racism in US residency system

[memberkane]

Advertisement - Members don't see this ad

It is a fact that IMGs especially from 3rd world countries face a lot of cultural bias/ racism during residency.

As a resident, the IMG on a visa takes up all kinds of degrading crap, and the one who has to put up with sarcastic and sadistic attendings. The IMG is especially vulnerable as he is a foreigner, on a visa, looks different etc and these force him to silently put up with racially biased attendings.

Residency in US is about ATTENDINGS AND STAFF liking you as a person, as much as your subject or knowledge. - and this is something that the racially biased person in power exploits!

In many, many instances while whites and american black population of the US are made to feel part of the system, specially 3rd world IMGs - Indians or Pakistanis or such people have it rough and are made to feel like beggars who should feel happy that they have the luxury to serve american patients.

Is this buggery fair? Is not america a land of immigrants and descendents of immigrants and that too basically a land of mongrel/ multi-ethnic/ mixed breed people? America is supposed to be a tolerant society and a melting pot of cultures, is it not?

Most of american medical faculty are fair and their evaluations are merit based, but there are A LOT OF BAD APPLES among faculty who actively indulge in racial bias against such IMGs under the pretext of "patient care and cultural competence".

To the culturally biased attendings or people in power, I say this on behalf of ALL THE COMPETENT Foreign MG (IMG) WHO HAVE BEEN RACIALLY ABUSED: Realize that Indians or third world doctors come to your country because they LOVE YOUR COUNTRY AS A HAVEN OF JUSTICE AND EQUALITY AND REGARD TRAINING AT YOUR COUNTRY AS AN EDUCATIONAL ACHEIVEMENT. Money is NOT the only reason that Indians or Africans or others come to US.

 

[142348]

As a physician who is Indian, but born and raised in the United States, i strongly disagree with the above sentiment. Throughout my medical training, from medical school through to residency now I have never felt that I was treated differently than my colleagues that are white, asian, african american, etc. With respect to the treatment of Indians/Pakistanis/etc. as FMG's, it has been my experience that they are treated equally to AMG's at my institution. In the past, 20-25 years ago, I would say there was a singificant disparity in the treatment but at this time I would argue that it has improved significantly.

 

[DarthNeurology]

Residency in US is about LOCAL ATTENDINGS AND STAFF liking you as a person, more than your subject or knowledge. Whites and american black population of the US are made to feel part of the system, while Indians or Pakistanis or such people have it rough and are made to feel like beggars who should feel happy that they have the luxury to serve american patients. Is this fair friends? Is not america a land of immigrants and descents of immigrants and that too basically a land of mongrel and mixed breeds?

All you attending or people in power, please realize that Indians or third world doctors come to your country because they LOVE YOUR COUNTRY AS A HAVEN OF JUSTICE AND EQUALITY AND REGARD TRAINING AT YOUR COUNTRY AS AN EDUCATIONAL ACHEIVEMENT. Money is NOT the only reason that Indians or Africans or others come to US.

I await your replies friends, please discuss this topic further among this SDN

I have worked with a lot of Indian and Pakistani and Iranian residents and they weren't treated any differently than anybody else. Everybody always tried to be understanding when an foreign doctor can't speak english as well if that is the issue.

There are more and more residency applications, even from U.S. citizens going to international medical schools so it will be harder and harder for residents from all countries outside the U.S. to get residencies at least for the next 10 years. Most of the foreign medical graduates who made it here are pretty happy I would say.

Medical training at the best institutions in India has very similar education as what is done here in the U.S., i.e. they use MRIs etc . . . so I would think that most physicians from India are not escaping a poorer system in some cases, and that they aren't political refugees either, so I am not sure how the U.S. would be considered a haven of justice and equality from an Indian perspective. I don't know enough about Pakistan, maybe a doctor there would want to escape that country. I could see a female physician from Iran definitely wantinged to escape to U.S. which may offer better freedoms to women physicians than Iran.

This post seems to be written from the standpoint of a residency applicant wanting to contact "people in power and attendings" to make sure that applicants from India, Pakistan, and "Africa" get good consideration because we are a nation of "mongrels" and made up of immigrants. I don't think this message will have the desired persuasive effect at all as this is a "guilt trip" basically accussing attendings/residency program director of being racist and that they should admit more foreign students to make up for this. I haven't seen this happen at places where there are such residents, not to say that it couldn't occur, but again this is a manipulative argument.

 

[chameleonknight]

Dear friends,

We cannot be blind to the fact that WHITE caucasian people are favored in US over Indians, Pakistanis and people from third world countries in the residency process or as attendings.

As a resident, the Indian is usually the one who gets the 4th nightduty or the extra sunday duty in the month, takes up all kinds of degrading crap, and the one who has to put up with sarcastic and sadistic attendings.

Whites and local blacks have it far better in US residency system.
Residency in US is about LOCAL ATTENDINGS AND STAFF liking you as a person, more than your subject or knowledge. Whites and american black population of the US are made to feel part of the system, while Indians or Pakistanis or such people have it rough and are made to feel like beggars who should feel happy that they have the luxury to serve american patients. Is this fair friends? Is not america a land of immigrants and descents of immigrants and that too basically a land of mongrels and mixed breeds?

All you attending or people in power, please realize that Indians or third world doctors come to your country because they LOVE YOUR COUNTRY AS A HAVEN OF JUSTICE AND EQUALITY AND REGARD TRAINING AT YOUR COUNTRY AS AN EDUCATIONAL ACHEIVEMENT. Money is NOT the only reason that Indians or Africans or others come to US.

I await your replies friends, please discuss this topic further among this SDN

Maybe that's true up north; I've never seen any degradation towards any of the Indian med students, residents, or fellows here. And yes, I have several friends who are Indian, so I'm pretty sure they would have spoken up if they thought things were out of line.

 

[Depakote]

Moved some posts/responses from various threads here. Please use this thread to discuss the OP's issue.

Thanks.

 

[Doowai]

I would never in a million years cry racism - but I am white. If an ethnic attending beat me with a club until I was unconscious screaming "die you white honkey bastard", I would never say it was racist. But again I am white.

It may be the case in some residencies. But I also have seen a residency I thought favored Eastern Indians over Carribean trained American citizens - I think the PD felt eastern Indian students who were able to go to schools in their own country were smarter than US students who were forced or chose to matriculate to the Carribean. But then again I am a US citizen who went to the Carribean.

I also experienced a black senior resident asking me to help them, which I did (I was an intern just weeks into the program) - as I felt it was the natural pecking order. I got chewed out by my black attending for complying with the black senior residents request for help - and the attending never said a word to the black senior resident. I personally felt like the black senior resident should bear some culpability, as I felt THEY should have known I should not have helped them process new patients when I was on another service - whereas nobody told me (a brand new intern) that I was not to go help backlogged senior residents on other services. I got in trouble for trying to help when asked, when nobody said otherwise. Was it because the attending was black and the senior resident black and I am white...

of course not, that would be racist. I should have just known, a priori, that I should not go help them. But I think sometimes the tendency to blame such factors exists when we feel we are treated in what we FEEL is an unfair way.

But it is possible racism is still alive.

May the best resident doctors prevail

 

[Old_Mil]

dear friends,

we cannot be blind to the fact that WHITE caucasian people are favored in US over Indians, Pakistanis and people from third world countries.
As a resident, the Indian is the one who gets the 4th nightduty or the extra sunday duty in the month, takes up all kinds of degrading crap, and the one who has to put up with sarcastic and sadistic attendings.

You gotta learn to play the game...and stop crying racism if things don't go your way. That's way too Jesse Jackson for an Indian dude to pull off. Especially since there are plenty of them kicking ass and taking names in the world of medicine - way out of proportion to their representation in the general population, I might add.

The objectivity in medical training ended when you got past 2nd year, Step 1, and Step 2. 2CS, 3rd year, 4th year, and residency is as much about who you know, how you come across, how you dress, how well you speak English, how well you fit in, how well you can converse with patients (how you smell, plays a part as well...here in America we tend to brush our teeth 2 or 3 times a day and shower daily. Twice daily if we work out)...

 

[tibor75]

this thread has to be a joke.

 

[Pinkertinkle]

Its more about nation of origin than race. Do FMG's get treated worse than AMG's? That's certainly a fact when it comes to competitive residencies and most likely occurs in more subtle ways such as getting the crummy call day.

 

[error404]

dear friends,

we cannot be blind to the fact that WHITE caucasian people are favored in US over Indians, Pakistanis and people from third world countries.
As a resident, the Indian is the one who gets the 4th nightduty or the extra sunday duty in the month, takes up all kinds of degrading crap, and the one who has to put up with sarcastic and sadistic attendings.

Whites and local blacks have it far better in US residency system.
Residency in US is about LOCAL ATTENDINGS AND STAFF liking you as a person, more than your subject or knowledge. Whites and american black population of the US are made to feel part of the system, while Indians or Pakistanis or such people have it rough and are made to feel like beggars who should feel happy that they have the luxury to serve american patients. Is this fair friends? Is not america a land of immigrants and descents of immigrants and that too basically a land of mongrel and mixed breeds?

All you attending or people in power, please realize that Indians or third world doctors come to your country because they LOVE YOUR COUNTRY AS A HAVEN OF JUSTICE AND EQUALITY AND REGARD TRAINING AT YOUR COUNTRY AS AN EDUCATIONAL ACHEIVEMENT. Money is NOT the only reason that Indians or Africans or others come to US.

I await your replies friends, please discuss this topic further among this SDN

I also feel like this is more an issue of nationalism than racism. And, like other posters, I haven't seen IMGs and foreign med students treated differently. Memberkane, perhaps there is a problem within your individual program? I've spent a fair amount of time at different programs, often talking with IMGs about their experiences in the US system, and know that those I've encountered don't feel this way.

I hope things get better for you!

 

[Doctor Bob]

we cannot be blind to the fact that WHITE caucasian people are favored in US

White caucasians? As opposed to what other kind of caucasians? Pink?

 

[memberkane]

Don't get me wrong friends. What i mean is that International Medical Graduates especially from Indian subcontinent are looked down upon. It is not always the case, and not in all residencies, BUt is very much prevalent.

Let me tell you about my experience:
My residency program 2007-2008 batch: 1 indian contract not renewed, 1 indian transferred programs due to the situation at program - the lucky indian; 2006-2007 batch: 1 pakistani contract not renewed and 1 indian transfers out because she "discovered she liked another specialty"; 2005-2006 batch: 1 indian sikh resident contract not renewed - other indian residents of his batch say that his was a struggle for dignity, 1 indian transfers out. I have no info reg, previous years.

The Program Director has wonderful stories regarding Indian applicants : he once told me and my indian PGY1 colleague at a afternoon conference that once an Indian applicant threatened to sue the program because he was not called for interview despite passing USMLE - everyone was laughing at his "true" story (read Indian applicants are desperate). I got the 2nd highest Inservice exam scores and the PD publicly states that "Well, you and many Indians seem to be good test-takers, but this does not mean that they can apply it" - and the majority of faculty vocally agreed. Many, many such instances.
Indian colleagues were in survival mode and were in a state of abject surrender to the attendings.

I went for PGY2 interviews to other programs as my contract was not renewed for pGY2 and guess what I found?? ALL the candidates for the pgy2 interviews were indian/ pakistani ( people who did not get PGy2 or whose contracts not renewed etc), and the residents whose vacated positions I went to fill were IMGs mostly from India. And the PD of one of the Family Practice programs says, " well a lot residents come here from India and what do you know! they get married, and start families here!!" She said it in a very demeaning way.

What should I make of these situations, people?

Most of IMG from India come to US for Post graduate training as the US is regarded as a center for good training. Money is not the only consideration - More money can be made in US in general, but in a big city in India, there are many,many doctors making more than equivalents of $ 500000 per year after taxes, and well established ones of course make a lot more money.

But it seems that many US Medical personnel do not know the cheap and abusive behaviour that these IMGs encounter right from Interviews to residency and beyond. Sad fact is that the IMGs get to all these issues only when they are in the system and not when they are in their home countries - maybe they would have reconsidered coming to US in the first place.

Look, I also did a Masters degree in the US before starting this residency, and the situation there was not like this. I felt NO racism there. You had a paper or a project report etc that you could show, and so there was a lot of objectivity in the evaluations.

In residency/ later objectivity is very minimal compared to the subjectivity of the evaluations. I think this is where bias, prejudice etc is coming out as basically the resident's performance is what the attending says it is. Looks, likes/ dislikes, etc are deciding evaluations on equal standing with performance.
People of Indian/ other IMGs on visas are especially more vulnerable as they have to leave and their medical career in US is going to end if their contracts are not renewed/ they are terminated. This fact is something that the perverted or racially biased director/ faculty/ senior resident is gloating at and exploting.

I am NOT saying that all PDs/ attending/ faculty are racist. Far from it. I feel that the USA medical system is one of the most objective and friendly in the world, which many bad apples are perverting and exploiting.

BUT the truth espeically for International Medical Graduates joining at the residency level is that the IMGs are being subject to a lot of abuse and harrassment. Bad evaluations especially bad evaluations before NON-renewal / termination for them are more often than not a case of "Before you shoot a dog, call it mad" cases.


I put up this post in SDN because many attendings, students, residents etc visit this forum and need to understand this reality - because they " the Local American doctors" are the ones who are most suited for devising methods to cure this abuse and remedy the system. Thanks and keep sharing your ideas reg. this topic

 

[142348]

As a Indian American and someone who has grown up in a family of doctors in this country, your statements seem way off base.

I think that a lot of your experiences are based on program selection more than racism. The programs that most FMG's end up (the majority of whom are Indian and Pakistani) are lower tier primary care specialties. These programs are often "the dregs" of medical education and it's impression that these same contract situations and poor treatment would happen to anyone who ended being a resident there, AMG's included.
As for the fact that FMGs are forced to go to lower tier programs where residents are treated like that, I feel that's the way things go. In my opinion, residency spots should go to AMG's first (MD/DO), then to foreign born FMG's, then American born IMG's. It doesn't always happen this way but you can see why Indians/Pakistanis/other FMG's end up where they do. If I wanted to residency in Europe or India or elsewhere I wouldn't expect to be on equal footing with my contemporaries who went to school within the country.

If you don't like the situation, then leave the program or hell the leave the country, and figure something to do with your life. Don't just scream racism at every corner hoping someone will jump on this ridiculous band wagon.

 

[McGillGrad]

Your examples are not racism. Where do you se racism in your examples? Those are examples of facts translating into true stereotypes.

When people of different cultures and languages (Indians, Chinese, Arabs and Pakis) start residencies in the US, they have to prove themselves clinically and culturally. If they do not, then they do not deserve the spot.

I am French-Canadian and I will be in a Visa in residency. If I could not pull my weight as a non-US grad, it is not racism. It is my inability to adapt culturally, linguistically or clinically.As others have mentioned, people who grow up in America (and are all colours of the rainbow) will be treated as Americans. Period. It is the cultural and language that is usually the issue. (yes yes, exceptions exist)

You are describing (non-racial) discrimination and that is a good thing in medicine. If people are walking down the hallways making fun of the indian/paki accents and refusing to interview anyone who is brown that is racism.

American is destroying itself with this cult of victimhood and overuse of PC nonsense.

 

[eforest]

I agree with some of the aforementioned sentiment that the issues may be more cultural than racist- And the thing about showering and brushing your teeth is a very important point. I've worked under IMG's as a student and I was actually grossed out by the grooming habits of some of them. This was the exception, not the rule, but I think it's important to remember that showering every day is important. If your hair is greasy (and not on purpose from a hair product) then that can really be a strike against you.

 

[Dral]

Just as a third year medical student, I've seen Indian residents who are not doing that great of a job. It just seems like a higher percentage. As someone mentioned, I think it may be cultural? I dunno.

On the other hand, I've worked with Indian residents who have been some of my favorites and are very efficient and good at what they do.

I think the important thing is for PD's/attendings to not hold any prejudices and to judge each individual on their own merits, abilities, and social skills. However, regardless of test scores, if an IMG (or AMG) is not fulfilling ALL aspects of their residency position, then that may be cause for remediation.

 

[AmoryBlaine]

The OP is right. If you go to Karachi or Dehli you will see that the hospitals there are clamoring to take in US medical grads, work around their limited language skills, pay them pretty good money, and launch them into a career where they make more than 98% of the people in those countries.

Oh, wait....

 

[DarthNeurology]

What i mean is that International Medical Graduates especially from Indian subcontinent are looked down upon. It is not always the case, and not in all residencies, BUt is very much prevalent.

In residency/ later objectivity is very minimal compared to the subjectivity of the evaluations. I think this is where bias, prejudice etc is coming out as basically the resident's performance is what the attending says it is.

I have meet several Indian residents, some really knew what they were doing, and some were in trouble with the PD, but this was for obvious problems on the service that was obvious to everyone. Yes, an IMG from India will have trouble integrating into American culture, if your knowledge of English is not as good as Americans then you will have real trouble taking care of patients in clinics and the ERs and I have seen language to be a problem for some, but not all Indian residents. Those Indian residnets who spoke almost flawless English seemed to do a better job. This is why there is the Step 2 CS, to make sure that residents who don't know English well aren't stuck.

The vast majority of Indian FMGs get through residency, so I think a good chunk of problemed Indian residents do have problems on the wards. There are residency programs that are almost 100% indian applicants in the U.S., and their faculty maybe made up almost entirely of Indian physicians, so it is hard to see how "racism" is a problem here

 

[dragonfly99]

I agree with wagy for the most part.
The IMG/FMG's who end up at crappy lower tier primary care programs are more likely to get treated poorly, regardless of being Indian vs. white or something else. That is the main issue.

Evaluations for upper levels of med school and residency are largely subjective. Get over it. I (white person born in the US) don't like it a lot either, but it is what it is. A good USMLE score only gets you so far. If you want to survive then you have to figure out how to get people to like you, or at least tolerate you.

I feel like often there is >> bias on the part of some patients than attendings. Some patients don't like "foreign doctors" because they have trouble understanding their accents and/or have a general prejudice/bias against foreign born people.

I am sure there are still people around who have bias according to ethnic origin, and also in some cases according to race. You can't do anything about that, and I think those people are the minority. There are sexist people too...I had an attending tell me not to do cardiology because I'm female and basically I will want to have babies and I won't want to work that hard. I couldn't do anything about it so just chose to soldier on and succeed in spite of him. There are more people who are NOT like that than who ARE like that.

 

[DarthNeurology]

I agree with wagy for the most part.
The IMG/FMG's who end up at crappy lower tier primary care programs are more likely to get treated poorly, regardless of being Indian vs. white or something else. That is the main issue.

I did an away elective at a "crappy lower tier" IM program, great experience and pathology i.e. infectious disease service/HIV/AIDS, almost 100% indian residents, community program. Many of the residents who were barely passing the residency there would never be able to survive in a high powered academic university IM program, no way, no how.

You can't continually mess up admissions and still be a resident at more prestigious medicine programs, the PD asked residents to do stuff and they dawdled and didn't do it, at least some of these residents, the chief residents were spot-on good as were the good indian residents, same thing with the indian attendings, all excellent IMHO, but yes, there were about 4-5 indian residents who didn't know what they were doing, but got into this program. Suspicious as ALL their residents were from India, so perhaps this is racism in reverse? Some you got the feeling would make great doctors, and some would never be able to function at a certain level.

Even at this "low tier" IM program I could find you a thousand or more US college students who had the grades to go to medical school in the US, couldn't and would love to be physicians in this program. So, the job of a resident while hard in some places, actually this place was pretty relaxed and were very understanding of some of the indian residents who would have been fired from a residency program with most AMGs. There are a couple more programs I know about like this, so no way is this country not being too accomodating to indian residents as there are residency programs that are almost 100% indian residents!

A residency program is 85% the quality of the residents who are in the program. John Hopkins is an excellent place to train in part because ALL of their residents really know what they are doing as evidenced by excellent exam scores AND excellent clinical evals in medical school. When you say a program is a "crappy third tier program" it does reflect badly on the residents as there ARE community based IM programs where the residents, although mostly FMGs, work their butts off to get into excellent fellowships, i.e. make the place their own little Mayo clinic. If there is an Indian resident who has "issues" about racist attendings and feels that their work is being subjectively judged by racist attendings then how do they know what is the real criticism or not? (There could be a racist attending, but I have seen attendings of all stripes interact well with indian residents, and it is about the medicine not about the color of your skin).

There are perhaps fewer Indian residents these days as there are more and more U.S. IMGs coming in from schools in the Caribbean, some of these students are excellent and have an obvious advantage as they speak english and can connect better with communities in the US in terms of cultural issues, historically India has sent a lot of doctors to the U.S., but it is perhaps not fair to rob another country of their doctors and so U.S. medical schools as well are ramping up their medical student production so it wil be very hard in the future for any foreign medical graduate to get a residency spot in the U.S.

 

[nitwit]

.My experience has taught me that the selection process for residency positions is very subjective and prone to bias and prejudice. This may translate into racism and many very competitive international grads are treated unfairly.

Residency programs do not exists as islands of equality in society. Racism exists in society and America has a strong history of it like many other part of the world. To deny it exists in the selection process or during residency is to be blind to it and pretend otherwise. I have seen many posts by Indian Americans and they tend to be blinder to it than anyone else. This is symptomatic of their denial of their parentage.

I strongly disagree when people say you have to conform to be a good resident. It will be a terribly boring world if everyone dressed, spoke and behaved like Americans. I absolutely agree that it is important to connect with patients to be a good clinicians and this requires a certain awareness of the local culture. This can be learned and if given the opportunity many IMGs can do so.

Browsing through SDN forums it struck me that AMGs use number of IMGs in a program as a yardstick to assess the quality of a program. This creates a cycle: where better programs do not take IMGs even if their qualified so as not to loose this reputation. This entire process is fuelled by racism and prejudice. Many programs take advantage of the naivety of IMGs to sell bad programs or manipulate them during this process.

It is amazing how talk about racism or a question about equality ends up being about "smelly Indians who do not take a shower or dress differently or have greasy hair". This is nothing but prejudice and stereotyping certain groups of people..

 

[beriberi]

It is probably really an issue of cultural competence.

Calling people "friends" on online forums/emails/etc. is a habit that I find really annoying and is not done by people born in the United States (regardless of their heritage - Indian/Pakistani/"white caucasian). This doesn't mean that someone is a bad doctor or should be terminated from residency, but it does imply that you have not sufficiently integrated the language, habits and customs of the people around you. Your written English is also peppered with phrases that are not commonly used here in the U.S. If you have completed pgy-1 and a masters degree you have been in the U.S. at least 3 years. By now you should have learned that saying "very much" this and "very much" that is not how most people talk. Again, this is not something that one should lose a position over, but I wonder if I were to meet you in person, how intelligible your speech would be and how well you have learned the language and behaviors of your peers.

Now, I'll go ask my unit clerk to page, Dr. Patel. "Which Dr. Patel?" she will say. The cardiologist. "Which cardiologist named Dr. Patel?" will be her response. Because even in my small community, there are tons of successful, talented physicians with specialty training from India.

It's not me. It's you.

 

[DarthNeurology]

.My experience has taught me that the selection process for residency positions is very subjective and prone to bias and prejudice. This may translate into racism and many very competitive international grads are treated unfairly.

Residency programs do not exists as islands of equality in society. Racism exists in society and America has a strong history of it like many other part of the world. To deny it exists in the selection process or during residency is to be blind to it and pretend otherwise. I have seen many posts by Indian Americans and they tend to be blinder to it than anyone else. This is symptomatic of their denial of their parentage.

I strongly disagree when people say you have to conform to be a good resident. It will be a terribly boring world if everyone dressed, spoke and behaved like Americans. I absolutely agree that it is important to connect with patients to be a good clinicians and this requires a certain awareness of the local culture. This can be learned and if given the opportunity many IMGs can do so.

Browsing through SDN forums it struck me that AMGs use number of IMGs in a program as a yardstick to assess the quality of a program. This creates a cycle: where better programs do not take IMGs even if their qualified so as not to loose this reputation. This entire process is fuelled by racism and prejudice. Many programs take advantage of the naivety of IMGs to sell bad programs or manipulate them during this process.

It is amazing how talk about racism or a question about equality ends up being about "smelly Indians who do not take a shower or dress differently or have greasy hair". This is nothing but prejudice and stereotyping certain groups of people..

Residency programs choose AMGs over IMGs as the PDs know these schools, of which many are among the best medical schools in the world. The average AMG has higher USMLE scores than the average IMG, this is partly why AMGs are more successful. Many AMGs from a small town in say Maine want to go back and practice there as a physician and have ties to the community there. It is not wrong in having an equally or better qualified applicant return to practice in the community where they grew up and the US needs to make more opportunities for such US students from disadvantaged backgrounds or rural backgrounds to do so.

The median score for an US senior matching in family medicine is 209 on Step 1, and is 197 for independent applicants. Scores in IM are pretty similar. Plus, AMGs who have been students in this country for 4 years having working in US hospitals for 2 clinical years, and this experience is valuable for doing residency here. Overall, US IMGs and FMGs match at similar rates into residency programs and have similar board scores and acceptance rates.

Once you are "in" medicine, i.e. have a residency spot, it is not about the color of your skin, it is bad to characterize the residency programs/attendings as being racist, 99% aren't most likely, but yes, residents of all color will be harassed during residency, this is how the US system is different than in India which is much nicer to subordinates. At some programs most residents are harrassed, this is how the program works, and if you take it personally then you will think it is your race. But this is real as Indian attendings treat students pretty nicely, so coming from India you wouldn't be accustomed to how mean people in the US are.

This is like the attorney general calling us a nation of "cowards" after peacefully electing a President with african american origins, it is manipulative and wrong to say how we are a racist society and must do so much more, etc . . . If I want to help poor/indigent patients in the US and abroad regardless of skin color, i.e. in a free clinic, does this make me racist? Should I be going out of my way to help poor black people over poor hispanic people? People in medicine do look down on patients, I have seen this, but it is mostly on poor patients regardless of color, i.e. "trailor park trash" or "gangsters", whatever . . .

I think the poster on race relations has cultural issues with attendings as he noted that black US residents don't have the same problems.

 

[AmoryBlaine]

People and posters can go around and around on this issue until they are blue in the face but once you actually work in medicine the truth will become apparent: medicine is intensely meritocratic, more so than probably any other field of study or area in society.

At the end of the day 95% of how you are judged as a student, resident, attending comes from how hard you work, how dependable you are, and how much you know.

Where I went to med school we had several attendings from Southeast Asia who spoke heavily accented and in some cases almost broken english who were universally loved by students, residents, and patients alike. Why? Because they were clearly experts in their fields, diligent clinicians, and kind people. Contrast this with some attendings/residents who were 100% white American with good pedigrees (Ivy League) who no one could stand because they were lazy and unpleasant.

Almost no one in medicine gives a damn what color you are or what sort of accent you have. They only care if they have to pick up your slack or fix your mistakes.

 

[JPR22]

for those of us who didnt know..
meritocratic:
n. pl. mer·i·toc·ra·cies
1. A system in which advancement is based on individual ability or achievement.
2.
a. A group of leaders or officeholders selected on the basis of individual ability or achievement.
b. Leadership by such a group.

merit·o·crat (--t-krt) n.
merit·o·cratic adj.

 

[Anka]

I agree with some of the aforementioned sentiment that the issues may be more cultural than racist- And the thing about showering and brushing your teeth is a very important point. I've worked under IMG's as a student and I was actually grossed out by the grooming habits of some of them. This was the exception, not the rule, but I think it's important to remember that showering every day is important. If your hair is greasy (and not on purpose from a hair product) then that can really be a strike against you.

Yeah, and these are things that people don't feel comfortable confronting someone on or discussing with them, even if they are otherwise friends. To elaborate a bit, Americans also wear deodorant usually applied immediately after showering, and again in the morning if the shower was in the p.m. We usually do not wear perfume or cologne in clinical settings, and even in non-clinical professional settings usually wear much smaller amounts than some foreigners wear (e.g., the rule I was taught as a child was that you spray the perfume in the air, and then step through the cloud). My advice is to not wear perfume/cologne if you're not from here, as it's unlikely you'll know when a little bit is too much.

What else? Oh, interpersonal things. For instance, I've noticed that Indian and Pakistani residents tend to be "sunny side up", i.e., they are all oil and polish, extremely polite when there is an attending around, but when they are alone with the medical student they ignore them, are dismissive, or even in some cases abusive. Or they are very patronizing. Just realize that while in your home country this sort of things is acceptable, in America it doesn't really fly. We're a little too egalitarian, and everyone talks to everyone else (a nurse might see or hear about it, pass it on to your higher ups; or the medical student may know the attending or a senior resident personally via an interest group or research experience, and pass it on).

Also RN-MD interactions in America are far less formal and heirarchical, from what I can tell, than in India/Pakistan. One Indian intern told an experienced ICU nurse, "Look, I'm the doctor, and I'm giving you an order. Do X,Y, and Z." The RN was on the phone with his senior in about 30 seconds getting a different order, and the intern had a very hard time getting anything done in the ICU after that. Which made him look like he didn't know what he was doing. RN on rounds "SOMEONE didn't order TPN yesterday, so now the patient doesn't have any TPN." RNs telling the resident things directly without telling the intern, then the intern appearing to be very uninformed about the patient on a.m. rounds. Now, obviously the RN was in the wrong for keeping patient info from the intern, but that didn't help him.

There are many cultural things that are difficult to learn for anyone coming from another country (I'm sure Americans abroad make many mistakes, too). Unfortunately, medicine is unforgiving of the learning curve on these things.

Best,
Anka

 

[Doowai]

I historically India has sent a lot of doctors to the U.S., but it is perhaps not fair to rob another country of their doctors and so U.S. medical schools as well are ramping up their medical student production so it wil be very hard in the future for any foreign medical graduate to get a residency spot in the U.S.

I think it was Darth who literally was struck in the face by an attending - I mean seriously - the attending bitch slapped him. I am guessing Darth is a white AMG - I cannot imagine the political bloodbath if a white attending bitchslapped a black resident.

But anyway - I really honestly seriously actually think everyone going into residency has to expect it to be abusive. If its not , then you are in for a pleasant surprise. But to expect it NOT to be, is probably going to result in a rude slap in the face....literally for people like DarthNeuro

I mean pretty much everyone is abused in residency.

 

[missense]

OMG OP, what a subject!? i am a US medical student (class ’09) and i do agree that FMG’s (especially those born and raised elsewhere) have a harder time joining the system on many levels (beyond tests, grades, or even language barriers). but as you can see from some of the posts, people just don’t get it. the thing is, if you have never experienced prejudices or racism first hand then it is easy to dismiss this complaint as a problem for someone else, somewhere else. and that is no excuse to ignore the problem.

maybe what OP is describing sounds more like prejudices or racial insensitivities than blatant racism, but when you get down to it – that’s all just semantics really and doesn’t negate what OP is trying to bring to the light here. as others have already stated, the problem is really much bigger than just residency programs in the US. so, it is a lot to try to discuss in this kind of a format.

but to stay on topic, i also agree that it is unfair to slam the entire US system, because every program doesn’t operate the same way. but we should all recognize that prejudices and racism exists worldwide (even among people in the same ethnic or racial groups). it’s hard to get away from them (prejudices). after all, we are human and our beliefs and habits are shaped by the world around us (MD or not). i’m even stunned by some of the ignorant and culturally insensitive comments posted within this thread among professionals (i won’t bother to quote them) – but where there is ignorance all we can try to do is educate!

i am not telling you all to go out there and be activists (i am not one by any means) but we can start with ourselves by refusing to tolerate prejudices and racism (among your colleagues, social circles, etc). if we look back at history we see that with a focused effort, we can bring about change.

i am sure we can all come up with examples about why OP’s original comment is true or not true, but i think that this problem is bigger than our own individual experiences and there is no denying that these types of things happen to someone, somewhere and we shouldn’t tolerate it one bit!

i don’t know where this particular discussion will end. but honestly, if nothing else, i hope this thread gets us all talking about this issue among our colleagues etc.

------------------------
My Friends... "We cannot forever hide the truth about ourselves, from ourselves." John McCain

 

[Doowai]

In my opinion, residency spots should go to AMG's first (MD/DO), then to foreign born FMG's, then American born IMG's. ....... Don't just scream racism at every corner hoping someone will jump on this ridiculous band wagon.

Ok seriously, no doubt racism as a state of mind and as a reaction still exist. It just is going to do you little good to use it as an excuse or a course of action - it will probably only cause you problems.

And in response to the above - I feel residency spots (with USMLE, clinical evaluations and LOR's being equal) should go to AMG's, then American born IMG's and then foreign born FMG's. The reasons are 1) US born IMG's tend to have done their clinical training in US hospitals, and knowing the ins and outs of everything from admissions to discharges is a big hurdle to have overcome - residencies want the people who are the easiest to utilize, and having someone already trained in the system in place here is a huge perk 2) While some see foreign born FMG's as perhaps smarter as they are going locally (where as US born IMGs are leaving for education), there is often less competition academically in other countries, and opportunity is often more fickle over seas. In the USA competition is fiercer, as opportunity is more evenly spread through the socioeconomic strata because of things like AFFIRMATIVE ACTION. This country goes to great lengths to make sure everyone gets a chance.

Social status plays a more decisive role in advanced academia in India than the US - how often does the poorest of the poor have a chance for high quality university education in Pakistan (or China)? Many very poor go to Harvard or Stanford - both of which are very generous in scholarships.

Many US born FMG's are fairly close to the average AMG - I had a 3.58 undergrad GPA (with a minor in chemistry) from a very old well-known private University, and just decided to go to the Caribbean without even applying to a US medical school because I did not want to bother with the struggle of competition in US medical school (MD program) and even more so did not want the staggering debt that would accrue from US medical school.

 

[sirus_virus]

A few points:

1) As a white guy, I cannot tell if indians or any other minority groups are experiencing racism, so I don't know why people are dimissing OP's claims without being in his shoes. I would like to hear from more minority physicians about this issue.

2) Prejudice exists in this society, but the U.S remains the most tolerant society period (YES I SAID IT). Look guys, no other country accepts the volume of foreign doctors the US accepts. The Europeans will spit in your face if you even remotely sugest you deserve a spot in their residency programs. They even have laws to make sure you are not garaunteed these rights, and if the agitation continues, look for the U.S to start pushing for those type of labor laws pretty soon.

3) Saying a foreign medical student has the same rights to U.S residency spots as a U.S citizen is like saying I have the right to sleep with your spouse, especially if I can show that I might be better at it.

4) There is a lot of work to be done in this country regarding race relations and tolerance, but this is the most rapidly evolving society when it comes to race and tolerance (BLACK PRESIDENT IN THE HOUSE), give it some time guys and make sure you do your part.

 

[memberkane]

Look at this example below.
This dude WAGY27 claims to be "a physician who is Indian" despite being born and raised in US. Dude, YOU are NOT an Indian. You are SUPPOSED to proudly call yourself an American. Somebody like you, born and brought up in US is still clinging or is having to cling onto his ethnic identity. Why? I dont know but maybe it is because you STILL do not feel at home. And you say that everything is great with racial relations. This is the point. And you are aggressively attacking me for putting forth my view and experiences, is it fair?
And all the while I have been clearly talking about INternational medical graduates from 3rd world countries like India, not American born people of Indian origin.

I am only asking for a more fair and objective system, not pleading for anybody to give Indians more residency positions. I hope I am clearly putting this forward.

Taking/ selecting people initially into residency programs is entirely the privilege of faculty. Once again I say that the most competent people should be selected into residency. If you dont think that a particular group will fit into your program, then dont take people from that group. That way both of you dont bother with each other. If you are taking people into your program, doubting all the time whether they will fit, you are dooming their careers - because you subconciously will be cynical of them. The golden rule of Medicine is "First do no harm". I mean, if there is such a high incidence of Indian people having to be kicked off midway in certain programs, then why in god's name are the programs taking them in?

Again, I NEVER said that everyone in US is racist. I like Americans, their country and beleive in their system - that is the reason I came there for residency and did not go to timbuktu or somewhere else. This discussion is about cultually biased faculty exploting IMGs. American residency system is truly good - but these bad apples - and there are a lot of such bad apples around -are perverting it and abusing IMGs via this system.

I am surprised at several people aggressively denying ANY racial prejudice in the residency system! Most of you are people through with residency, or AMGs or senior attendings who do not want to accept this bitter reality. There is racial prejudice all over the world, even in India, among several sub races of India. It would be childish to say that people have completely gone beyond racial preferences.

THis is my point- in several ways misunderstood in this thread. Here goes:

All residents (AMG, IMG) are vulnerable - residency is a period where your technical and personal skills are evaluated in a very subjective manner. Attendings or senior residents are HUMAN too. they have likes, dislikes just like a man on the street - just because they are highly trained in Medicine does not mean that they become dispassionate judges of people. OK.
IMGs especially are more vulnerable because they are foreigners, look different, have different accents, different personal approach etc., PDs, faculty, nurses, senior residents everyone know these simple facts.

I do not and am not supporting technically incompetent residents - this entire discussion is about competent IMGs facing cultural bias. Some unfortunate AMGs are facing personal bias, but unfortunate IMGs hve to face personal bias + cultural/ racial bias.

These IMGs esp. on visas will have to go back to home countries, if they are terminated, and will practically NOT have a second chance. So, if a program is taking such IMGs into their program to fill in their slots, then maybe they should also be more culturally flexible. They should maybe ask the applicants technical questions, present a case etc during the interview to know their technical skills and english skills. And the IMGs would have passed USMLE of course. If they then decide to take the IMG after ascertaining all these things, they maybe ask him to do a 1 month observership/ externship with them. They should think about ranking the IMG for the match ONLY if they fit their technical and cultural grade.

What is happening, is programs taking IMGs on visas into the programs, treating them in a "DIME A DOZEN" manner, expecting the moon from them even in comparison to other AMGs, terminating them basically because they are not "cool enough" or won't suckup enough to them - and doing all this in the name of "clinical skills or patient care."

I have seen these kangaroo-court like evaluations and judgements happening to Indian IMGs on visas more than any other race/ nationality. I hope the readers will look around non-renewed, terminated resident examples and see that this is indeed true. Why? I don't know. But programs are doing it with impunity as people from the Indian subcontinent seem to be soft targets.

I am just asking for PDs and people in power especially the biased ones to be more humanistic and practical in their initial resident selection. Don't take Indians into your programs if you don't think you like them or will not fit, then they will know that they are unwanted, will not spend their time and money coming to your program or even possibly the US for training and getting treated 2nd class. Beleive me, people never want to go to a place where they are unwanted. Some of the people here dont seem to know these realities about the abuse of IMGs/ Indian IMGs on visas, and maybe it's because they are not IMGs or Indians.

Again, thanks and keep contributing your ideas on this subject.

As a physician who is Indian, but born and raised in the United States, i strongly disagree with the above sentiment. ....... In the past, 20-25 years ago, I would say there was a singificant disparity in the treatment but at this time I would argue that it has improved significantly.

 

[memberkane]

Here goes:

2. Europeans are ethinic - Americans in general are of mixed racial origin. A slavic white from Russia considers himself different from a Nordic white from say Germany. Being white does not mean you and them are the same. USA was built by immigrants and descendents of immigrants. You are probably a descendent of immigrants - and you won't let others in now? Europe was not built by immigrants - I think their laws are fair.

3. Nobody wants to sleep with your spouse. Bad analogy - doctors come to US for a better education and better life.

4. The black president is there because of his personal merit - not because of your sympathy or your pity - don't take credit for it.

A few points:

1) As a white guy, I cannot tell if indians or any other minority groups are experiencing racism, so I don't know why people are dimissing OP's claims without being in his shoes. I would like to hear from more minority physicians about this issue.

2) Prejudice exists in this society, but the U.S remains the most tolerant society period (YES I SAID IT). Look guys, no other country accepts the volume of foreign doctors the US accepts. The Europeans will spit in your face if you even remotely sugest you deserve a spot in their residency programs. They even have laws to make sure you are not garaunteed these rights, and if the agitation continues, look for the U.S to start pushing for those type of labor laws pretty soon.

3) Saying a foreign medical student has the same rights to U.S residency spots as a U.S citizen is like saying I have the right to sleep with your spouse, especially if I can show that I might be better at it.

4) There is a lot of work to be done in this country regarding race relations and tolerance, but this is the most rapidly evolving society when it comes to race and tolerance (BLACK PRESIDENT IN THE HOUSE), give it some time guys and make sure you do your part.

 

[memberkane]

Medicine is supposed to be and should be a meritocracy. But remember that in a meritocracy, objective parameters define that merit, no subjective parameters.
And by the way, who told you that I was arguing for anything anti-meritocratic? I am for meritocracy and against cultural bias.
Prejudice and cultural bias should not pass in the name of "merit".

People and posters can go around and around on this issue until they are blue in the face but once you actually work in medicine the truth will become apparent: medicine is intensely meritocratic, more so than probably any other field of study or area in society.

 

[memberkane]

I am answering this for Darth and others who compare Blacks and IMGs. But, the truth is that the "different looking" and vulnerable IMGs are the soft targets here.

I am happy that Black residents are not so vulnerable.

In fact, I dare any racist/ biased PD or faculty to create problems for black american residents. These faculty will be scared to do that, because they will get their a** kicked.

The american blacks had to face prejudice in different walks of life for a long time, atleast they don't have to face it helplessly in the residency system.

I think the poster on race relations has cultural issues with attendings as he noted that black US residents don't have the same problems.

 

[memberkane]

Hey wagy,

Are you saying that IMGs should put up with cultural/ racial bias or just leave the country. Who are you trying to cozy up to?

You are not an IMG, not an Indian, not on a visa - how do you think your situation is similar to their situation?

Cool down your ranting and digest reality if you can.

If you don't like the situation, then leave the program or hell the leave the country, and figure something to do with your life. Don't just scream racism at every corner hoping someone will jump on this ridiculous band wagon.

 

[bjackrian]

Cool down your ranting and digest reality if you can.

Pot, meet Kettle. Kettle, Pot.

It seems that a lot of people on this thread have tried to give honest and sincere reactions to the OP's original comments. The OP doesn't seem to want to hear anything other than that he's right and has been discriminated against. Dismissing everyone else's comments as rants or as not valuable because they are not an international student or because they have had different experiences is not the way to a productive conversation.

 

[142348]

Memberkane-

1) "This dude WAGY27 claims to be "a physician who is Indian" despite being born and raised in US. Dude, YOU are NOT an Indian. You are SUPPOSED to proudly call yourself an American. Somebody like you, born and brought up in US is still clinging or is having to cling onto his ethnic identity. Why? I dont know but maybe it is because you STILL do not feel at home."

Are you seriously saying that I can't claim to be Indian because I was born and raised in the United States. I think of myself as an Indian-American and am quite proud of both aspects, my Indian heritage, and my own life as an American. As to not feeling at home, I love where I'm from and have extremely strong ties, so much so that I came back for my residency training.

2)"And all the while I have been clearly talking about INternational medical graduates from 3rd world countries like India, not American born people of Indian origin"

This is the problem...you don't realize that the reason you may be getting treated differently isn't because of your brown skin(which I share with you) but your failure to conform to social norms. I do believe that it is my position as an Indian-American to stand up and say that you are wrong and not let people believe that all Indians believe in your viewpoint.

3)"What is happening, is programs taking IMGs on visas into the programs, treating them in a "DIME A DOZEN" manner, expecting the moon from them even in comparison to other AMGs, terminating them basically because they are not "cool enough" or won't suckup enough to them - and doing all this in the name of "clinical skills or patient care."

Seriously....I think that some culpability lies with the applicants here. It is quite easy, if you take the time, to ascertain which programs have a history of behavior such as this. I can list off program I know of that use AMG/FMG's for a year or 2 of prelim and dump them or that are fairly malignant. Is this fair? No. However, you should be an informed applicant and stay away from these programs. If these are the only programs you can get into then think about strengthing your application, accepting the spot and dealing with the garbage, or choose not to come over to the country. As to the last component, I think this is the case whether or not you are an Indian FMG or not. PD/Attendings will find it much easier to relate with someone who can hold a social conversation with them and are aware of social norms. I'm sure I got better evaluations over the years from male attendings who are into football because it's a shared interest we could discuss on top of medicine. That's part of having a subjective system that will be there regardless of where you matriculated from. Your problem with this is that Indian-FMG's often don't have these social norms down and fail to "schmooze" as you call it.

"Cool down your ranting and digest reality if you can"
Growing up in a family with a mother who was an Indian-FMG, who came here and did residency 30 years ago under racial conditions that were abhorrent has led me to be sensitive to this topic. I have, over the course of my life seen this country become more and more accepting of Indians. That isn't to say that there are still people who hold a prejudice against Indians. If you knew what your predecessors went through maybe you wouldn't be so quick to scream racism at every corner and would instead see progress.

 

[memberkane]

WAGY 27,

Please realize that you are diverting this conversation. This thread is about competent (physically+emotionally+technically+socially competent) IMG residents on visas becoming soft targets at the hands of PDs and faculty - who are racially/ culturally biased. In my experience in the US I saw Indian IMG residents become unfair targets, at my program as well as other programs -hence putting forward an argument for fair treatment.

You are aggressively denying racism/ cultural bias in US residency system, and trying to dilute my argument by saying that you are a brown skinned and hence an Indian - and because you had it good, there is no bias in residency.

let me answer your questions:

1. first, I am glad that you have some respect and pride for your country of origin. unfortunately, you cannot be called an "Indian" because being born in USA and enjoying a US passport, you do not have an Indian passport or identity. You are required to CHOOSE whether you want to be Indian or American ( India does not allow double citizenship) and you chose American for your benefit and convenience. You are an American of Indian origin, say like Mr. Khan is an American of Pakistani origin - but NOT an Pakistani. I can stay in the US for a long time, or whole life - but cannot be called an American unless I am truly an American citizen.

This discussion is not about American people/ US born citizen residents like you - this is about the vulnerability and bias faced by IMGs on visas from 3rd world countries - which you are not. Being Brown is not equal to being Indian.

2. You are making stereotyped assumptions:
Conforming to social norms: I went to school in the US until high school, my dad worked here then. I did excellent there. I went to graduate school in US- did great there. Did clinical research and rotations in US hospitals - great recos and experience there.
What makes you think that I or Indian IMGs fail to conform to social norms here? or do not know US culture? and that you conform better?

3. It is NOT easy/ practically possible for applicants to "figure out" biased programs from regular programs. If it is easy, do everyone a favor and put up a list of programs which are "good" and a list of which are "bad" - Aha!!. What makes you think you are better than IMGs or others at holding social conversations with PDs and currying favor with them? BIAS cannot be corrected through conversations.

4. Look, you are coming to the point. You say that conditions were "racially abhorrent" 25 years ago. If you had stated that over forums/ other ways 25 years ago, people -white, black and brown would have vehemently disagreed, and stated that you are saying so because YOU are socially misfit here.
I agree that racial/ cultural understanding has definetely improved over the years, but don't say that there is NO or negligible racism/bias. You can FEEL it only when it hits YOU. Maybe you had all good experiences - count your blessings, but that definitely does NOT mean that racism/ bias/ cheap treatment of 3rd world IMGs does not exist in US residency system.

AND "Cool down your ranting and digest reality if you can" is a reply to your rough and insensitive statement:

Originally Posted by wagy27
If you don't like the situation, then leave the program or hell the leave the country, and figure something to do with your life. Don't just scream racism at every corner hoping someone will jump on this ridiculous band wagon.

Memberkane-

1) "This dude WAGY27 claims to be "a physician who is Indian" despite being born and raised in US. Dude, YOU are NOT an Indian. You are SUPPOSED to proudly call yourself an American. Somebody like you, born and brought up in US is still clinging or is having to cling onto his ethnic identity. Why? I dont know but maybe it is because you STILL do not feel at home."

Are you seriously saying that I can't claim to be Indian because I was born and raised in the United States. I think of myself as an Indian-American and am quite proud of both aspects, my Indian heritage, and my own life as an American. As to not feeling at home, I love where I'm from and have extremely strong ties, so much so that I came back for my residency training.

2)"And all the while I have been clearly talking about INternational medical graduates from 3rd world countries like India, not American born people of Indian origin"

This is the problem...you don't realize that the reason you may be getting treated differently isn't because of your brown skin(which I share with you) but your failure to conform to social norms. I do believe that it is my position as an Indian-American to stand up and say that you are wrong and not let people believe that all Indians believe in your viewpoint.

3)"What is happening, is programs taking IMGs on visas into the programs, treating them in a "DIME A DOZEN" manner, expecting the moon from them even in comparison to other AMGs, terminating them basically because they are not "cool enough" or won't suckup enough to them - and doing all this in the name of "clinical skills or patient care."

Seriously....I think that some culpability lies with the applicants here. It is quite easy, if you take the time, to ascertain which programs have a history of behavior such as this. I can list off program I know of that use AMG/FMG's for a year or 2 of prelim and dump them or that are fairly malignant. Is this fair? No. However, you should be an informed applicant and stay away from these programs. If these are the only programs you can get into then think about strengthing your application, accepting the spot and dealing with the garbage, or choose not to come over to the country. As to the last component, I think this is the case whether or not you are an Indian FMG or not. PD/Attendings will find it much easier to relate with someone who can hold a social conversation with them and are aware of social norms. I'm sure I got better evaluations over the years from male attendings who are into football because it's a shared interest we could discuss on top of medicine. That's part of having a subjective system that will be there regardless of where you matriculated from. Your problem with this is that Indian-FMG's often don't have these social norms down and fail to "schmooze" as you call it.

"Cool down your ranting and digest reality if you can"
Growing up in a family with a mother who was an Indian-FMG, who came here and did residency 30 years ago under racial conditions that were abhorrent has led me to be sensitive to this topic. I have, over the course of my life seen this country become more and more accepting of Indians. That isn't to say that there are still people who hold a prejudice against Indians. If you knew what your predecessors went through maybe you wouldn't be so quick to scream racism at every corner and would instead see progress.

 

[McGillGrad]

WAGY 27,

Please realize that you are diverting this conversation. This thread is about competent (physically+emotionally+technically+socially competent) IMG residents on visas becoming soft targets at the hands of PDs and faculty - who are racially/ culturally biased. In my experience in the US I saw Indian IMG residents become unfair targets, at my program as well as other programs -hence putting forward an argument for fair treatment.

You are aggressively denying racism/ cultural bias in US residency system, and trying to dilute my argument by saying that you are a brown skinned Indian - and because you had it good, there is no bias in residency.

You do not deserve to continue in a program if you cannot communicate fluently in the national language, cannot adapt culturally or cannot perform your required duties (pertaining to the local traditions).

If you are brown (paki or dot-Indian) and cannot speak or perform then it is positive discrimination and it is the best type of discrimination. It is not racism and your insistence that anything that discriminates someone different is racism is a prime example of your totalitarian intolerance.

 

[memberkane]

Mcgillgrad,

Did you read my sentences that you quoted?? I suggest you read them once again.

I am talking about culturally+technically+socially+emotionally competent IMGs with excellent or very good english speaking skills getting discriminated against by biased people in power, just because of their race/national origin/appearence/vulnerability.

Your use of derogatory words like "dot-indian" or "Paki" suggests that you have some bias yourself. and you are trying to talk holy, and lecture about discrimination!!!!

You do not deserve to continue in a program if you cannot communicate fluently in the national language, cannot adapt culturally or cannot perform your required duties (pertaining to the local traditions).

If you are brown (paki or dot-Indian) and cannot speak or perform then it is positive discrimination and it is the best type of discrimination. It is not racism and your insistence that anything that discriminates someone different is racism is a prime example of your totalitarian intolerance.

 

[dragonfly99]

Could we please refrain from personal attacks on this thread (all of you!).
Thanks.

 

[McGillGrad]

You are erecting a strawman argument. No one ever said that people who fit in and are competent should be discriminated against. Who are you debating here? What proof do you have of such people being discriminated against? This is just your imaginary fantasy world where you imagine yourself to be all that you described (when you probably lack in some areas) and are trying to cry foul over your own faults.

Since when is the use of paki or dot-indian derogatory? It sounds like you are overly sensitive and irrational. If you were culturally north American you would realize that there are American Indians here too. Hence the need to differentiate between the two. Yet, Another reason why culture is important to reduce confusion for people like you.

Mcgillgrad,

Did you read my sentences that you quoted?? I suggest you read them once again.

I am talking about culturally+technically+socially+emotionally competent IMGs with excellent or very good english speaking skills getting discriminated against by biased people in power, just because of their race/national origin/appearence/vulnerability.

Your use of derogatory words like "dot-indian" or "Paki" suggests that you have some bias yourself. and you are trying to talk holy, and lecture about discrimination!!!!

 

[AmoryBlaine]

Medicine is supposed to be and should be a meritocracy. But remember that in a meritocracy, objective parameters define that merit, no subjective parameters.
And by the way, who told you that I was arguing for anything anti-meritocratic? I am for meritocracy and against cultural bias.
Prejudice and cultural bias should not pass in the name of "merit".

I actually didn't say anything at all about you in particular. In the same vein as your last sentence -- people can't suck at their jobs and then claim that they are being discriminated against based on race.

Seriously just wait until you get to residency. Behind 95% of unfair treatment is a resident who sucks.* Look if you show up on time, are organized, present well, follow up on things, and get along with people you can have purple skin and the heaviest accent in the world and people are going to like you and respect you. I know on some level some people would like to believe that there are more sinister forces at work but for the most part it is not the case.


* Sucking as a resident has little if any correlation to race, creed, color, primary language.

 

[MediumDef]

Since when is the use of paki or dot-indian derogatory? It sounds like you are overly sensitive and irrational. If you were culturally north American you would realize that there are American Indians here too. Hence the need to differentiate between the two. Yet, Another reason why culture is important to reduce confusion for people like you.

I don't agree with most of the OP's statements but he was right about this. I feel it is at a minimum disrespectful if pressed I would vote for derogatory. If you're not sure then next time you meet someone from the Indian subcontinent ask them if they're a Paki or Dot-Indian and see their reaction.

 

[RebelWarriorUK]

Since when is the use of paki or dot-indian derogatory? It sounds like you are overly sensitive and irrational. If you were culturally north American you would realize that there are American Indians here too. Hence the need to differentiate between the two. Yet, Another reason why culture is important to reduce confusion for people like you.[/QUOTE]

In the interests of cultural education and sensitivity, I feel compelled to reply to this statement even though it is off-topic from the thrust of the main thread.

"Paki" is an extremely offensive term, although not used much in the US against people of south asian descent. It is akin to using another racist word that we have all heard against Black people. It is a racist term that is used in many different countries around the world and I am surprised that you are not aware of this, since you state you are from Canada (where it is used in this manner). Given that people from all over the world read this forum, I wanted to clarify things so that this discussion could stay civil. So trust me, many people are not "sensitive" or "irrational" when they take offense to this term. Its a term that has been used for decades as a derogatory, blanket term for south asians in countries like England, Australia.

"Dot-Indian" is also offensive but more than anything shows laziness, how difficult is it to write "Asian Indian" or "Native American"?

Its very easy to dismiss this as people being overly-sensitive when you don't know the history/cultural impact of these terms. It is obvious that you are unaware of this, and so I just wanted to clarify things. However, I couldn't just "let this go" without setting the record straight. Anyway, back to the discussion.....

 

[Indiandok]

Memberkane and friends, listen, this ppls are foolish and cann0t comprehend racism????!!!!!

I had this experienzes in my program and got written ups many times so I know your difficulties. Some writeups from these dummies included -----

1. talking in hindi to my mother on phones in patient room
2. putting the oils on my hair and head every day because this will stop the hairs from falling.
3. having fights with these unreasonable pakistaniz in dis slum hole
4. eating once the patientz foods - this I never did.
5. eating rice with hands at annual lunch (but this the program manager gave me warning that it will not be polite).

Thos unreasonable people don't know racism. Also, Obama is white man. I suggest to you to post in www.usmleforum.com. Our sisters and cousins will understandz is with clearness????????!!!!!!!!

I am also dot indian like they are referring. sorry for mistakes. I learnt the english while doing usmle!!!!!!!! the private message is best contacts for me.

 

[McGillGrad]

This board is not much for sarcasm, apparently?

The whole point of the paki and dot-not-feather indian remark was to get a rise out of the person to which I was replying.

Anyone without a thick skin will get emotionally irrational over simple words like ni*ger, chink, ****, camel-jockey, injun, cracker etc etc. That is a sign of weakness and will be exploited by the person using the word to hurt someone.

They are just words and have no power unless you act like a victim and let it take control over you. There are many protocols in place to correct people who use those terms in their professional lives.

I appreciate the pseudowikipedia education from a citizen of a nation that enslaved and exploited all of Asia and a good portion of Africa. Ironic, don't you think, govn'er?

In the interests of cultural education and sensitivity, I feel compelled to reply to this statement even though it is off-topic from the thrust of the main thread.

"Paki" is an extremely offensive term, although not used much in the US against people of south asian descent. It is akin to using another racist word that we have all heard against Black people. It is a racist term that is used in many different countries around the world and I am surprised that you are not aware of this, since you state you are from Canada (where it is used in this manner). Given that people from all over the world read this forum, I wanted to clarify things so that this discussion could stay civil. So trust me, many people are not "sensitive" or "irrational" when they take offense to this term. Its a term that has been used for decades as a derogatory, blanket term for south asians in countries like England, Australia.

"Dot-Indian" is also offensive but more than anything shows laziness, how difficult is it to write "Asian Indian" or "Native American"?

Its very easy to dismiss this as people being overly-sensitive when you don't know the history/cultural impact of these terms. It is obvious that you are unaware of this, and so I just wanted to clarify things. However, I couldn't just "let this go" without setting the record straight. Anyway, back to the discussion.....

 

[McGillGrad]

lmao!

So wrong, yet so funny!

Memberkane and friends, listen, this ppls are foolish and cann0t comprehend racism????!!!!!

I had this experienzes in my program and got written ups many times so I know your difficulties. Some writeups from these dummies included -----

1. talking in hindi to my mother on phones in patient room
2. putting the oils on my hair and head every day because this will stop the hairs from falling.
3. having fights with these unreasonable pakistaniz in dis slum hole
4. eating once the patientz foods - this I never did.
5. eating rice with hands at annual lunch (but this the program manager gave me warning that it will not be polite).

Thos unreasonable people don't know racism. Also, Obama is white man. I suggest to you to post in www.usmleforum.com. Our sisters and cousins will understandz is with clearness????????!!!!!!!!

I am also dot indian like they are referring. sorry for mistakes. I learnt the english while doing usmle!!!!!!!! the private message is best contacts for me.

 

[RebelWarriorUK]

Obviously you are not a minority. I am a British indian, so I've had the experience of growing up in the UK and hearing these terms (so the irony is lost on me smarty-pants). Trust me its not a matter of having a thick skin when neo-nazis are trying to pick a fight with you on the bus and are hurling these terms around. You obviously haven't experienced it, and the frivolity with which you are handling this topic shows your ignorance. I was merely trying to educate you because these terms are hurtful and dredge up years of discrimination and the fact that you would use them to "get a rise" out of someone else is pretty apalling. Use your head before you write things.

This board is not much for sarcasm, apparently?

The whole point of the paki and dot-not-feather indian remark was to get a rise out of the person to which I was replying.

Anyone without a thick skin will get emotionally irrational over simple words like niger, chink, ****, camel-jockey, injun, cracker etc etc. That is a sign of weakness and will be exploited by the person using the word to hurt someone.

They are just words and have no power unless you act like a victim and let it take control over you. There are many protocols in place to correct people who use those terms in their professional lives.

I appreciate the pseudowikipedia education from a citizen of a nation that enslaved and exploited all of Asia and a good portion of Africa. Ironic, don't you think, govn'er?

 

[McGillGrad]

Obviously making assumptions is dangerous because you are wrong. I have been a minority my whole life, just not a visible minority.

Once again, you are allowing yourself to be controlled by words. As for the "neo-nazis" that were "trying to pick a fight" with you, that sucks but that is what the police and self-defense classes are for. Stop being a victim.

Obviously you are not a minority. I am a British indian, so I've had the experience of growing up in the UK and hearing these terms (so the irony is lost on me smarty-pants). Trust me its not a matter of having a thick skin when neo-nazis are trying to pick a fight with you on the bus and are hurling these terms around. You obviously haven't experienced it, and the frivolity with which you are handling this topic shows your ignorance. I was merely trying to educate you because these terms are hurtful and dredge up years of discrimination and the fact that you would use them to "get a rise" out of someone else is pretty apalling. Use your head before you write things.