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Some highlights:
>30K active applicants in match for 1st time ever.

More unmatched US seniors 1078 than PGY-1 spots available in scramble 1060
First time this has ever happened!.
So we are now looking at some US seniors who are going to be unemployed.

Dropping match rates for USIMGs (47.3%) and IMGs (39.8%).

More US seniors in primary care residencies.

I think it is safe to predict these trends will continue.
http://www.nrmp.org/data/advancedatatables2010.pdf
A lot of crowing here ( http://www.aamc.org/newsroom/pressrel/2010/100318.htm ) about more US seniors going into primary care. With the increases in med school enrollment more US seniors are going to be forced into primary care.
 
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Yeah, the "more US seniors going into primary care" is probably more a factor of them being forced into it. There are always a lot of good US seniors who want to do FM, but there are also quite a few who were forced into it.

I would love to know data about the 1000 unmatched US seniors and why they went unmatched. I suspect a lot of them tried to land fields that they weren't competitive for, and others ****ed up their rank list because they thought they were more competitive than they were. But there are probably others who just got squeezed out. I would love to know the factors involved and what these folks end up doing. If most of them who can't scramble into a spot (or those who scramble into something they don't want to do) re-enter the match next year, it's going to compound the problem.

Definitely agree the trends will continue. I think a lot of places are adding primary care residency spots - this is good and bad. Good because there are more spots, but bad because a lot of these places have really sucky training programs or shouldn't have them at all, and are only doing them to increase the hospital bottom line.

Also amazing that >50% of USIMGs went unmatched. That is a lot of tuition money being thrown into shady characters' pockets basically for no reason.
 
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Actually, when I look at that data, the number of unmatched US grads isn't that much different. It is over 1,000 this year but even in 2005 it was over 900. And it was over 1000 in 2007 and 2009. I guess the difference is number of positions in the scramble.
 
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Wow, that's really amazing to me that almost 1100 seniors were unmatched. I know some schools have very high unmatched rates for a variety of reasons, and not just because students were going for things like derm, or whatever.

I got three calls but no job. One program told me they had received 3200 eras applications and this was at 1245 or 1 pm. It is really a terrible, terrible feeling to be so highly trained and without a job. I would do something else if it made sense, but we are trained to be physicians (and I want to be one!) and our education and the loans really limit us to just keep trying. It's incredibly upsetting, an a very difficult process. :oops:
 
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Parietal Lobe

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Does the term "U.S. senior" include osteopathic students or is that just allopathic? If it's only allo, any idea how many osteo students who entered the allo match went unmatched?
 

funshi baba

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dont know the answer to that question, but according to past stats, only 70% of DO students that went into NRMP matched. I am one of those 30%. I wouldnt think its different this yr. Most of my close friends that i know that we all went into the NRMP match got a spot. Come to think of it, i am the only one who didnt match........... wow, i need a drink.
 

badasshairday

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Since we now have more than enough qualified US seniors, it is time to close off the match. It should be for AMGs only, most other countries are biased like this as well. There is nothing wrong with that, we are just looking out for our own.
 

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At our match day, the dean announced 100% placement rate (he did say match rate, but I know of several who didn't match and scrambled, as well as people who undermatched, ie, got prelim but not advanced, and a few who got advanced but not prelim).

Of those that didn't match:
-One couple must have messed up the rank list, because they were both Junior AOA, 260+ step 1's... she in particular (ENT... now a prelim in surgery with me this coming year) was a shoe-in at nearly anywhere.
-One guy who matched Peds Neuro at CHOP only ranked CHOP for Peds because they "assured" him a spot there... now he has scrambled into a Peds position in Baton Rouge at a program that is brand new this year

another undermatched (prelim but not derm) only had 4 interviews... others in rads i guess were just underqualified... tough year for some, but overall success at my school
 

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Since we now have more than enough qualified US seniors, it is time to close off the match. It should be for AMGs only, most other countries are biased like this as well. There is nothing wrong with that, we are just looking out for our own.
You wouldn't really need to close the match, just give funding preference. At any rate the AAMC has had the stated goal by increasing US school spots of driving the offshore (caribbean) programs out of the market, and I suspect this is a huge step towards that goal, because now offshore folks have to compete with US folks for every spot, even in the scramble.
 

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..... for our own.
Be careful with that phrase. Many IMGs are US-born/raised people who simply attend(ed) schools a few miles off the mainland.

But I do see what you're trying to say.
 

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A lot of crowing here ( http://www.aamc.org/newsroom/pressrel/2010/100318.htm ) about more US seniors going into primary care. With the increases in med school enrollment more US seniors are going to be forced into primary care.
You can't be "forced" into primary care. You have to match into it, just like any other field. If you don't want to do primary care, don't apply for it.

Believe it or not, we don't just want warm bodies. We want people who want to do the job, not people who will be pissed off every day because they couldn't match into (insert specialty here).
 

Law2Doc

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You can't be "forced" into primary care. You have to match into it, just like any other field. If you don't want to do primary care, don't apply for it.

Believe it or not, we don't just want warm bodies. We want people who want to do the job, not people who will be pissed off every day because they couldn't match into (insert specialty here).
Sure, but you cannot ignore the fact that a lot of the spots that historically go to IMGs are in primary care largely because those particular ones are the ones less sought after by US seniors. Now that US seniors outnumber spots, you are going to see lots of US folks taking these spots because they trained to be a doctor and that's the road left open to them. I agree the better primary care folks are going to be the ones who wanted to be there, but I don't think having US seniors taking what they can get will be any worse than having IMGs taking what they can get.
 

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Since we now have more than enough qualified US seniors, it is time to close off the match. It should be for AMGs only, most other countries are biased like this as well. There is nothing wrong with that, we are just looking out for our own.
I would agree with you if medical school admissions were fair.

Maybe it could be for US seniors and US citizen IMGs.
 

badasshairday

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I would agree with you if medical school admissions were fair.

Maybe it could be for US seniors and US citizen IMGs.
That would be fine with me. Just get rid of the prematch, that way everyone who has to scramble has a fair shot at it.

Do you guys think after this years match, the prematch rule will change? It looks really bad having so many AMG's not match with so few scramble spots available. It is only going to get worse from here on out.
 
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Ban all IMGs from the first match process like they apparently do in Canada, and promote them to a second iteration. Also, disallow this ******ed thing known as pre-matching, if programs are going to be allowed in the NRMP. Although I got my first choice and had many secure options, I am infuriated on behalf of people that were not able to get anything in the match after being a bona fide US grad, since some IMG prematched their spot or whatever.
 

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In Canada, there are two matches run in parallel.

One, with several thousand spots (enough for all the CMGs in Canada at about a 1:1 ratio) is for grads of Canadian med schools.

The other match, with about 200 spots, is for Canadian citizens/PRs who trained abroad (IMGs).

So IMGs are not excluded from the first iteration per se, but certainly there are only a handful of spots dedicated to them. However, this is the reason that you can see an "IMG" get a plastic surgery residency or ENT residency in Canada: there will be ONE dedicated residency position somewhere in the country, and one lucky IMG will get it.

The reason that these exist is because some outside agency (usually a province or a health region within a given province) has coughed up the cash to fund the spot (to the tune of $400K). Naturally, there is a return in service contract attached to each IMG residency spot (usual duration = 5 years). Typically, the health region is getting a family doc or general internist who grew up in the suburbs of Port Coquitlam, wasn't competitive enough to get into UBC, went to Ireland or SABA, and then comes back and serves a community for five years. Generally works fairly well.

There's no pre-matching in Canada - all residency positions are administrated through CaRMS. No exceptions.

There is no scramble in Canada - there's just a second iteration "match" where all of the spots - CMG and IMG - open up to everyone (there are exceptions to this rule, but in general this is how it works). Usually the ROS contracts remain attached to the IMG spots (even if a CMG fills it). Traditionally, the CMGs who are left over do VERY well in the second round (if they don't match in the US in the meantime).

I am surprised that the US currently has a system that accepts so many non-US grads; I can't think of another country that does the same. But it sounds as though, with increases in med school enrollment, that the US may be headed towards a Canadian-style matching process in future.
 

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I am surprised that the US currently has a system that accepts so many non-US grads; I can't think of another country that does the same. But it sounds as though, with increases in med school enrollment, that the US may be headed towards a Canadian-style matching process in future.
I have always been equally perplexed myself why up to a quarter of all incoming residents are imported and thousands of American citizens are shut out altogether. I agree with your assessment on the future as well. The party is about to come to an end. The hangover is going to hurt.
 

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I have been saying this for some time and I think this year's match results confirm this.

1) Pre-matches need to be eliminated
2) AMG's need to be given the 1st crack at all spots
3) US IMG's and FMG's should have a go at the rest

While some may say that US IMGs should fall with AMGs, I argue that they couldn't get into a US school and shouldn't be provided the same protection as those students who got through the admission process and into an LCME accredited school.
 

vhawk

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I have been saying this for some time and I think this year's match results confirm this.

1) Pre-matches need to be eliminated
2) AMG's need to be given the 1st crack at all spots
3) US IMG's and FMG's should have a go at the rest

While some may say that US IMGs should fall with AMGs, I argue that they couldn't get into a US school and shouldn't be provided the same protection as those students who got through the admission process and into an LCME accredited school.
Can you explain WHY this should be the case? I'm curious if there is anything other than naked self-interest and misplaced sense of entitlement motivating you. Why do you feel like you should be able to force residency programs to suffer for your own benefit? I say "your" because lets face it, you arent an IMG.
 

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Out of curiosity, does anyone know if the number of IMGs/FMGs that train in the US leave post-training vs. total trained?

I think because Medicare is funding (at least for 3 years) most of the available spots, there ought to be a service commitment that comes with funding (and subsequent) training. Though this also has the chance to become a slippery slope, because then it gives the gov't a foot in the door to decide where you work as a grad (in this case within the US vs. abroad) but the American people ought to get a return on their investment in training physicians. The requirement wouldn't have to be too long, maybe a 1:1 or 2:1 years of service per year of funding with a buyout clause something along the lines of paying back the funding invested in you x2 over the same time period you were funded by Medicare as a resident.

It won't stop many FMGs from coming here, as I'm guessing a great number of them come to stay, but it may cut down on coming to the US for training and going home to be a big fish in a little pond in BFE.

Just a thought.
 

vhawk

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There are more AMGs scrambling than there are positions available in the scramble. If you graduate from a US medical school, if you are US citizen, if you have passed all your classes, and if you passed the USMLE board exams, you should be ENTITLED to a residency in the US. It's absolute bullsh*t to go through this horrendous process, accumulate massive debt, and not obtain a residency in something.
So your answer is "no, I cannot explain why." Probably used a few too many characters to say it, but thanks for the prompt response.
 
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There are more AMGs scrambling than there are positions available in the scramble. If you graduate from a US medical school, if you are US citizen, if you have passed all your classes, and if you passed the USMLE board exams, you should be ENTITLED to a residency in the US. It's absolute bullsh*t to go through this horrendous process, accumulate massive debt, and not obtain a residency in something.
Vhawk: Read above.

Also, residency programs are not suffering by taking American students and not prematching IMG's. AMG's have been taught in a strictly regimented LCME-accredited fashion. You're getting a consistent product at baseline. A student from an IMG factory can study, find ways to master the USMLE (really, once you know the tricks, it's not that hard to get a very high score), go to some random community hospitals and get LOR's, and find her way to a prematch. Not to generalize, but one of the absolute worst H&P's I've ever read in my entire life was done by a Caribbean 4th year student from a "good" Caribbean school with great board scores; she thought she had an excellent document but no one had the heart (or the time) to tell her how bad it was, and the attending who would write her a LOR isn't going to read some random student H&P. These were glaring rookie mistakes that not even an American MS2 would make, because there are guidelines and requirements that say we have to learn how to do this well and get feedback, or we get reamed. I helped her out and she improved after that, and still pre-matched somewhere. Quality is inconsistent and the "objective" measures we currently have are insufficient to assess QC for IMG's compared to AMG's.
 

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What about the DOs? I can understand all the anti IMG sentiments but don't thousands of DOs match into allo spots when they have their own match? And don't they also have hundreds of empty slots, year after year in their own match?
 

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What about the DOs? I can understand all the anti IMG sentiments but don't thousands of DOs match into allo spots when they have their own match? And don't they also have hundreds of empty slots, year after year in their own match?
I believe there are a ton of primary care spots vs. other fields, and thus nearly all the spots left open are primary care or transitional year. Here are the results from the last 2 years:

http://www.do-online.org/index.cfm?PageID=sir_match08res
http://www.do-online.org/index.cfm?au=D&PageId=aoa_profmain&SubPageId=sir_match10res

2009: 2435 Spots - 1433 Filled = 1002 Open
2010: 2443 Spots - 1473 Filled = 970 Open
 

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vhawk

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Vhawk: Read above.

Also, residency programs are not suffering by taking American students and not prematching IMG's.
Of course they are. You know how we know? Because they are given a choice, and they choose some IMGs. Forcing them not to do this would cause them suffering. Its very simple.
AMG's have been taught in a strictly regimented LCME-accredited fashion. You're getting a consistent product at baseline. A student from an IMG factory can study, find ways to master the USMLE (really, once you know the tricks, it's not that hard to get a very high score), go to some random community hospitals and get LOR's, and find her way to a prematch.
Are you the smartest person in the history of the world? Do you think you are the first person to ever consider this? And yet somehow, for some reason, programs dont merely select AMGs to the exclusion of all others. I wonder why? Probably its because they are all just so stupid, and need you to make up rules to force them to do things "for their own good" right?
Not to generalize, but one of the absolute worst H&P's I've ever read in my entire life was done by a Caribbean 4th year student from a "good" Caribbean school with great board scores; she thought she had an excellent document but no one had the heart (or the time) to tell her how bad it was, and the attending who would write her a LOR isn't going to read some random student H&P. These were glaring rookie mistakes that not even an American MS2 would make, because there are guidelines and requirements that say we have to learn how to do this well and get feedback, or we get reamed. I helped her out and she improved after that, and still pre-matched somewhere. Quality is inconsistent and the "objective" measures we currently have are insufficient to assess QC for IMG's compared to AMG's.
If all of your nonsense was even remotely true, the it would not be necessary to say things like "Programs should fill spots with AMGs first, and then fill whats left over with the rest" because PROGRAMS WOULD ALREADY DO THIS!

The level of critical thinking from some is disheartening, and so often the gap made up by this lack is filled with "for their own good" justifications.

Why not just be honest? You are entitled to those spots! Someone OWES them to you!
 

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Why not just be honest? You are entitled to those spots! Someone OWES them to you!
Yep, we are entitled to those spots. If you go to med school in another country, then stay there and be a physician there. I'm sure they need you there more anyways.

Also if you couldn't cut it and had to go to the Carib's, sorry, tough luck you shouldn't be able to prematch either. With all the new American medical schools opening MD/DO alike, you should be able to get into an American Med school. We should get less spill over now since the people who traditionally went to the Carib's were either less than stellar students or good students who just barely missed out getting into a US school. Now that more US schools are opening, those good students who fell through the cracks and had to go to the Carib's should not have to do so anymore since we have more spots in the USA.

I know too many kids in college who were substellar students talking out of there asses like how they were gonna be doctors and make big money. None of them could go to a US med school so they flooded the Carib's and POLAND (wtf right?). For them, I could care less.

Just get rid of the prematch bull****, and we will all be happy. We'll even let you IMGs participate in the match. You should be happy with that.
 

badasshairday

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If all of your nonsense was even remotely true, the it would not be necessary to say things like "Programs should fill spots with AMGs first, and then fill whats left over with the rest" because PROGRAMS WOULD ALREADY DO THIS!
They would already do this... you have a point. But remember in the past, we had much fewer AMG's so there were always plenty of spots for the IMG crowd. Those programs didn't want to go unfilled, hence the prematch. But now, with so many AMG's not matching, and so few scramble spots, these programs should fill spots with AMG's FIRST, then fill what is left over with the rest.
 

Knicks

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I have been saying this for some time and I think this year's match results confirm this.

1) Pre-matches need to be eliminated
2) AMG's need to be given the 1st crack at all spots
3) US IMG's and FMG's should have a go at the rest

While some may say that US IMGs should fall with AMGs, I argue that they couldn't get into a US school and shouldn't be provided the same protection as those students who got through the admission process and into an LCME accredited school.
Well, then that is a poor argument, since you are assuming that [and therefore, making it sound like] that's the reason that US IMGs attend off-shore schools. There are a whole slew of possible reasons for US IMGs to do so.



Vhawk: Read above.

Also, residency programs are not suffering by taking American students and not prematching IMG's. AMG's have been taught in a strictly regimented LCME-accredited fashion. You're getting a consistent product at baseline. A student from an IMG factory can study, find ways to master the USMLE (really, once you know the tricks, it's not that hard to get a very high score), go to some random community hospitals and get LOR's, and find her way to a prematch. Not to generalize, but one of the absolute worst H&P's I've ever read in my entire life was done by a Caribbean 4th year student from a "good" Caribbean school with great board scores; she thought she had an excellent document but no one had the heart (or the time) to tell her how bad it was, and the attending who would write her a LOR isn't going to read some random student H&P. These were glaring rookie mistakes that not even an American MS2 would make, because there are guidelines and requirements that say we have to learn how to do this well and get feedback, or we get reamed. I helped her out and she improved after that, and still pre-matched somewhere. Quality is inconsistent and the "objective" measures we currently have are insufficient to assess QC for IMG's compared to AMG's.
Good thing you said, "Not to generalize....", because considering that, your post and long, bitter example doesn't hold much water.
 
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Law2Doc

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What's the point of increasing the number of US medical schools then. http://www.nytimes.com/2010/02/15/education/15medschools.html
Where are these new students expected to find residencies, given this years scramble statistics? Is the US government (i.e., taxpayers) going to spend more Medicare money for additional residencies, so that programs can continue to choose FMGs if they want? Something has to give.
Residencies previously looked outside of US seniors because they weren't filling the need. That US grads were the first choice is IMHO obvious by the fact that 93% of US seniors historically match, while something like 45% of non-US schooled applicants match. Now that US seniors approximate US needs, you are going to see a precipitous fall-off of successful non-US folks. Probably a deterioration of the prematch as well. If the small community programs that couldn't attract US folks suddenly find that they can, it may change how they approach the match. Time will tell. But this was clearly the AAMC's plan, if you look back to 2005 press releases (indicating that US schools should fill US needs).
 

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Well, then that is a poor argument, since you are assuming that [and therefore, making it sound like] that's the reason that US IMGs attend off-shore schools. There are a whole slew of possible reasons for US IMGs to do so.

Really what other reasons are there for a US citizen to go to an offshore med school?

#1) The vast majority are they couldn't get into a US MD school, plain and simple

2) Quicker programs (i.e 6 year programs in Poland/India elsewhere)- we have those in the US so those that choose to go elsewhere didn't apply or couldn't get into those

really what other reasons are there, there love of island life? the fine research being produced by these schools? I'd like to hear what pressing reasons one would have for picking a foreign school over a US MD school if your intention is to practice in the US.
 

badasshairday

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wagy27 said:
Well, then that is a poor argument, since you are assuming that [and therefore, making it sound like] that's the reason that US IMGs attend off-shore schools. There are a whole slew of possible reasons for US IMGs to do so.

Really what other reasons are there for a US citizen to go to an offshore med school?

#1) The vast majority are they couldn't get into a US MD school, plain and simple

2) Quicker programs (i.e 6 year programs in Poland/India elsewhere)- we have those in the US so those that choose to go elsewhere didn't apply or couldn't get into those

really what other reasons are there, there love of island life? the fine research being produced by these schools? I'd like to hear what pressing reasons one would have for picking a foreign school over a US MD school if your intention is to practice in the US.
the other reason is to enjoy the carib beaches and gloat in glee that they got into medical school just like you did, without having to bust their asses to get a high GPA, solid MCAT score, and good extracurriculars. "Weee, i'm gonna be a doctor to" is what they say as they skip off to the beautiful islands (or poland, india, insert country). :laugh:

Sorry, that was mean, especially to some of the good students who come from overseas, but honestly that is my experience with the vast majority of them. Too many tools from undergrad have led me to believe that the majority are like this.
 

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really what other reasons are there
I'm not here to list the reasons for you, nor do I have the time or energy.

Your sarcastic reasons aside, there are other legitimate reasons for US citizens to attend off-shore schools. If you 'really' want to know what they are, then God speed in your search.
 

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I'm not here to list the reasons for you, nor do I have the time or energy.

Your sarcastic reasons aside, there are other legitimate reasons for US citizens to attend off-shore schools. If you 'really' want to know what they are, then God speed in your search.
It's not unfair or out of line for him(her?) to ask for what you view as the "real" reasons that many students attend island schools. You have refuted his reasoning, sans explanation, but offered no real counterpoints. It equates to saying "Nah nah nah," on the playground in elementary school. It would help your position to offer what you view to be the legitimate reasons people attend international medical schools, only to return to the US for residency training.

FWIW, I don't intend this to be an attack on you, but if you want real discussion, you have to participate in one to a degree greater than your above contribution.
 

Knicks

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It's not unfair or out of line for him(her?) to ask for what you view as the "real" reasons that many students attend island schools. You have refuted his reasoning, sans explanation, but offered no real counterpoints. It equates to saying "Nah nah nah," on the playground in elementary school. It would help your position to offer what you view to be the legitimate reasons people attend international medical schools, only to return to the US for residency training.

FWIW, I don't intend this to be an attack on you, but if you want real discussion, you have to participate in one to a degree greater than your above contribution.
Fair enough. :)
 

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The trend is inevitable for anyone who looked at the numbers and had some common sense. I don't know why this is a surprise to anyone. There are many threads talking about this. It will get worse with each year until we reach a plateau starting in 2016. That's when the class of 2012 graduates. Remember that the AAMC's goal is to have 30% increase in enrollment by 2012 over 2004 numbers. It's gonna suck trying to match in the future, especially if you're an FMG.
 
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Yep, we are entitled to those spots. If you go to med school in another country, then stay there and be a physician there. I'm sure they need you there more anyways.
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I graduated from a nice prestigious European medical school. I would love to go back there and practice there. But my fate brought me to the US, I followed my family here. So now what? Flip burgers for the rest of my life? Toss 6 yrs of my hardship in garbage?
So I flipped my burgers and waited my tables for a year while taking my steps and etc.
I am now a proud resident at a university hospital and I am doing better than most of my peers.
Let the hard workers get what they deserve, no matter where they come from.

For some IMGs getting a residency in US is not :hungover: an option.
 

Knicks

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....Let the hard workers get what they deserve, no matter where they come from....
Pretty much irrefutable. :thumbup:
 

Law2Doc

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Pretty much irrefutable. :thumbup:
LOL. Except for the fact that no other country takes this position. So you are asking the US to open it's doors to the best of the world, while the world wouldn't reciprocate. There are lots of good reasons for being self sufficient as a profession -- to have US generated students fill US needs. You never want to be in a position where you have to import talent, particularly when the need is something as important as healthcare. Every other country on the planet realizes this. The US realizes this too, but has been slow to close the door. It's closing now. Additionally, when you invest so many hundreds of thousands of dollars on someone's education (as the US does with it's loans), you need to make sure they get into a position to pay you back. That means the US dude who borrowed all those Stafford loans had better find a good job afterwards or we made a bum investment. So we NEED this person to get a spot over someone coming from a foreign venue. We, as taxpayers are footing the bill if this person doesn't get in a position to pay us back. So yeah, the US collectively has a fundamental interest in getting this person a good paying job, even at the expense of a slightly smarter overseas person who wants to come here for training. that's just common sense. So common that EVERy other country on the planet does it this way. So yeah, it is refutable. It's called good business.
 

Knicks

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Ok.

:)
 

beefballs

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There are a whole slew of possible reasons for US IMGs to do so.
bullspit

how many of your Carib classmats applied to US MD/DO schools then went Carib after not getting in? You and I both know that it is the vast majority. I don't begrudge an individual from taking the only path open to them to achieve their goals, this isn't to denigrate carib grads who matched just to point out that the idea of "prematching" is only open to a select few and with the larger med school graduating classes and the static number of residency slots requires this unfair practice needs to be halted.
 
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EaglesPA

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-One guy who matched Peds Neuro at CHOP only ranked CHOP for Peds because they "assured" him a spot there... now he has scrambled into a Peds position in Baton Rouge at a program that is brand new this year-------

I just don't understand why people do this!
The only reason not to rank a place you interviewed at is if you would rather go unmatched than train at that place....
When I interviewed for residency, I interviewed at abou 10 places and ranked them all (even though I was very confident about matching at one of my top 3 choices) - because I knew that I would almost certainly rather train at my #10 than any program that would have spots available in the scramble.
Some in the same position howver only ranked 3 or 4, which doesn't make any sense.

Anyway, this should be a cautionary tale to future applicants.
 

Phur

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As a US-IMG set to start clinicals soon, good to see the kind of reception I'll be getting. I think the generalizations are a little out of control. First, most people are lumping all USIMG's and FMG's into the same category which is a little confusing. A lot of people are saying that everyone who studied outside the US is either a 50 year old from wherever with an accent so thick no one can understand or they're all slacker kids from undergrad who all went out and partied and got a 2.5 GPA with a 15 MCAT. Everyone comes in with their few examples of this clueless person, but I mean c'mon. I have a story about a friend of mine who is in PA school and has an annoying 4th year AMG asking how to do this and that all day and can't write an H&P for crap. Do I think all are idiotic like that? Of course not. There are really good AMG's and crappy ones in the same way there are terrible IMG's and good ones. So chill with the mass generalizations.

With regards to prematching, it's hard not to be biased since it very well could benefit me in the future. Should it exist? Probably not, but without a huge push from AAMC, LCME or whoever would fight it, it's probably not going anywhere anytime soon. It clearly benefits the programs. You have to remember the match is as big a crapshoot for programs as it is for students. I'm sure there are programs complaining that they had to go to number 64 to fill up 6 spots. They have an opportunity at a sure thing, to know exactly who they are getting, why wouldn't they take advantage of that? And further why would they give it up without a fight? Sure they could just rank these people, but then they're in the same predicament of not getting the person they want. So it's probably a fault in the system, and I don't the history of why it's in there to begin with, but it's how it is for the time being.

I feel for everyone who didn't match regardless of where they went to med school. It has to be a horrible feeling to go through 4 years of blood, sweat and tears and not have a job after. I can only imagine how devastated I would be. I'm probably going to get roasted for this, but I suggest we all look at the bigger picture. I think everyone in the medical profession needs to unite and let Congress know that what they're doing is crap. All over the news is doctor shortage this and that. Their idiotic idea is just to increase enrollment. All they are doing is creating a bottleneck that we are just seeing the beginning of now and is only going to get worse in coming years. Whether it's through AMSA or getting in touch with your congressional members or whatever. They need to know they're making the problem worse unless the number of GME slots is increased.

I think those were the high points I wanted to add. Maybe more will come to me later.
 
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Well, then that is a poor argument, since you are assuming that [and therefore, making it sound like] that's the reason that US IMGs attend off-shore schools. There are a whole slew of possible reasons for US IMGs to do so.

Good thing you said, "Not to generalize....", because considering that, your post and long, bitter example doesn't hold much water.
There is absolutely no way of telling why a USIMG went to an offshore school. The vast majority attend because they were academically deficient, as the data show for incoming students at those places. As a residency program director, there is no way to say "oh, this guy went there bc he enjoyed the weather" vs "oh, this guy went there because there's something off about him". In such a case, the only valid assumption that is proven with data is that people go to the Caribbean because they were DENIED admission to American schools.

There are more incompetent people in the Caribbean than there are in American schools. The much more strict American filter has already eliminated most of the incompetent, and the Caribbean seems to take it all in like a huge fishing net, and send it right back to America.
 
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Of course they are. You know how we know? Because they are given a choice, and they choose some IMGs. Forcing them not to do this would cause them suffering. Its very simple.

Are you the smartest person in the history of the world? Do you think you are the first person to ever consider this? And yet somehow, for some reason, programs dont merely select AMGs to the exclusion of all others. I wonder why? Probably its because they are all just so stupid, and need you to make up rules to force them to do things "for their own good" right?


If all of your nonsense was even remotely true, the it would not be necessary to say things like "Programs should fill spots with AMGs first, and then fill whats left over with the rest" because PROGRAMS WOULD ALREADY DO THIS!

The level of critical thinking from some is disheartening, and so often the gap made up by this lack is filled with "for their own good" justifications.

Why not just be honest? You are entitled to those spots! Someone OWES them to you!
1) No suffering on the part of programs if IMG's were denied prematches. "I wouldn't offer these if I didn't know what I was going to get in the match". Mainly places which have *had to* have IMG's fill their spots because American grads think it's a crappy place. You're not seeing top hospitals offering them. More and more, medium tier schools are offering them and by NOT matching American graduates, they suffer.

2. There are plenty of programs that don't select US-IMG's. Beggars can't be choosers though. Cleveland Clinic will always have a good number of IMG's because they can't beg enough American grads to go there.

3. As for your final point, that's when a separate scramble would come in, if a separate match were to take place. As a US-IMG, your rank list is going to look vastly different from mine. You may put the Univ of Mississippi as your #1, and I may not ever consider it (nor would any of my classmates), but come scramble time, I'd rather go to that University-affiliated program than to something even worse.
 

Smashweasel

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I agree the prematch stuff needs to be outlawed. But its not just IMGs that use it. DOs, MDs switching specialties, MDs reentering the match all can and do use it.
 
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vhawk

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LOL. Except for the fact that no other country takes this position.
So?
So you are asking the US to open it's doors to the best of the world, while the world wouldn't reciprocate. There are lots of good reasons for being self sufficient as a profession -- to have US generated students fill US needs. You never want to be in a position where you have to import talent, particularly when the need is something as important as healthcare.
Why? This is not a trusim. In fact it seems exactly the opposite: you ALWAYS want to be in a position where you are able to import the best and the brightest from around the world. What you NEVER want to do is artificially limit your own talent pool. Protectionism ALWAYS makes the whole worse off, although it can be beneficial for small segments of the population in the very short run.
Every other country on the planet realizes this.
When you dont assume that this thing that they "realize" is actually a good thing, then you'll see that this is not a selling point.
The US realizes this too, but has been slow to close the door. It's closing now. Additionally, when you invest so many hundreds of thousands of dollars on someone's education (as the US does with it's loans), you need to make sure they get into a position to pay you back. That means the US dude who borrowed all those Stafford loans had better find a good job afterwards or we made a bum investment. So we NEED this person to get a spot over someone coming from a foreign venue. We, as taxpayers are footing the bill if this person doesn't get in a position to pay us back. So yeah, the US collectively has a fundamental interest in getting this person a good paying job, even at the expense of a slightly smarter overseas person who wants to come here for training. that's just common sense.
Yes, it is common sense. That is ONE of the factors to consider. It is not the only one, and consideration of the consequences of a decision that only consider their impact on one single group, at one instant of time, is how you end up making poor decisions. Thats how common sense works. Are you familiar with the Broken Window fallacy?
So common that EVERy other country on the planet does it this way. So yeah, it is refutable. It's called good business.
lol. Good for who?
 

gametown19

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This thread seems to be filled with anti-US-IMG feelings. I agree most Carib grads are US med school rejects but they are still US citizens who payed tax dollars that fund the residencies. They got filtered out b/c of poor MCATs and GPA while a lot of URMs get into US med schools even with similar stats. Why are they better qualified to be doctors than Carib grads with similar stats???? AMGs don't want to go into Primary care b/c of low pay. Only 44% of FM spots were filled by AMGs. Who would work these jobs??? US-IMGs are still US residents and they take huge amounts of loans to get these jobs that AMG don't want. These guys pass the same exams and have to demonstrate similar level of knowledge in order to become doctors in the US. They need to have better step scores than US grads to get pretty much any residency.

I am a little against FMGs. Simply because the countries that they come from use watever limited resources they have to educate these doctors and then these doctors turn around and leave those countries with no loans for a better lifestyle in the US. Rural India actually have a doctor shortage right now and the US is filled with Indian educated doctors.