I am worried about this, and mostly since I will barely match at a third-tier program this year, that when the S&*% hits the fan soon about the problems with rads' future, people will flee the rads match next year...and if I would have waited a year, I would have been able to go where I really wanted to go. A similar thing happened in anesthesia some years ago.
The problem is there are too many disparate, well-thought out opinions from very intelligent people on this.
Also, there is a lot of emotional bias; people have the ability to convince themselves of only the positive outlook. When you go on residency interviews, everyone will tell you they are "happy"; when some, especially at third tier programs, are obviously not...which they later tell you on your second look. Nobody will tell you they regret their choice, because they have CONVINCED themselves that's the way it is...it's their psychological survival mechanism...the positive spin is everywhere and is SO frustrating when you want to be open-minded.
Current attendings have relatively less to lose than students about to start a radiology residency...rads residents, again, have to convince themselves (and thusly, other people) that everything will be fine, and they haven't made a mistake.
Even though I have spent hours reading everyone's point of view, I am still scared. At the end of this posting, I will share what I've heard can be done about this...and I welcome anyone corrections, because I want to be proven wrong.
Also, most importantly, I haven't heard a PEEP out of *any MGH rads resident* on any discussion boards...if you're out there, can you please share your thoughts? If anybody knows one, can they please inquire?
We have nothing to fear form foriegn docs doing PRELIM reads, which is being done now...in addition to being done by er docs and rads residnts here...it just won't make a huge dent. But Harvard's design to outsource FINAL reads is what is scary.
What scares me is that MGH (Harvard's hospital) brings the thunder...if they put their will into it, I don't think they will be swept under the rug. The outcry form the radiology community is as loud as it will *ever* be (the people who care about this pretty much already know about it), and they are proceeding full steam ahead. The people with real power to wield are not threatened by this because it won't hit for a number of years, and they can probably benefit too (50 yr old rads docs who have already made their money and sit on medical boards will be happy with not having to take call, they already are partners, maybe they can get a piece of the action somehow, etc). I don't think the public's general outcry over "outsourcing" will cover this when they find out radiologists will still make close to six figures, and they (the public) will save so much money. The idea of Indian docs reading X-rays is much more palatable if they are "Harvard trained and supervised". It is very important to understand exactly what they are doing...
The state of MA only requires one to have 2 years of graduate medical education to get a MA license. But who's going to sponsor a 2 year residency/fellowship for any reason? you won't be able to get hospital priveleges with just that, whe you haven't has a US intern year, passed all 3 parts of the USMLE, be board certified, etc.
EXCEPT Harvard.
The following is taken form articles quoting MGH's radiology professor Sanjay Saini...to confirm, visit Aunt Minnie.
MGH wants to bring over the most promising indian radiologists for their fellowship and then send them back...(they will have no choice but to go back...they will only have a MA license, not a VISA or citizenship, etc) Don't think the indian docs aren't smart enough, look around at the smart indian docs you already know...plus these will be the best of the best, will receive Harvard training, will super-specialize, will get regularly updated training, over the web and in Boston once in a while, and spend less more time on fewer films....their income will be doubled back in India while still remaining one-tenth of the standard US rads salary.
They will do FINAL reads for MGH (and maybe other MA hospitals) because they will be licensed to do so and will get hospital priveleges from MGH. They will NOT be able to do any reads for Medicare patients, which is a federal program and will not reimbursed for any reads done on foriegn soil...that will be the lawmaker's symbolic gesture to the public ("No outsourcing of Federal contracts" but I doubt they will micromanage a small program by Harvard...or meddle in the workings of MA's medical boards). So after proving the program, and using Harvard's name, MGH will market this service to other hospitals, and cherry-pick all the films that will be reimbursed by third party payors.
Harvard puts clout behind this novel idea. They will obviously grant hosptial priveleges to their own graduates. Right now they are employing indian rads to do 3-d reconsructions. One of India's largest companies, Wipro, is on board. Sanjay Saini has admitted publicly that he is trying to circumvent current regulations. I think Harvard probably has pull on the MA medical board.
How many people will this effect? I don't know. PLEASE point out how I am wrong. PLEASE investigate the thoughts of current MGH rads residents.
I am sorry for not posting the links to the articles I sources...if you search in the resident's forum in aunt minnie you can find them.
So what can be done? Go to the ACR's website, and find out who your state's representatives are...email them (or better yet, get someone from your school's rads club to take a letter around to get signed by students and rads residents, then mail it). Tell the rep that the ACR needs to put this issue of outsourcing (not just prelim reads, specifically what MGH is doing) before committee at the next meeting and come up with a position statement. That may be the only thing that can influence the MA medical board, which the ACR has no power over.
word is born.
