What do you AMGs REALLY think about IMGs?

[ResidentMD]

I know doctors/professors from Europe who to America simply because they can get more money for their research. They get about the same salary as in Europe. Academic salaries in the US are not extraordinary.

I am sure lots of doctors (the majority) move to America because of the money. But what the heck is wrong with that? When your forefathers moved to America from e.g. Europe some 100 years ago they moved for exactly the same reason. I do understand that some of you don´t like competition but I´d never think you would find it morally wrong to do the same thing your forefathers did.

morally wrong? how easy is it for a U.S. citizen from a U.S. med school to do a residency in Europe (or most any other country)? almost impossible compared to somebody from any med school in the world getting a residency in the U.S. didn't the U.K. effectively ban foreign doctors from their residencies? foreign countries all but eliminate competition from doctors outside their own country, so what entitles them to our residencies when they don't reciprocate?

Answer the question..you have made the point above before.

---

Members don't see this ad.

 

[PostCall]

Answer the question..you have made the point above before.

my point more than answers his question. besides it's already been discussed how U.S. med schools are increasing the number of seats in their classes and also brand new med schools opening. which over time will result in the number of U.S. grads equaling or very near equaling the number of residency spots and thus less and less need for FMGs. eventually it will be like other countries where we fill almost all of our residency spots with U.S. grads and whatever may be left over can be allocated to others.

 

[JeffLebowski]

I know doctors/professors from Europe who to America simply because they can get more money for their research. They get about the same salary as in Europe. Academic salaries in the US are not extraordinary.

I am sure lots of doctors (the majority) move to America because of the money. But what the heck is wrong with that? When your forefathers moved to America from e.g. Europe some 100 years ago they moved for exactly the same reason. I do understand that some of you don´t like competition but I´d never think you would find it morally wrong to do the same thing your forefathers did.

Yeah I don't think people really think foreign doctors wanting to come to America (for any reason) are "morally wrong". Some of us just argue that it's not a healthy system because:
1) Foreign doctors' home countries lose doctors
2) Domestic training spots are funded by american tax dollars and american grads are starting to have more trouble getting spots. Not to mention, american tax dollars shouldn't be going toward training doctors for other countries when we're experiencing a "doctor shortage" too (if they leave after training, that is. if they stay here, see point #1).
3) If the foreign doctors ship the money they make here to their home country, our economy loses out.
4) Often language/cultural barriers exist with foreign doctors. This is not necessarily a big deal, but when people are coming in droves, then more and more patients are getting frustrated that they can't understand their doctor. Sorry to say it, but this phenomenon exists, and I really feel sorry for the patients of perhaps really good or well-meaning doctors/residents who have thick accents that are hard to understand.

So you can see why this is a situation in which basically everyone loses except the person seeking to come here for training/practice. And that is what strikes some of us as unsettling, it feels a little bit like the U.S. has created a system that allows America to be taken advantage of. I'm not saying NO doctors should be allowed to come here for training or practice. I'm just saying in general, we need to drastically drop our dependence on foreign grads/doctors, especially when capable americans are out there ready to fill those shoes. And the powers that be all seem to agree with this concept (because it makes sense).

 

[Obnoxious Dad]

If foreign nationals think that they are getting a bad deal from the US because they will no longer get residencies here they should remember that the US has been carrying the world with respect to basic medical research and applied research for the last 50 years.

Americans have won more Nobel prizes in medicine and physiology than the residents of all other countries combined. The reason for that phenomenon is that the US spends money on basic research while the citizens of other countries just wait for us to do something. This is one of the reasons that medical education in the US is obscenely expensive.

Foreign countries are unwilling to pay anything for pharmaceuticals above and beyond the cost of manufacturing the product and its distribution. It's up to Americans to pay the cost of development and clinical trials.

We owe the world zilch.

 

[Apollyon]

morally wrong? how easy is it for a U.S. citizen from a U.S. med school to do a residency in Europe (or most any other country)? almost impossible compared to somebody from any med school in the world getting a residency in the U.S. didn't the U.K. effectively ban foreign doctors from their residencies? foreign countries all but eliminate competition from doctors outside their own country, so what entitles them to our residencies when they don't reciprocate?

It's not "foreign countries" - it's "the European Union". Within the EU, all countries have to give equal consideration to medical graduates of other countries. The UK tightened up after this happened early in the 2000s. Italy graduates thousands and thousands of doctors, who flood the UK system. All the EU schools have "full registry" with the GMC, so UWI (in the Caribbean) got squeezed out, and "limited registry" places were booted entirely. Now, to get a training spot in the UK, non-registry graduated people have to pass the PLAB, which people in the UK have said their own graduates couldn't and can't pass. There are a few other steps, so it's not impossible, but MUCH harder.

 

[tncekm]

If foreign nationals think that they are getting a bad deal from the US because they will no longer get residencies here they should remember that the US has been carrying the world with respect to basic medical research and applied research for the last 50 years.

Americans have won more Nobel prizes in medicine and physiology than the residents of all other countries combined. The reason for that phenomenon is that the US spends money on basic research while the citizens of other countries just wait for us to do something. This is one of the reasons that medical education in the US is obscenely expensive.

Foreign countries are unwilling to pay anything for pharmaceuticals above and beyond the cost of manufacturing the product and its distribution. It's up to Americans to pay the cost of development and clinical trials.

We owe the world zilch.

I have to say that your post, which should be a painfully obvious truth to people, is brilliant

 

[Rabbit Hole]

:1) Foreign doctors' home countries lose doctors

This is true. However, for some countries, it really doesn't really make a huge impact how many doctors they lose because they don't have a shortage. The countries that have a shortage in doctors probably have a shortage in most other professional sectors due to - no money, politics, dangerous working environment, civil unrest. (I posted 2 articles earlier in this thread on "Brain Drain", you should read it if you have time).

:2) Domestic training spots are funded by american tax dollars and american grads are starting to have more trouble getting spots. Not to mention, american tax dollars shouldn't be going toward training doctors for other countries when we're experiencing a "doctor shortage" too (if they leave after training, that is. if they stay here, see point #1).

Foreign doctors will have to pay american tax dollars on the paychecks they receive from residency training. Also, they'll have to pay a tax on everything else they purchase while training here. I think for the most part many of them end up trying to stay in the U.S. (but I don't know anything about the actual #'s).

:3) If the foreign doctors ship the money they make here to their home country, our economy loses out.

No way, I can't agree with this for numerous reasons. Do you think any money that leave the US automatically translates to our economy losing out? What about all those Americans traveling to countries in Europe and spending all their money on fancy-Euro products like paintings and weird looking hats.

:4) Often language/cultural barriers exist with foreign doctors. This is not necessarily a big deal, but when people are coming in droves, then more and more patients are getting frustrated that they can't understand their doctor. Sorry to say it, but this phenomenon exists, and I really feel sorry for the patients of perhaps really good or well-meaning doctors/residents who have thick accents that are hard to understand.

I think the language/cultural barrier IS a big deal and I completely agree with you about the impacts this would have on patients and co-workers. A lot of foreigners have a warped view on what "American culture" is based on what they see in movies. I mean, even a lot of Europeans have some funny notions about American society. In any case, I think communication is one of the most important factors because many things can get "lost in translation" and that is something which would have a huge impact on patients. I think that's what the whole behavioral science part of the USMLE is about... oh.. that and Step 2 CS, which seems to be the arch nemesis of foreign doctors.


I don't know if some of your arguments would hold ground in immigration policy. It's not like doctors are coming here and working illegally and not paying tax and contributing back to society. They're coming here by legal means and they worked pretty damn hard to get a visa sponsorship.

PS, Every time I see your user name I get an urge to watch that movie and start calling everybody Dude. Thanks a lot pal!

 

[PlutoBoy]

You guys are full of ****. First of all, the biggest lie being repeated over and over in this thread is that americans can´t train elsewhere. Thats such a huge lie I cannot even measure it. Reality is americans don´t go abroad because, let´s face it, there is simply not a much better place out there, not because "you can´t". I invite you to go to Mexico or Argentina to train, I know a whole lot of people training there. In Europe, Spain is flooded with residents from abroad (Spain is 1st world and the 8th largest economy in the world. A bit of info for the culturally impaired).

I´d tend to think the UK is in the same position, but I really don´t know. The examples given shall suffice, though.

People go to the UK and US mostly because of language, because most educated people can speak english. German, not so easy. Or are you telling me that Germany´s healthcare is subpar?

Having said that, cut it with the tax dollar issues. Better say "we don´t like foreigners" and stop making excuses. Reminds me of the guy on youtube that said "I don´t wanna sound racist, but I don´t want a black man running my country" .

Americans are using money to train these doctors, but also to get much needed health care. It´s an investment. Nobody is giving away money here. Nobody is doing it for humanistic reasons. Fact is America gets a doctor and the doctor gets America. It´s a trade. Since when is the most capitalistic and interest driven country giving away anything? Accept the fact: it is a trade, just as anything else.

Can you do away with these doctors? Deport them all and let´s see what happens. I´d also recommend deporting all engineers, PhD´s, teachers, artists and athletes. I never would have thought it is so painful for somebody to acknowledge they (as a society) need help.

What I´ve also learned is that the whiners tend to be underachievers of some sort that just want to have standards brought down so they can fit in. For example, supporting the creation of an extra 15,000 positions so they can get a spot .

I am a foreigner and studied in my home country. We see these guys every year, coming to our schools and thinking "oh, this is 3rd world, it should be easy here". A bunch of slackers I´d say. Not one of them has made it to the top of any class. Not even average. (I don´t know about the caribbean schools, seems like is not the same). These are the people that later create threads of the sort of "All US Citizens and GC holders join here" . Is not my fault it took you 10 years to graduate. Is not my fault you graduated "Summa Difficultie". Is not my fault you had 3 failed attempts at each USMLE step and barely hit the pass mark.

America, being as it is, will not stop getting doctors, engineers, nurses, scientist and all you want to mention. At least not in the foreseeable future. Do you know how much money it brings to test 10,000 people, getting them to pay for air tickets, hotels, etc?? And yes, FMGs and FMS pay more for the tests.

In the meantime schools are producing more doctors, guess what is going to happen? America´s population will grow, and it economic need for foreign talent will grow as well. Your arguments are the same as the IT arguments... yet IT professionals keep arriving and they will keep doing so. It´s a different world, about time you accept it.

Heck, take away professionals and all that, still countries need to keep their population numbers stable. Being by immigration or child birth. That´s why it doesnt matters how much a few australians complain (or americans), their immigration policy is not going to drastically change any sooner. Immigration also bring economic growth. Sometimes economic growth fuel the need for immigrants. Either way, you end up with immigrants. Wake up! Countries do not receive lots of immigrants out of love!

Third, being more humble and stop thinking "the US is training the world´s doctors" would be nice. There is doctors and schools elsewhere. For God´s sake stop it with the thought that you are doing a favor to anybody. Even more, if you really are providing the world´s doctors, shouldn´t you be happy you are doing such an altruistic action?

Most of the whiners are just people with subpar statistics. So much, they fear somebody from India, different culture, no contacts, poor, different language, facing prejudice, not knowing the system, and a long etcetera succeds and gets a spot. Why? Because they know their multiple attempts, poor scores, lack of any meaningful activity makes them no competition to the average joe. What scares them the most is not being competition to the average FMG. Their sense of entitlement and pride gets hurt when they realize that so much people are better than they are and they got to be better even coming from a third world empoverished country with no technology. What would have happened if some of these doctors studied in America?

I can understand you want to protect the US citizens. But guess what? They are being protected already. A little bit of extra, logical, protection? Thats fine. But just because 1 guy fails and that guy happens to be you doesnt means the system is 100% flawed. The beauty of America is it´s freedom and standards. And thats what you want to change just to try to get a spot. "Let´s put restrictions on PD" "Hospitals should act like blah blah". Next thing you notice is some crazy "Patriot Act" being enacted. Ooops, that already happened.

 

[JelloBrain]

Extremely well said PlutoBoy, you said what I want to without losing diplomacy. I agree that the few whiners are those AMGs that are subpar. If you are good, you know you can beat any competition, AMG/IMG/FMG, whatever.

Jeff said that AMGs should get the spots as they are funded by US tax dollars. But everyone pays into the taxes, and IMGs are not getting anything for free. If anything, they pay a lot more to get anywhere in the system-exam fees, more widespread applications causing more travel expenditure, etc.. And they have to be twice as good as an AMG to reach half as far.

As for all the quibble about prematch-what is the caliber of programs offering prematch? It's not like UCSF, Harvard, Stanford, Johns Hopkins that are offering prematches now, is it? Small-ish programs in far flung rural areas offer prematch to good but desperate IMGs. These places get good doctors for their population and good doctors get training, money and lifestyle. Fair trade-off, yes?

Foreign doctor sending a part of their savings from their hard-earned income after paying taxes to help their families back home does not cause loss to US economy. Isn't this a better option than everyone getting into debt to "keep up with the Jones-es", and buying ridiculous knick-knacks that are made in China anyways? If anything maybe it is a loss to Chinese economy.

I also want to correct Apollyon's misconception about training in UK. I finished my surgical training in UK. The PLAB is a difficult exam that only foreigners have to take, not their own students, unlike the USMLE which is fair in that aspect. PLAB is pass/fail only, and the scores don't matter for training purposes. But the pass percentage used to be very low, barely 25%. Just after I finished PLAB in 1999, there was a huge protest about the unfairness of the system. To disprove it, GMC administered PLAB to hand picked top of class medical graduates from Cambridge and Oxford-2% passed! GMC conceded defeat, made the exams very easy-everyone from the Indian subcontinent flooded UK (no visa issues like USA)-unemployment grew like crazy among doctors there-I don't even want to go into the appalling conditions many lived waiting for a lucky break!

The biggest disadvantage of freely allowing people from the EU to train/practice in UK is language. Just as an example: During my observership in an ER setting, the German doctor completely misunderstood the patient-Mom brought child in with "fit" (colloquial term for a seizure in UK), the doctor wrote prescription for "itch". I intervened, and the patient got managed appropriately-he had a brain tumor! EU might be similar in culture to UK compared to the Indian subcontinent, but most of Europe doesn't speak English well again unlike the Indian subcontinent-our British legacy.

Everyone I have ever worked with comment on how hard we work and how good our surgical skills are. Maybe because we don't spend time wasting on too much talk and mollycoddling patients with too many choices, and go straight to the cut? Patients in the western world get too many choices, understand not enough of everything, demand what they think is right for them (like toddlers) and we have defensive medicine where we only care about covering our asses and not doing right by exercising our knowledge and skills. Imagine if parents raise their kids this way giving in to whatever the child demands afraid they might be sued? Communication skills are important but not such as to lead to a practice of completely defensive medicine.

Another thing that no one has mentioned is the emphasis on different disease aspects in different parts of the world. As an example, in India, when I trained, respiratory system predominantly consist(ed) of TB related stuff, meningitis usually meant Tubercular, abdominal pain usually was due to perforated ulcer (gas under diaphragm), fever usually was Malaria. I was surprised that in UK for the PLAB I had to learn so much about asthma and allergies, multiple sclerosis, etc. things that were relatively minor in India. In USA, more emphasis is on a lot of parasitic diseases, just as an example.

So if someone from a so-called inferior medical education system performs as well as an AMG in all the various scenarios (own country, UK PLAB, USMLE, etc.) surely they are really good at something? So they deserve as fair a chance as an AMG who may or may not be able to perform well in a different cultural/educational setting.

Last but not the least, today's IMGs are raising tomorrow's AMGs.

And now I am done rambling on so early in the morning,

 

[142348]

A reply to PlutoBoy’s points in bold

“You guys are full of ****. First of all, the biggest lie being repeated over and over in this thread is that americans can´t train elsewhere. Thats such a huge lie I cannot even measure it. Reality is americans don´t go abroad because, let´s face it, there is simply not a much better place out there, not because "you can´t". I invite you to go to Mexico or Argentina to train, I know a whole lot of people training there. In Europe, Spain is flooded with residents from abroad (Spain is 1st world and the 8th largest economy in the world. A bit of info for the culturally impaired). I´d tend to think the UK is in the same position, but I really don´t know. The examples given shall suffice, though.People go to the UK and US mostly because of language, because most educated people can speak english. German, not so easy. Or are you telling me that Germany´s healthcare is subpar?”

While there may be spots available in other countries, the numbers available don’t compare to the spots available in the US. Also, unlike many other countries, the cost of medical education is astronomical in this country and so AMG’s cannot afford to take a training positions that won’t pay the bills. The language barrier is a real issue. In many countries, including India, students are taught English as a 2nd language. This is not the case as much in the US.

Having said that, cut it with the tax dollar issues. Better say "we don´t like foreigners" and stop making excuses. Reminds me of the guy on youtube that said "I don´t wanna sound racist, but I don´t want a black man running my country" .

Tax dollars aren’t only paid during residency. AMG’s pay taxes (as do their families) growing up in the country and these taxes provide the government with the funds to finance Medicare which finances medical education. This is a really issue, not a xenophobic rant.

Americans are using money to train these doctors, but also to get much needed health care. It´s an investment. Nobody is giving away money here. Nobody is doing it for humanistic reasons. Fact is America gets a doctor and the doctor gets America. It´s a trade. Since when is the most capitalistic and interest driven country giving away anything? Accept the fact: it is a trade, just as anything else.Can you do away with these doctors? Deport them all and let´s see what happens. I´d also recommend deporting all engineers, PhD´s, teachers, artists and athletes. I never would have thought it is so painful for somebody to acknowledge they (as a society) need help.

There was a time when this country did not have enough doctors to take care of the population. In that time, we accepted many FMG/IMG doctors to help fill in the gaps and they readily came over for a chance at a better life. However, with the expansion of US medical schools that deficit is coming to an end shortly. As a country becomes self sufficient in a field it no longer needs to rely on foreign talent being imported which I see as a benefit.

What I´ve also learned is that the whiners tend to be underachievers of some sort that just want to have standards brought down so they can fit in. For example, supporting the creation of an extra 15,000 positions so they can get a spot .

You might want to watch your stereotypical comments. I am a strong proponent of a AMG preferred match and not because I needed it. I was at the top of my class, scored 250 + on my boards. Further, I am against additional residency spots. I would like to keep the supply and demand in medicine.


P.S. Watch your hostile tone, it doesn’t do much to prove your point. I am the son of an Indian IMG, so I understand where you are coming from. However, my mother, who has been a physician in this country for 30 years now readily admits that the time for FMG/IMG is passing since there are more than enough applicants in the AMG pool. In her opinion, as a FMG, she still prefers to take an AMG over an FMG because she believes for similar reasons above that AMG’s should be taken over FMG’s at all costs.

 

[PlutoBoy]

By hostile tone you mean your condescending comments?

Families pay taxes so they can get a doctor, among other things. If not you, then somebody else. If not american born, then a foreigner.

"However, my mother, who has been a physician in this country for 30 years now readily admits that the time for FMG/IMG is passing since there are more than enough applicants in the AMG pool."

Last time I checked the number of positions offered exceeded by the thousands the number of graduates. It will always happen. Sure, some schools will open up, but the population will also grow, and more hospitals will be built that will open new residency positions. Existing hospitals may increase the number of positions. The gap will be narrower for some time and after a couple of years it will open up again. This effect is not likely to stop.

If America doesn´t needs foreign labor, then obviously it will not (and should not) take immigrants. Remember, America is not doing a favor to all those IMGs (or IT professionals). They are brought to America for a reason, not as a gift.

A lot of people seem to think they know every issue involved and the government (or IMG´s sometimes?) is trying to bust them. It has been and IS in the public and national interest to get these doctors. National interest is above yours. Only thing is you don´t see it.

 

[ResidentMD]

A lot of people seem to think they know every issue involved and the government (or IMG´s sometimes?) is trying to bust them. It has been and IS in the public and national interest to get these doctors. National interest is above yours. Only thing is you don´t see it.

While I agree with many (but not all) of your comments, this has to be "the quote" of this thread.

 

[tncekm]

If America doesn´t needs foreign labor, then obviously it will not (and should not) take immigrants. Remember, America is not doing a favor to all those IMGs (or IT professionals). They are brought to America for a reason, not as a gift.

Sometimes yes, sometimes no. E.g. yeah, we bring in physicians because we need them. But, we bring in construction workers because they're cheap.

A lot of people seem to think they know every issue involved and the government (or IMG´s sometimes?) is trying to bust them. It has been and IS in the public and national interest to get these doctors. National interest is above yours. Only thing is you don´t see it.

 

[europeanIMG]

The American taxpayers do NOT lose money from paying the IMG residents´ salaries. That is just plain stupid! They get lots of health care for a very modest salary. Also, eventhough you AMGs have huge student loans your education is also subsidized by the tax payers. (In state tuition fees, federal loans etc. etc.) Of course it is favorable for America to import doctors without having to pay for their education.

The losers are the AMGs who don´t get into the residency they want since the PD prefer to hire an IMG. You may argue that the PDs sometimes make mistakes and hire the wrong ppl but I can assure you that they don´t let an IMG in just to be kind, The PDs hire IMGs since he/she think they are better than certain AMG (or because they can not fill the spot with an AMG).

And again, please explain to me why it is unethical to come to America with the aspiration to create a better life for yourself and your children. After all, the dream of a better life has always made ppl move to America. The only Americans who can rightfully claim it is unethical to move abroad are the Native Americans.

Language and culture can certainly be a problem but it shouldn´t be exaggerated. You don´t have to eat apple pie and drive chevrolet to be a good doctor in America. (Eventhough I will certainly do both if I´ll move to the US)

 

[europeanIMG]

It is simply not true that AMGs can´t get a job in Europe. In my Scandinavian country we have doctors from most European countries, Iraq, Iran, South East Asia, South America etc. etc.

Very few Americans around though, but I am 100 % sure they are very welcome to work here. But they would have to accept the same salary as we get, so they choose not to come. (For the very same reason we have lots of doctors from Eastern Europe in Western Europe but the Westerners is Eastern Europe are very rare or even nonexistent).

 

[Rabbit Hole]

P.S. Watch your hostile tone, it doesn’t do much to prove your point. I am the son of an Indian IMG, so I understand where you are coming from. However, my mother, who has been a physician in this country for 30 years now readily admits that the time for FMG/IMG is passing since there are more than enough applicants in the AMG pool. In her opinion, as a FMG, she still prefers to take an AMG over an FMG because she believes for similar reasons above that AMG’s should be taken over FMG’s at all costs.

Can you please tell us more about what your mom thinks?

 

[tncekm]

The American taxpayers do NOT lose money from paying the IMG residents´ salaries. That is just plain stupid! They get lots of health care for a very modest salary. Also, eventhough you AMGs have huge student loans your education is also subsidized by the tax payers. (In state tuition fees, federal loans etc. etc.) Of course it is favorable for America to import doctors without having to pay for their education.

The losers are the AMGs who don´t get into the residency they want since the PD prefer to hire an IMG. You may argue that the PDs sometimes make mistakes and hire the wrong ppl but I can assure you that they don´t let an IMG in just to be kind, The PDs hire IMGs since he/she think they are better than certain AMG (or because they can not fill the spot with an AMG).

And again, please explain to me why it is unethical to come to America with the aspiration to create a better life for yourself and your children. After all, the dream of a better life has always made ppl move to America. The only Americans who can rightfully claim it is unethical to move abroad are the Native Americans.

Language and culture can certainly be a problem but it shouldn´t be exaggerated. You don´t have to eat apple pie and drive chevrolet to be a good doctor in America. (Eventhough I will certainly do both if I´ll move to the US)

 

[ResidentMD]

The American taxpayers do NOT lose money from paying the IMG residents´ salaries. That is just plain stupid! They get lots of health care for a very modest salary. Also, eventhough you AMGs have huge student loans your education is also subsidized by the tax payers. (In state tuition fees, federal loans etc. etc.) Of course it is favorable for America to import doctors without having to pay for their education.

The losers are the AMGs who don´t get into the residency they want since the PD prefer to hire an IMG. You may argue that the PDs sometimes make mistakes and hire the wrong ppl but I can assure you that they don´t let an IMG in just to be kind, The PDs hire IMGs since he/she think they are better than certain AMG (or because they can not fill the spot with an AMG).

And again, please explain to me why it is unethical to come to America with the aspiration to create a better life for yourself and your children. After all, the dream of a better life has always made ppl move to America. The only Americans who can rightfully claim it is unethical to move abroad are the Native Americans.

Language and culture can certainly be a problem but it shouldn´t be exaggerated. You don´t have to eat apple pie and drive chevrolet to be a good doctor in America. (Eventhough I will certainly do both if I´ll move to the US)

Awesome stuff.

It is simply not true that AMGs can´t get a job in Europe. In my Scandinavian country we have doctors from most European countries, Iraq, Iran, South East Asia, South America etc. etc.

Very few Americans around though, but I am 100 % sure they are very welcome to work here. But they would have to accept the same salary as we get, so they choose not to come. (For the very same reason we have lots of doctors from Eastern Europe in Western Europe but the Westerners is Eastern Europe are very rare or even nonexistent).

Can you please tell us more about what your mom thinks?

. This thread is now getting interesting.

 

[PostCall]

as i said before this is all about self-interest. FMGs want to come here for the money/lifestyle despite whatever else they say. that is why there are FMGs driving taxis and delivering pizzas in the U.S. and trying over and over again to get a residency spot, rather than being a doctor in their own country. the fact they would rather deliver pizzas or drive taxis here rather than be a doctor in their country tells you everything you need to know about why they come here.

 

[Czech Mate]

Everyone has brought up the American dream, wanting a better life, best candidate for the job irrespective of citizenship, loans, tax dollars, etc. Everyone has valid points, varying level of opinions, on one side or the other.

Now people are bringing up the fact that an AMG can go train in Europe or somewhere else and he/she would be welcome. Are you kidding me? What kind of backward ass logic is this. Some student has busted his butt all his life and grown up in America and now we tell him/her so no jobs for you because we filled them with foreigners and since you are a Doctor you cant do anything else so LEAVE YOUR COUNTRY OF BIRTH!!

Its different if you do it voluntarily for a better life, education, etc but if AMGs dont have positions to train in then you are effectively forcing them to train somewhere else. They have no choice other then leave the medical field.

As an IMG from Eastern Europe who is an American citizen I can tell you that all of the European countries graduates can and do find work in their respective country. It might be for less money and less desirable but there are jobs for them.

So taxes aside and all other things aside, due to the uniqueness of Medicine and the requirement of residency the country is obligated to train its citizens because while people will say you have an option, you really dont.

Try to tell a new American grad --> Congrats you made it through undergrad, got into medical school, passed all of the required licensing exams and fulfilled all requirements for licensure but because you may have had some bad days, lower USMLEs, had a family, kids, didnt have time to study 24/7 and didnt get straight A's you are now going to have to move to Europe, learn a new language and culture and get trained there and stay there for the rest of your career because the US does not recognize foreign residency training.

My recommendation to the below average AMGs, according to the survival of the fittest mentality of most posters, is to learn German, French, or Swedish cause thats where you are going to have to go to practice medicine!!! (Sarcasm )

 

[ResidentMD]

This thread reminds me of the Speakers' Corner in London. "Just because I think so, it must be true. It doesn't matter if I have absolutely no basis for what I am saying...my sample size may be n=1 (or even zero, just because my mom told me). It do not care what is the context of this thread, what other people before me have commented. It doesnt even matter if he or she is supporting me or not (though there could be a chance they are). Just because I feel it is true, it must be true. And just because I have a username on SDN and posting privileges, I am going to talk any random crap that I want".

I mean seriously, PostCall, you think most of the FMGs are delivering pizzas and driving taxis in the US? Get a life. So you are telling me that when you or any of your colleagues were in med school (or undergrad), you did not do ANY jobs on the side at ANY TIME to attempt to earn money and pay back your debt?

And the poster above me, read the threads above. No one is saying AMGs HAVE to go to Europe. They are refuting the claim that "no other country welcomes AMGs the way the US allows IMGs to come and work there". Its just about the open doors. Thats all.

 

[PostCall]

I mean seriously, PostCall, you think most of the FMGs are delivering pizzas and driving taxis in the US? Get a life. So you are telling me that when you or any of your colleagues were in med school (or undergrad), you did not do ANY jobs on the side at ANY TIME to attempt to earn money and pay back your debt?

where did i say "most"? but the fact that there are FMGs who would rather do these kind of jobs in the U.S. rather than be a doctor in their own countries says a lot about why FMGs come here. and this has nothing to do with these basic jobs that undergrads/med students might do in their spare time. we're talking about DOCTORS (residents and even attendings) from other countries working these kind of unskilled jobs rather than be a DOCTOR in their own country. i met one FMG who was doing an "observership" during the day and driving a cab at the night. i later learned he had done a bunch of observerships over the years while applying over and over again for any residency. he would rather do that than be a doctor in his own country. how likely is it you think for a U.S. resident/attending to go drive a cab in another country in hopes of getting a residency there? but FMGs do so all the time because they know once they get a residency they will make more money than they ever will in their country. in fact they can probably make more money driving a taxi in a big U.S. city than they can as a resident in some countries. as i said, it all comes down to the money no matter what else they might pretend it's about.

 

[ResidentMD]

where did i say "most"? but the fact that there are FMGs who would rather do these kind of jobs in the U.S. rather than be a doctor in their own countries says a lot about why FMGs come here. and this has nothing to do with these basic jobs that undergrads/med students might do in their spare time. we're talking about DOCTORS (residents and even attendings) from other countries working these kind of unskilled jobs rather than be a DOCTOR in their own country. i met one FMG who was doing an "observership" during the day and driving a cab at the night. i later learned he had done a bunch of observerships over the years while applying over and over again for any residency. he would rather do that than be a doctor in his own country. how likely is it you think for a U.S. resident/attending to go drive a cab in another country in hopes of getting a residency there? but FMGs do so all the time because they know once they get a residency they will make more money than they ever will in their country. in fact they can probably make more money driving a taxi in a big U.S. city than they can as a resident in some countries. as i said, it all comes down to the money no matter what else they might pretend it's about.

So your sample size is n=1? Give me your sample size, then talk.

 

[silas2642]

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'm just a med student, but after working the floor for about a year and tagging alont and working alongside numerous MD's I'll give you my two cents:

As someone who is going to enter the match next year, I will say that yes, it would be kind of nice to exclude IMG's/FMG's so that US allopathic students match first; it helps eliminate the competition a little bit for me and it also helps to ensure that US citizens who are in allopathic schools get allopathic residencies (DO's have their own match, which MD's can't enter).

That being said, I've worked with some brilliant, wonderful foreign grads. I've also worked with some pretty horrible ones as well-- but the jist of it is that you take FMG's like everyone else; one at a time. Some are great, some are so-so, and some just suck. The same can be said of US allopathic grads.

 

[silas2642]

where did i say "most"? but the fact that there are FMGs who would rather do these kind of jobs in the U.S. rather than be a doctor in their own countries says a lot about why FMGs come here. and this has nothing to do with these basic jobs that undergrads/med students might do in their spare time. we're talking about DOCTORS (residents and even attendings) from other countries working these kind of unskilled jobs rather than be a DOCTOR in their own country. i met one FMG who was doing an "observership" during the day and driving a cab at the night. i later learned he had done a bunch of observerships over the years while applying over and over again for any residency. he would rather do that than be a doctor in his own country. how likely is it you think for a U.S. resident/attending to go drive a cab in another country in hopes of getting a residency there? but FMGs do so all the time because they know once they get a residency they will make more money than they ever will in their country. in fact they can probably make more money driving a taxi in a big U.S. city than they can as a resident in some countries. as i said, it all comes down to the money no matter what else they might pretend it's about.

I've also met some FMG's who have been able to experience way more than the average AMG (this applies to attendings as well) because their system is different-- the fact that they had to do more with less makes them more creative and better physicians.

I have yet to meet a doctor who drives a cab.

 

[ResidentMD]

I'm just a med student, but after working the floor for about a year and tagging alont and working alongside numerous MD's I'll give you my two cents:

As someone who is going to enter the match next year, I will say that yes, it would be kind of nice to exclude IMG's/FMG's so that US allopathic students match first; it helps eliminate the competition a little bit for me and it also helps to ensure that US citizens who are in allopathic schools get allopathic residencies (DO's have their own match, which MD's can't enter).

That being said, I've worked with some brilliant, wonderful foreign grads. I've also worked with some pretty horrible ones as well-- but the jist of it is that you take FMG's like everyone else; one at a time. Some are great, some are so-so, and some just suck. The same can be said of US allopathic grads.

generalizations are generally true otherwise they wouldn't exist. who do u think most of those applicants are when a residency reports they received 4,000 applicants for a few spots?

If you want to start generalizing, let us know your gender, your religion, and where your ancestors came from. I'll start generalizing from there on.

Generalizations is why the world is in the state we are in currently....much of the hate among countries and people is due to generalizations. So just take a back seat....no one is in it to"get you". The cake is big enough for everyone, provided everyone doesn't want the piece with the cherry on the top.

 

[PostCall]

So your sample size is n=1? Give me your sample size, then talk.

lol, nice way to avoid the issue by using the n=1. there are many more FMGs working these kind of jobs in the U.S. rather than working as doctors in their own country. in the hospitals i have rotated at there are a ton of FMGs working as "lab assistants"...the type of job that undergrads do during their summer vacation. but they do it because they haven't got a residency and want to make "connections". what do you think happens to the >50% of FMGs who don't match every year? anyway it doesn't matter to me because if you read my other posts i already got my residency. i'm just telling you how it is. makes no difference if you want to believe it or deny it as n=1 or whatever.

 

[PostCall]

The cake is big enough for everyone, provided everyone doesn't want the piece with the cherry on the top.

that used to be the case. but in case you haven't heard U.S. med schools have been increasing the number of seats in their classes and opening up brand new med schools. if you had been paying attention then you'd know every year less and less FMGs get residencies. that's the pattern and it's going to continue that way unless more residency spots open.

 

[Coastie]

Agreed.

FMGs want to come here because America is the best nation in the history of the world. Even with Chairman Maobama, we have more freedom and economic opportunity than any other country in the history of the world.

I believe AMGs should get pref in match and scramble, followed by AMG-DO's, then US-IMG, then FMG.

Finally, we should take the best FMGs from their respective nations. If they train here, they stay here, and work for us.

If foreign nationals think that they are getting a bad deal from the US because they will no longer get residencies here they should remember that the US has been carrying the world with respect to basic medical research and applied research for the last 50 years.

Americans have won more Nobel prizes in medicine and physiology than the residents of all other countries combined. The reason for that phenomenon is that the US spends money on basic research while the citizens of other countries just wait for us to do something. This is one of the reasons that medical education in the US is obscenely expensive.

Foreign countries are unwilling to pay anything for pharmaceuticals above and beyond the cost of manufacturing the product and its distribution. It's up to Americans to pay the cost of development and clinical trials.

We owe the world zilch.

 

[RKNY]

Best person for the job isn't it? If they're here and have all the legal papers for it then I wouldn't care regardless if an IMG would fill a residency position. Sorry but that's the way it's been since this country even started. What is this discrimination of IMGs when the fact that most of our ancestors went through the same ordeal?

There are some unmatched AMGs and yes it is a concern. But what it really boils down to is why that particular unmatched AMG wasn't able to fill a slot in the first place and not play the blame game on the IMG that was able to fill up a slot. Is it because they only wanted dermatology and plastic surgery? Was it because they didn't apply to enough programs or were their scores low in the first place? Or maybe the PD just didn't like that person? Who knows what the reason for the unmatched AMGs but I do feel strongly that it's not because of an IMG. It's hard to say that IMGs aren't discriminated on in the first place.

Medical students should know about competition as it's been there ever since they were trying to get into their undergrad school, med school...etc. It's no different for this match/residency situation. Maybe it's a broken system, maybe it isn't. You just have to learn how to play your cards right.

There are some good apples and bad apples of every bunch...same when you talk about IMGs/AMGs.

 

[Impromptu]

If foreign nationals think that they are getting a bad deal from the US because they will no longer get residencies here they should remember that the US has been carrying the world with respect to basic medical research and applied research for the last 50 years.

Americans have won more Nobel prizes in medicine and physiology than the residents of all other countries combined. The reason for that phenomenon is that the US spends money on basic research while the citizens of other countries just wait for us to do something. This is one of the reasons that medical education in the US is obscenely expensive.

Foreign countries are unwilling to pay anything for pharmaceuticals above and beyond the cost of manufacturing the product and its distribution. It's up to Americans to pay the cost of development and clinical trials.

We owe the world zilch.

I was recently told that about 1/2 of my tuition went to support research grants for our med school's researchers. They do a lot of good work and make some great discoveries, but I still wonder whether my med school debt should really be supporting research.

In the grand scheme of things residents are mediocre doctors, be they American or foreign. Don't delude yourself otherwise, no matter the board scores. Residents don't become great doctors until they have been out practicing for many years, let's say 10 years. I'm in favor of the cream of the foreign doctors coming to the USA to train as long as they remain in the USA after their residency to start providing great care. Stick around, it is actually a great place to live. Taxpayers have the expectation of great care that, which is why they make the investment into residency training. So come and pursue the American dream for longer than the 3-4 years of residency training.

I've looked into practicing in Switzerland...even though I am fluent in German, it is not an easy task.

 

[Crazy Diamond]

If foreign nationals think that they are getting a bad deal from the US because they will no longer get residencies here they should remember that the US has been carrying the world with respect to basic medical research and applied research for the last 50 years.

Americans have won more Nobel prizes in medicine and physiology than the residents of all other countries combined. The reason for that phenomenon is that the US spends money on basic research while the citizens of other countries just wait for us to do something. This is one of the reasons that medical education in the US is obscenely expensive.

Foreign countries are unwilling to pay anything for pharmaceuticals above and beyond the cost of manufacturing the product and its distribution. It's up to Americans to pay the cost of development and clinical trials.

We owe the world zilch.

EASY... TIGER...relax the tone a little bit

In 2009 the Nobel Prize in Physiology or Medicine was awarded to Elizabeth Blackburn an Australian-born " American" , Carol W. Greider and Jack W. Szostak Born in London, grew up in Canada.

This is only one year ... ah last year!

 

[JelloBrain]

but the fact that there are FMGs who would rather do these kind of jobs in the U.S. rather than be a doctor in their own countries says a lot about why FMGs come here. we're talking about DOCTORS (residents and even attendings) from other countries working these kind of unskilled jobs rather than be a DOCTOR in their own country. as i said, it all comes down to the money no matter what else they might pretend it's about.

You are so clueless! Have you even thought that for most of these FMG/IMG doctors, it is a matter of honor (maybe misplaced), that they would rather commit suicide than go back home as a "failure", as the one who did not make it in USA as a doctor? Have you thought of the loss of face their families would face if they returned a "failure"? Some families would even disown them outright or commit mass suicide themselves! I am not exaggerating.

To avoid these, they (appear to) survive somehow day by day just to shield their family from this shame, but dying a slow death every day in the process. Try to even imagine what it would be like to be in their shoes-you matched relatively easily (as far as I can tell), but have been unhappy about that as well and are unable to appreciate how lucky you are, how easy life is for you! Why not offer up your post to one of these cabbie/pizzaman doctors?

Another thing is in the western world to some extent all vocations and/or professions are considered relatively equal, none are looked down upon unlike in the developing world. So a doctor from a foreign land can lose himself in the anonymity of any job here without losing face.

Money doesn't play a big part in the picture-the only (better) alternative to going back to their homeland is suicide!

 

[JeffLebowski]

You are so clueless! Have you even thought that for most of these FMG/IMG doctors, it is a matter of honor (maybe misplaced), that they would rather commit suicide than go back home as a "failure", as the one who did not make it in USA as a doctor? Have you thought of the loss of face their families would face if they returned a "failure"? Some families would even disown them outright or commit mass suicide themselves! I am not exaggerating.

To avoid these, they (appear to) survive somehow day by day just to shield their family from this shame, but dying a slow death every day in the process. Try to even imagine what it would be like to be in their shoes-you matched relatively easily (as far as I can tell), but have been unhappy about that as well and are unable to appreciate how lucky you are, how easy life is for you! Why not offer up your post to one of these cabbie/pizzaman doctors?

Another thing is in the western world to some extent all vocations and/or professions are considered relatively equal, none are looked down upon unlike in the developing world. So a doctor from a foreign land can lose himself in the anonymity of any job here without losing face.

Money doesn't play a big part in the picture-the only (better) alternative to going back to their homeland is suicide!

For the life of me, I can't figure out what the hell you're talking about....and how it's relevant to the discussion at hand.

 

[Crazy Diamond]

Alright now everybody had vented out their angers and frustrations ..OP I think you get the picture now..you are not welcomed .. don't bother and take the exams ..just stay where you are..
and for all the AMGs US citizen IMGs, US citizen FMGs ,Green Card Holders tax paying rest assured that the numbers of thickly accented, darkly colored , non communicating, difficult-to-get, weird looking non classified poorly organized I/FMG , like myself are decreasing that is supported by the numbers issued by the NRMP this year,abnoxious dad , residentMd , Jeff leboski, rabbit hole and post call ..... try to find that
actually the numbers are decreasing since five years that means there is a god! I mean somebody is playing god and taking care of business .... the moment the numbers of US nationals unmatched increases the numbers of " those others" obviously decrease.
So European IMG somebody above indicted that you wont find difficulty integrating ..so take it for its value. the moment all of us smelly FMGs get kicked out you will be the butt of the joke

all of the others .. enjoy working in Bronx Lebanon hospital,NY Morgans town, WV, the inner city of Newark NJ, Flint, MI and Mobile AL no offense to any of these places that try to take care of sick people and do what is right

i am really really disappointed and disheartened by all the responses .. I post a question about some educational topic and nobody responded and now here a thousand responses is it over willingness to help our friend the European FMG or is it something else.

 

[mochief2000]

this thread started off really really bad. Like very ignorantly bad. I could not even read some of the things some clowns where saying cus i refuse to believe people where really that ignorant. I am glad to see people ON BOTH sides saying some good arguments.

Let me ask you this though, if you owned a business which onr would you hire the best person for the job or the best politically correct person for the job.

US residency is like a race. EVERY SINGLE US student (DO or MD) was given a gaint headstart. Which is fair being that its their home field. Some student run with everything that had plus with the fact that they had a head start made the impossible to catch (and hence got into their 1# field that they ranked number 1#). Some students didn't give all they had but still ran a good race plus the fact they had a head start = not impossible to catch but unlikely your gonna catch (avg US student still getting into the field of his choice, but maybe not the one he ranked 1#). Then you have the the US student the got complecent and didn't/wouldn't run a good race so their headstart was overtaking by some ambitious person who started off with a defiecit but pushed through.

Lets be real the main reasons a US student didn't match are:
1. didn't apply to enough places (ie overestimated their competitiveness)
2. Limited geographically. I always hear my friends talk about how they want to do so and so field, but when I ask them would they do it in middle of nowhere they say hell no.
3. applying for a very freaking crazy competitive field where a possiblity of not matching is known from the jump.
4. Applying for a semi-competitive field with very low scores.

So for the most part most US grads match in their field but their are always exceptions.

Now usually what you see IMG's go into are non-competitive fields in non-competitvie programs that were NOT gonna match no how, unless they got IMGs. Are ya really fighting over these places? And if you see a IMG at a place that does not take IMG's, he must have been amazing, hands down. Their is no way a great program is gonna open their ivory coated doors to some avg IMG.

While I am at it. Most IMGs/DO's hate the prematch(unless you are a borderline applicant). Why? Because its unfair. Shocker hun.....Think about, you are a IMG/caribbean/DO whatever, and a PD at crappy program offers you a prematch. You are scared that you will not match, and the PD knows this so plays on your fear. He knows you are too good of an applicant so does not want to loose you so offers it to you on the spot with like a week to respond. What if you reject it? well kiss that Program goodbye, they are not gonna rank you,once again limiting you options. So tell how is this good? So all this "prematch is unfair" ....I like hell yeah its unfair.

 

[JelloBrain]

For the life of me, I can't figure out what the hell you're talking about....and how it's relevant to the discussion at hand.

I have quoted Postcall's statement, but not completely I guess-His (?her) statement that FMG doctors would rather do unskilled jobs like a cab driver or a pizza delivery boy in USA rather than work as a doctor in their own country, and that is only due to money! I just wanted to say that it is not due to money for many of them, more due to a (? misplaced) sense of honor, and they cannot go back to their own country having failed to make it in the USA.

 

[Obnoxious Dad]

I am astounded that someone has finally come clean on the issue of students subsidizing research at American medical schools. American medical schools since the Flexner report have not been designed, managed or financed to produce competent clinicians at the lowest possible cost. The major emphasis is on research and graduates are just a by product.

I have never seen anyone seriously ask how could we produce physicians more efficiently. The result is that American medical students are getting soaked. In the long run the whole world benefits because Americans pay the price while everyone else just waits with their hands out.

I was recently told that about 1/2 of my tuition went to support research grants for our med school's researchers. They do a lot of good work and make some great discoveries, but I still wonder whether my med school debt should really be supporting research.

In the grand scheme of things residents are mediocre doctors, be they American or foreign. Don't delude yourself otherwise, no matter the board scores. Residents don't become great doctors until they have been out practicing for many years, let's say 10 years. I'm in favor of the cream of the foreign doctors coming to the USA to train as long as they remain in the USA after their residency to start providing great care. Stick around, it is actually a great place to live. Taxpayers have the expectation of great care that, which is why they make the investment into residency training. So come and pursue the American dream for longer than the 3-4 years of residency training.

I've looked into practicing in Switzerland...even though I am fluent in German, it is not an easy task.

 

[Obnoxious Dad]

These two people are brilliant scientists. They are so brilliant that they came to the US to get their research funded. They could not find the money in Canada or Britain but they knew they could get it here.

I am not claiming that Americans are smarter. I'm simply stating that we put up the cash for research in volumes that no other country or continent even tries to match. Everyone in the world benefits and Americans pick up the tab!

My statement about Nobel prizes is no exaggeration It is the truth!!

EASY... TIGER...relax the tone a little bit

In 2009 the Nobel Prize in Physiology or Medicine was awarded to Elizabeth Blackburn an Australian-born " American" , Carol W. Greider and Jack W. Szostak Born in London, grew up in Canada.

This is only one year ... ah last year!

 

[Obnoxious Dad]

We started a little bit late but I think we caught up.

Thomas H. Morgan, George H. Whipple, William P. Murphy, George R. Minot, Edward A. Doisy, Herbert S. Gasser, Joseph Erlanger, Hermann J. Muller, Gerty Cori, Carl Cori, Edward C. Kendall, Philip S. Hench, Selman A. Waksman, Fritz Lipmann, Thomas H. Weller, Frederick C. Robbins, John F. Enders, André F. Cournand, Dickinson W. Richards, Edward Tatum, Joshua Lederberg, George Beadle, Severo Ochoa, Arthur Kornberg, Georg von Békésy, James D. Watson, Konrad Bloch, Francis Peyton Rous, Charles B. Huggins, George Wald, Haldan Keffer, Hartline Marshall, Warren Nirenberg Har, Gobind Khorana, Robert W. Holley, Salvador Luria, Alfred Hershey, Max Delbrück, Julius Axelrod, Earl W. Sutherland Jr., Gerald Edelman, George E. Palade, Howard Martin Temin, Renato Dulbecco, David Baltimore, Daniel Carleton Gajdusek, Baruch S. Blumberg, Rosalyn Yalow, Andrzej W. Schally, Roger Guillemin, Daniel Nathans, Hamilton O. Smith, Allan M. Cormack, George D. Snell, Baruj Benacerraf, Roger W. Sperry, David H. Hubel, Barbara McClintock, Joseph L. Goldstein, Michael S. Brown, Rita Levi-Montalcini, Stanley Cohen, George H. Hitchings, Gertrude B. Elion, Harold E. Varmus, J. Michael Bishop, E. Donnall Thomas, Joseph E. Murray, Edwin G. Krebs, Edmond H. Fischer, Phillip A. Sharp, Martin Rodbell, Alfred G. Gilman, Eric F. Wieschaus, Edward B. Lewis, Stanley B. Prusiner, Ferid Murad, Louis J. Ignarro, Robert F. Furchgott, Günter Blobel, Eric R. Kandel, Paul Greengard, Leland H. Hartwell, H. Robert Horvitz, Sydney Brenner, Paul C. Lauterbur, Linda B. Buck, Richard Axel, Craig C. Mello, Andrew Z. Fire, Oliver Smithies AND Mario R. Capecchi

 

[Impromptu]

Let me ask you this though, if you owned a business which onr would you hire the best person for the job or the best politically correct person for the job.

Businesses are no fools. The 'best' person for the job may not be the one with the slightly better resume if that person doesn't plan on staying around very long. If you tell them you will only work there for 3 years before jumping ship, then the business will go with someone else who is willing to make that place his/her lifelong career, even if that someone else has a slightly 'lesser' resume. After 3 years the employee is just starting to realize their full potential, which will take many more years to develop. After 5 years I doubt you would be able to tell the difference between the ones with the initially slightly 'lesser' and 'better' resumes. After 10 years, they are finally a great and productive worker, able to accomplish far more in a lesser amount of time than ever they would have been able to as a 'trainee'.

The point is, stick around. We want the best, but only if the best are going to stay here to actually become the best. Otherwise they are just mediocre trainees in a field full of other mediocre trainees (mediocre compared to doctors who have been in practice for 10 years or more).

 

[Integrity]

Someone mentioned self-interest. The entire system, the residency/post-training, needing residency to be allowed to work with autonomy, the amount of residency spots and so on is a result of politics, and not the mathematical calculation of something so vague as "the nation's interest." Making such a claim is nothing short of a ruthless, manipulative strategy to claim moral superiority whilst pushing one's own agenda.

Face it, it is the selfish need for 1) controlling the quality of doctors on the american market, 2) keeping doctors dependent on residency to keep their services available regardless of hazing and working conditions, 3) keeping the ratio of doctors to population low (as measured in recent OECD statistics), to keep supply low in relation to demand.

This is perpetuated by having AMGs locked in by debt, thus serving as a further incentive to uphold a PROTECTIONIST system, to maintain your post-residency position as top-earners,which again, is necessitated by the low income as a resident, and high debt.

This has nothing to do with moral superiority. This is nothing short of a fascist system, a variation of the socialist control mechanisms played out in scandinavian countries, germany (where doctors don't earn jack, but are granted autonomy to create their own practices as soon as they finish their "praktisches Jahr"), france, netherlands (where you hardly attain a residency) and so on.

I do not claim that you should do anything else than keeping on supporting your own interests in a cynical and psychopathic fashion, but I marvel at how scientifically educated individuals lack the integrity to at least admit they subscribe to nihilism and amoralism.

The best option to ensure medical treatment to EVERYBODY, and have it affordable, would be to GET RID OF THE RESIDENCY REQUIREMENT, and grant work permits TO ALL FOREIGNERS. Total market freedom. If you believe credentials and AMG status are important - sell it.

 

[Integrity]

Americans pick up the tab!

The tab of the joint interests of your hospital owners (granted cheap residents for several whooping years) and the misinformed and unknowing public, led to believe that many years of slavery is a necessity to ensure safe medical treatment, contrary to all other countries, hardly any european countries prescribe 2+ years of PG-training to practice. Blame this miserable situation on your own miserable arses, instead of taking it out on ambitious IMGs sweeping the floor with sorry ppl like yourself.

 

[ResidentMD]

These two people are brilliant scientists. They are so brilliant that they came to the US to get their research funded. They could not find the money in Canada or Britain but they knew they could get it here.

I am not claiming that Americans are smarter. I'm simply stating that we put up the cash for research in volumes that no other country or continent even tries to match. Everyone in the world benefits and Americans pick up the tab!

And so? You want to stop them from coming here now? I dont see your point.

We started a little bit late but I think we caught up.

Thomas H. Morgan, George H. Whipple, William P. Murphy, George R. Minot, Edward A. Doisy, Herbert S. Gasser, Joseph Erlanger, Hermann J. Muller, Gerty Cori, Carl Cori, Edward C. Kendall, Philip S. Hench, Selman A. Waksman, Fritz Lipmann, Thomas H. Weller, Frederick C. Robbins, John F. Enders, André F. Cournand, Dickinson W. Richards, Edward Tatum, Joshua Lederberg, George Beadle, Severo Ochoa, Arthur Kornberg, Georg von Békésy, James D. Watson, Konrad Bloch, Francis Peyton Rous, Charles B. Huggins, George Wald, Haldan Keffer, Hartline Marshall, Warren Nirenberg Har, Gobind Khorana, Robert W. Holley, Salvador Luria, Alfred Hershey, Max Delbrück, Julius Axelrod, Earl W. Sutherland Jr., Gerald Edelman, George E. Palade, Howard Martin Temin, Renato Dulbecco, David Baltimore, Daniel Carleton Gajdusek, Baruch S. Blumberg, Rosalyn Yalow, Andrzej W. Schally, Roger Guillemin, Daniel Nathans, Hamilton O. Smith, Allan M. Cormack, George D. Snell, Baruj Benacerraf, Roger W. Sperry, David H. Hubel, Barbara McClintock, Joseph L. Goldstein, Michael S. Brown, Rita Levi-Montalcini, Stanley Cohen, George H. Hitchings, Gertrude B. Elion, Harold E. Varmus, J. Michael Bishop, E. Donnall Thomas, Joseph E. Murray, Edwin G. Krebs, Edmond H. Fischer, Phillip A. Sharp, Martin Rodbell, Alfred G. Gilman, Eric F. Wieschaus, Edward B. Lewis, Stanley B. Prusiner, Ferid Murad, Louis J. Ignarro, Robert F. Furchgott, Günter Blobel, Eric R. Kandel, Paul Greengard, Leland H. Hartwell, H. Robert Horvitz, Sydney Brenner, Paul C. Lauterbur, Linda B. Buck, Richard Axel, Craig C. Mello, Andrew Z. Fire, Oliver Smithies AND Mario R. Capecchi

Can you narrow down that list to those who were born in the USA and/or whose parents were born in the USA?

Thanks .

This is my last post on this thread. The quality of this thread has deteriorated significantly, and a lot of people are just ranting. Its difficult to get up in the morning and try to reply to so many ridiculous posts, most of which are just mudslinging at each other, often in improper English.

 

[PlutoBoy]

The best option to ensure medical treatment to EVERYBODY, and have it affordable, would be to GET RID OF THE RESIDENCY REQUIREMENT, and grant work permits TO ALL FOREIGNERS. Total market freedom. If you believe credentials and AMG status are important - sell it.

This one is new

P.D.: I stand in awe of your integrity

 

[DrBacchi]

as i said before this is all about self-interest. FMGs want to come here for the money/lifestyle despite whatever else they say. that is why there are FMGs driving taxis and delivering pizzas in the U.S. and trying over and over again to get a residency spot, rather than being a doctor in their own country. the fact they would rather deliver pizzas or drive taxis here rather than be a doctor in their country tells you everything you need to know about why they come here.

You probably didn't mean to stereotype, but I would like to point out that "FMG" doesn't mean that you come from a 3rd world country. I'm from Western Europe (from a country which is above U.S. in the Human Development Index), and U.S. is only one of my options for residency training, mainly because it's one of the few english-speaking countries and is very advanced in the field of medicine. I would never drive a cab over working as a doctor in my home country/somewhere in Europe. But I know that I might be a minority in the "FMG-group", since it seems that e.g. India has a lot more people immigrating to the U.S. for training and a better lifestyle.

So while it's true that my intentions also lies within self-interest, it lies in becoming excellent in the practice of medicine and not in seeking better living conditions - there are many equally good places to live in much nearer. I have actually read only about one guy who did his residency in the US from here, but I know many who have done a few years of post-doc research in the US. I guess it's not very motivating to go through the USMLE-steps when there are so many quicker alternatives, and many interesting specialities that are practically impossible to get as an FMG in the US. "FM, IM, Peds, Psych" isn't really a great selection if you can do any type of specialty in your home country. That's why I'm wondering a bit about the comments of FMGs taking spots that are meant for AMGs, because from what I've read you really have to be a lot better to be considered before an AMG for a residency spot, and even then it's impossible in many cases/specialties.

Anyways, I feel like Americans are more open and friendly to foreigners (in terms of hospitality, not immigration laws ) than many EU countries. Cultural diversity in the form of highly educated people shouldn't be considered as a threat, IMO.

 

[Nerve Gas]

This is a very interesting discussion with many valid points. I feel the following point has to be emphasized – It is clear that this country benefits most from the influx of foreign MDs (and PhDs). They come here as almost finished products – they were processed in their home countries and their taxpayers & governments invested a LOT of money in their education, just to have them leave and work in the US. That sounds like a good deal for this country.

 

[Impromptu]

It's not a very good deal if they don't stay.

 

[PlutoBoy]

It's not a very good deal if they don't stay.

I can stay, dont hate .

 

[Nerve Gas]

It's not a very good deal if they don't stay.

True. Although if you think of residents in general as relatively cheap labor, the deal should still be fair. Anyhow, the large majority do stay.