Read this before you think about doing a long fellowship or surgical residency

[voxveritatisetlucis]

Special Consideration Pathway Pilot Program for International Medical Graduates Who Meet ACGME’s Exceptionally Qualified Candidate Criteria

The ABIM Council—which comprises the chairs of the individual specialty boards and advisory committees, as well as public and patient members—is exploring the idea of pursuing a pilot program to create a pathway to initial certification and MOC for international medical graduates (IMGs) who have completed their internal medicine training in another country and then completed accredited fellowship training in the U.S. The Accreditation Council for Graduate Medical Education (ACGME) has established criteria for exceptionally qualified internationally trained residents to enter accredited fellowship programs and continue if they are successfully assessed on the core competencies of ACGME and the American Board of Medical Specialties (ABMS). Physicians with that training background are currently ineligible for certification/MOC because their residency training is not ACGME-accredited.

What would something like this mean for US graduates? Likely more fellowship positions, more IM doctors, and therefore lower salaries. Imagine doing 4 years of undergrad, 4 years of med school, 3 years of residency, and 3 years of fellowship only to make 100k and not be able to pay off loans because the market is so saturated. Seems likely that this would lead to a dramatic expansion of heme onc fellowship positions. It also seems likely that this is coming to all specialties

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[GoSpursGo]

This means nothing for AMGs. Nobody is going to make $100k post-fellowship.

 

[DrStephenStrange]

Bruh, that’s some real mental gymnastics.

 

[voxveritatisetlucis]

Why are they doing it then? Isn’t heme onc already a tough match? Why make it harder?

 

[GoSpursGo]

Why are they doing it then? Isn’t heme onc already a tough match? Why make it harder?

There are not that many "exceptionally qualified international residents." In general AMG who have completed US residency have an overwhelming advantage in the fellowship match, which they will retain. This policy is simply a recognition that for the international applicants who are truly exceptional, it is idiotic to then make them go back and do a general IM residency.

 

[pierty]

I am not surprised that you continue to focus on this and every other event in the most anxious manner possible.

Why medical school? You sound like you aren't happy and ultimately just want to make money (it is the focus of every single post). There are so many other pathways that would be much more appealing to you. Regardless, I don't think that constantly making posts neurotically obsessing over "wage potential" as a first-year medical student is doing much for you or anyone. At some point, one has to realize how much of their personality and perspective taints every aspect of their life and profession.

 

[Bored Snorlax]

America is fortunate to have "Exceptionally Qualified Candidates" choosing to work here. As long as they meet ACGME criteria, an alternate pathway seems reasonable. I won't comment on the $100k salary speculation .

 

[operaman]

I think the numbers here will be fairly small as programs will still prefer AMGs and a known product. Nice option for some foreign docs though and seems like a better approach to put them through an acgme program rather than something like TN’s new bill where it’s more nebulous supervised practice. These folks will be trainees and non billing so there’s not much immediate profit motive.

Salaries in medicine are influenced by too many factors to reduce everything to simple supply and demand. For one, physicians can work independently and form groups. There are many obstacles to this, but I’ve seen plenty of employed docs get fed up with their hospital and set up their own shop successfully. It may have some downward impact on wages but I don’t think this alone will drive them down to 100k.

Like for me, I generate well over $2m in revenue annually. Even if my overhead were 90%, I could generate more than 100k in private practice. I have no desire to do that, but if they cut my pay by that much I probably would! So in medicine I think the employed salary floor will be supported by the realistic potential income from solo or small group practice.

 

[voxveritatisetlucis]

I am not surprised that you continue to focus on this and every other event in the most anxious manner possible.

Why medical school? You sound like you aren't happy and ultimately just want to make money (it is the focus of every single post). There are so many other pathways that would be much more appealing to you. Regardless, I don't think that constantly making posts neurotically obsessing over "wage potential" as a first-year medical student is doing much for you or anyone. At some point, one has to realize how much of their personality and perspective taints every aspect of their life and profession.

I had a well paying job that I left for medical school so clearly it’s not all about money but I do think that it’s important. Some people don’t have inheritances, high paying spouse or substantial savings etc. that they can rely on. I’m not paying for medical school but feel bad for friends who are going 400k+ (updated coa at school is like 101k) in debt for something that may no longer have the potential to pay it off. To even buy a house in most states now, one needs to make like 120k+ and that’s without massive loans. If one is 30 something with that salary and debt, they will likely never own a house, be able to help kids with education etc.

 

[AnonymousDoctorGuyPerson]

I had a well paying job that I left for medical school so clearly it’s not all about money but I do think that it’s important. Some people don’t have inheritances, high paying spouse or substantial savings etc. that they can rely on. I’m not paying for medical school but feel bad for friends who are going 400k+ (updated coa at school is like 101k) in debt for something that may no longer have the potential to pay it off. To even buy a house in most states now, one needs to make like 120k+ and that’s without massive loans. If one is 30 something with that salary and debt, they will likely never own a house, be able to help kids with education etc.

I'll be in my mid-30s before I start making an attending salary with ~500k in debt.
I'm not worried about the ability to pay off my loans and buy a home. There is no writing on the walls for the job market to suddenly crash for physicians.

Really the only thing my massive debt prevents me from doing is getting a bottom-bracket academic position in a VHCOL area straight out of training, and even then I could given PSLF.

 

[Ho0v-man]

Special Consideration Pathway Pilot Program for International Medical Graduates Who Meet ACGME’s Exceptionally Qualified Candidate Criteria

The ABIM Council—which comprises the chairs of the individual specialty boards and advisory committees, as well as public and patient members—is exploring the idea of pursuing a pilot program to create a pathway to initial certification and MOC for international medical graduates (IMGs) who have completed their internal medicine training in another country and then completed accredited fellowship training in the U.S. The Accreditation Council for Graduate Medical Education (ACGME) has established criteria for exceptionally qualified internationally trained residents to enter accredited fellowship programs and continue if they are successfully assessed on the core competencies of ACGME and the American Board of Medical Specialties (ABMS). Physicians with that training background are currently ineligible for certification/MOC because their residency training is not ACGME-accredited.

What would something like this mean for US graduates? Likely more fellowship positions, more IM doctors, and therefore lower salaries. Imagine doing 4 years of undergrad, 4 years of med school, 3 years of residency, and 3 years of fellowship only to make 100k and not be able to pay off loans because the market is so saturated. Seems likely that this would lead to a dramatic expansion of heme onc fellowship positions. It also seems likely that this is coming to all specialties

Most of your posts are complaining about money and the fear of further reimbursement decreases and IMGs “takin’ our jerbs.” Dude just go into admin if you’re so focused on money. It’s a much better option if that’s your goal and sounds like you have the background for it already anyway.

 

[qwerty89]

FYI radiology has had the "alternate pathway" for years. Still a massive rads shortage right now with no end in sight.

Alternative Pathway for IMGs