1. Dismiss Notice
  2. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice
  3. Hey Texans—join us for a DFW meetup! Click here to learn more.
    Dismiss Notice

let's explore a common theme . . .

Discussion in 'Psychiatry' started by Arctic Char, Nov 12, 2005.

  1. Arctic Char

    10+ Year Member

    Joined:
    Sep 23, 2005
    Messages:
    1,061
    Likes Received:
    6
    Status:
    Resident [Any Field]
    so we all know about the debates and unending posts regarding IMG/FMg's and the stigma attached to MD's from overseas. but one thing that i haven't seen explored is: WHY? india, china, i understand. they simply have a drastically different educational structure. but Germany, the UK, and most notably Israel have excellent medical education (and israel has questionably superior technology than the US).

    so why does such a stigma exist, especially considering the USMLE is a generalized barometer of one's knowledge base. is it because of suspicions of an applicant's ability to adjust to a new hosptial system? that is the only thing i can think of. i don't know, i am at a loss.

    it reminds of a famous line about religions: why is everything so cool just because its from another country?

    likewise, why is someone considered inferior just because they come from another country?
     
  2. Note: SDN Members do not see this ad.

  3. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    I wouldn't say this is the general theme at all institutions. I think in reality we as humans just have an issue accepting things that are different from us, we will always find something or someone to not like or to ostracize. Its quite unfortunate because I think that a lot of FMG's have a very unique perspective they can bring to US medicine. For example, a resident I know trained in the Phillipines and was discussing how there, it is still quite common to keep the mentally ill locked in cages without protection from the elements. What does this offer to our medical society? A perspective on patient care we may not have had (they are pursuing research in this area and getting US grads involved), and a resident that is dedicated to protecting the rights of the mentally ill (both here and overseas). I'm not saying these things can't be found in US grads, but I do think unless you saw this first hand, you'd have no where near the devotion or drive to protect patients rights as this person does.

    Its ironic that many medical doctors consider themselves to be so worldly and intellectually driven, yet they can't even see past their own prejudices. I've been guilty of doing it myself at times, but I try to identify when I have issues and address them immediately. I think medicine as a whole should be a more worldly profession, especially since the entire idea is supposed to be to help people as a whole.

    This is not to say that I think FMG's should overrun a specific specialty, because here again,whenever you saturate any specialty with one type of trained individual over another, I think you lose diversity. Institutions should seek a balanced program with both FMG's and US grads as long as both are equally qualified. What I think is the saddest occurence is that people think residencies that have a lot of FMG"s or DO's are less competitive or no good -thats just downright insulting to all of the people that hold these degrees but is none-the-less a common idea.
     
  4. Miklos

    Miklos Guest

    Joined:
    Nov 26, 2003
    Messages:
    729
    Likes Received:
    0
    Status:
    Resident [Any Field]
    IMO, primarily because IMGs (in whatever form) are perceived as unwanted competition by many US grads, who feel entitled to "their" residency spot.

    [I will merely point out in passing that IMGs very rarely and only under near exceptional circumstances outcompete US grads for competitive spots.]

    As for me, I've decided to judge (yes, we all do that, whether we admit it or not) physicians strictly based on their abilities regardless of their "sheepskin".
     
  5. Arctic Char

    10+ Year Member

    Joined:
    Sep 23, 2005
    Messages:
    1,061
    Likes Received:
    6
    Status:
    Resident [Any Field]
    IMGs very rarely and only under near exceptional circumstances outcompete US grads for competitive spots

    thats the crux of the question though. yes, thats the trend. but the question is why? are PD's just tunnel-sighted by the familiarity of US transcripts? i'm sure that has a lot to do with it.

    i only ask because i have recently read so much about medicine in Israel and how fanstastic it is. their curriculi seem so advanced in the training of patient care in parallel with advanced technology. their hospitals have more beds, and do more procedures, and are all the while more efficient than in the US. i mean, i read this and feel like i should go there to train!
     
  6. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    Perhaps you could go there and do part of your training - there is an option for international electives for some residency programs - just check Frieda and it will say it on the survey whether they allow them or not. I think just getting a residency in another country is a bit more difficult though - but I'm not sure. If you're matching this year, you should talk to the PD's at the programs you're applying to, I'm sure they'd have some insight into this.

    MIKLOS: "IMO, primarily because IMGs (in whatever form) are perceived as unwanted competition by many US grads, who feel entitled to "their" residency spot."

    I don't know that I agree with this, since it seems some US grads don't even seek positions that are primarily (or should I say historically) filled by FMG's, do you really think they would percieve them as competition? As I had stated before, it seems more like a lot of US grads attempt to avoid those residency positions. This I've gotten from reading a lot of the posts here, and from talking to a few applicants, this definitely is not something I've run into consistently though.

    However, I will say (and I will NOT disclose which program it was) - a program did NOT want me to interview on a specific day that they were having FMG's interview and the coordinator slipped up by telling me this- I was SHOCKED to hear this, and mortified that some of my counterparts would actually "not consider a place because they have a lot of FMG's" :eek:
     
  7. Hurricane

    Hurricane Senior Member
    5+ Year Member

    Joined:
    Aug 14, 2005
    Messages:
    977
    Likes Received:
    3
    Status:
    Resident [Any Field]
    So what do they do with their FMG residents on interview days? Hide them in the closet?
     
  8. mosche

    mosche Senior Member
    5+ Year Member

    Joined:
    Aug 10, 2004
    Messages:
    473
    Likes Received:
    0
    I tend to agree with Miklos (i.e. FMGs/IMGs increase the competition). I also think that it also extends to DOs, PAs, and even to psychologists -- though there are other considerations as well.

    Why?

    We all want to graduate and make the money that those who have gone before us have made. With the increasing influence of HMOs and the reduced compensation from Medicaid/Medicare, I think that we view any additional influences on our desired incomes as a threat. Thus, Pathologists and Radiologists hate outsourceing. Psychiatrists vehemently oppose psychologists wanting to perscribe medications -- though the arguement tends to focus on "medical training", which IS LEGITIMATE, but could be easily rectified by incorporating it into psychology training.

    BTW, I'm not trying to start a war!!!!! I'm just giving my observations/opinion, and I am very aware that I may be wrong! :thumbup: :thumbdown:
     
  9. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]

    TROUBLE MAKER MOSCHE!!! just kidding :D Mosche, isn't my avatar CUTE? hehe <wink wink>

    However Mosche, I don't know that there really is an overabundance of docs that we're competing for salaries for whether they are IMG or US grad - I think there is a definite need for physicians across the board.

    Hurricane: I KNOW RIGHT? I can't say much, except that this program apparently even has a lot of FMG's, something which is odd since they did not want to interview both at the same time?! Perhaps its because of some comments US grads have made that make FMG's feel uncomfortable? I have no idea, but I was surprised and quite honestly offended that it occured at all because I would HATE for someone to think that most US grads are like that, which I hoep they are not - and btw, I let the coordinator know I have NO PROBLEM interviewing with FMG's because it doesn't matter - a good doc is a good doc is a good doc is a good doc - I don't care who you are or what your title (DO, MD, US grad, FMG, IMG-foreign national) who cares as long as you are good to patients and know your stuff!
     
  10. Solideliquid

    Solideliquid Members Only
    5+ Year Member

    Joined:
    Aug 22, 2005
    Messages:
    898
    Likes Received:
    1
    Status:
    Resident [Any Field]
    I think most of the stigma is being attached to IMG's from caribbean schools.

    First off, many people attach the idea that IMGs from caribbean schools are inferior. Not to say that many schools in the caribbean are better than the US schools, I will say that a small number of caribbean schools are as good as many mid-level schools in the US. And I will go as far as saying the top three caribbean schools are better than some of the low-end US schools IMHO.

    Boards can be a problem for some coming out of caribbean schools, the problems arise from the school not being able to spoon feed the students USMLE material as the US schools do. I think if an IMG or FMG passes the USMLE boards there shouldnt be any stigma about his or her education.

    Poety - HOW CUTE!!!
     
  11. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    <blush> thanks :D <beaming mom>
     
  12. mosche

    mosche Senior Member
    5+ Year Member

    Joined:
    Aug 10, 2004
    Messages:
    473
    Likes Received:
    0
    I agree with the "stigma" arguement. I think that this same arguement extends to DO schools as well. In the general residency forum there is a thread in which one student asks whether she/he will be able to get into a competitive residency if she/he decides to go to a DO school. The answer is: Probably. However, there are PDs out there who, out of ignorance or out-right bias, would discount a top-notch DO student into their program, in favor of a lower calibur MD student, because they view DO schools as sub-par.

    But I still think that there is some truth to the salary paradigm. When discussing bias, reality is often relegated to a tertiary consideration. So, while there may be plenty of room for everyone to play, perception is another issue.
     
  13. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    What tertiary consideration Mosche? I'm a simpleton here and I got lost with this statement :oops:
     
  14. mosche

    mosche Senior Member
    5+ Year Member

    Joined:
    Aug 10, 2004
    Messages:
    473
    Likes Received:
    0
    i.e. No one want's to admit that they are all about the money; so, people put up smoke screens to hide the real issue. Thus, they offer arguements like: "IMGs are not as well trained", "DO schools are for those who can't get into an MD program", etc.... Such arguements force their victims --IMGs and DOs-- to defend themselves against the attacks, and the real issue is never addressed. Therefore, it has become a "tertiary" consideration at best.
     
  15. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    Ok, but I'm confused as to why this would be an argument, do people think they aren't going to get a job or something? Who is putting up the smoke screen? Residency programs? I don't see how this would apply to the US grads, I know I know, I'm just not getting it sorry!
     
  16. mosche

    mosche Senior Member
    5+ Year Member

    Joined:
    Aug 10, 2004
    Messages:
    473
    Likes Received:
    0
    The OP asked about the stigma. I posit that the stigma is actually entrenched by those who fear that their pocket-books will be negatively affected should the stigma cease to exist.

    Heck, I dunno -- I'm just a bored fourth year who has nothing more to do on a Saturday night that speculate about silly stuff on SDN!

    BTW, I read your IM, and I will NOT be held responsible for your inability to understand my dribble -- you are a mother, therefore you should have already passed "Dribble 101"! :hardy:
     
  17. Poety

    5+ Year Member

    Joined:
    Dec 22, 2004
    Messages:
    2,227
    Likes Received:
    1
    Status:
    Resident [Any Field]
    :laugh: :laugh: so I'm not the only one stuck on here for lack of something better to do? You got baby makin you could be doing right? :laugh: Then you could be just like me, sitting here with a little one sleeping next to you. And by the way, I felt the SAME way after I posted that thread about illegal questions, you ever go back and go, what was I thinkin? :laugh:
     
  18. mosche

    mosche Senior Member
    5+ Year Member

    Joined:
    Aug 10, 2004
    Messages:
    473
    Likes Received:
    0
    Shhh! Don't say "baby makin". People read this stuff ya' know! :laugh:
     
  19. Miklos

    Miklos Guest

    Joined:
    Nov 26, 2003
    Messages:
    729
    Likes Received:
    0
    Status:
    Resident [Any Field]
    I have trouble believing this from a strictly financial standpoint. Although the U.S. wastes a lot of money delivering healthcare, it still spends 14.2% of GDP on healthcare versus 9.1% in Israel. In addition, Israel's GDP per head is roughly half of the US at direct exchange rates.

    http://www.who.int/countries/isr/en/
    http://www.who.int/countries/usa/en/

    That's not to say that there aren't excellent facilites in Israel. The question then is whether you are then comparing the best of Israel with the "average" US facility.
     
  20. Miklos

    Miklos Guest

    Joined:
    Nov 26, 2003
    Messages:
    729
    Likes Received:
    0
    Status:
    Resident [Any Field]
    Much of it is, but I believe that it goes much farther than that. As many of the non-US IMGs are from developing countries, one always wonders about an element of racism.
     
  21. Solideliquid

    Solideliquid Members Only
    5+ Year Member

    Joined:
    Aug 22, 2005
    Messages:
    898
    Likes Received:
    1
    Status:
    Resident [Any Field]
    That may be true, but I think most caribbean schools cater mostly to US-citizens far more than people from that actual island or other countries.
     
  22. Miklos

    Miklos Guest

    Joined:
    Nov 26, 2003
    Messages:
    729
    Likes Received:
    0
    Status:
    Resident [Any Field]
    Right, but what I meant was that the majority of IMGs are not US-IMGs.

    See http://www.nrmp.org/res_match/tables/table2_05.pdf

    For last year, there were 5,564 active applicants in the match who were "true" IMGs (or using the terminology of the NRMP, non-US FMGs) versus merely 2,091 US IMGs (NRMP: US FMGs).

    If we look at the geographical distribution of the IMGs, the best public source I've found is an old annual report by the ECFMG.




    Note that this is a straight comparison between Indian citizens and US IMGs. When accounting for all the other countries, many of which are in the developing world, US IMGs are (no matter where their med school) a minority in comparison to the true IMGs.


     
  23. Solideliquid

    Solideliquid Members Only
    5+ Year Member

    Joined:
    Aug 22, 2005
    Messages:
    898
    Likes Received:
    1
    Status:
    Resident [Any Field]
    Wow, that was great research!!!

    How can you find all that stuff at this late hour? I'm debating going to the kitchen for a glass of water lol.
     
  24. Miklos

    Miklos Guest

    Joined:
    Nov 26, 2003
    Messages:
    729
    Likes Received:
    0
    Status:
    Resident [Any Field]
    Well, I've got a couple advantages going. First, I'm on Central European Time. Second, I must admit that I've posted that bit of info at least 10 times on other fora.
     

Share This Page