What do you AMGs REALLY think about IMGs?

[europeanIMG]

Hi,

What do you AMGs REALLY think about IMGs? Since you are all anonymous, tell me what you really think, no politically correct bull****!

I saw a post on the forum that some ppl are upset about IMGs getting paid by federal money. Is taht a general opinion among American doctors?

Do you think we come and take your jobs and lower your salaries? Do you think we are less well trained and lack communication skills? Don´t you like working with ppl with a foreign accent and less than perfect grammar? (even if you understand what they say)

In my Scandinavian country it works like this if you generalize: Scandinavian doctors don´t mind working with doctors from other countries in western Europe as long as they understand what they say. Some ppl even find it interesting and exotic that they come from a different country. Doctors from eastern Europe and other foreign countries other than countries in Western Europe may have a tougher time. Some doctors think their education is inferior to ours and that their culture is "difficult" in a way that make it hard for them to communicate with doctors, nurses and patients. Ppl complain about their accent (even if they actually have no problem understanding them).

I have always thought about Americans as friendly and welcoming towards foreigners but some posts on this forum made me doubt.

I do not want to come to America if I´ll be "a second class doctor".

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[BlondeDocteur]

It's tough to answer this without putting your foot in it, but fools rush in, etc...

The same generalities are true here. IMGs from countries similar to the US-- either English-speaking (UK, Australia, South Africa) or "First World" (Northern/Western Europe) are scarce but integrate well. The bulk of foreign grads attempting to secure residency spots here are from the Indian subcontinent, and they (plus East Asians, Africans and Latin Americans) suffer from the dual prejudice of accent & language issues and questionable quality of education.

(Not that they *don't* receive good educations and can't be top-notch residents, but that's the prejudice).

Lastly, a lot of the outrage is based on the idea that foreign medical graduates somehow feel America has a duty to educate the physicians of the world, and that the "best qualified" person should win a spot. Obviously people here have issues with that-- most think the US residency system has a duty towards its own citizens first, and is under no obligation whatsoever to consider a Korean/Eritrean/Indian/Danish doc simply because he did well on the USMLE. Ever since the British system clamped down on Commonwealth grads (mainly Indians and Pakistanis) securing training spots, the focus has shifted over here instead, creating a lot of the tensions you see on these message boards.

 

[Impromptu]

Communication is a big issue. Many have such a deep accent that communication is very difficult. They may be incredibly smart and talented, but if you can't understand them, all the education in the world is worthless, just like poor penmanship makes your handwritten consult or prescription worthless.

There is also the issue of Americans first. We do have an obligation to train our own. I think this has been reflected in the recent increase in American medical school spots, without corresponding increase in residency slots. We'll still take foreigners, but now they must compete extra hard, which means only the best of the best of the best will come over. That'll also help stem the brain drain from the rest of the world.

 

[exPCM]

Hi,

What do you AMGs REALLY think about IMGs? Since you are all anonymous, tell me what you really think, no politically correct bull****!

I saw a post on the forum that some ppl are upset about IMGs getting paid by federal money. Is taht a general opinion among American doctors?

Do you think we come and take your jobs and lower your salaries? Do you think we are less well trained and lack communication skills? Don´t you like working with ppl with a foreign accent and less than perfect grammar? (even if you understand what they say)

In my Scandinavian country it works like this if you generalize: Scandinavian doctors don´t mind working with doctors from other countries in western Europe as long as they understand what they say. Some ppl even find it interesting and exotic that they come from a different country. Doctors from eastern Europe and other foreign countries other than countries in Western Europe may have a tougher time. Some doctors think their education is inferior to ours and that their culture is "difficult" in a way that make it hard for them to communicate with doctors, nurses and patients. Ppl complain about their accent (even if they actually have no problem understanding them).

I have always thought about Americans as friendly and welcoming towards foreigners but some posts on this forum made me doubt.

I do not want to come to America if I´ll be "a second class doctor".

I am an attending and here is my viewpoint:
I think FMGs filled a void in the past and there are many excellent FMG physicians in the US.
US med schools have had massive enrollment increases in the last few years.

We are now getting close to parity between the number of US grads (MD and DO) and the number of US first year residency slots. This will be the first year we will see significant numbers of unmatched and unemployed US grads as there will not be enough positions left in the scramble for the unmatched.

If you are able to think it all through the bottom line now is that each additional FMG (FMG total of X+1 versus FMG total of X) that gets a slot results in one more unemployed US grad (In 2009 there were only 1087 spots in the scramble for 1072 US allopathic med school seniors- in addition there were over 600 unmatched US osteopathic grads although they also have the option of trying to find osteopathic GME spots - see below).
I am not in favor of US grads with big debts being unemployed. Therefore I think we really need a system that mandates preference for US grads and then after all US grads have gotten spots then I believe the remainder should be opened to FMGs.
For all those AMGs who think FMGs should be on equal footing in the match with AMGs, please feel free to go to your unemployed classmates after this year's match/scramble and tell them how an FMG deserves a residency spot more than your classmate who has no residency position for next summer.

I also have no respect for US med school administrators who charge their students big bucks tuition and then do not fight to help ensure that their highly indebted graduates will have jobs after successfully completing their medical school programs.

I am sure there are many Scandinavians who would be fine doctors here but I do not want to see ever increasing numbers of our US medical students unemployed after med school graduation.

Last year:
On Thursday, March 19, nearly 30,000 applicants to the National Resident Matching Program (NRMP) learned where they will obtain their residency training. The 2009 Match was the largest in history, with 29,890 applicants competing for 22,427 first-year positions.

Just over half the applicants (15,638) were U.S. medical school seniors -- 400 more than in 2008. The growth of US MDs as well as DOs and US IMGs over the last few years has increased the competition for positions. As a result, only 1,087 PGY1 unfilled positions were available in the Scramble for 1,072 unmatched US MD seniors and more than 7,000 other applicants.

Active but unmatched applicants in the scramble
Seniors of U.S. Allopathic Medical Schools
1,072
Previous Grads of U.S. Allopathic Medical Schools
677
Students/Graduates of Osteopathic Medical Schools
607
U.S. Citizen Students/Grads of International Med Schools
1,771
Non-U.S. Citizen Students/Grads of Intl. Med Schools
4,372
All Applicants
8,550

P.S. I believe it is certain that the number of applicants in this year's match will crack the 30K barrier for the first time in history.

 

[SukaNeNauka]

When I visited Cleveland Clinic this year for anesthesia interview they told us that they pre matched 6 FMGs out of 24 available spots this year. All FMGs were from India according to another reliable source. Enough said. I am sure everyone is aware how popular and desired anesthesia is nowadays among AMGs, and some will not attain their dream through the match even with decent stats. There is something not right about this.

 

[exPCM]

When I visited Cleveland Clinic this year for anesthesia interview they told us that they pre matched 6 FMGs out of 24 available spots this year. All FMGs were from India according to another reliable source. Enough said. I am sure everyone is aware how popular and desired anesthesia is nowadays among AMGs, and some will not attain their dream through the match even with decent stats. There is something not right about this.

This is an excellent example. You can be certain there will be more than 6 AMGs who are well qualified but do not match in anesthesiology this year. Whether they can find anything at all in the scramble is a dicey proposition.
Again those of you AMGs (both MD and DO) who support giving FMGs equal footing in the match and who continue to support the use of prematches are basically saying that you are willing to throw some of your classmates under the bus.
I think I had a lot more loyalty to fellow classmates back when I was a med student.

 

[MacchinaDaCaffe]

When I visited Cleveland Clinic this year for anesthesia interview they told us that they pre matched 6 FMGs out of 24 available spots this year. All FMGs were from India according to another reliable source. Enough said. I am sure everyone is aware how popular and desired anesthesia is nowadays among AMGs, and some will not attain their dream through the match even with decent stats. There is something not right about this.

I agree with you, there is definitely something not right with this. How can the NRMP pretend that there is integrity in the match when all throughout the interview season there have been deals like this going on behind the scenes unbeknownst to AMGs such as myself who have been busy trying to win the favor of the program directors to secure a residency spot and who are prevented by contract from accepting any offers outside of the match. The only solution I see is to ban the practice of offering/accepting positions outside the match altogether. I would go further and say that there should be two stages of the scramble process, the first stage being open only to AMGs with any remaining unfilled spots after that being available for scramble by IMGs.

 

[sunset823]

When I visited Cleveland Clinic this year for anesthesia interview they told us that they pre matched 6 FMGs out of 24 available spots this year. All FMGs were from India according to another reliable source. Enough said. I am sure everyone is aware how popular and desired anesthesia is nowadays among AMGs, and some will not attain their dream through the match even with decent stats. There is something not right about this.

I agree this is a big problem. I grew up in Cleveland, and I'm interested in anesthesia, and while admittedly going back to Cleveland would not be my first choice, I would certainly apply there for residency and would hope to be considered over an FMG from India who would have a very hard time coping with the overwhelmingly non-immigrant population in that city (as a South Asian growing up in a 97% white community in the Cleveland metro area, I know all too well the issues that can be faced by immigrants there).

Unfortunately, I think this lies in the history that places like Cleveland, and many other cities in the Rust Belt, had a very hard time getting AMGs interested in them in the past, and therefore instituted the pre-match, and they haven't adjusted this practice to the hugely increased numbers of AMGs, who all can't match to the desirable east and west coast programs.

I know there's been a lot of talk about making two matches, the first for AMGs and the latter for IMGs. I don't know how feasible this is in the short-term, but I certainly think it is imperative to get rid of pre-matching, make it illegal if possible.

 

[eforest]

Most of the IMG's I've worked with have been well trained and competent. The biggest issue is with the accent. I've heard complaints that IMG's believe step 2 CS discriminates against those with thick accents. Why shouldn't it? If someone is difficult to understand- it affects communication among members of the medical team, and also communication with the patient.

 

[Saladin MD]

after all US grads have gotten spots then I believe the remainder should be opened to FMGs.

I understand where you are coming from, but what about an AMG who has failed the steps multiple times, was at the bottom of his class, etc etc., compared to an American citizen who studied abroad and got triple 99's, top of his class, research experience, etc etc.

 

[Speculatrix]

I understand where you are coming from, but what about an AMG who has failed the steps multiple times, was at the bottom of his class, etc etc., compared to an American citizen who studied abroad and got triple 99's, top of his class, research experience, etc etc.

Tough titties. If you chose to go to St George or some random island and were not offered admission to American schools (or more stupidly, turned them down or didn't apply in the first place), you should have to live with the consequences of that decision. Or, consider the student who cheats in undergrad, is not accepted to any US med school as a result, and thus has to go to school in some tropical shanty town, with third tier clinical "rotations" in St Generic county "hospital". That has got to be some huge driving force to study and do well, to get out of the unfortunate hole -- trapped in that situation, anyone would want to buckle down and do well on the boards. If I were heading a residency program, I would know that LCME medical schools have already done the background work to weed out people with such shady academic pasts... but know that kind of QC isn't compulsorily done for island diploma mills. Similarly, it's pretty obvious when an American grad has a sketchy Deans letter/past. In this system, this American grad would technically go through the first iteration match, but you'd have to be pretty stupid or desperate to hire this person. There aren't really many complete "crap" AMG students that make it to graduation/match though.

 

[exPCM]

I understand where you are coming from, but what about an AMG who has failed the steps multiple times, was at the bottom of his class, etc etc., compared to an American citizen who studied abroad and got triple 99's, top of his class, research experience, etc etc.

Somebody is going to be at the bottom of every med school class. That does not prove by itself that they are incompetent and do not deserve a shot at residency.
The standard sayings include:
Q:What do you call a med student who graduates at the bottom of their class?
A: Doctor
or
P=MD or DO where P=Passing med school requirements
Are you saying that US med schools should have two sets of diplomas?
One set saying Dr. X our graduate and qualified to start residency
Another set saying Dr. X our graduate but not qualified to start residency
I think people who go through the rigors of US medical education and graduate from medical school at least deserve a shot. Will some not make it through residency? Yes.
However I do not think they should be denied a chance in favor of FMGs.

 

[filter07]

It would be a crying shame if there were too many medical students to each match into a residency spot. Can you imagine going through medical school with 100-300K debt and not having a way to pay it off? That would be a horrible situation. Although most of the FMGs I've worked with are pretty great, I think a US grad should have priority, even if they suck. Of the prelim surgery residents we've had in my program, the FMGs were good, the US grads were a mixed bag, and some were just god awful. That being said, the FMGs can match in their own country, and the Caribbean folks, well, I don't have much sympathy for those who attend unaccredited diploma factories.

I think if we get into a situation where a significant number of US grads are not able to get residency spots, there should be a deafening outcry. I'd hate to push out the qualified FMGs but we can't have US grads trying to find unaccredited residencies or selling quack medicines on infomercials.

 

[142348]

Hopefully, when PD's see that US grads are going unmatched they will stop offering prematches ensuring all spots are available for US grads first and other comers 2nd. This is an issue where PD's and attendings need to stand up and protect the interests of the US grad and not themselves. It is not a good thing to have US grads with 100's of thousands of dollars in debt not having a residency. While some may say the same for Caribbean grads, they took that inherent risk when going to a substandard school.

 

[exPCM]

Hopefully, when PD's see that US grads are going unmatched they will stop offering prematches ensuring all spots are available for US grads first and other comers 2nd. This is an issue where PD's and attendings need to stand up and protect the interests of the US grad and not themselves. It is not a good thing to have US grads with 100's of thousands of dollars in debt not having a residency. While some may say the same for Caribbean grads, they took that inherent risk when going to a substandard school.

I do not see any guarantee of this happening without rule changes or mandates.
25% of US physicians overall are now FMGs and there are now many PDs who are FMGs. I have met several FMG PDs who have a track record of pulling in residents who are also FMGs.
http://www.ama-assn.org/ama/pub/abo...medical-graduates/imgs-in-united-states.shtml
Here you can find a list of new PDs - click on list of new program directors:
http://www.acgme.org/adspublic/

 

[rhmtascp]

What about all the programs that would go unfilled if no IMGs pre-match?

 

[bullpup777]

What about all the programs that would go unfilled if no IMGs pre-match?

Last year I would have cheerfully taken any one of those positions, and I am an AMG.

 

[Gastrapathy]

What about all the programs that would go unfilled if no IMGs pre-match?

Why can't that happen post-match? To me, if you are going to require our core allopathic medical students to participate in the match (and I just argued FOR that in another thread), you absolutely can't disadvantage them in any other way.

If you want to participate in the match as a program, you shouldn't be allowed to offer slots to anyone else until after the match.

Let them fill up with FMGs or IMGs or unmatched MDs or DOs on an equal footing after the match. Remember, all those prematches were people who could have participated in the match.

 

[logos]

I have to admit I have a little bit of a bias against them. Not from any experience with them being any better or worse than AMGs or for any real reason. In thinking about it, I don't think I have any bias against folks that immigrate to the US from a home country, but more for the folks that went to off shore medical schools because they couldn't get into a US school. I don't know why that is because several of those Caribbean schools are known for giving a good education and they even do their rotations in the US. Nonetheless the whole idea of it gives me a bit of a negative impression.

 

[thedrjojo]

I'll break it down two ways: IMG's in practice/that are residents, and IMG's applying for residency.

Those that are residents/in practice, for the most part, are very good and I have great respect for them. I have seen some Surg Prelim FMG's who have been very weak (which in contrast made me look very good) even though they had 250+ step scores... which goes to show the scores mean nothing (even though I too have 250+ scores on 1 and 2)... This counts DO, Caribbean (one of my better chiefs this past year was a SGU alumni), and true FMG's. Language barriers have made problems at times, but it has for attendings as well as well as a few of my classmates...

As for the IMG's applying for residency, I think you both get a raw deal and taking away places that should be more guarenteed or atleast given equal shot to AMG's. I hate the prematch system and think it should be done away with. They both feed on your fear of not matching, and deprive worthy AMG even a fair chance at the spot (by removing it from the match). This is particularly true for some FM places that fill entirely via prematch (Hoboken Univeristy Medical Center this year filled entirely by prematch so I have heard) so if any AMGs wanted that place, they wouldn't have even had the option...

 

[Pons de Leon]

the match was created because the whole making offers thing wasn't working...

so WTF can programs make out of match offers to non AMGs? the NRMP match does NOT favor AMGs... especially MD students (who only have one match to participate in).

btw.. im not bitter.. i got a good email today. but still. i hurt for everyone else.

 

[europeanIMG]

Thanks for your sincerity.

I guess it all boils down to the fact that it is getting increasingly difficult to match in the US because more ppl attend med school than b4.

I am not sure the US is for me then. If I move to America I would like to be a part of the community of American doctors and not looked upon as a foreigner to took a former classmate´s job.

In my country, as I told you, ppl tend to look down on doctors from countries outside western Europe. If they do something wrong it´s because they are foreigners and have a bad education, if a Scandinavian doctor does the same error it´s bad luck and not a very serious mistake anyway. If a patient doesn´t understand the Scandinavian doctor it´s because the patient is deaf or suffer from dementia. If the very same patient doesn´t understand a foreign doctor it is because of their accent.

I would not like to be treated like that, seems like that may be the case in the US... I have the feeling American docs would not like to hang out with me during our spare time. I have nothing against ppl frmo India, would love to work with good doctors from that part of the world, but the guys from India I´ve met were very different from us in the western part of the world and had very different interests and ideas of what to do for example for Saturday night.

 

[Touchdown]

^Your fears are unfounded, the United States is unlike any country in Europe. We are a melting pot of cultures that for the most part get along. You also have a huge advantage in being from Europe, it is extremely easy for Europeans to integrate into our society. You asked about obtaining a residency spot and people told you their opinions, once you are out in the real world things change drastically.

 

[europeanIMG]

^Your fears are unfounded, the United States is unlike any country in Europe. We are a melting pot of cultures that for the most part get along. You also have a huge advantage in being from Europe, it is extremely easy for Europeans to integrate into our society. You asked about obtaining a residency spot and people told you their opinions, once you are out in the real world things change drastically.

In what way do "things change drastically"? Ppl who don´t like IMGs now will not start loving me once I am in the US... Why should they?

My impression was that Americans are friendly. I always feel so much at home when I am in the US. (Much more at home than in any other country outside Scandinavia). But I have never worked in the US so maybe ppl will not be as friendly once I´ve taken their friends´jobs.

 

[Apollyon]

Somebody is going to be at the bottom of every med school class. That does not prove by itself that they are incompetent and do not deserve a shot at residency.

The standard sayings include:

Q:What do you call a med student who graduates at the bottom of their class?
A: Doctor

What else do you call them? Defendant!

Your point revolves around a strictly ordinal ranking, without consideration of grades and so on. If it's pyramidal, and SOMEONE has to fail, then your point has more merit. If everyone has a chance to pass well, and no failures are required, then the question of a multiple step failing, academically challenged student does not bode well for that student.

What's the hardest thing about professional school? Getting in. What's the hardest thing about graduate school? Getting out.

 

[Touchdown]

You are asking a bunch of neurotic 4th year students what they think about IMG Residents. Of course there is going to be backlash about the "people taking our spots" you are a nameless threat to our ablility to get a residency postion.

Thats not to say that once you get here people will base their opinions solely on that fact. People will get to know you on a personal level and things will change. As for your patients, the biggest hurdle to former IMG docs is getting a patient to see them for the first time, as a European this will not be a problem as no one will be able to pinpoint your not an American until you open your mouth. Aftter that first visit weither or not they come back will be based on weither or not they liked the service they got from you, not what country you are from.

 

[europeanIMG]

OK, got your point.

I do not doubt I would get along with patients in America. I know I will have no problems intergrating in America. (Of course it depends on what part of the US we are talking about, I would have a tough time intergrating in the more rural areas of Scandinavia too).

My only concern is that AMGs would be hostile towards me as an IMG.

You are asking a bunch of neurotic 4th year students what they think about IMG Residents. Of course there is going to be backlash about the "people taking our spots" you are a nameless threat to our ablility to get a residency postion.

Thats not to say that once you get here people will base their opinions solely on that fact. People will get to know you on a personal level and things will change. As for your patients, the biggest hurdle to former IMG docs is getting a patient to see them for the first time, as a European this will not be a problem as no one will be able to pinpoint your not an American until you open your mouth. Aftter that first visit weither or not they come back will be based on weither or not they liked the service they got from you, not what country you are from.

 

[md2010sgu]

My only concern is that AMGs would be hostile towards me as an IMG.

Just bust your butt during residency, and the AMG's will respect you for it. I did this during all my clinical rotations as a MS3 & MS4, and all the attendings, residents, and students who were AMG's were nothing but respectful towards me for showing them that an IMG student can be as equal as an AMG student. I intend to keep this up during my residency... I'm sure you will do the same since your already worried about people not liking you

 

[SukaNeNauka]

Just bust your butt during residency, and the AMG's will respect you for it. I did this during all my clinical rotations as a MS3 & MS4, and all the attendings, residents, and students who were AMG's were nothing but respectful towards me for showing them that an IMG student can be as equal as an AMG student. I intend to keep this up during my residency... I'm sure you will do the same since your already worried about people not liking you

Do you think everyone will like the most hardworking, motivated, bright individual in residency? just remember that the most important thing in any group is to be low key, but do your work at the same time. People are not as nice as we sometimes think they ought to be. Fly low and far. This is especially true in an academic setting where everyone is fighting for their turf, where egos are super inflated, and where nobody like an ambitious newcomer. When you are doing your rotations, short bursts of ambition and hard work are well taken, but this all changes when you are there for 3-4 years.

 

[europeanIMG]

I am not the best student here in my country so I doubt I will be the best resident in America either. I will definately do my best and I hope I will make at least an average resident.

If I have to be better than everyone else to be accepted it is not for me.

I know I am very privileged compared to all the IMGs from India etc. The conditions in their country are so bad they want to come to America at any price. I like it here in my country, conditions are OK. My reason for going to the US is that the medical education is even better and that I´d love to live in America for at least a few years. When I say live in America I mean live in a nice part of America. E.g. Cleveland is not for me...

 

[md2010sgu]

Do you think everyone will like the most hardworking, motivated, bright individual in residency? just remember that the most important thing in any group is to be low key, but do your work at the same time. People are not as nice as we sometimes think they ought to be. Fly low and far. This is especially true in an academic setting where everyone is fighting for their turf, where egos are super inflated, and where nobody like an ambitious newcomer. When you are doing your rotations, short bursts of ambition and hard work are well taken, but this all changes when you are there for 3-4 years.

Oh don't be bitter...you love me don't you True... I'm sure I pissed off some of my peers, but I never flaunted around or bragged about my hardwork, nor did I ever... EVER... burn or make my peers look bad in terms of knowledge. In fact, I would do just the opposite...I always helped them out so they seemed bright on rounds or in front of attendings.

I disagree with your comment to "Fly low and far." though...that will make you the "ghost" medical student, and will get you nowhere except being looked down upon. My belief is that if you are truly a good person, it will reflect in your actions, and you will not be hated for it.
Anyways, let's not be a .

 

[MacchinaDaCaffe]

In what way do "things change drastically"? Ppl who don´t like IMGs now will not start loving me once I am in the US... Why should they?

My impression was that Americans are friendly. I always feel so much at home when I am in the US. (Much more at home than in any other country outside Scandinavia). But I have never worked in the US so maybe ppl will not be as friendly once I´ve taken their friends´jobs.

I can't be absolutely sure, but I have a feeling that the attitude towards IMGs is highly variable from one specialty to another. For example, in less competitive specialties such as Family Medicine, Psych or Internal Medicine then IMGs are largely welcomed as they help fill residency positions that otherwise might go unfilled. As long as you are well qualified and competent I doubt anybody would even view you as stealing an AMGs job. I suspect that with the more competitive specialties in which even extremely well qualified AMGs fail to match every year, then you may be viewed as someone who took an AMG's spot. Does that make sense?

 

[Eta Carinae]

Hi,

What do you AMGs REALLY think about IMGs? Since you are all anonymous, tell me what you really think, no politically correct bull****!


I have always thought about Americans as friendly and welcoming towards foreigners but some posts on this forum made me doubt.

[YOUTUBE]http://www.youtube.com/watch?v=z7X2_V60YK8[/YOUTUBE]

 

[lipomas]

My opinion: The average FMG is a weaker physician than the average AMG. But there is so much variation that this statement only has any validity if you are looking at the resident roster of programs you are considering. That is, if a program is almost all FMGs it is probably not a great program that you would want to train at. But once you get down to the individual level it's meaningless and you generalize at your own peril. I never judge someone up front because they are an FMG - I may make sure they have adequate communication skills because that is a common area where they are problematic. But that's about it. Otherwise, the evaluation would proceed identically. Work ethic, intelligence, similar things, all are highly variable.

 

[jdh71]

FMGs . . . most of the one's I have worked with have been fine as far as physicians go . . . but the culture clash is one that while tolerable, I'd really honestly prefer not to deal with. I realize that may make me sound like a bit of a bad person, but I prefer my peeps, the same way I'm sure they prefer theirs. The more "Americanized" the FMG the better they get along. I have had zip, zero, zilch issues working with Western Europeans outside of the occasional thick french or german accent (I'm bad with accents, so it's really more my issue than theirs, I realize this). Eastern europeans are just weird to me. I actually prefer the Indians, Pakistanis, or Jordanians to eastern europeans. I DREAD working with the Chinese, mostly because I can't understand a word they are saying most of the time.

So what do I really think? I prefer not to deal with FMGs unless they are Western European.

 

[knockoutMice]

... all the IMGs from India etc. The conditions in their country are so bad they want to come to America at any price...

@ europeanIMG: Get your facts straight!

The motivations for most Indian grads are same as yours - We LOVE it here in our country, conditions are GREAT (not just OK, lifestyle is much better! For just a mere $24k to 32k per annum we can live much, much comfortably in India than a doc earning say $120k to $180k in US).

Our reasons for going to the US are that the infrastructure for research are much better and that just like you we´d love to live in America for at least a few years (because we have love and respect for the good things in American culture and way of living) AND something which you didn't think of: learning something there and bringing it back to our country to further improve the standard of education and practice of medicine as a whole.

Most of the Indians I know (barring quite a few) who are pursuing residencies in US or are thinking of doing that have been ace students who have topped most of the toughest entrance exams in India or are equally capable. So for many Indians USMLE is the EASY way to higher education.

I don't blame AMGs for their point of view, they have some (but not complete) justification.

Someone had posted something like this on SDN (I don't remember who and where) "... just as AMGs deserve a fair chance to residencies, the American people deserve an equally fair chance to be treated by the best doctors... and this entire philosophy is compromised when a program director chooses an average of even a good AMG over a much much better IMG/FMG...." Honestly if this were the situation in India, then I would always prefer a foreign doctor to treat my family over an Indian doctor knowing that the foreign doctor had had much better credentials than his Indian counterpart

I don't know how much you people are informed about the credentials of FMG candidates who prematch at good programs, but let me tell you these people have stellar credentials besides excellent MLE scores (250-260+), like multiple publications in US/International publications/presentations by the time the graduate out of med school.

What's happening in UK right now is just a glimpse of what might happen to US if the less knowledgeable and more prejudiced people among you have their way -
NHS brain drain fears raised by appeal to Indian doctors -
Fears of a brain drain in the NHS have been raised after the Indian government appealed to 15,000 doctors based here to work in new medical centres. The Telegraph UK http://j.mp/4HxXLp
Just note that the same figure for US nearly equals to 36,000 (physicians of Indian origin serving in the US)

At one conference I saw a presentation by this professor which talked about Immigration of Doctors, Brain Drain and stuff. He talked about some European country having to pay this huge compensation to these poor African countries because most of the doctors from those countries had immigrated there. He also went on to do some calculations according to which US owes India some $88.9 billion or something for the cost to educate the doctors who are currently serving in US.

Anyways, UN is bringing in new regulations to limit the no of doctors that certain first world countries (including USA, UK, Canada etc) can accept every year from third world countries to limit the brain drain occurring. I hope it'll be good for both the parties or will it be?

PS I have no intentions to offend/insult/argue with anybody. I have just put in my opinions and facts to the best of my knowledge. If you have found any portion of my post offensive/wrong in any way, please PM me as I would really want to clear up the matter.

 

[Sam212]

Someone had posted something like this on SDN (I don't remember who and where) "... just as AMGs deserve a fair chance to residencies, the American people deserve an equally fair chance to be treated by the best doctors... and this entire philosophy is compromised when a program director chooses an average of even a good AMG over a much much better IMG/FMG...." Honestly if this were the situation in India, then I would always prefer a foreign doctor to treat my family over an Indian doctor knowing that the foreign doctor had had much better credentials than his Indian counterpart

I don't know how much you people are informed about the credentials of FMG candidates who prematch at good programs, but let me tell you these people have stellar credentials besides excellent MLE scores (250-260+), like multiple publications in US/International publications/presentations by the time the graduate out of med school.

This my friend is somewhat flawed thinking. Just because you studied for USMLEs for a year and scored a 250 doesn't mean you are more qualified than an AMG. We only get 6-8 weeks to study for the exam, some times even less. You even admitted in your post that America provides better opportunities for training, and AMGs are products of this system, hence more qualified by default to work in this system.

 

[Bassix]

Tough titties. If you chose to go to St George or some random island and were not offered admission to American schools (or more stupidly, turned them down or didn't apply in the first place), you should have to live with the consequences of that decision. Or, consider the student who cheats in undergrad, is not accepted to any US med school as a result, and thus has to go to school in some tropical shanty town, with third tier clinical "rotations" in St Generic county "hospital". That has got to be some huge driving force to study and do well, to get out of the unfortunate hole -- trapped in that situation, anyone would want to buckle down and do well on the boards. If I were heading a residency program, I would know that LCME medical schools have already done the background work to weed out people with such shady academic pasts... but know that kind of QC isn't compulsorily done for island diploma mills. Similarly, it's pretty obvious when an American grad has a sketchy Deans letter/past. In this system, this American grad would technically go through the first iteration match, but you'd have to be pretty stupid or desperate to hire this person. There aren't really many complete "crap" AMG students that make it to graduation/match though.

Oh please, as if the med school app process is 100% fail proof. Contrary to your wild imagination, not every US med student can handle medical school. They have the fortunate comfort of the school helping them to not fail.

 

[Bassix]

Somebody is going to be at the bottom of every med school class. That does not prove by itself that they are incompetent and do not deserve a shot at residency.
The standard sayings include:
Q:What do you call a med student who graduates at the bottom of their class?
A: Doctor
or
P=MD or DO where P=Passing med school requirements
Are you saying that US med schools should have two sets of diplomas?
One set saying Dr. X our graduate and qualified to start residency
Another set saying Dr. X our graduate but not qualified to start residency
I think people who go through the rigors of US medical education and graduate from medical school at least deserve a shot. Will some not make it through residency? Yes.
However I do not think they should be denied a chance in favor of FMGs.

No. This is nearly analogous to affirmative action. For some reason, you want to provide the population with the least qualified individual based on some entitlement notion. Now grades certainly play a backseat role, so I'm referring to the primary measuring stick, ie. board scores. If a student is toward the bottom of the class and gets mediocre board scores, they are not as qualified as someone who is sitting at the top of their class and gets better board scores, regardless of school.

 

[Bassix]

This my friend is somewhat flawed thinking. Just because you studied for USMLEs for a year and scored a 250 doesn't mean you are more qualified than an AMG. We only get 6-8 weeks to study for the exam, some times even less. You even admitted in your post that America provides better opportunities for training, and AMGs are products of this system, hence more qualified by default to work in this system.

Everyone has the capability to study for the step starting from MS1. You have 3-4 months in between MS1/MS2, a long xmas break, and spring break. That's certainly more than a lot of us get. We could take more time right after, but we don't because we get shafted on where we can do clinicals, depending on the semester we enter in. Nearly everyone who gets out of basic sciences takes it within 4-6 weeks.

 

[bullpup777]

My board scores are fine, thanks to my knack for taking standardized exams. I am, however smart enough to know that my performance on a multiple choice exam does not make me a good physician. Anyone who thinks they are God's gift to medicine because of high board scores is going to be a lousy resident and physician. Go into your residency with appropriate humility and respect for the training process and things will go better.

 

[greenbean]

please stay in your own country and do everyone, especially yourself a favor

i mean this in the sincerest, nicest way possible(which probably wont be conveyed the way i want it to on this electronic method)

my mom , an IMG, came here 30 yrs ago for family reasons; lots of her friends from med school are here too and back then life was great, passing the flex and ecfmg was not as hard as it is now and jobs/residnecy spots were easy to get

nowadays , not the case; most IMG are faced with more exams(step 1,2,cs,3); residency spots for competitive fields are almost impossble to obtain; and those they get are for these dinky community hospitals, where malignant practices and PDs abound; every spot an IMG gets takes away from an AMG who is unmatched; not just that with all the AMGs, DOs, IMG and caribs, there are WAY more applicants than spots; so PDs can pick and choose who they want, not the other way around. therefore, there is no shortage of candidates

after all, would you like it if IMG came to your country and took spots and left your classmates w/o spots entirely?

if i had to revamp the match, i would have AMGs (med students)ranked and only AMGs; and then each applicant would choose either a specialty they wanted or locations according to preference, maybe give everyone 5 choices; these choices would go to the program and they could either say yay or nay to the AMG candidates; this is how the programs would be filled

once all the AMGs have spots,if there are spots left over, then would come DOs who would be ranked as well. the DOs should be filling spots in their osteo programs, so really once all the DO programs are filled, then the leftover DOs could join the leftover allo programs

if there is still leftover, then go caribs get ranked and placed

more leftover? FMGs turn

that i think it what is fair, AMGs are screwed constantly, so im not holding my breath

peace
green

 

[rhmtascp]

I read a good point above. Med school admissions are FAR from perfect. Just as a any screening test can classify diseased people (lousy students) as healthy (going to US schools) and healthy ones (perfectly good students) that are classified as diseased (those going offshore) so too, can admission committees. Good science can show that there IS an overlap.

It is also true that a good bit of AMGs make it though med school only by the grace of PDs, who might otherwise fail miserably at any European or Caribb school. So who is it gonna be?

This argument is more politics than anything else, so it's more complex than anyone here makes it out to be, but the fact of the matter is that the US needs good doctors, whether AMGs or FMGs.

By the way, lousy FMGs DO NOT get residencies in the US; however, a good bunch of lousy AMGs are already looking forward to July.

 

[jdh71]

Oh please, as if the med school app process is 100% fail proof. Contrary to your wild imagination, not every US med student can handle medical school. They have the fortunate comfort of the school helping them to not fail.

That's an interesting accusation. Every student who actually couldn't handle med school was let go where I went.

 

[jdh71]

No. This is nearly analogous to affirmative action. For some reason, you want to provide the population with the least qualified individual based on some entitlement notion. Now grades certainly play a backseat role, so I'm referring to the primary measuring stick, ie. board scores. If a student is toward the bottom of the class and gets mediocre board scores, they are not as qualified as someone who is sitting at the top of their class and gets better board scores, regardless of school.

How do board scores "qualify" anyone to work clinical medicine?

 

[medsRus]

How do board scores "qualify" anyone to work clinical medicine?

Agreed!

 

[Bassix]

That's an interesting accusation. Every student who actually couldn't handle med school was let go where I went.

Yes, and I'm sure it was after significant intervention by the school. Prestige of a university is on the students side, and as such, tarnishing a name with people who aren't producing is the last thing the school wants.

 

[Bassix]

How do board scores "qualify" anyone to work clinical medicine?

If you read my reply carefully, I wrote that it is a primary measuring stick. Of course there is more to an individual than just scores. However, since the boards are essentially a test of your knowledge (mental regurgitation or whatever you want to call it), it goes without saying that one would be naive to take someone who got a 215 over someone who got a 240 (pending the interview of course). It is one aspect of qualification into medicine.

 

[vhawk]

When I visited Cleveland Clinic this year for anesthesia interview they told us that they pre matched 6 FMGs out of 24 available spots this year. All FMGs were from India according to another reliable source. Enough said. I am sure everyone is aware how popular and desired anesthesia is nowadays among AMGs, and some will not attain their dream through the match even with decent stats. There is something not right about this.

lol at the bolded. No there isnt. But its amusing that this "something" you apparently cannot specifically describe, but you wanted to throw that last line in there anyway for the appeal to emotion points.

WHAT, exactly, is "not right" about this?

 

[vhawk]

How do I feel about IMGs? I feel bad for them. Misplaced nationalism and ignorance of basic economics, not to mention plain old xenophobia and greed, make it so that their road to a quality education is that much more difficult, all because they happened to be born inside the wrong imaginary lines.

But the people who suffer most from artificial barriers to entry are rarely the competitors themselves.