notdeadyet

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Two words: holy...crap...
:smack: :help:
Meh. The last line says that health care folks would have to "meet all medical professional criteria to practice". By my read, that means that they'd have to be have their internship done.

Doesn't the military currently take IMG/FMG grads who have US internships completed? So I don't see there necessarily being any dip in quality.

The only difference will be country of origin. Actually, not even that, as some officers are already foreign-born. It'll just be citizens vs. non-citizen, right?

So far I'm underwhelmed.
 

Gastrapathy

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Just another step in the gradual erosion of quality in military medicine.
 
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iatrosB

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Private sector has been using IMG/FMG's for years...if it's good enough for every other American, why not the soliders?
 

IgD

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From a DoD press briefing:

"...we are pleased to announce that effective immediately we are going to recruit foreign citizens and foreign medical graduates in order to improve the quality of care and graduate medical programs. This critical action literally solidifies the world class standing of our medical system and training programs. The DoD leadership is absolutely committed to the issue of recruiting and retention and will do anything short of correcting the underlying problems in order to ensure the exceptional quality and vitality of our medical system."
 

Gastrapathy

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I'm sorry but what is so funny? Do you actually think that the transition over the last decade from a program that had far more MD applicants than slots to a noncompetitive AMG program(with an ever increasing percentage of DOs) to needing IMGs to fill is funny?

There are lousy MD's, great DO's and world class IMGs. However, on average, this reflects a sad decrease in the overall academic competitiveness of our programs.
 

BOHICA-FIGMO

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To me, the announcement is tacit acknowledgment that the DoD has essentially given up on fixing the recruitment and retention problems in military medicine.
 

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To me, the announcement is tacit acknowledgment that the DoD has essentially given up on fixing the recruitment and retention problems in military medicine.

What's sad is that by dangling the citizenship carrot, this will allow the status quo to continue for another number of years.

I hope FMG's do their homework, and see what they're getting into.

Military leadership has no scrupples.
 

a1qwerty55

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To me, the announcement is tacit acknowledgment that the DoD has essentially given up on fixing the recruitment and retention problems in military medicine.
Incredibly disappointing. I think you are right on target. Why change when we can import some Filipino nurses and some docs from India. Awesome, now I can add culture and language barriers to our already weak nursing cadre. Maybe my new colleague to can teach me cupping.
 

IgD

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I worked hard on active duty and did a lot of good but then stuff like this would happen and it would leave you just scratching your head. It seems like there is a disconnect between the deckplate and control tower.
 
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speedyk

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I'm sorry but what is so funny? Do you actually think that the transition over the last decade from a program that had far more MD applicants than slots to a noncompetitive AMG program(with an ever increasing percentage of DOs) to needing IMGs to fill is funny?
It was abundantly obvious that I was laughing at the naive/ignorant idea that all civilians can choose their health care provider.
 

BigNavyPedsGuy

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It was abundantly obvious that I was laughing at the naive/ignorant idea that all civilians can choose their health care provider.
Most civilians do choose their provider. I was on a PPO until a year adn a half ago and I had a choice of dozens of doctors. HMOs give you options too.

It's abundantly obvious that you are condescending and wrong.
 

iatrosB

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Most civilians do choose their provider.
Negative...in the rural areas, often all you have is one "choice"...and it is usually an FMG/IMG earning J-1 Visa, be that good or bad, it's reality.

Add that to the looming/already present shortage of primary care physicians, and you will see less options in the bigger cities as well.
 

notdeadyet

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It was abundantly obvious that I was laughing at the naive/ignorant idea that all civilians can choose their health care provider.
Eh, even the cheapest (read: most restrictive) HMO still lets you choose from a fair number of doctors in your area. For years I was self-employed and opted for the absolute least I could pay as I was a young guy in good health and I always had a fair number of doctors to choose from even on my craptastic policy.

Not sure what you're thinking of exactly.
 

BigNavyPedsGuy

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Negative...in the rural areas, often all you have is one "choice"...and it is usually an FMG/IMG earning J-1 Visa, be that good or bad, it's reality.

Add that to the looming/already present shortage of primary care physicians, and you will see less options in the bigger cities as well.
Most people don't live in extremely rural areas. Most people have insurance. Therefore most people do choose their provider.
 

AF_PedsBoy

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Of course you mean most people choose their provider ...from the list the HMO gives them, sooo if there's a FMG who plays ball with them and a USG who is idealistically saying "I'm not taking this bundling crap!" guess which one they'll be seeing :D But true, most doctors have had the idealism kicked out of them in residency so you're right, they are probably being seen by US grads...
 

iatrosB

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Most people don't live in extremely rural areas. Most people have insurance. Therefore most people do choose their provider.
I never said MOST couldn't...merely that the rural areas, and even some bigger cities can't always choose. I took issue with the blanket statement made "civilians can choose their providers"...not all can. By the same token, MOST military personnel wouldn't have an FMG/IMG...but some would.
 

IgD

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It was abundantly obvious that I was laughing at the naive/ignorant idea that all civilians can choose their health care provider.
I work in a major city and all the big insurance plans allow patients to pick their doctors including seeing a subspecialist without a referral. There is a $20 co-pay for appointments. If you see a physician at our medical center, the co-pay is decreased.

Where do you work where you can't chose your health care provider?
 

IgD

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Negative...in the rural areas, often all you have is one "choice"...and it is usually an FMG/IMG earning J-1 Visa, be that good or bad, it's reality.

Add that to the looming/already present shortage of primary care physicians, and you will see less options in the bigger cities as well.
At least you see a doctor. In the military recently there is a good chance you would see a nurse practitioner in primary care for even a complicated issue or a social worker in the "mental health" clinic IF YOU CAN EVEN GET AN APPOINTMENT.
 
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notdeadyet

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I never said MOST couldn't...merely that the rural areas, and even some bigger cities can't always choose.
I know nothing about rural areas.

But for bigger cities, you almost always have a choice, even with the crappiest of plans.

You might not have YOUR choice. When I had lousy policies, I was always troubled by the fact that I knew physicians I wanted to see who weren't on my policy, but I always had a choice of providers I could see. Though on the bad policies, the ones still taking new patients were inevitably new grads or foreign grads (not that I have a problem with either).

But if you find yourself anywhere other than the total sticks and you are literally assigned a doctor without any choice or options, you should really look at other policies. I've never seen this, and as I mentioned, I pretty much specialized in low end health policies.
I took issue with the blanket statement made "civilians can choose their providers"...not all can.
No, not all. But I'd say that all but the smallest of a small minority have options. You aren't just assigned a single physician with no alternate choices.
 

iatrosB

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I think most of you are also underestimating the ammount of FMG/IMGs in primary care in the US. They make up a significant percentage of the workforce. There are not enough american grads in primary care to meet the demand...hence there is lack of choice in regards to US vs IMG.
 

notdeadyet

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I think most of you are also underestimating the ammount of FMG/IMGs in primary care in the US.
Ah. Sorry. I didn't realize that's what you meant by choice. That's very true. I'd say about half the PCP I've seen in recent years have been FMGs/IMGs. And about 1/2 of the rest have been DOs. I can't say I've noticed any particular quality trends based on where anyone got their degree though.
I think most of you are also underestimating the They make up a significant percentage of the workforce. There are not enough american grads in primary care to meet the demand...hence there is lack of choice in regards to US vs IMG.
For me the choice issue isn't US vs IMG. It's this doctor vs that doctor. In all civilian HMOs I've seen (granted, none rural), you have a choice of doctors, so if you don't like one, you switch to another doctor with a phone call. From my understanding in milmed, you don't have quite that freedom in shopping around. Folks can correct me if I'm wrong.

Out of interest, iatrosB, have you had freedom in choice of PCP on Tricare? I've heard problems of lack of doctors not taking it, but a search found lots in my neighborhood.
 

iatrosB

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Out of interest, iatrosB, have you had freedom in choice of PCP on Tricare? I've heard problems of lack of doctors not taking it, but a search found lots in my neighborhood.
Absolutely zero trouble. Everyone in my area takes Tricare...and although there are several FMGs in the area, I could choose American grads because of my medical connections.
 

notdeadyet

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Absolutely zero trouble. Everyone in my area takes Tricare...and although there are several FMGs in the area, I could choose American grads because of my medical connections.
Glad to hear it. I've heard horror stories, but was surprised at the amount of folks who accepted it (including some great docs I know personally). Especially as the reimbursements from Tricare look pretty miserable.
 

Chonal Atresia

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I whole heartedly agree with this forum - shame on the medical corps for letting this happen! Obviously there are plenty of quality FMGs as well as substandard USMGs; however, this is a CLEAR move by the surgeon generals to circumvent recruitment and retention problems without shelling out increased pay to poorly compensated military physicians. It is the active duty soldier and his/her family who gets caught in the crossfire. Anybody have any idea how to make the REAL story public? This was obviously publicized on various threads but the average layperson doesn't understand the implications. The story is billed as a way for more foreigners to get their US citizenship faster (what a bunch of B.S.)! If the TRUE story could be made public and a network like say CNN would run with it, things MAY change (i.e. similar to the you tube video of the pathetic enlisted housing at Ft. Bragg). This is the ONLY way the military ever changes anything for the better - they are reactionary and not proactive. Anybody have any ideas?
 

BOHICA-FIGMO

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I think most of you are also underestimating the ammount of FMG/IMGs in primary care in the US. They make up a significant percentage of the workforce. There are not enough american grads in primary care to meet the demand...hence there is lack of choice in regards to US vs IMG.
Agree here. I am from a relatively rural MD school and we have a ton of FMGs form India and Lebanon. Quality is a mixed bag as it is with anyone. In many cases I would rather see an FMG that a NP or PA. I think the main problem is that the DoD is trying to do everything EXCEPT fix the underlying problem. It is almost like telling a cancer patient take two asprin and call me in the morning.
 
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