Unmatched EM applicant commits suicide

[stemi8]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

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[HoosierdaddyO]

I’ll be the first one to say that this is absolutely tragic and I wish this young physicians family nothing but the utmost respect and well wishes in their time of need!!! This is one hell of a stressful ride and you need to have a strong body mind and soul to go along for it. And may she Rest In Peace!!!

But I must also add that everyone that I’ve know that didn’t match... never committed suicide!! I’m sure the not matching was perhaps another cog in the wheel that may have led her down a slippery slope, and sadly so!!! But I think to say that the Match needs to change because of her scenario is not fair. Life is full of adversity!!! And the older I get, the more I feel the younger generation has no coping skills to deal with said adversity. Life is hard, people get fired and laid off from there jobs (even when they are 45 and in a mid life crisis to begin with with kids and a family to support etc). Resiliency is the name of the game, however wish this young new Docotor had the avenues to help battle potential depression, but you can not blame life.

Life is 10 percent what happens, and 90 percent how you react to it :/!!!

 

[Dr Mantis Toboggan]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

Really sad and brutal. The match system blows.

 

[anonperson]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

Sad story but sounds like there was a lot of underlying mental illness. The match system is not perfect but it works well for what it needs to accomplish in a fair manner.

It's not reasonable to say that the match system was the cause.

 

[ShockIndex]

Neither the Match nor the programs that didn’t competitively rank her are in any way responsible for her decision to commit suicide. We are adults here. We are responsible for our actions.

 

[FMtoEM]

Wow so tragic. How did she get into medical school in the first place with that record and being a felon?? For many applicants that kind of application would have made the do not interview/trash pile. Preventing future heartache and dashing of dreams. Very unfortunate. How do you let someone go through the system and then screw them in the end.

 

[thegenius]

If the match caused her to commit suicide, then there would be have something else that would have caused it too. It's not the match but the unfortunate underlying psychiatric disorder(s) she had which caused her to commit suicide. I just wished she had prepared for the possibility of not matching and come up with an alternate plan.

 

[JulyMorning]

She overcame a lot of adversity and didn’t match three years in a row. Perhaps it was too much. What a shame.

 

[thegenius]

She overcame a lot of adversity and didn’t match three years in a row. Perhaps it was too much. What a shame.

Ahhhhh

 

[Modstopizdy]

Yeah I mean many people overcome adversity, but I primarily respect those whose adversity was not of their own creation. This person died because she killed herself and she killed herself because she didn't match, which frankly isn't a very good reason for killing yourself. Furthermore, she didn't match because she was a felon, she was a felon because she hit a cop while on parole, and she was on parole because of various crimes and drug use. Every step of the way, her outcomes were created entirely as consequences of her own actions. I'll reserve my pity for those who did everything right only to end up dead before their time, that's real tragedy.

Anyway, saying the match process needs to change because of this is just beyond crazy. Must we also do away with divorce, termination from jobs, and other common obstacles people encounter in life that drive suicide? Divorce on its own drives more men to kill themselves every week than the match has in the entire history of its existence.

 

[thegenius]

Couldn't some of these problems (e.g. matching and being employed by a hospital) been anticipated given her past? Every time I credential at a hospital, I have to answer all of these questions about whether I've been convicted of a crime, etc.

 

[FMtoEM]

The system thoroughly screwed her. In medicine you need a clean slate and have to be almost superhuman. I mean how many felons is the system letting in? Again why let her in if the plan is to totally F$&@ her in the end. Shameful.

 

[hundreddaysoff]

Obviously a tragedy all around.

Per the article, sounds like scoring 99th percentile on the MCAT went a long way toward getting her into med school.

Agree that there may be a disconnect between med schools and residencies here. Maybe med schools don't care as much about criminal records vs residencies/hospitals/the rest of the medical system. Not judging her, just agreeing that med schools shouldn't get greedy and admit people who don't have a great chance of matching. But I'm not sure it's in med schools' best financial interest to distinguish here?

It's funny, my buddy has a very similar background (early DWI, addiction issues, etc) and is now a great doctor. One difference is he never went out of his way to publicize this background to anyone official. The other difference might be that he didn't need to publicize it since he happened to befriend the right judge early on and so in my understanding the DWI was ultimately sealed.

 

[FMtoEM]

U Rochester accepted her into medical school. Given her unique case and mountain to climb to attain residency, you’d think U Rochester EM or U Rochester Orthopedics residency would have given her a chance.

 

[deleted480308]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

The match didn’t kill that poor woman.

Hope her family finds peace

 

[cyanide12345678]

Yeah I mean many people overcome adversity, but I primarily respect those whose adversity was not of their own creation. This person died because she killed herself and she killed herself because she didn't match, which frankly isn't a very good reason for killing yourself. Furthermore, she didn't match because she was a felon, she was a felon because she hit a cop while on parole, and she was on parole because of various crimes and drug use. Every step of the way, her outcomes were created entirely as consequences of her own actions. I'll reserve my pity for those who did everything right only to end up dead before their time, that's real tragedy.

Anyway, saying the match process needs to change because of this is just beyond crazy. Must we also do away with divorce, termination from jobs, and other common obstacles people encounter in life that drive suicide? Divorce on its own drives more men to kill themselves every week than the match has in the entire history of its existence.

Agreed. Blaming the match doesn't make sense. It appears there is a lot of underlying psychiatric issues. The match could have easily put her in a depression that she wasn't able to cope with.

She had done a prelim year per the article, so she had 1 year post grad training. I believe you can practice in some rural areas in some capacity since you can acquire a state license with one year of training. Also, applying to orthopedic surgery with red flags on your application isn't truly the best choice. People with stellar applications don't get in. And following this up with EM, that's still fairly competitive. She should have tried and applied to every family medicine program in the country. The outcome could have been different.

Either way, she had over come a lot, can't imagine going from jail to becoming a doctor. That is truly an amazing turn around which is impressive.

 

[Birdstrike]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

I've known three people who tragically committed suicide. Each chose the act for their own reasons. Although it's tempting to blame outside factors we dislike for this act, ultimately the act by those who commit it, for their own reasons. This young woman was very smart. She knew what she was doing. She could have scrambled into an open internal medicine position like many people do, then fought to make changes in the match system. Instead she chose to leave everyone around her alone, devastated and forever changed, while she got the end to the pain she wished for. May she rest in peace.

 

[ace_inhibitor111]

As someone who’s worked with several patients in recovery before, I find this story extremely sad. With a felony drug conviction, it is very difficult for anyone to find a career, get a mortgage, or much of anything that one considers part of “normal” life. Many opt to keep using because the thought of going through withdrawal only to work as a barista for eternity sounds like hell. A few (like this medical student) found a way to escape through education or whatever other means. But a felony conviction stays with you regardless of how many years since you’ve quit.

I find it hard to believe even rural areas would have allowed her to practice given her history and without a residency. She’s already attempted to match 3 times. In her mind, she overcame her addiction only to wind up in the same position she was in 5 years ago, except with $300k in debt.

I think focusing too heavily on the idea of suicide here misses the point. She could have ended this story in many different ways; but I doubt any of them have a “happy” ending, especially given her initial dreams and level of debt.

Yeah I mean many people overcome adversity, but I primarily respect those whose adversity was not of their own creation. This person died because she killed herself and she killed herself because she didn't match, which frankly isn't a very good reason for killing yourself. Furthermore, she didn't match because she was a felon, she was a felon because she hit a cop while on parole, and she was on parole because of various crimes and drug use. Every step of the way, her outcomes were created entirely as consequences of her own actions. I'll reserve my pity for those who did everything right only to end up dead before their time, that's real tragedy.

Anyway, saying the match process needs to change because of this is just beyond crazy. Must we also do away with divorce, termination from jobs, and other common obstacles people encounter in life that drive suicide? Divorce on its own drives more men to kill themselves every week than the match has in the entire history of its existence.

I don’t think this is accurate. Rear-ending a cop isn’t a felony, although possession of a Schedule 1 substance like heroin is.

 

[miacomet]

Terrible, but someone with addiction problems from middle school was already unstable- I'm surprised she made it into medical school, and no idea how she would get a license.

If this is Georgia Southern's finest, they need to do some soul searching.

 

[Birdstrike]

As someone who’s worked with several patients in recovery before, I find this story extremely sad. With a felony drug conviction, it is very difficult for anyone to find a career, get a mortgage, or much of anything that one considers part of “normal” life. Many opt to keep using because the thought of going through withdrawal only to work as a barista for eternity sounds like hell. A few (like this medical student) found a way to escape through education or whatever other means. But a felony conviction stays with you regardless of how many years since you’ve quit.

I find it hard to believe even rural areas would have allowed her to practice given her history and without a residency. She’s already attempted to match 3 times. In her mind, she overcame her addiction only to wind up in the same position she was in 5 years ago, except with $300k in debt.

I think focusing too heavily on the idea of suicide here misses the point. She could have ended this story in many different ways; but I doubt any of them have a “happy” ending, especially given her initial dreams and level of debt.



I don’t think this is accurate. Rear-ending a cop isn’t a felony, although possession of a Schedule 1 substance like heroin is.

I used to know a guy who as a surgeon was scrubbing out of the OR, mid operation, to leave and smoke crack. He got caught, lost his license, went into rehab and had to leave the state. It was in the newspapers, total rock bottom, and humiliation. He could have taken one last hit off the pipe and taken a ride on his motorcycle off the edge of a ledge in the Grand Canyon and no one would have been surprised. He chose to fight on. After staying clean for a while he begged to get his license back and got hired in some **** town in the rural south. He built his rep back by staying clean and doing good work. He's actually a good guy and a good surgeon. Then, once he had a few solid years behind him, he got a job in a desirable hospital in a desirable location. Now he's many years clean, sober, has a repaired reputation and a wife and three kids.

Then there's the guy who went through a tough divorce. He got cheated on in the most horrendous, humiliating way, by his girlfriend, literally at work with the one person who meant the most to him. Not surprisingly, things got physical and the cops were called. Not only did he get tagged with a strangulation charge, but also had some weed on him. Needless to say, his life went to ****, his face was plastered across the town newspaper, and he tasted enough humiliation for ten lifetimes. Did he swallow the end of a 12 gauge shotgun a la Curt Cobain? No one would have been surprised if he had, but he didn't. Instead, he went to rehab, clawed his way back from the depths of his own doing, and started interviewing for jobs as a "clean, sober, changed and reformed" man. He was hired, and as far as I know, he's plugging along, sober as a potato, in recovery from substance abuse and working as a doc despite a history of criminal charges.

I should write a ****ing novel. Maybe about my life, or these two dudes. Or maybe about the pizza delivery guy I used to work with who got shot in the ass, or the one who never gave up even after being thrown in a jail-hell hole in Detroit for having an unregistered AR-15 that wasn't his during the commision of a crime. I could write a chapter about the ER doc I worked with who survived a plane crash by crawling over people and rows of seats while others more polite and less virile burned alive in the back rows, only to go on to become a pilot himself, who offered rides in his plane with a malfunctioning autopilot between shifts while still working with a full head of lightning-white hair into his 70's.

And I could throw in all my past SDN-EM stories and tie them all together with a great ending with a shootout where the main character survives and realizes the guy whose life he just saved was actually plotting to kill him and run off with his insurance policy and his wife who he never liked, only to be told the very next day by his long lost high school sweetheart he thought was dead that a long lost billionaire uncle he never knew he had, died with no other next of kin, making him a billionaire. Or maybe I won't and it'll all just live in my head and go with me to the grave along the names to protect the innocent.

 

[miacomet]

I used to know a guy who as a surgeon was scrubbing out of the OR, mid operation, to leave and smoke crack. He got caught, lost his license, went into rehab and had to leave the state. It was in the newspapers, total rock bottom, and humiliation. He could have taken one last hit off the pipe and taken a ride on his motorcycle off the edge of a ledge in the Grand Canyon and no one would have been surprised. He chose to fight on. After staying clean for a while he begged to get his license back and got hired in some **** town in the rural south. He built his rep back by staying clean and doing good work. He's actually a good guy and a good surgeon. Then, once he had a few solid years behind him, he got a job in a desirable hospital in a desirable location. Now he's many years clean, sober, has a repaired reputation and a wife and three kids.

Then there's the guy who went through a tough divorce. He got cheated on in the most horrendous, humiliating way, by his girlfriend, literally at work with the one person who meant the most to him. Not surprisingly, things got physical and the cops were called. Not only did he get tagged with a strangulation charge, but also had some weed on him. Needless to say, his life went to ****, his face was plastered across the town newspaper, and he tasted enough humiliation for ten lifetimes. Did he swallow the end of a 12 gauge shotgun a la Curt Cobain? No one would have been surprised if he had, but he didn't. Instead, he went to rehab, clawed his way back from the depths of his own doing, and started interviewing for jobs as a "clean, sober, changed and reformed" man. He was hired, and as far as I know, he's plugging along, sober as a potato, in recovery from substance abuse and working as a doc despite a history of criminal charges.

I should write a ****ing novel. Maybe about my life, or these two dudes. Or maybe about the pizza delivery guy I used to work with who got shot in the ass, or the one who never gave up even after being thrown in a jail-hell hole in Detroit for having an unregistered AR-15 that wasn't his during the commision of a crime. I could write a chapter about the ER doc I worked with who survived a plane crash by crawling over people and rows of seats while others more polite and less virile burned alive in the back rows, only to go on to become a pilot himself, who offered rides in his plane with a malfunctioning autopilot between shifts while still working with a full head of lightning-white hair into his 70's.

And I could throw in all my past SDN-EM stories and tie them all together with a great ending with a shootout where the main character survives and realizes the guy whose life he just saved was actually plotting to kill him and run off with his insurance policy and his wife who he never liked, only to be told the very next day by his long lost high school sweetheart he thought was dead that a long lost billionaire uncle he never knew he had, died with no other next of kin, making him a billionaire. Or maybe I won't and it'll all just live in my head and go with me to the grave along the names to protect the innocent.

As I'm sure you know, strangulation is one of the strongest predictors of homicide in domestic violence. Also, I always consider it surprising when things get physical. I don't know if he was convicted, but that's extremely concerning and scary.

 

[Brigade4Radiant]

She could’ve still practicing medicine without a residency even for one year. The state boards would still allow her to get a license. She had an urgent care and do nursing home management.

 

[HoosierdaddyO]

I’m also going to have to question the level of advice and counseling she got from her Med school advisors. Like I get it, ok, orthopedics is your passion and your dream... but you know you have a serious background red flag. Maybe if you want apply for orthopedics but also something less competitive like IM as a backup .

Year two of not matching... advisor should be like ok maybe it’s time to forget about anything that’s sort of competitive and to shell some money out and apply to IM, psych and Peds... and there are people that still live in and need medical care in the Dakota’s and Ozarks and missilousiabama etc... sounds like a case of not having your application in a reality check kind of mode :/. Still a shame that she felt her only option was suicide nonetheless!!!

 

[miacomet]

I don't know if she would have matched anywhere, in anything, with that record. But Rochester should have offered her whatever crap program went unfilled.

 

[MechEDoc]

There must have been some family med position in the middle of nowhere (like Rochester NY) that would have (or should have taken her....

 

[Brigade4Radiant]

I don't know if she would have matched anywhere, in anything, with that record. But Rochester should have offered her whatever crap program went unfilled.

People have mashed with worse for a pre-limb I am or family medicine from the US MD graduate school with a competitive step score however she would’ve had the best chances the first or second time.

Emergency medicine is competitive especially if you don’t have a SLOE.

 

[Lexdiamondz]

There must have been some family med position in the middle of nowhere (like Rochester NY) that would have (or should have taken her....

Why?

There is a surplus of residency applicants (if you count DOs and IMGs) relative to residency spots, and there is an abundance of MS4s with clean records and relatively little bagage. There's almost zero incentive to roll the dice on a convicted felon and former drug addict - especially as depression, suicide and substance abuse are already rampant among trainees.

People change and grow but the biggest predictor of future behavior is past behavior and a felony conviction is a big @ss red flag

 

[MechEDoc]

There's almost zero incentive to roll the dice on a convicted felon and former drug addict - especially as depression, suicide and substance abuse are already rampant among trainees.

True, but Rochester was her medical school and new about her past.

 

[Modstopizdy]

Why?

There is a surplus of residency applicants (if you count DOs and IMGs) relative to residency spots, and there is an abundance of MS4s with clean records and relatively little bagage. There's almost zero incentive to roll the dice on a convicted felon and former drug addict - especially as depression, suicide and substance abuse are already rampant among trainees.

People change and grow but the biggest predictor of future behavior is past behavior and a felony conviction is a big @ss red flag

I'm going to have to take issue with the bolded assertion. One of the most ridiculous aspects of the match process is that the number of spots is like 10k greater than the number of US grads yet you still have hundreds of US grads going unmatched each year. I'm sure most of those failed to match because they applied for competitive specialties, but a not insignificant number of US grads go unmatched in favor of foreign grads, which is just crazy. These residency spots are taxpayer funded!

In the case of criminal records particularly, how is it fair that a relatively minor criminal record can prevent a US citizen from practicing medicine in the United States, while we let over ten thousand foreign citizens train here every year whose criminal histories we know absolutely nothing about? It's a disgusting double standard. What kind of carnage would you have to cause in some of those less developed, corrupt third world nations before residency programs and licensing bodies in the United States could get so much as sniff of it? But if you're an American, get caught for so much as smoking a blunt as a teenager and you have to sweat bullets for the entirety of your medical career, lol.

 

[ShockIndex]

This is essentially an obituary and I suspect that we do not have the full story. for example, we have no idea how her prelim year at Rutgers really went. Then, there is the issue of her failing to match in Ortho and then jumping over to EM. This alone can be an issue on the interview trail aside from her criminal history.

Finally, I know that it’s popular to believe in redemption and second chances, but we probably need to clear the air and inject a little reality. There are certain jobs in America that you will never get if you are a felon and that is not necessarily a bad thing. For example, you will never get a national security clearance, military commission, or own a gun store. We can probably add emergency physician and orthopedist to that list. It has nothing to do with fairness and everything to do with protecting the public.

 

[cyanide12345678]

I'm going to have to take issue with the bolded assertion. One of the most ridiculous aspects of the match process is that the number of spots is like 10k greater than the number of US grads yet you still have hundreds of US grads going unmatched each year. I'm sure most of those failed to match because they applied for competitive specialties, but a not insignificant number of US grads go unmatched in favor of foreign grads, which is just crazy. These residency spots are taxpayer funded!

The imgs that get these spots are usually far superior than the US grads. It is ridiculously difficult for them to get in despite stellar applications.

My img friend who applied last year, 265+ both step 1&2 hardly had 10 interviews after applying to 100+ IM programs.

My img wife is in a family medicine program. Scores 240 both. The us grads there have 200-215 scores and are just not smart, infact many of them did not match previous years.

So in comparison, it is ridiculously difficult for imgs to get these spots, The US grad counter parts have significantly worse applications for equivalent positions and often get picked over these imgs. And eventually the imgs that get in, usually are stellar applicants.

 

[Modstopizdy]

The imgs that get these spots are usually far superior than the US grads. It is ridiculously difficult for them to get in despite stellar applications.

My img friend who applied last year, 265+ both step 1&2 hardly had 10 interviews after applying to 100+ IM programs.

My img wife is in a family medicine program. Scores 240 both. The us grads there have 200-215 scores and are just not smart, infact many of them did not match previous years.

So in comparison, it is ridiculously difficult for imgs to get these spots, The US grad counter parts have significantly worse applications for equivalent positions and often get picked over these imgs. And eventually the imgs that get in, usually are stellar applicants.

There are two separate issues here. The one I don't really even want to get into much because it's besides the point is that you can't compare Step scores from US grads who have 3 weeks to prepare during M2 year to Step scores from FMGs who can take their sweet time and take the test whenever they feel ready.

The larger issue here is that this shouldn't be about meritocracy. Residency training slots aren't regular jobs, they're basically federally funded sinecures paid for from taxpayer money. How are you going to give these slots to foreign citizens who have never so much as stepped foot inside this country while rejecting perfectly qualified US citizens? Even private companies looking to hire for positions that don't receive a penny of taxpayer subsidy are supposed to prove no qualified Americans are available before they can bring in overseas workers.

How ludicrous is it then that we are ruining the lives of our own citizens by having them take on undergraduate and medical school debt and go through all the hoops of graduating medical school and passing the licensing exams only to then reject them in favor of foreigners? To add insult to injury, now they have to try to get out from under their crushing med school debt while being taxed to pay for the residency training of the foreign grads who took their spot! I understand that the USA isn't a real country, but still, it offends me on just the level of being against natural logic alone lmao.

 

[deleted480308]

There are two separate issues here. The one I don't really even want to get into much because it's besides the point is that you can't compare Step scores from US grads who have 3 weeks to prepare during M2 year to Step scores from FMGs who can take their sweet time and take the test whenever they feel ready.

The larger issue here is that this shouldn't be about meritocracy. Residency training slots aren't regular jobs, they're basically federally funded sinecures paid for from taxpayer money. How are you going to give these slots to foreign citizens who have never so much as stepped foot inside this country while rejecting perfectly qualified US citizens? Even private companies looking to hire for positions that don't receive a penny of taxpayer subsidy are supposed to prove no qualified Americans are available before they can bring in overseas workers.

How ludicrous is it then that we are ruining the lives of our own citizens by having them take on undergraduate and medical school debt and go through all the hoops of graduating medical school and passing the licensing exams only to then reject them in favor of foreigners? To add insult to injury, now they have to try to get out from under their crushing med school debt while being taxed to pay for the residency training of the foreign grads who took their spot! I understand that the USA isn't a real country, but still, it offends me on just the level of being against natural logic alone lmao.

Because it’s just a method of getting a trained doc in the Us, no one cares where from

 

[VA Hopeful Dr]

Fantastic job, you managed to string a sentence together. My challenge to you is next time try your hand at forming an argument. Baby steps but one day we'll get there.

The point of the match isn't to provide jobs to American citizens, it's to provide America with trained physicians. The origin of those physicians doesn't matter for the purpose of the match.

That being said, the system as it's currently done at the program level is heavily weighted in favor of US grads. You have only to look at the average statistics of matched US grads versus IMG/FMGs to see that. The post by @cyanide12345678 is proof of that. I'm FM and my stats were way worse than his wife's and I matched my #2 spot.

 

[Mad Jack]

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

It seems the match system may have played some degree of fault in this tragic death. I wonder if there is any way to improve upon it to perhaps decrease the likelihood of such events.

The match didn't do this, mental illness did. Plenty of people go unmatched every year and move forward to match later. She could have done any number of things, as there are many other options than suicide to move forward abs have a meaningful and productive career. The real solution is better identifying students who need help and providing them with the support they need before things like this happen.

 

[Mad Jack]

I'm going to have to take issue with the bolded assertion. One of the most ridiculous aspects of the match process is that the number of spots is like 10k greater than the number of US grads yet you still have hundreds of US grads going unmatched each year. I'm sure most of those failed to match because they applied for competitive specialties, but a not insignificant number of US grads go unmatched in favor of foreign grads, which is just crazy. These residency spots are taxpayer funded!

In the case of criminal records particularly, how is it fair that a relatively minor criminal record can prevent a US citizen from practicing medicine in the United States, while we let over ten thousand foreign citizens train here every year whose criminal histories we know absolutely nothing about? It's a disgusting double standard. What kind of carnage would you have to cause in some of those less developed, corrupt third world nations before residency programs and licensing bodies in the United States could get so much as sniff of it? But if you're an American, get caught for so much as smoking a blunt as a teenager and you have to sweat bullets for the entirety of your medical career, lol.

The system is built to train the best candidates to serve the American public, not to severe the candidates themselves. If you ask the average taxpayer if they'd prefer to be training the best doctors possible or the most American ones regardless of quality, they're probably going to pick the former over the latter.

 

[Lexdiamondz]

I'm going to have to take issue with the bolded assertion. One of the most ridiculous aspects of the match process is that the number of spots is like 10k greater than the number of US grads yet you still have hundreds of US grads going unmatched each year. I'm sure most of those failed to match because they applied for competitive specialties, but a not insignificant number of US grads go unmatched in favor of foreign grads, which is just crazy. These residency spots are taxpayer funded!

In the case of criminal records particularly, how is it fair that a relatively minor criminal record can prevent a US citizen from practicing medicine in the United States, while we let over ten thousand foreign citizens train here every year whose criminal histories we know absolutely nothing about? It's a disgusting double standard. What kind of carnage would you have to cause in some of those less developed, corrupt third world nations before residency programs and licensing bodies in the United States could get so much as sniff of it? But if you're an American, get caught for so much as smoking a blunt as a teenager and you have to sweat bullets for the entirety of your medical career, lol.

I'm sorry but this assertion is silly.

The mach is very heavily weighted in the favour of US grads already - most people even at the bottom of the USMLE score spectrum match and the majority of USMDs who fail to match usually have a red flag on their application or have interpersonal issues which became apparent at some point on interview day. Of course there are some people who just get screwed by sheer bad luck, but the vasy, vast majority have personal factors to address.

It is absolutely fair that a criminal record can prevent a US citizen from practicing medicine in the US. As mentioned earlier - there are some jobs that felons probably shouldn't have, and a job where you have frequent access to narcotics is probably one of those "felons need not apply" jobs. Your former criminality doesn't define you per se, but it definitely shouldn't be something that society just forgets.

 

[deleted480308]

Fantastic job, you managed to string a sentence together. My challenge to you is next time try your hand at forming an argument. Baby steps but one day we'll get there.

Argument: The US doesn’t, and shouldn’t, care where they get their doctors from as long as we end up with the most talented and capable ones we can find

 

[Mad Jack]

There are two separate issues here. The one I don't really even want to get into much because it's besides the point is that you can't compare Step scores from US grads who have 3 weeks to prepare during M2 year to Step scores from FMGs who can take their sweet time and take the test whenever they feel ready.

The larger issue here is that this shouldn't be about meritocracy. Residency training slots aren't regular jobs, they're basically federally funded sinecures paid for from taxpayer money. How are you going to give these slots to foreign citizens who have never so much as stepped foot inside this country while rejecting perfectly qualified US citizens? Even private companies looking to hire for positions that don't receive a penny of taxpayer subsidy are supposed to prove no qualified Americans are available before they can bring in overseas workers.

How ludicrous is it then that we are ruining the lives of our own citizens by having them take on undergraduate and medical school debt and go through all the hoops of graduating medical school and passing the licensing exams only to then reject them in favor of foreigners? To add insult to injury, now they have to try to get out from under their crushing med school debt while being taxed to pay for the residency training of the foreign grads who took their spot! I understand that the USA isn't a real country, but still, it offends me on just the level of being against natural logic alone lmao.

How astoundingly self-centered. The training system isn't about doctors, it's about patients. This country is built on the core belief that people can come here from any nation or walk of life and make something of themselves through a meritocratic system; the manner in which residency selection functions is reflective of that.

99.7% of taxpayers aren't doctors. They are the ones that are largely paying for residency, not you. Many of the ones that are doctors are IMGs. They've all paid into a system that attempts to cultivate the best of the best from around the world to care for patients. So take a deep breath and remember that the world doesn't revolve around you, not even a little bit.

 

[Mad Jack]

Argument: The US doesn’t, and shouldn’t, care where they get their doctors from as long as we end up with the most talented and capable ones we can find

It's funny, premeds and med students all seem to argue US grads first but residents and attendings just seem to want the best colleagues. It's almost as if those who haven't yet entered the residency pipeline are shortsighted and unable to see what is in their own long-term best interest as a future physician that will also someday be a patient

 

[BoardingDoc]

So take a deep breath and remember that the world doesn't revolve around you, not even a little bit.

If you read any of this person's other posts I think you'll realize that convincing them of this fact is going to be exceedingly difficult.

 

[VA Hopeful Dr]

It's funny, premeds and med students all seem to argue US grads first but residents and attendings just seem to want the best colleagues. It's almost as if those who haven't yet entered the residency pipeline are shortsighted and unable to see what is in their own long-term best interest as a future physician that will also someday be a patient

It's not so much that, at least for me, it's that I recognize that US grads already get preference at the program-level. We don't need to make it a rule as most PDs already have a preference for US grads.

@Lexdiamondz made the point better a few posts back

 

[deleted480308]

It's funny, premeds and med students all seem to argue US grads first but residents and attendings just seem to want the best colleagues. It's almost as if those who haven't yet entered the residency pipeline are shortsighted and unable to see what is in their own long-term best interest as a future physician that will also someday be a patient

Yep, once you start trusting other doctors to particpate in the care of the patients who trust you....their original nationality means nothing, you just want them to be badasses who will give amazing care

 

[Mad Jack]

It's not so much that, at least for me, it's that I recognize that US grads already get preference at the program-level. We don't need to make it a rule as most PDs already have a preference for US grads.

I mean, there's also this. Being a US MD is far more beneficial than any other factor, so the way I look at it the ones that don't match are bottom of the barrel applicants competing against top-tier IMGs. Who do I want to work with, the US grad with a 198 on Step 1 or the IMG with multiple pubs, prior training in the field, and a 260? A US-first policy would force us to take the former, but I'd rather work with the latter.

 

[Brigade4Radiant]

People keep on using step scores as if they mean something. How are you practice clinically it’s not correlated to a step score. I mean what did you guys get on the in-service? Oh right it doesn’t matter because you did residency and you have a base level of knowledge that you will continue to accumulate.

How are you actually perform on your clinical rotations has a far greater value and how you actually perform as a doctor then a standardized test. We just use this to stratify applicants But please don’t fool yourself into thinking just because you’re IMG friend got a higher step score that suddenly they’re the best doctor in that residency program.

Also step scores and MCAT scores have been going up are we saying that now we have better doctors compared to what we’ve had in the past? The best indicator of a doctor is one that continues to learn and strives to better there health of their patient.

I mean I think we’ve all worked with people who came from a competitive program or had an MD PhD but they were awful clinically or just couldn’t pass muster such as not seeing patients in a reasonable manner being awful with the nurses and so on and so on.

 

[VA Hopeful Dr]

I mean, there's also this. Being a US MD is far more beneficial than any other factor, so the way I look at it the ones that don't match are bottom of the barrel applicants competing against top-tier IMGs. Who do I want to work with, the US grad with a 198 on Step 1 or the IMG with multiple pubs, prior training in the field, and a 260? A US-first policy would force us to take the former, but I'd rather work with the latter.

Especially since we already have an unofficial US first policy.

In 2019, 94% of US MD students Matched. When you take out the 2.5% who either didn't submit a list or withdrew from the Match the true percent who went unmatched despite submitting a list is only 3.5%.

 

[Birdstrike]

Also keep in mind, none of those other factors, MCAT, Step I, Step II, Inservice or Board scores are even remotely close to as important as the TAT score. That's the "Total A-hole Test." A failing score on that test instantaneously voids a 99th percentile on all the others. It's a quick easy class to pass, but some never do.

 

[NurWollen]

There are two separate issues here. The one I don't really even want to get into much because it's besides the point is that you can't compare Step scores from US grads who have 3 weeks to prepare during M2 year to Step scores from FMGs who can take their sweet time and take the test whenever they feel ready.

The larger issue here is that this shouldn't be about meritocracy. Residency training slots aren't regular jobs, they're basically federally funded sinecures paid for from taxpayer money. How are you going to give these slots to foreign citizens who have never so much as stepped foot inside this country while rejecting perfectly qualified US citizens? Even private companies looking to hire for positions that don't receive a penny of taxpayer subsidy are supposed to prove no qualified Americans are available before they can bring in overseas workers.

How ludicrous is it then that we are ruining the lives of our own citizens by having them take on undergraduate and medical school debt and go through all the hoops of graduating medical school and passing the licensing exams only to then reject them in favor of foreigners? To add insult to injury, now they have to try to get out from under their crushing med school debt while being taxed to pay for the residency training of the foreign grads who took their spot! I understand that the USA isn't a real country, but still, it offends me on just the level of being against natural logic alone lmao.

Many of those IMGs "taking their sweet time" are supporting families while working abroad as physicians on meager incomes. Others might be single, well-off financially, and have the 'luxury' of taking their time. But their human beings with the same anxieties and hopes for their careers that you have. They no more want to put it off forever than you do. But they do, because they might have only one shot. They can't screw it up with a low step score like you or me and still have a good shot at matching.

Sent from my SM-G930V using SDN mobile

 

[MechEDoc]

The system is built to train the best candidates to serve the American public, not to severe the candidates themselves. If you ask the average taxpayer if they'd prefer to be training the best doctors possible or the most American ones regardless of quality, they're probably going to pick the former over the latter.

Yep, those doctorally prepared NPs and PAs with full practice authority are really demonstrating the upwards trajectory of American medical (I mean advanced nursing) education.

 

[Brigade4Radiant]

Yep, those doctorally prepared NPs and PAs with full practice authority are really demonstrating the upwards trajectory of American medical (I mean advanced nursing) education.

Yeah doctors can’t argue about quality when NP and PA exist.

Also that begs the question would she be better off being an ortho PA? After two years less that and with her resume she got into med school she should’ve gotten into PA school and I know many NPs and PAs have substance abuse issues who are gainfully employed.

It seems the NP and PA degree is a more “powerful “degree than MD degree in by itself.

Even financially when you compare the risk of MD you lose 7 years of PA like income and compounding student loans.

For nontraditional’s or people have a less than stellar record I would argue that medical school is just too risky and you’d be better off pursuing NP or PA school. Even a nursing degree is incredibly flexible non-clinical and you could easily go into management.

Not to mention the flexibility a PA brings you You could go into ER you could do Ortho how are you could even do Derm and you won’t be locked out of these by a standardized test just apply to these places or ask to be on an academic place and there you have it.

In residency not only are you working you got to study imagine if you worked really hard like 80 hour weeks you would be making 20k.

Even in times of a pandemic we would all get ask to leave to cut costs than a very productive PA.