The Answer of why elective/residency are becoming impossible for IMGs

[stronghold]

---

Members do not see this ad.

I just found that topic & I thinks it is true...we can discuss it
I received that answer from all universities & they shared the same idea. Some of them were direct, others meant it indirectly.

Why elective/Residency become more difficult each year ? Simply, because India & Pakistan don't have Universities! when all students from hundreds of what called universities there just want to have electives & Residencies in USA....Why ACGME did not increase the residency spots with the increase of AMG graduates ? because they want to get rid of you..They have all the right to do that..because when a country open the door you start to immigrate to that country like it is the only country in the world!!.
Why Universities constructed elective course ? it is to explore other culture for one month or 2. But you guys come to USA & start to impede the resources & spoil the system.

Say Good bye in the few next years like you said it before to UK. The cause was the same & UK limited the spots to European citizens & they have the right to do that.
You don't have universities to specialize in ? you don't have money & want money ? But you have money & spend thousands of $$$ for electives & match.
So understand why elective was created & learn from your experience in UK before.

 

[koc123]

Am I the only AMG who finds this post repugnant and xenophobic? I think IMGs have contributed greatly to our healthcare system. Many of them are great clinicians and teachers. The high cost of the American health system cannot be blamed solely on IMGs training in the US.

 

[michaelrack]

Am I the only AMG who finds this post repugnant and xenophobic? I think IMGs have contributed greatly to our healthcare system. Many of them are great clinicians and teachers. The high cost of the American health system cannot be blamed solely on IMGs training in the US.

I found it incoherent and confusing

 

[Sneezing]

I found myself digging in my pocket for troll spray. They show up every so often.

 

[HondoCrouch]

Am I the only AMG who finds this post repugnant and xenophobic? I think IMGs have contributed greatly to our healthcare system. Many of them are great clinicians and teachers. The high cost of the American health system cannot be blamed solely on IMGs training in the US.

He is trying to express the fact that AMCAS pushed to increase medical school enrollment to push IMGs and FMGs out of the US system. LCME does not want so many IMGs and FMGs in the system.

 

[odieoh]

I just found that topic & I thinks it is true...we can discuss it
I received that answer from all universities & they shared the same idea. Some of them were direct, others meant it indirectly.

Why elective/Residency become more difficult each year ? Simply, because India & Pakistan don't have Universities! when all students from hundreds of what called universities there just want to have electives & Residencies in USA....Why ACGME did not increase the residency spots with the increase of AMG graduates ? because they want to get rid of you..They have all the right to do that..because when a country open the door you start to immigrate to that country like it is the only country in the world!!.
Why Universities constructed elective course ? it is to explore other culture for one month or 2. But you guys come to USA & start to impede the resources & spoil the system.

Say Good bye in the few next years like you said it before to UK. The cause was the same & UK limited the spots to European citizens & they have the right to do that.
You don't have universities to specialize in ? you don't have money & want money ? But you have money & spend thousands of $$$ for electives & match.
So understand why elective was created & learn from your experience in UK before.

You not grammer good.

 

[cyneuron]

He is trying to express the fact that AMCAS pushed to increase medical school enrollment to push IMGs and FMGs out of the US system. LCME does not want so many IMGs and FMGs in the system.

A better way to describe this trend would have been like this - http://forums.studentdoctor.net/showthread.php?t=858100

This guy is doing nothing but expressing his frustration. Hope he gets well soon.

 

[cyneuron]

And if it helps to you OP, you should know that all these IMG's don't come here begging. They take part in a competitive process, give all the required exams, spend money and then appear in interviews and get selected only by American Professors and doctors just like all other AMG.

So may be you can just go to one of psychiatrist (which one you will choose ? AMG or IMG ?) and seek some help.

 

[Slevin]

Back to the OP. There are probably more reasons than you think than just getting rid of IMG's/FMG's from the USA. If you hadn't heard there is a physician shortage in the US, and one way to address that is to increase the number of students. However increasing the number of residency spots is more difficult due to the funding and financing of those spots. Thus you can have more students and not increase the number of residencies.


In addition, it isn't the job of the USA to train FMG's and IMGs we are under no obligation to do so. So if you secure a residency spot then good for you but if you don't then that sucks and you'll have to try again

 

[MSmentor018]

I just found that topic & I thinks it is true...we can discuss it
I received that answer from all universities & they shared the same idea. Some of them were direct, others meant it indirectly.

Why elective/Residency become more difficult each year ? Simply, because India & Pakistan don't have Universities! when all students from hundreds of what called universities there just want to have electives & Residencies in USA....Why ACGME did not increase the residency spots with the increase of AMG graduates ? because they want to get rid of you..They have all the right to do that..because when a country open the door you start to immigrate to that country like it is the only country in the world!!.
Why Universities constructed elective course ? it is to explore other culture for one month or 2. But you guys come to USA & start to impede the resources & spoil the system.

Say Good bye in the few next years like you said it before to UK. The cause was the same & UK limited the spots to European citizens & they have the right to do that.
You don't have universities to specialize in ? you don't have money & want money ? But you have money & spend thousands of $$$ for electives & match.
So understand why elective was created & learn from your experience in UK before.

sounds lost and frustrated....sorry man. here's the solution to all your problems--> do well on the boards, slam dunk the rotations, excel at the interview then you won't have any problems with IMG/FMG and residencies

 

[Laryngophed]

I found it incoherent and confusing

I think you are being too kind.

 

[TheLesPaul]

I think this guy is an FMG who is saying:

1) ACGME is keeping total # of residency spots constant to limit the amount of FMGs who match here, and that they are within their rights to do that,

2) the reason why this was necessary is that there aren't enough post-graduate programs in other countries, so these foreign countries are training physicians without opportunities for them to train in their own country after graduation for med school such that they have to come to another country,

and 3) this leads to abuse of the elective month, which is intended as exposure to a different culture, not as a bridge for eventual immigration.

Doesn't really seem inflammatory to me, just a bit incoherent.

 

[peppy]

I think this guy is an FMG who is saying:

1) ACGME is keeping total # of residency spots constant to limit the amount of FMGs who match here, and that they are within their rights to do that,

2) the reason why this was necessary is that there aren't enough post-graduate programs in other countries, so these foreign countries are training physicians without opportunities for them to train in their own country after graduation for med school such that they have to come to another country,

and 3) this leads to abuse of the elective month, which is intended as exposure to a different culture, not as a bridge for eventual immigration.

Doesn't really seem inflammatory to me, just a bit incoherent.

That's pretty much how I took it as well. I think this poster is an Indian or Pakistan FMG who is trying to warn other FMGs that soon it will be more difficult to get residencies in the US. I think he's right that things will be more difficult for FMGs soon.
As for the clarity of the post, this person's English is better than my Hindi, so I wouldn't give him a hard time for not getting it quite right in an informal setting like this (although I do think there are times in a hospital setting when language barriers can be an issue).

 

[michaelrack]

That's pretty much how I took it as well. I think this poster is an Indian or Pakistan FMG who is trying to warn other FMGs that soon it will be more difficult to get residencies in the US. I think he's right that things will be more difficult for FMGs soon.
As for the clarity of the post, this person's English is better than my Hindi, so I wouldn't give him a hard time for not getting it quite right in an informal setting like this (although I do think there are times in a hospital setting when language barriers can be an issue).

My guess is that he is an FMG from a country other than India/Pakistan, and is angry at those 2 countries. I could be wrong

 

[michaelrack]

x

 

[stronghold]

I think this guy is an FMG who is saying:

1) ACGME is keeping total # of residency spots constant to limit the amount of FMGs who match here, and that they are within their rights to do that,

2) the reason why this was necessary is that there aren't enough post-graduate programs in other countries, so these foreign countries are training physicians without opportunities for them to train in their own country after graduation for med school such that they have to come to another country,

and 3) this leads to abuse of the elective month, which is intended as exposure to a different culture, not as a bridge for eventual immigration.

Doesn't really seem inflammatory to me, just a bit incoherent.

This reply summarized my message. Thanks🙂

 

[Arcan57]

I don't know if someone has done an economic study, but I would think that the Indian subcontinent and Africa lose out on the whole "paying to educate a physician that never practices in their home country". And knowing that x% of your best and brightest are going to pursue residency and a career in foreign lands would mean you have to educate more docs than you have residencies spots for because of attrition due to first world siphoning.

 

[Domenech]

You have quite the nerve to say that when 25.9% (Source: ECFMG official website section on ECFMG certification) of all American physicians are actually International Medical Graduates.

Most of these physicians offer their kind services at community based hospitals, and at small towns that desperately require expert physician services, places where your typical AMG wouldn't even think once to go.

It's true that obtaining electives and residencies is becoming more difficult with each passing year but such spots and fundings for international people wouldn't exist in the first place if there was no demand. Both VISA issues and the growing number of international applicants are factors to blame. I think over the past decade or so, only about 50% of all IMG applicants have been able to secure a residency spot in US and this percentage has been kind of stable.

 

[Arcan57]

You have quite the nerve to say that when 25.9% (Source: ECFMG official website section on ECFMG certification) of all American physicians are actually International Medical Graduates.

Most of these physicians offer their kind services at community based hospitals, and at small towns that desperately require expert physician services, places where your typical AMG wouldn't even think once to go.

It's true that obtaining electives and residencies is becoming more difficult with each passing year but such spots and fundings for international people wouldn't exist in the first place if there was no demand. Both VISA issues and the growing number of international applicants are factors to blame. I think over the past decade or so, only about 50% of all IMG applicants have been able to secure a residency spot in US and this percentage has been kind of stable.

Who are you addressing? Also if the percentage of IMG applicants securing a residency spot is constant, doesn't that argue against "it's becoming more difficult to secure a residency with each passing year"?

 

[dragonfly99]

It's not the fault of the FMG's, but the system we had was crazy. It used to be really, really difficult for US kids/students to get into any med school...yet there were way more residency spots than US med school training spots. This left a golden opportunity for foreign students to come in. The only thing the US med schools have been trying to do in the past few years was train more students from the US...which is totally logical...and fair. I mean, it used to be kind of ridiculous. I had a 3.8 GPA as a science major from a good school, a pretty decent amount of volunteer work, lots of college extracurricular activities, and a good MCAT score and I still had to try twice to get into med school...ANY medical school. In a lot of other countries people can just go to med school if they are a decent student...and if they can't hack it maybe they flunk out. In the US, for a very long time there has been a bottleneck @the level of med school admissions, in the sense that there were far more qualified students who wanted a spot than there were spots in medical school. It was a different situation than some fields like computers or engineering, where there truly has been a pipeline problem and in order to get qualified people we have had to recruit from other countries. Our problem was an illogical training system where we had lots more residency spots than we had medical school seats.

I have several FMG friends from residency. I don't think that people from other countries are entitled to get/have a residency here in the US, though. I'm not saying that "stronghold" thinks that or said that, but it has been said by others on this site repeatedly in the past. Just because you are smart (and maybe from a rich or upper class family in some other country) does not mean you are entitled to a residency in the US. I wouldn't go to YOUR country and try to say that, or I wouldn't complain if I tried to get into a university or training program in your country and was denied a spot.

 

[cyneuron]

It's not the fault of the FMG's, but the system we had was crazy. It used to be really, really difficult for US kids/students to get into any med school...yet there were way more residency spots than US med school training spots. This left a golden opportunity for foreign students to come in. The only thing the US med schools have been trying to do in the past few years was train more students from the US...which is totally logical...and fair. I mean, it used to be kind of ridiculous. I had a 3.8 GPA as a science major from a good school, a pretty decent amount of volunteer work, lots of college extracurricular activities, and a good MCAT score and I still had to try twice to get into med school...ANY medical school. In a lot of other countries people can just go to med school if they are a decent student...and if they can't hack it maybe they flunk out. In the US, for a very long time there has been a bottleneck @the level of med school admissions, in the sense that there were far more qualified students who wanted a spot than there were spots in medical school. It was a different situation than some fields like computers or engineering, where there truly has been a pipeline problem and in order to get qualified people we have had to recruit from other countries. Our problem was an illogical training system where we had lots more residency spots than we had medical school seats.

I have several FMG friends from residency. I don't think that people from other countries are entitled to get/have a residency here in the US, though. I'm not saying that "stronghold" thinks that or said that, but it has been said by others on this site repeatedly in the past. Just because you are smart (and maybe from a rich or upper class family in some other country) does not mean you are entitled to a residency in the US. I wouldn't go to YOUR country and try to say that, or I wouldn't complain if I tried to get into a university or training program in your country and was denied a spot.

+1

Completely agree as an IMG.

 

[glykon]

I have several FMG friends from residency. I don't think that people from other countries are entitled to get/have a residency here in the US, though. I'm not saying that "stronghold" thinks that or said that, but it has been said by others on this site repeatedly in the past. Just because you are smart (and maybe from a rich or upper class family in some other country) does not mean you are entitled to a residency in the US. I wouldn't go to YOUR country and try to say that, or I wouldn't complain if I tried to get into a university or training program in your country and was denied a spot.

Yes you would complain if u learnt 10,000 pages in another language to apply for a spot where u were supposed to have a chance based on ur merit!! It's easy to have a big mouth when you can't see the other side of the story.
And for an IMG to get 250+ in the USMLEs, they have to be pretty damn smart and very fluent in English.
If ACGME doesn't want IMGs in the U.S., they should just say so and save everyone the effort, money and frustration. Or,what, u think it's fun to spend 5 years in a system where u are silently discriminated? It's not. Some people come here because ur system is supposed to be "merit based" and they are that good! And u should thank them, because everyone benefits from these great doctors.
Some others come because their dream is to work in the "country of all possibilities" so are u saying they are not entitled to dream? If u were to come to my country, I would never tell u that.

 

[J-Rad]

A reminder to keep things civil and professional, please. Thank you.

 

[tkim]

so are u saying they are not entitled to dream?

They are entitled to dream. They are not entitled to their dream.

 

[Rollo]

Yes you would complain if u learnt 10,000 pages in another language to apply for a spot where u were supposed to have a chance based on ur merit!! It's easy to have a big mouth when you can't see the other side of the story.
And for an IMG to get 250+ in the USMLEs, they have to be pretty damn smart and very fluent in English.
If ACGME doesn't want IMGs in the U.S., they should just say so and save everyone the effort, money and frustration. Or,what, u think it's fun to spend 5 years in a system where u are silently discriminated? It's not. Some people come here because ur system is supposed to be "merit based" and they are that good! And u should thank them, because everyone benefits from these great doctors.
Some others come because their dream is to work in the "country of all possibilities" so are u saying they are not entitled to dream? If u were to come to my country, I would never tell u that.

You are forgetting that most IMGs have several MONTHS to study for the boards...not to mention they have the benefit of clinical experience before they take their boards.

In contrast, AMGs have couple of months to study for Step 1 and a whopping 1 year of clinical experience before taking Step 2.

I'm not saying that if AMGs had 6+ months solely to focus on and study for Step 1, we would all be scoring 250+ but surely our average would go up significantly.

And the argument that "everyone benefits from great doctors" is not exactly a good one. Reason is that the rest of the world, except USA, NEEDS GREAT doctors. Why do you think many US physicians are traveling abroad to do medical missions and such? It's because these countries are lacking good doctors who, wouldn't you know it, are all over here chasing the mighty dollar.

I'm going to go out on a limb here and say that most IMGs are driven by greed of the almighty dollar. "Opportunities", "dreams" are nothing but veils to cover up true motivation. I was brought up and my family is from a foreign country and I have the first hand experience of seeing physicians in that country who enjoy high social status and power.

Fact is, a doctor is a well-respected and valued member of ANY society/culture. I don't think doctors in foreign lands are being treated like trash, and they are being paid very well RELATIVE to that country's economics.

 

[glykon]

You are forgetting that most IMGs have several MONTHS to study for the boards...not to mention they have the benefit of clinical experience before they take their boards.

In contrast, AMGs have couple of months to study for Step 1 and a whopping 1 year of clinical experience before taking Step 2.

Rollo, that is just a misunderstanding. You guys study for 2 years the material required for Step 1 and have indeed 2 months to review it. But what really helps you score high on Step 1 is the long period of study, the fact that your teachers prepare you to think how to answer these board-questions. Whereas most IMGs Kaplan+ FA (total aprox. 3,300 for Step 1) for 6 months. Plus, it's medicine in another language, which makes it double hard.
You can argue medicine is the same everywhere, but truly it isn't. The focus for Step 1 is something most schools from around the world don't even cover.As for hands-on experience with patients, that is true, but helps little for the boards.
I understand you point of view because medical school is very expensive here, that is why I said ACGME should do something about this. It is unfair to you guys and to us as well.
But I need you to understand that not all countries know how to appreciate their doctors (you can't argue with me here, since I come from one such country). Also, some people are not driven by the greed for money.Different people have different reasons and instead of generalizing, you could start a thread to get to know better the reasons that make some people choose this long and steep path. Not only will that make you less judgemental, but also more empathetic- which is helpful since all patients love empathetic doctors.

 

[glykon]

This is a ridiculous arguement. In the past, the US was willing to train and employ lots of IMG's because the number of spots far outnumbered the number of domestic graduates. Times change and that is no longer the case. As an US grad, I would find it quite difficult to get a training position in the EU or Asian nations as they protect their own graduates as well. Why then is the increasing protection of US grads any different. You are entitled to dream, study hard, and try to get a residency. You studied medicine in English (a foreign language to you) because a) you wanted a shot at praticing in the US and b) because the common lanuage of medicine globally is english. If you took the time to learn about the process before reading those 10,000 pages you would have learned that there has always been a bias towards US grads over foreigngrads and it has only been magnified recently by the increased number of US grads. While that's not the current system my thought is that as things tighten up in the next few years that there will be a push to protect all US grads at the expense of IMGS.

I don't see where my argument pledging for empathy was 'ridiculous'. However, I totally agree with you that AMGs are protected and this trend is becoming more and more pronounced. Why do you think you have the first shot to interviews and some specialties (Derm, ENT, Plastics) are even SF for IMGs? I find this somehow normal, it happens in the EU as well.
So I knew about this before I started to learn for the Steps, although I doubt many IMGs did. And I didn't study medicine in English because coming to the U.S. and being a rich doctor was not my dream.
If you read more carefully what I wrote, I was just against the discriminating attitude of 'dragonfly99'. As I said, it's easy to be like that when you can't see the two sides of the story.

 

[glykon]

And the argument that "everyone benefits from great doctors" is not exactly a good one. Reason is that the rest of the world, except USA, NEEDS GREAT doctors. Why do you think many US physicians are traveling abroad to do medical missions and such? It's because these countries are lacking good doctors who, wouldn't you know it, are all over here chasing the mighty dollar.

Let's clarify this.
Of course everyone needs great doctors.
However, let us put two doctors, same very high intelligence, same passion for oncology, in two different cultures:
- culture a. merit based, lots of opportunities for doing clinical trials, funding your research, getting the appropriate lab equipment, reactives, access to latest publications and whatever else he may need
- culture b. is based on connections, family relations and if you are just a poor smart doctor your way to having your merits recognized is a very very long one. Let's say u're that smart so u succeed. But you government doesn't fund more than 10 projects/year and the money u eventually get are not enough to equip appropriately a lab. Plus you definitely don't have access to the peer-reviewed journals because your institution cannot afford it.
As I said, both doctors are very smart. Who do u think will do better?
Now, how about if you put them together in culture a.? Will they make more discoveries? Will these discoveries help us uncover the mistery of carcinogenesis/ find some therapeutic targets/etc?
Now, put them together in culture b. What do u think will happen?

So, this is why I said everyone benefits from great physicians.

 

[Rollo]

Let's clarify this.
Of course everyone needs great doctors.
However, let us put two doctors, same very high intelligence, same passion for oncology, in two different cultures:
- culture a. merit based, lots of opportunities for doing clinical trials, funding your research, getting the appropriate lab equipment, reactives, access to latest publications and whatever else he may need
- culture b. is based on connections, family relations and if you are just a poor smart doctor your way to having your merits recognized is a very very long one. Let's say u're that smart so u succeed. But you government doesn't fund more than 10 projects/year and the money u eventually get are not enough to equip appropriately a lab. Plus you definitely don't have access to the peer-reviewed journals because your institution cannot afford it.
As I said, both doctors are very smart. Who do u think will do better?
Now, how about if you put them together in culture a.? Will they make more discoveries? Will these discoveries help us uncover the mistery of carcinogenesis/ find some therapeutic targets/etc?
Now, put them together in culture b. What do u think will happen?

So, this is why I said everyone benefits from great physicians.

Then fix the culture b. Fix it's laws. Lobby for physicians' rights.

You can't run away from the problem. Someone needs to step up to the injustices and government's failures and say no.

I realize I'm asking you for a lot but I want you to understand that eventually US will have to close its doors and then what will happen?

 

[Andreji]

But what really helps you score high on Step 1 is the long period of study, the fact that your teachers prepare you to think how to answer these board-questions.

For that same token, what really matters for AMG selection is the fact that their teachers/attendings prepare them to work in the demeanor desired by the american health system, hence they are automatically more desirable.

the match isn't all about scores, albeit they help. But while scores may warrant you're smart, there's much more than meets the eye (or why is it that so many double-99er IMGs go on to fail the CS).

Like it or not, the very warrant that the US remains merit-based and friendly is that foreigners as much as their own graduates must meet the same exams and there is still a significant chunk (my guess is tens of times larger than the next "most welcoming" country) going to IMGs (even if we're increasingly speaking of citizens studying abroad).

As an non-citizen IMG, i hardly feel represented by your comments and am flabbergasted at how unbalanced your frustration is. First and foremost, you ought to be frustrated with your own country first. Mine can only guarantee GME for about 30% of its physicians and they pay for it (around 10K a year), have very little academia and work in place of lazy attendings. if yours is any similar, you ought to be protesting outside your local ministry of health, not ranting towards a crowd w/o any power to change things and simply firing up the usual AMG vs. IMG divergence.

I'm currently going through the match season, applying to one specialty I feel passionate about (I echo someone's sentiments towards there being so many IMGs chasing "the almighty", provided I've come across people applying to 250+ progs in 3 very different specialties and conferring on how they'll do a PA or RN course if they don't match; that can only mean you want to emigrate at all costs). I have few interviews but also applied fairly selectively. I got the same rejections that (to my surprise!) many AMGs in these fora have received, and received great interviews too. I'm respectful of the preference of some programs even if it means I'm going to end up in brooklyn instead of boston.

You may criticize someone else around here for not seeing both sides of the story, but if you do see them both then it seems you intently are choosing to opine in an unbalanced fashion.

 

[glykon]

Rollo, it breaks my heart to say that nobody can. You think they haven't tried? Doctors don't even have needles, perfusions or antibiotics in the hospitals, patients have to buy them if they need to have surgery. No compensated medications- you pay a lifetime for the insurrance and when you actually need it, you have to pay for everything with the little money you get when you're retired. Fair? Definitely not. When doctors went on strike, the president of the country told them that if they don't like it here (in our country), they should just go somewhere else.
And most of them did. Half of my colleagues are leaving to other countries (not U.S. cause it's too hard).
Anyway. You're either like them, always thinking about ur own good and trying to make money while stepping on others, or you are not, in which case you leave. In my country, from a residents' income you can't even pay a decent rent. And I just couldn't ask an old and poor lady for money for my services (like others do), when I know she doesn't even have money for her medication.
And many other doctors are like me, that is one of the reasons why they leave.
In my country they are closing hospitals (when the hospitals we have are not enough for our patients). They are turning them into elderly homes because that is profitable.
I cannot change that and I cannot stay and adapt to that because it breaks my heart. My thinking is that if I get a good training as a resident, I will be able to help people in my country. Did you know that because of the lack of access to the latest medical information 1 in 2 doctors in the U.S. don't give the best care to their patients? This is official data. Now imagine how many doctors give the best care in a country where 90% of them cannot access the newest peer-reviewed articles because they would have to pay 10% of their monthly income just to read 1 article!
My hope is that I could create a web between here- where the care is much better- and the doctors in my country. It's sort of providing them with documentation about the actual standard of care, and this way I could indirectly help so many people at home!
So, I am not in this for the money and definitely it's not greed that drives me towards this incredibly steep path.🙂

 

[glykon]

Andreji, that is just my opinion, you don't have to feel represented by it nor are you obliged to agree. If you view it differently, that's fine.
I am not ment to represent the entire IMG population and I am neither ranting nor firing up an old dispute. As for the problems with my country, I was just talking about one of the reasons that led me to U.S. You said only 30% of your country's medical graduates can pursue GME. Do you have any other reasons why you decided to come to U.S.?
You said you participate in the Match. How many programs did you apply to? How many interviews did you get?

 

[Rollo]

Rollo, it breaks my heart to say that nobody can. You think they haven't tried? Doctors don't even have needles, perfusions or antibiotics in the hospitals, patients have to buy them if they need to have surgery. No compensated medications- you pay a lifetime for the insurrance and when you actually need it, you have to pay for everything with the little money you get when you're retired. Fair? Definitely not. When doctors went on strike, the president of the country told them that if they don't like it here (in our country), they should just go somewhere else.
And most of them did. Half of my colleagues are leaving to other countries (not U.S. cause it's too hard).
Anyway. You're either like them, always thinking about ur own good and trying to make money while stepping on others, or you are not, in which case you leave. In my country, from a residents' income you can't even pay a decent rent. And I just couldn' ask an old and poor lady for money for my services (like others do), when I know she doesn't even have money for her medication.
And many other doctors are like me, that is one of the reasons why they leave.
In my country they are closing hospitals (when the hospitals we have are not enough for our patients). They are turning them into elderly homes because that is profitable.
I cannot change that and I cannot stay and adapt to that because it breaks my heart. My thinking is that if I get a good training as a resident, I will be able to help people in my country. Did you know that because of the lack of access to the latest medical information 1 in 2 doctors in the U.S. don't give the best care to their patients? This is official data. Now imagine how many doctors give the best care in a country where 90% of them cannot access the newest peer-reviewed articles because they would have to pay 10% of their monthly income just to read 1 article!
My hope is that I could create a web between here- where the care is much better- and the doctors in my country. It's sort of providing them with documentation about the actual standard of care, and this way I could indirectly help so many people at home!
So, I am not in this for the money and definitely it's not greed that drives me towards this incredibly steep path.🙂

You must not be too familiar with the state of US healthcare and the business of medicine in the US because the problems you mention in the first 3 bolded statements are the exact same problems we're facing here.

And if you don't mind, please share this official data that shows 1 in 2 US doctors don't give the best care to their patients.

 

[glykon]

I attended a presentation where Dr. Blumenthal SJ said that, while talking about the challenges health is facing now. I don't have the presentation but I believe you could find more info if you look into the next links:
http://jama.ama-assn.org/content/287/1/109.long
http://www.ncbi.nlm.nih.gov/pubmed/21730248
Or go to PubMed and look it up more if you have the time. Anyway, because that's a major issue, she said the U.S. government is financing some projects to elaborate more free guidelines for all physicians.