Missouri but this is still lacking Medicare payment approval so pay rates are close to minimum wage and there are restrictions for who can utilize this based on YOG and exam dates. PD's tell unmatched docs to go get clinical experience but don't realize how hard that is without malpractice insurance.
I am fine with that but there should be a separate match for FMGs after AMGs.
IMGs are more likely to serve underserved areas and populations that US grads don't want to or don't care to serve, precisely because they have no ties to any particular community. In fact, they practice in underserved areas at three timss the rate of US grads. Board pass rates correlate with Step 1 scores and we don't want people coming into our programs that won't pass their boards because it 1- seriously limits their ability to practice and 2- can get our programs shut down. Furthermore, many of the people who don't get ranked have disciplinary issues or other red flags, and we know that poor behavior in medical school correlates with board actions against physicians later.
journals.lww.com
I live in an underserved community and can't practice. So I do want to practice in rural family practice. I know 500+ unmatched doctors that would do the same. This mechanism to place FMGs into these roles is outdated and needs to be better regulated. All that stuff about step scores may affect the program if they don't pass their boards has truth to it. Fair, but nothing you said there has to do with better care being given by those with higher test scores which was your initial point. I think it is fair to say this is flip flopping and you don't have proof that higher board scores correlate with better care. Also, where is your proof on the 98% of FMG's stay? I mean I would imagine a lot of them stay because of medical reimbursement in America which is the impetus to come in the first place but there is nothing stopping them from leaving with $450,000 of U.S. tax payer funded training in their pocket. I would also point out that the unmatched would do residency for free if it resulted in them having the chance to practice.IMGs are more likely to serve underserved areas and populations that US grads don't want to or don't care to serve, precisely because they have no ties to any particular community. In fact, they practice in underserved areas at three timss the rate of US grads. Board pass rates correlate with Step 1 scores and we don't want people coming into our programs that won't pass their boards because it 1- seriously limits their ability to practice and 2- can get our programs shut down. Furthermore, many of the people who don't get ranked have disciplinary issues or other red flags, and we know that poor behavior in medical school correlates with board actions against physicians later.
Unprofessional Behavior in Medical School Is Associated... : Academic Medicine
ciplined by the Medical Board of California from 1990–2000 (68). Control graduates (196) were matched by medical school graduation year and specialty choice. Predictor variables were male gender, undergraduate grade point average, Medical College Admission Test scores, medical school grades...
I would contend that any accredited allopathic med school in the United States gives you roughly equivalent education and training as any other accredited allopathic med school in the US.
A great physician can come from any Medical School with equivalent training. That is why we have ACGME to make sure they are equivalent. There are plenty of great medical schools in other countries and I wouldn't look down my nose at someone who went to another country to study. The Medical curriculum is very similar no matter where you go to school especially for basic sciences. I would say your schools involvement in clinical rotations is an important factor and also how much they help with mentorship for residency is also a plus for U.S. schools.
I'll just put it this way- I don't think a guy with a 198 on Step 1 is going to be breaking any ground in revolutionizing medicine. The guy with multiple BMJ pubs and a 260 from India just might. I would rather that guy come to the states where he can obtain the resources needed to do research and change the world. The smarter the people we have in the field, the better off we will be. If I've got an esoteric question I need to work through to save someone's life, like the time we had a patient with an extremely rare 1:100,000 presentation that we caught by putting our heads together and thinking about it really damn hard, how much do you think the US IMG with two board fails on their record is going to contribute to the situation? And I never said they provide better care for patients, merely that they're better doctors more often than not and they're the ones I want by my side. Because being a doctor isn't just about patient care, it's about education, research, leadership, and knowledge, amongst other things. I want the person that brings a much of that to the table as possible, not the guy who happens to be from Jersey.
From what I've seen, a fair number of us are sympathetic to those in your situation as Caribbean schools prey on the desperation and naivetes of potential students. Most posters here have also been civil and have made factual statements that are backed by publicly available data. Just because you don't like the facts, doesn't mean that those stating them are "bullies". Perhaps somewhat ironically, the most outrageous statements and accusations in this thread have actually been made by you (e.g. saying that someone should be stripped of their license for disagreeing with you).
Ok these are all your opinions. Thank you for those.
They're why every time this legislation is pushed PDs and physician groups push back, it's bad for our country and the profession
I think you are taking my comments out of context. My comment about stripping his license was in regard to him blaming unmatched and not wanting to help other doctors in need and the ethical/moral implications of that. The fact that doctors are actively blaming 6,570 unmatched U.S. citizen doctors rather than attempting to help them with the many thread ideas I have posted is egregious. I think you and others are bullying because you are all repeating the same things and teaming up on the only person in the chat that has a difference of opinion with you (definition of bullying). This was a level headed decision. I am not angry. Please think about ways you may curtail your behavior to help the unmatched and bring light to this issue rather than blaming unmatched doctors for being in the situation they are in. For example, how many of those 6,570 doctors deserve it? How many of the 20,000 plus doctors that have been left behind deserve it? Why do you think that you get decide who deserves to be a doctor? Making judgements like this is purely and unequivocally not a helpful way to approach the situation. Also very unfortunate to see this from people who have taken the Hippocratic oath. Your comments are not not helpful and more harmful in my opinion.
Some people are simply unteachable and cannot be helped. Best of luck to you.
If that is true, it is funny that those PDs and physician groups think they know what is good for the profession because those decisions are not being made scientifically with evidence to back them up. The bottom line is we need all of our doctors and should be helping the ones who haven't matched.
I guess so. Good luck with your future endeavors and please try to help your fellow citizens and unmatched doctors if you have the chance.
The number of doctors is equal either way, the question is only where they come from and where they practice. Given that this nation has a crisis in underserved areas and community health clinics and that non-US IMGs fill these positions three times more often and have higher chances of passing the boards (thus keeping your program from being shuttered and costing the country doctors for years), the evidence is clear. Pick the best candidate, and often, that candidate will be a non-US IMG that will help in keeping your program afloat and helping you serve the communities that need it most
We need doctors. Qualified, vetted doctors. Just because you have an MD does not make you that.
Listen, I am a qualified, vetted doctor but have gone unmatched after graduating from medical school and all of my USMLEs. Remember 61% match rate that started this up from 50% in recent years? All of that is fine and good but I don't come from money and I didn't have support to apply to residency. I was already tapped out financially after applying for three years. I couldn't find clinical training and I took a position in research which took a long time to turn into a publication. My point was that we should not be charging people $3000 a year and filtering them out when they have no means of paying or improving their application. This prioritizes people who have family money or people of a higher social standing. I am talking on here about ways to change the system because I thought I would be dealing with open minded individuals who could empathize with others and because this is an open forum. I guess you all just want to hear people parroting back your own views rather than listening to someone who has gone through a difficult situation and has come out the other side with different views because of the environmental exposures they have had. I do think that every unmatched U.S. citizen MD and LPR deserves a chance at residency and it is unfortunate that you don't. Whatever the issue is we should be there to help them through it and at least give them a chance to finish their training for many reasons but mainly because it should make you feel like a decent human being.
Actually, the position being advocated, which lurks just below the surface, with OP's redefinition of American Medical Graduate as a US citizen with a MD degree, is that all US citizens with MD degrees and passing test scores should be matched before any non-US candidates, apparently including those who graduated from Harvard as well as any school in their home country. So, while increasing residency slots would certainly help, his bigger issue is using merit as a metric as opposed to citizenship, and not treating Caribbean MDs as equivalent to LCME accredited ones.
), because Stephen Miller, Trump and the Republican Congress of 2017 might have actually been receptive to something like this, but, whatever.It doesn't matter what the government thinks right? It more has to do with the private non-profits that run things. I think we don't prioritize U.S. citizens and LPRs as every other developed nation in the world does because people are making so much money the way things are currently set up.Actually, the position being advocated, which lurks just below the surface, with OP's redefinition of American Medical Graduate as a US citizen with a MD degree, is that all US citizens with MD degrees and passing test scores should be matched before any non-US candidates, apparently including those who graduated from Harvard as well as any school in their home country. So, while increasing residency slots would certainly help, his bigger issue is using merit as a metric as opposed to citizenship, and not treating Caribbean MDs as equivalent to LCME accredited ones.
Unfortunately, OP is around 4 years too late (apparently this wasn't his issue then!
Yes
I doubt that you will find any more open minded people then those that are on the SDN forum. I think that your attitude and accusatory nature turns people off. If you are looking for empathy, I would try to change the way that you are expressing your message. Just my opinion.
Whether they pay a US citizen or an IMG doesn't matter, the money is provided by the US government through Medicare with the goal of treating Medicare patients officially. Everything else is secondary.
So you think that people who graduate from schools outside the U.S. are just worse applicants and that is why the match rate is so low. I thought it was common knowledge that U.S. grads are prioritized. The reason they are being rejected is because there are not enough spots. That is what I am getting at and why I am suggesting the solutions I have suggested. All I am saying is that there are plenty of good applicants in the 6,570 U.S. citizen unmatched population and when doctors are burning out from COVID and need help it is a real shame we haven't trained them to help.
Yes it does. I detailed the economic loss's that make it matter. I'll say it again two matches. 1 for U.S. citizens LPRs and then for FMG's like everywhere else.
The net economic activity created by someone putting their money into the economy rather than student loans is much higher. The better solution would be to stop offering loans for students going overseas and forgive the loans of those that already have done so and not matched.
