<cracks knuckles> Lets punch these all out at once, rather than racheting up my post count by tackling each one seperately. My apologies, this will be lengthy.
Wow, so the only for-profit medical school in the developed world has no different stigma than being a DO? Stigma, prejudice and others' perceptions exist, fair or unfair and no amount of self-confidence/pride will make them go away. There are PD's in the country, both AOA and ACGME, that consider RVU students equivalent to Caribbean. A simple fact to consider, along with other facts about any school. Fair? Irrelevant, fair is a place to get balloons and cotton candy.
Cite your source since you say it's fact. Seriously.
Okay. I will. Just in NYC: NYU and Columbia (the first one being important as its very DO friendly) have residents that have told me point blank their current program directors will never admit a RVU student on the issue of the for-profit status and have openly stated this in conversation when the school graduated their first class. It was a bigger deal than you think... a lot of MD schools were watching that military match to see if they fared well or not (some hoping for success, some failure) and at least two in manhattan seemed put off that RVU did do well.
Lets jump to AOA. I stated before that I have talked DIRECTLY to two ophtho program directors, and indirectly through a senior resident of a derm program who said they wont take any RVU students. One ophtho director said (paraphrasing) "...even if its wasnt for-profit, I just dont expect their students to match up to a NFP program. The stigma is a downward selective pressure." (personal note: I disagree with him, but he runs the program). The other ophtho program just said he will never take RVU students in his tenure on principle (he also really hates offshore schools). The derm program senior resident said that the topic came up in conversation with the program director and she felt that they should reject all applications from RVU for 5-6 years until they are sure the AOA wont reverse their stance on for-profit education.
As I said when i first referenced it: these are only three directors. The only three i know an opinion from, but the caveats are that people dont talk openly about things they are A-OK with (so comments from PDs always trend negative), and I am really damn far away from colorado so the RVU applicants to this area are more limited than in farther west states. But thats your proof (I have no reason to make this stuff up) and cited facts. You can quote me in court and I'll swear to it under oath.
May be some consider RVU as Caribbean school, but again, only some. But you may be forgetting the FACT that RVU is getting accreditation from a US agency, that makes a big difference. The same only some that consider DOs as unequivalent to MDs, even foreign MDs. There are many residency programs that take foreign MDs (from for-profit schools) before they take any DOs. Heck many program wont even let DOs rotate through their programs. One example: look at UTSW IM current resident list, they have plenty of FMGs, but no DOs. So yeah, no different stigma.
You sort of glazed over the fact that RVU is both DO and for profit. So it gets 100% of the same "anti-DO" prejudiced programs as well as an additional helping of "anti-for profit" feelings that you'd need to go to the international students forum on here to get a real grip on (since DO and MD students dont experience it normally). When you're getting double blacklisted, there are still thousands of spots open to you, but it does REALLY suck to have a few hundred that are closed to you when someone else at a completely equivalent school can count them as a possibility.
Thousands of spots means it prob wont affect your chances of matching, but it is a fact of life that its going to suck for some poeple when they realize a few of the many doors are locked to them. More than are locked to, in this case, the KCUMB grad.
And to address the schools that take foreign grads in huge numbers. They fall into three categories.
1) Hospitals like Miamonides and Staten Island University Hospital, that are generally seen as good hospitals and good programs. They have a long standing tradition of picking up foreign *physicians* for their residency programs. You will really only see US-MDs and DOs (in roughly equal numbers) speckled into some of their more elite programs (i.e. maimonides has urology and matches US students about as often as foreign physicians to it). But outside of that, their entire training model is based on getting physicians, who are already fully trained in another country, to fill their residency spots.
2) Hospitals like Harlem Hospital Center that likely ranks every single US-MD and US-DO that applies to it... but the hospital/program is pretty crappy and the actual number of US applicants is small, and the number who dont get a better offer before dropping down to Harlem Hospital on their match list is tiny. They fill up almost entirely with IMGs who see it as a good program from their POV. It may not even necessarily be a bad program (HH isnt) but it may be so far from civilization, or so low down the list of hospitals in the area (as HH is) that the demand to go there is pretty low in a sea of highly in demand hospitals.
3) The program is malignant. There are some plain malignant programs. And they may trains people extremely well. I'm thinking of Cleveland Clinic. Its a massive honor to be trained there, but it is known for truly abusing its residents and that scares off enough people where you see a real blend of US MD, IMG, and DO students there who don't heed the warnings (but then again, get an amazing training). There are less elite malignant programs too, why you'd go there is beyond me.
You really will *not* see "normal" programs that will take IMGs before DOs. I challenge you to present one that doesnt fall into the above 3 categories of explanations for a high IMG count.
Anyone who says LECOM is not out for profit is fooling themselves. They make money hand-over-fist and do it under the guise of being non-profit. They just found other ways to make the money and say it wasn't the school. The owners are still making crazy amounts of money, like making the school rent the land it sits on and paying the rent directly to the owners... If you take issue with RVU, then you MUST take issue with LECOM as well. There really isn't a difference between them, the only schools that are NOT out to make a profit are the state run schools, MSU, TCOM, OSU.... That's it, all the rest are trying to make money whether or not they are non or for profit
You make this argument a lot and its a nice combination of a red herring and a reductio ad absurdum. Its also a complete crock and should be basically disregarded because it serves no purpose (especially being a double logical fallacy) in this conversation.
1) LECOM is not the issue here, so attempting to shift the argument towards it is disingenuous. and...
2) even if LECOM was the issue here, no matter how much their CEOs get paid and they put relatives on the board... their flaw is nepotism and cronyism, not the flaw of a for profit business model. No one amount of payment to the board or convenient placement of family members in powerful positions changes the fact that they have actual constraints on how much the board can earn (yes, believe it or not, they are within a legal limit of how much an NFPO leadership can earn as its a percentage of income. Three schools with one bank account means there is a lot of profit in that small percentage.). As was stated by someone else, there is no requirement that excess money be reinvested, that incomes be capped, or that prices not be gauged. Similarly there is no protection for the student that is provided by the NFPO model. The student is a consumer in this model, and in that sense, they can be denied the product and services at any point the owner so wishes without any recourse.
Are any of these things happening? Not that I know of. Might they happen in the future? Probably not because COCA would take a cleveland steamer on them if they did. Can they happen? Yes. 100% they can. There are plenty of totally believable scenarios for any of the above things, they're just not likely.
The issue here is that good old Abraham Flexner published a study in 1910 that proved that for-profit education in the US was directly correlated with worse education and abuse of students. 100 years, later for profit medical schools were extinct within the borders of the US until RVU. No one doubts that RVU can succeed wonderfully... but we are scientists. And we have statistical correlation of huge strength saying that 100 years ago saying for profit education makes significantly worse physicians. As scientists we cannot believe our senses and "logic" over actual data and evidence. People are inclined, with sound *scientific* reason, to assume that this will turn out the same way it did 100 years ago. But the economic ecosystem is different now... and perhaps "scientific" reason isnt the right reasoning to be using. Maybe just maybe this for-profit model will turn out different than the ones 100 years ago. We will see. Its a test of the theoretical model, to be sure. Some people do not want the model tested at all.
I don't think I fall in that latter category. I appreciate that its being tested. But my "hypothesis" is that in some long run Flexner will be right, and we'll all have our feet in our mouths over this test of the theory. But feel free to kick ass (as you have) RVU, and prove me and the other skeptics wrong.
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