US-IMGs in Military Medicine - WHY NOT?

[medsRus]

There is a great shortage of military docs. Why not accept US citizens trained abroad??? I just don't get it...

---

Members don't see this ad.

 

[sethco]

I think US-IMGs can be in the military, assuming they can get a security clearance and meet physical standards. As long as you have a state license, you can practice in the military. However, for whatever reason (probably cost and other issues), the military will not give out HPSP scholarships to people attending overseas med schools.

 

[BigNavyPedsGuy]

There is a great shortage of military docs. Why not accept US citizens trained abroad??? I just don't get it...

Did someone train abroad at Oxford? In Paris? or at Jose's Casa de Tires and Medicine in Mexico City?

There's no standard for international schools. They need docs that are well trained and at least US schools have standard requirements to meet.

 

[medsRus]

Did someone train abroad at Oxford? In Paris? or at Jose's Casa de Tires and Medicine in Mexico City?

There's no standard for international schools. They need docs that are well trained and at least US schools have standard requirements to meet.

Absolutely absurd commentary since there certainly are standards. It is called ECFMG certification. IT IS A RATHER EXTENSIVE PROCESS with very stringent safeguards, verifications, and standards. And, schools must be listed in the International Medical Education Directory (IMED), so your make-believe school would not qualify.

I don't see any reason to deny military residency positions -- and for that matter HPSP scholarships -- to US-IMGs that attain ECFMG certification -- or attend IMED schools -- respectively.

 

[DrRoast]

Absolutely absurd commentary since there certainly are standards. It is called ECFMG certification. IT IS A RATHER EXTENSIVE PROCESS with very stringent safeguards, verifications, and standards. And, schools must be listed in the International Medical Education Directory (IMED), so your make-believe school would not qualify.

I don't see any reason to deny military residency positions -- and for that matter HPSP scholarships -- to US-IMGs that attain ECFMG certification -- or attend IMED schools -- respectively.

They won't give HPSP scholarships to people training at foreign schools b/c they don't want to give US government money to foreign countries. That's what a Military Doc told me anyway. Makes total sense to me, I agree. Do FAP if you want to be a military doc.

 

[medsRus]

They won't give HPSP scholarships to people training at foreign schools b/c they don't want to give US government money to foreign countries. That's what a Military Doc told me anyway. Makes total sense to me, I agree. Do FAP if you want to be a military doc.

Ridiculous argument... Students are already using FEDERAL Stafford Loans to pay for medical education abroad.

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

 

[DarthNeurology]

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

You can apply for military residency spots, but there are more graduates of the military medical school than spots PLUS US med students applying for them as well. If you want to serve as an IMG/FMG you need to do a residency in the states first and THEN when you are an attending apply for the military. The military ramped up recruitment of attendings for the Iraq war etc . . . and when the wars are over there may not be as much of a need for military medicine.

 

[DrRoast]

Ridiculous argument... Students are already using FEDERAL Stafford Loans to pay for medical education abroad.

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

It was by no means a rediculous argument and came straight from the mouth of someone on the Army HPSP Board. So this is why they are not given to US-IMG's at this point, which is the question you asked. I'm not trying to start a pissing match, just telling you what an extremely credible source told me face to face. W/ stafford loans, the student is going to pay them back so the US hasn't eaten any cost to a foreign government, also stafford loans don't come from government money's they come from the lender to which you barrow from. So, rediculous argument on your part.

 

[notdeadyet]

Absolutely absurd commentary since there certainly are standards. It is called ECFMG certification.

ECFMG standards are a lot different from LCME standards. The military knows LCME standards well, and there's very little variation allowed in the curriculum, hours, testing practices, and such between schools. This is why (as much as folks pretend otherwise) you pretty much get the same education regardless of which US allopathic medical school you go to.

ECFMG is much looser by design. Your school needs to be listed in IMED, then you need to pass the Step I and Step II.

But because an international school is listed in IMED is not meant to indicate that it is an equivalent education to an LCME school. It only means that you are considered to have graduated "from med school" for the sake of enrolling to take the USMLE exams.

Essentially an ECFMG is the equivalent to a GED holder. You've passed tests that demonstrate High School-level proficiency. But some jobs ask for an actual High School diploma, not a GED. Milmed's asking for the diploma.

I don't see any reason to deny military residency positions -- and for that matter HPSP scholarships -- to US-IMGs that attain ECFMG certification -- or attend IMED schools -- respectively.

There's no way the military is going to give federal HPSP scholarships to foreign schools the U.S. government has no authority over. No way.

The U.S. military allows internationally-trained physicians to practice medicine in the U.S. military as soon as they have a license to practice medicine in the U.S.

In fact, ECFMG folks can do military residencies. But they must do so after a U.S. internship in which they pass the USMLE Step 3 and can then get their full medical license.

 

[notdeadyet]

Ridiculous argument... Students are already using FEDERAL Stafford Loans to pay for medical education abroad.

Yes. These are loans. This is money people will pay back to the government coffers with interest.

HPSP is not a loan. It is money the U.S. government pays out that never comes back.

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

They can. Once they have their U.S. medical license.

If you qualify for an internship in the U.S. (which you would once you finished your Step I and II via ECFMG), you would just have to do a one-year internship, then you are eligible to join the U.S. military as a physician. You would most probably be asked to do a GMO tour for 1-2 years, then be eligible to apply for a military residency, since you can not start the application process to military residencies without being in the military.

 

[crazybrancato]

Did someone train abroad at Oxford? In Paris? or at Jose's Casa de Tires and Medicine in Mexico City?

Classic!

OP: All of the comments above are right on. There's no way the American gov't (particularly the DOD) is going to give HPSP funding to foreign schools, nor should they. It's U.S. money, it should stay here. MilMed may be hard up for docs, but i don't think the situation is that dire. Have you thought about doing an intership somewhere, then having passed USMLE Step 1-3, you could maybe come in as a GMO and eventually apply for military PGY2 programs ???? (I don't know if that's allowed, just a thought).

And please, don't get pissy here. It's obvious that you went to a foreign med school (despite being a U.S citizen) because you couldn't hack up the MCAT/GPA to get into an American school . . . and as a result you're aggrivated. But don't take your aggression out on the fine folks here!

 

[orbitsurgMD]

Ridiculous argument... Students are already using FEDERAL Stafford Loans to pay for medical education abroad.

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

So you think a Stafford Loan, which must be repaid to its lender, is the same as the HPSP scholarship, which is not repaid as such under ordinary terms?

Even if it was the same, which it obviously isn't, why would it be necessary for the military to offer the same terms to students studying outside the USA? It would seem to me a valid purpose of both USUHS and HPSP to ensure that there was at least a significant percentage of U.S. military physicians being graduates of U.S. medical schools. And there is good reason for wanting things that way, not least of which is that there is a valid perception that medical students accepted to U.S. medical schools have stronger records of academic achievement overall than American applicants who resort to study in other countries. And as the poster cited above, there is a bias toward "buying American."

 

[BigNavyPedsGuy]

Ridiculous argument... Students are already using FEDERAL Stafford Loans to pay for medical education abroad.

Why not just let US-IMGs that are ECFMG certified apply to military residency spots? This has yet to be addressed.

Writing in a bigger font doesn't make your argument better.

You can do a civilian residency and do FAP if you want to.

 

[deegs]

Writing in a bigger font doesn't make your argument better.

Thank you for pointing out what we all were thinking, BNPG!

 

[medsRus]

ECFMG standards are a lot different from LCME standards. The military knows LCME standards well, and there's very little variation allowed in the curriculum, hours, testing practices, and such between schools. This is why (as much as folks pretend otherwise) you pretty much get the same education regardless of which US allopathic medical school you go to.

ECFMG is much looser by design. Your school needs to be listed in IMED, then you need to pass the Step I and Step II.

But because an international school is listed in IMED is not meant to indicate that it is an equivalent education to an LCME school. It only means that you are considered to have graduated "from med school" for the sake of enrolling to take the USMLE exams.

Essentially an ECFMG is the equivalent to a GED holder. You've passed tests that demonstrate High School-level proficiency. But some jobs ask for an actual High School diploma, not a GED. Milmed's asking for the diploma.

There's no way the military is going to give federal HPSP scholarships to foreign schools the U.S. government has no authority over. No way.

The U.S. military allows internationally-trained physicians to practice medicine in the U.S. military as soon as they have a license to practice medicine in the U.S.

In fact, ECFMG folks can do military residencies. But they must do so after a U.S. internship in which they pass the USMLE Step 3 and can then get their full medical license.

Many if not all US states and the US Federal Government listed ECFMG certification as equivalent to a MD in the States (and some even provide a MD issued by the state medical board to the licensee).

It makes no sense that US-IMGs would otherwise be treating the general population (and veterans in VA hospitals), but they cannot enter military residencies? We undergo the same USMLE exams -- and if we beat the US-senior competition, why not offer us the spot?

 

[orbitsurgMD]

Many if not all US states and the US Federal Government listed ECFMG certification as equivalent to a MD in the States (and some even provide a MD issued by the state medical board to the licensee).

It makes no sense that US-IMGs would otherwise be treating the general population (and veterans in VA hospitals), but they cannot enter military residencies? We undergo the same USMLE exams -- and if we beat the US-senior competition, why not offer us the spot?

As concerns getting a state medical license, a state may consider IMGs and U.S. graduates equally eligible, but that doesn't mean they are the same.

Why should the military have to prefer only what you suppose is the minimum requirement accepted by the states? Just because you might be allowed on staff at one hospital doesn't mean you will be admitted to Johns Hopkins. And passing the USMLE, while a requirement, shouldn't be assumed to be the only requirement. Nor does beating "the U.S. senior competition" on a USMLE score make the education obtained at an overseas school necessarily the equal of a U.S. school education.

Maybe it doesn't make sense to you, but the preference of the military is to select students attending U.S. schools and to direct its funds toward those schools. There are valid and rational reasons for wanting to do things that way, reasons that do make sense.

If you are a U.S. citizen who goes overseas to go to medical school, even if it is solely for the reason of costs, you are not unreasonably presumed to be a less competitive candidate for medical school admission than those who go to a U.S. school.

Not every employer has to have enthusiasm to hire you, no matter how much "sense" you think it makes to you that they should.

 

[notdeadyet]

It makes no sense that US-IMGs would otherwise be treating the general population (and veterans in VA hospitals), but they cannot enter military residencies? We undergo the same USMLE exams -- and if we beat the US-senior competition, why not offer us the spot?

You have the ability to apply for military residencies as soon you have a medical license (after your Step 3 during your internship year). Given that you're coming with a medical education that is not under LCME control, this seems pretty fair.

Everyone applying to medical school is aware that you will face hurdles if you leave the country to go to medical school (or dental school, nursing school, or any career path that has lots of government oversight).

If this is really a big deal for you, you possibly should have considered taking more time to improve your application to the point of being accepted to a U.S. allopathic or osteopathic program. I'm surprised when someone is shocked that foreign credentials are viewed with less confident than more familiar domestic ones. Thankfully, it's a rare complaint.

 

[DH78]

This isn't just a milmed thing. I knew a doc who was trained as an MD/PhD in another country (not China), was a Fulbright scholar, and an extensive track record of practice in his home country, but still couldn't treat patients when he arrived in the US for a research job with a hospital. He would have had to jump through all the hoops; another residency, boards, etc if he wanted to practice here. It's very difficult, it seems, for non-US licensed docs to actually practice in the US. It logically extends to milmed too.

 

[DH78]

Actually, IMG's have it easier than FMG's. OP, there is some good practical advice on this thread if you really have your heart set on milmed.

 

[sethco]

Writing in a bigger font doesn't make your argument better.

You can do a civilian residency and do FAP if you want to.

What did you say? I can't hear you. You need to speak louder!

 

[DrRoast]

This isn't just a milmed thing. I knew a doc who was trained as an MD/PhD in another country (not China), was a Fulbright scholar, and an extensive track record of practice in his home country, but still couldn't treat patients when he arrived in the US for a research job with a hospital. He would have had to jump through all the hoops; another residency, boards, etc if he wanted to practice here. It's very difficult, it seems, for non-US licensed docs to actually practice in the US. It logically extends to milmed too.

This is very true. I once worked for an MD, PhD who was the lead pathologist for a country in the former soviet union, but when arrived in the US was forced to repeat his residency.

 

[DH78]

This is very true. I once worked for an MD, PhD who was the lead pathologist for a country in the former soviet union, but when arrived in the US was forced to repeat his residency.

I suppose it's easier to just throw out a blanket rule - all FMG's must do a US residency to practice - than to consider each on a case by case basis.

 

[medsRus]

It certainly looks like folks in this thread/forum (military medicine) perhaps are a bit lacking above the neck. Maybe they just don't want the competition from US-IMGs in their residency programs. ECFMG certified US-IMGs can get any allopathic residency spot, but no-one thus far has given a solid rationale on why military graduation medical education is closed for us.

I will speak with my congressional folks to see if I can get some real answers, and hopefully institute change. If there is a shortage of military docs, why not have US citizens who studies abroad and had their medical education deemed "equivalent" by governmental boards/agencies at least compete for military residencies.

 

[BrickHouseMD]

Broseph, you've had plenty of good answers. Just because they're not what you want to hear so you refuse to listen doesn't mean the people on this forum are stupid. Not a single person on this site had their hand in making these rules. Go have a brew, relax, and think about what other options there are for you because US military ain't one of them.

 

[DH78]

It certainly looks like folks in this thread/forum (military medicine) perhaps are a bit lacking above the neck. Maybe they just don't want the competition from US-IMGs in their residency programs. ECFMG certified US-IMGs can get any allopathic residency spot, but no-one thus far has given a solid rationale on why military graduation medical education is closed for us.

I will speak with my congressional folks to see if I can get some real answers, and hopefully institute change. If there is a shortage of military docs, why not have US citizens who studies abroad and had their medical education deemed "equivalent" by governmental boards/agencies at least compete for military residencies.

:troll:

 

[psychbender]

MedsRus, why are you so deadset on making the armed forces let you apply to our programs? Can't you find one in the civilian world?

If you want to serve the troops, then do a civilian residency, and join through FAP. If you want one of our spots, do a civilian internship, get a license, join the military, kick around the sandbox for a year or two, then do a residency.

 

[orbitsurgMD]

It certainly looks like folks in this thread/forum (military medicine) perhaps are a bit lacking above the neck. Maybe they just don't want the competition from US-IMGs in their residency programs. ECFMG certified US-IMGs can get any allopathic residency spot, but no-one thus far has given a solid rationale on why military graduation medical education is closed for us.

I will speak with my congressional folks to see if I can get some real answers, and hopefully institute change. If there is a shortage of military docs, why not have US citizens who studies abroad and had their medical education deemed "equivalent" by governmental boards/agencies at least compete for military residencies.

Time for your reality check.

As said above, we didn't make the rules you disagree with. Resorting to ad hominem suggestions that somehow those posting in reply here but not agreeing with you is due to a lack of intelligence reveals a lack of objectivity and insight on your part. You should direct your energies elsewhere. Even if you could convince me of the correctness of your notions, it still would not do you a bit of good.

Best you write your congressman.

 

[crazybrancato]

It certainly looks like folks in this thread/forum (military medicine) perhaps are a bit lacking above the neck.

And if you weren't lacking above the neck, maybe you couldn've gotten into a U.S. med school--instead of boondoggling in the Caribbean for 4 years--and then you wouldn't have this issue to begin with!

I will speak with my congressional folks to see if I can get some real answers, and hopefully institute change.

Yeah, good luck with that!

 

[Gastrapathy]

First, feel free to call your elected representatives.

Second, your obvious anger is totally misdirected. You made a choice when you chose to go overseas for medical school. You know that many specialties and institutions are essentially closed off to people in your situation. notdead already explained the path to you. Complete an internship, get licensed and you could potentially join as a GMO. After serving a tour, you would be able to apply for residency. There are IMGs in milmed, just not very many. This isn't different from when YOU chose to go overseas. So, if military medicine was the only way you could be happy, then blame yourself. If, on the other hand, you are interested in military medicine because you think it would be easier to get trained or we owe you in some way (your posts sound a tad entitled), then you might see why you've pissed people off.

Third, your basic premise that milmed is short of physicians is false. We are short of experienced physicians but, with the exception of a couple of years, they have met recruiting goals. So your "solution" is really only a solution to your problem (getting a US residency) and not the military's problem.

 

[notdeadyet]

I'm actually signing off this thread, because I think now it's mostly just feeding the troll.

But I did want to say one thing...

I don't look down on IMGs. I think a lot of posters here don't look down on IMGs.

• Many of us wanted to go to Harvard, but ended up at a lesser top 20 school.
• Many of us wanted to go to a lesser top 20 school, but ended up at a local state med school.
• Many of us wanted to go to a local state med school, but ended up going to an osteopathic school.
• Many of us wanted to go to an osteopathic school, but ended up going to one of the Big Four Caribbean schools.
• Many of us wanted to go to a Big Four Caribbean school, but ended up going to a no-name international med school.
• Some could have gotten into a top 20 allopathic, but preferred the osteopathic philosophy. Some could have gone to a U.S. allopathic, but really wanted to study in Ireland.

Nothing is wrong with any of this. We all have to settle with the option we choose based on our inclinations or aptitude.

But the sense of entitlement or "fairness" grates on folks' nerves, because we all have to come to terms with the consequences of our actions and make the best of the cards we're dealt.

What's beautiful about medicine is that nothing is a deal killer. You can go to Ross and end up in a stateside Derm residency, if you're willing to jump through the hoops. And you're able to do an international med school and end up a U.S. military physician if you're willing to jump through the hoops. Do a U.S. internship, swear in and do a GMO tour, and do a military residency.

No door isn't being closed to you, medRus. You can't complain that it's impossible, because it's not. You're complaining that it's too hard.

Tough. Welcome to medicine. We all have to make sacrifices to achieve our goals. If you're not willing to... well, so be it. But please, no whining about what's fair.

I had to deal this month with a patient who is dying of a disease she shouldn't need to die of because she couldn't get insurance due to a pre-existing condition that was unfortunately diagnosed when she was without insurance to do a lay-off that wasn't her fault. Listening to a physician whine about the fairness of specific licensing laws is so low down on the totem pole right now that I have to suck in dirt to even smell it.

 

[rotatores]

Maybe they just don't want the competition from US-IMGs in their residency programs.

Ya...that must be it! Chill out man...you've gotten your answer already...so stop trying to start a pissing match. After quickly looking at some of your other posts...this appears to be the norm for you.

 

[BigNavyPedsGuy]

It certainly looks like folks in this thread/forum (military medicine) perhaps are a bit lacking above the neck. Maybe they just don't want the competition from US-IMGs in their residency programs. ECFMG certified US-IMGs can get any allopathic residency spot, but no-one thus far has given a solid rationale on why military graduation medical education is closed for us.

I will speak with my congressional folks to see if I can get some real answers, and hopefully institute change. If there is a shortage of military docs, why not have US citizens who studies abroad and had their medical education deemed "equivalent" by governmental boards/agencies at least compete for military residencies.

You're right. We're all wrong. They should let you in. It's all better now isn't it?

 

[NavyFP]

There is a great shortage of military docs. Why not accept US citizens trained abroad??? I just don't get it...

I started to answer this after initially reading and then decided to read the rest of the thread.

There is a very simple reason that HPSP is not available to International Students. Under Title 10 the Secretary of Defense is able to designate which schools are eligible for enrollment in concurrence with HPSP. He has, and they are US and Canadian Allopathic and Osteopathic schools.

He could choose to designate foreign schools, but he has not and there is no movement to do so. As to the great shortage, there really is not a great shortage of medical students. The class of 2009 for the Navy was indeed short, but it is the nader, and they have now graduated. The classes of 2010 and 2011 are less than full, but not at the level of 2009. For the past 2 years, the Navy has met its goals with US students. The Air Force has consistently met its goals and I believe Army has this year and I think last year also. So, that part of the pipeline is doing OK. (could it be better, yes, but that is not addressing the current question)

Where the DoD is in need of physicians is in the resident and practicing physician areas particularly procedural based specialties (and FM). Simply adding International students to the mix will not change that part of the equation. Again this does not push for change in current policy.

IMGs who are ECFMG certified are free to apply for direct accession as a practicing physician or enter the FAP program. This better addresses the DoD's need without a need to change policy. Last year the Navy did allow International students with ECFMG certification to apply for internships. I believe 2 or 3 were actually accepted.

So this is a rather long winded answer to your question. The answer, they don't need to change at this time.

 

[DH78]

HPSP and USUHS has to go through the military match. While deferment is possible, it's rare. We already have limited residency options, and OP thinks IMG's should have a shot at those slots too?