Thoughts on the future of US match?

[Drud0616]

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[FONT=Calibri, Verdana, Helvetica, Arial]Was wondering about thoughts some of you may have about the increasing difficulty and competition for U.S citizens to match into their desired residency.
When researching the 2011 Match statistics published by NRMP, my jaw dropped to see the amount of unmatched US citizen IMGs.
For me the most upsetting statistics are listed on page 9, which shows
50% of US Citizen Students of International Medical Schools were left unmatched. This is pretty much the same as saying there is a 50% unemployment rate among U.S. Citizen IMGs. I'm not aware of any large industry in the U.S. with such unemployment rates for U.S. citizens.

Table 2. Page 5
5,121 Internal Medicine positions were available of which:
2,940 were taken by US medical students
512 were taken by U.S. Citizen IMGs
And a staggering 1,215 were taken by Non-U.S. IMGs
This last statistic is where I believe the injustice truly begins. I understand that students who graduate from U.S. Medical schools should have priority over IMGs when it comes to choosing residency positions, however I believe U.S. Citizens in general should have priority over non-US citizens who require a Visa to work. 1,215 non-U.S. individuals are receiving work Visas for residency and effectively taking jobs from U.S. Citizens. It is a simple concept...our country should employ it’s own citizens first, regardless of whether they went to a U.S. or a Caribbean medical school. Not to mention that I personally know quite a few non-U.S. Students who matched and plan to go back to their home country after residency. This means that many non-US residents are “milking” the system, not providing any benefits to the country. One does not have to stretch their imagination too far to see that this is a widespread problem that is only increasing with each Match year.
I'm just curious what all of your thoughts are on this situation?
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[Apollyon]

Is there any reason you are using huge type?

 

[Drud0616]

No reason, sorry first time posting.

 

[EM_Rebuilder]

I dont want to step on toes.. but..

Usually, the US IMGs have already been self-selected as lower standard score test takers (i.e. MCAT) and probably have some other 'black marks' on their history... Therefore, one can assume a bit lower Step Scores and perhaps whatever 'issues' happened to prevent them from getting into a US medical school, might come back around and hamper their IMG education..... Now, there are a certain subset of students (so I hear) that just wanted to go to school elsewhere and did not bother applying to the US. Regardless, I think we are very safe to assume that most US IMGs applied at least once and did not match into a US school.

Non US FMGs occasionally may be some of the brightest folks around, score awesome on tests, have a stellar undegrad record, etc etc... and thus, I think are more likely to land a residency position as their undergrad record shined and continued to shine in medical school and shines on the residency trail.

Opinons on what should happen and what does happen are probably very mixed and I will keep mine to myself... but I think the above is the logical/statistical answer to your question?

UD below makes an awesome point also. How often do we see US IMGs posting in here wanting EM? It can be done, but I bet its less than 5% of the spots and decreasing every year. Many of them want to do surgery or something else that has similiar numbers. The NonUS FMGs more tend to do primary care and try to specilize later into fellowships where residency performs is looked at more than medical school education.

 

[UnderwaterDoc]

They do give priority to the US citizens, they're just not asking for the IM, FP, or Peds spots. The international IMGs are filling the gaps.

 

[gutonc]

Short answer?

IMGs (US and otherwise) are going to get completely hosed in the next 3-5 years. Anybody sending a check to Ross or SGU for their first semester's tuition right now is going to be in a world of hurt when Match Day comes...either go DO or pick a different career.

 

[flatearth22]

I agree that, all things being equal, program directors should favor US MD > US DO > US Citizen international grad (IMG) > Non-US Citizen foreign grad (FMG) when selecting candidates. And I believe that for the most part they do. However, all things aren't always equal and the reason why FMG's are posing a threat to IMG's has to be because they outscore them on the USMLE and come with more research and work experience making them better candidates for residency positions.

Remember, the FMG's are generally the cream of the crop in their countries whereas the US citizen IMG's are not (hence why they had to leave the country for their medical education). This difference is reflected in their applications.

Also program directors don't care about their residents do post-residency. All they want is a competent physician to work long hours and get the job done and often times they believe an FMG is better suited for that than an IMG.

With the recent increase in US med school seats coupled with a stagnant amount of residency spots though, slowly both IMG's and FMG's will be squeezed out such that only the best and brightest will be able to match at all.

 

[Drud0616]

This is clearly a touchy subject and I do not want to step on any toes as well.
The reality is that priority given to US citizen IMGs is marginal. Non-U.S. IMGs had a 40.9% match rate in 2011. I do not doubt that many non-U.S. IMGs are extremely bright and have excellent exam scores and in fact do have better credentials than U.S. citizens IMGs, one can argue that they may have better credentials than some U.S. med students as well. Does that mean they should have priority over some U.S. med school grads? The fact remains that regardless of who has better exam results, residency priority will always go to the U.S med student (and rightfully so). I simply believe that the U.S. citizen should always have priority to work in his or her country. This is not a problem that is focused mainly on medicine...there has been a long lasting debate regarding increasing foreign competition, outsourced jobs, growing immigration, etc.

 

[Chakrabs]

In the end, residency programs are going to take who they feel is the most qualified candidates. When life and livelihood are concerned, the most qualified applicants will take precedence. Nationality will play a very little role.

 

[sineapse]

..

Supply and demand, supply and demand.

Your medical schools can't meet the demand for residency slots, so they fill from the rest of the world.

Whilst I agree AMGs should get first preference, if you go outside the US to train (Carib or otherwise) you are in the same boat as the rest of the IMG world imo.

Non-U.S. IMGs had a 40.9% match rate in 2011

The question is, where did these non US IMGs match?

 

[docB]

Belongs in Allo so moved the posts from the EM thread here.

 

[Drud0616]

I do not doubt that many non-U.S. IMGs are extremely bright and have excellent exam scores and in fact do have better credentials than U.S. citizens IMGs, one can argue that they may have better credentials than some U.S. med students as well. Does that mean they should have priority over some U.S. med school grads? The fact remains that regardless of who has better exam results, residency priority will always go to the U.S med student (and rightfully so). The reality is that priority given to US citizen IMGs is marginal. Non-U.S. IMGs had a 40.9% match rate in 2011 and occupied 1,215 residency positions in IM comparted to U.S. citizen IMGs which occupied 512 positions. I do disagree with FMGs working only harder than U.S citizen IMGs, the fact is many have worked as physicians in their native countries and already know medicine, therefore one can argue that many are more experienced and can work harder than U.S. grads as well (and U.S grads should be happy that they are not competing with them)
I simply believe that the U.S. citizen should always have to compete with other U.S. citizens. This is not a problem that is focused mainly on medicine...there has been a long lasting debate regarding increasing foreign competition, outsourced jobs, growing immigration, etc.