ucla2usc said:
As an american who has traveled to quite a few foreign countries, I have been "victim" to anti-american sentiment and blatent prejudice. And I would bet that this would not stop in the professional world. Just a hunch, but I would think that it would be next to impossible if not completely impossible to get trained in a professional career in one of these countries, no matter what kind credentials I have. Kind of unfair? NOT REALLY...I just accept this. But in the US we open our doors to over 25% IMG's in internal medicine training. So yeah, they have harder time getting the same quality positions, so what...they are still given grand opportunities to train and practice here.
That is kinda rediculous. Look in American medical journals and you will likely find more than a few adds for american physicians to practice in Australia, New Zealand United Arab Emirates, Saudi Arabia, etc. Americans, like physicians, are disliked as a group more so than individually. For example, the average american (if Gallop polls are that) thinks that doctors as a profession are greedy, but not their individual doctor. Likewise, I have travelled extensively, and people are always a little hard on Americans (albeit less hard than we are on them) but when I tell them I also think GW Bush is a dumbsh%!, they are cool and we get drunk together. My point is, we condescend more on the rest of the world, than they do on us. (Hate/terrorist filled countries exempted).
Regarding IMGs
I am an American born and raised guy, currently in my fourth year at a U.S. allopathic school. So I can't say that I am particularly oppressed. My dad was born and raised and did his medical school in India. He came here in 1974 after 1 year of practice in India, joined the US Navy after a year of Internship in Iowa and then did his residency in the Navy. Yeah he had a "funny" accent but spoke and still speaks better English than most people I have met in Texas (Where he practices). He is a great physician, is loved by his patients, and does very well for himself, his family, and his community.
My point is - IMGs can and do make great physicians. There is no reason to doubt this. Yeah they need to adjust to the system. But the main deficiencies they have are communication and system differences. By this I mean mastery of English is a challenge. And regarding this, I'm sorry IMGs, if you don't speak good English, tough, learn to. I can say from my experience, IMGs from former British Colonies like India, Pakistan, and Israel speak awsome English, though with an accent. That's cool. I have noticed that people from the far east and middle east, have poorly constructed English and that is less unnaceptable (in some placed they learn medicine in their native language). Please don't ream me for that, it was not an evidence based study, just my observation from my home hospital. Regarding system differences, IMGs in many countries (i.e., India) learn medicine without the total reliance on Labs and CT scans that we do here. I can't lie, I think I am reasonably smart and will be a good Internist. But I am lost without labs and imaging. Physical exam is often something foreign grads bring to the table, better than we do here. Technology is something any of us can pick up quickly, esp if you got something like the Wash U manual.
People on this board need to remember that residency is time to learn, not a place where you show up as an attending. Some will show up on day with more tools and some with fewer tools, but by the end of training, everyone should have essentially the same set of tools, with different people having different strengths. For every thing they don't know about the way something works here, I would bet my life that there is something they know, that we wouldn't. I just think we judge them harder than us for the same wrong answer.
Also consider, that studies have shown (I believe an AMA or ACP study, but I could be mistaken about the source) that IMGs are overwhelmingly more likely to practice in rural settings. You can argue about why this is but the fact remains, rural America relies on IMGs. I bet you can find that THE doc in many small towns has a last name like Patel, Khan, Reddy, etc.
Regarding the idea that American students are denied opportunities to go to medical school. That is an over-simplified conclusion. The number of medical school seats is tighly controlled by the AMA/AAMC for whatever reasons (likely selfish, which I guess I'm cool with). You can increase the number of medical seats in the US, but with that you have America(ans) bearing the cost burden of educating them as well as the burden of having 10 3rd year students on a ward team. Also, when there is no longer an undersupply of physicans, what do you do, do you cut a bunch of seats and have med schools totally re-allocate their resources. It is simply easier to accept IMGs to fill the gaps because we don't pay for their education, they do or their home country does. And if there is an oversupply, that would be an easier problem to address, simply by lowering the number of residency spots or restrictring physician immigration. (not things I agree with, just what some would offer as solutions)
My bottom line:
- I have no beef with IMGs, I wish them all the luck in the world.
- All things being EQUAL, an AMG is getting the spot - that's fair because
America has to serve Americans first.
- IMG > AMG - it still favors the AMG because of the two differences noted
above. Fair? I don't know. But I have no doubt that the IMG is PERFECTLY
as capable of completing the residency and passing IM boards as I am.
- IMG>>>AMG - probably should favor IMG and there are some good programs
that recognize this (Baylor Houston and Wash U STL). I say this because
they have a decent number of IMGs and they are often brilliant and from
very reputable foreign schools (i.e. Agha Khan Univ. and All India Institute -
sure there are more but these are the ones I know about) In any case, if
one of those people gets in there and I don't. I should have studied harder
and done more research.
- This business about hospitals getting paid more from medicare for AMGs
than IMGs. That sounds criminal and I doubt it is true. If it is true it would
be a supreme court case because the federal government is held to the
highest standards of non-discrimination. If it is true (im going to look into
it), I encourage any IMG with the means to persue it in court.
- Don't knock people for having accents - that makes you a prick
There is a difference between ACCENTED English and BAD English.
BAD English is good enough reason, in my opinion to not take a highly
qualified IMG. The flip side is true as well. At county-USC in LA, a spanish
speaking applicant should be at an advantage.
Wow, that was a lot to say and my fingers hurt. I apologize for typos
