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DrWhozits

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Alright so just for the sake of argument. Let’s introduce a tiered match system. @Small Cell Carcinoma

in 2019, there were 30,550 positions filled in the match.

So naturally USMDs all get matched because they are the most super American of all. That’s 19,417.

USMDs from past classes trying to match would get spots then accounting for 1,779 spots.

Well then USDOs would come next, because they are still super American but just not quite as good as the USMDs. All of them get spots which is another 7,090. (This does not include some of the AOA applicants who did not apply to any ACGME programs)

Now on to the still American but for some reason chose not to be at an American school. They make up 6,975 applicants, but oh...wait. 19,417 + 1,779 + 7,090 = 28,286.

That means 2,264 US IMGs would get spots. Which is less than 2,997 US IMGs who actually matched in 2019.

If we throw out a meritocracy and just go by our red-blooded “Americanness”, USIMGs still lose. They just lose worse.
 

7331poas

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This is just unreasonable. Someone with multiple board failures who refuses to leave Boston should match at the top medical centers of the world?
Only if those centers haven't filled their spots with IMGs
 
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DrMcLovin

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But....she still matched over another qualified American citizen and that in and of itself is a problem. There is somebody else on the other end who was born and raised in this country and now has 8 years worth of debt and a complete inability to practice medicine. Medical training in whatever country she comes from is most certainly a fraction of the cost, is only 5-6 years in length, and she was likely already working as a doctor before she decided to try and come here. This is what I am trying to draw attention to despite all the bickering and put downs that are plaguing this thread. How can anyone possibly justify this? There would still be spots left for her (if she is truly so special) after every American is placed.
When you decide to leave your country for medical school, you should not expect your country to reserve a training position for you.

I think it's fair that once you decide to leave the country for medical training, you are now on the same playing field with the other foreign medical graduates. Therefore, the best candidate deserves the spot.
 

MSTP18

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You are right, it is merely an assumption since this issue has never really been brought up in legislation/media. It's just something that I feel many Americans outside of medicine would agree on.
Given that articles about med schools moving towards holistic admissions are usually met with comments like "I don't care if my doctor knows Shakespeare, I want the smartest doctor possible!" I think that "Hospitals will stop choosing the best med school graduates possible to take care of you and instead will make sure that all American graduates, including ones who couldn't pass their boards the first time around, are hired before hiring the best foreign trained physicians possible." would actually be met with mostly backlash.
 

MSTP18

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Just trying to be fair. I’m a DO student.

Edit: 100% of Caribs applying for residency passed step 1. The same can’t be said of DOs.
That's because DO schools don't prevent you from taking step 1 if you don't score high enough on an NBME or kick you out or prevent you from applying to DO residencies if you fail to pass step 1.
 

DrWhozits

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Given that articles about med schools moving towards holistic admissions are usually met with comments like "I don't care if my doctor knows Shakespeare, I want the smartest doctor possible!" I think that "Hospitals will stop choosing the best med school graduates possible to take care of you and instead will make sure that all American graduates, including ones who couldn't pass their boards the first time around, are hired before hiring the best foreign trained physicians possible." would actually be met with mostly backlash.
Unfortunately that sentiment is held mostly by semi-well-educated/well-off people.

This is one point I can’t really argue with Small Cell about. There is a significant portion of our country that would prefer that “you wuz white and speak American!”

Source: I’m a white male in the South, where patients constantly remind me about their feelings about foreign doctors like we are best racist buds
 

MSTP18

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I’ve completed preclinical education/boards so I believe I do understand it. The evals; well time will tell.

I’m trying to draw attention to the whole DO>>Carib thing. The argument is usually from DOs that Caribs couldn’t get a good GPA and MCAT for DO. But when the same argument is made for comparing DO to USMD, all of a sudden undergrad shouldn’t matter. So I just think that argument against Caribs is poor.

Really not sure about how clinical Ed compares between DO and Caribs and was genuinely asking.

Congratulations on your residency match and all of its associated bragging rights.
DO education is superior. It's not that complicated.
 

MSTP18

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Unfortunately that sentiment is held mostly by semi-well-educated/well-off people.

This is one point I can’t really argue with Small Cell about. There is a significant portion of our country that would prefer that “you wuz white and speak American!”

Source: I’m a white male in the South, where patients constantly remind me about their feelings about foreign doctors like we are best racist buds
I replied to the one where Small Cell walked it back a bit but he initially said "the vast majority" of americans would feel that way. There are plenty of racists and I think largely they assume the foreign trained docs have to be inferior because they are foreign trained (just like "the blacks" and "the lady doctors" are inferior). If it was established that we are choosing demonstrably inferior Americans I think some of those racists would change their tune.
 

radsisrad

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Unfortunately that sentiment is held mostly by semi-well-educated/well-off people.

This is one point I can’t really argue with Small Cell about. There is a significant portion of our country that would prefer that “you wuz white and speak American!”

Source: I’m a white male in the South, where patients constantly remind me about their feelings about foreign doctors like we are best racist buds
Sure. Sure you are.
 

KnuxNole

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This has nothing to do with me personally. I scored over 240 on my step 1 so it is unlikely I won't match. But if I had a barely passing score like many of my classmates and ended up unmatched to community level IM/FM programs while they are filled with people who have no allegiance to this nation whatsoever (and have hundreds of thousands of dollars in debt with no other skills), you better believe I would feel that this country has failed me.
I would blame the student not the country.
 
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Goodness! Well OP after reading your rants, I went over to the General Surgery program at the Cleveland clinic and laughed to myself because I think I counted 15 IMGs currently training, and multiple Prelim positions offered to IMGs.

Fact is, every single one of those IMGs earned their spot through bitter work.
 
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This has nothing to do with me personally. I scored over 240 on my step 1 so it is unlikely I won't match. But if I had a barely passing score like many of my classmates and ended up unmatched to community level IM/FM programs while they are filled with people who have no allegiance to this nation whatsoever (and have hundreds of thousands of dollars in debt with no other skills), you better believe I would feel that this country has failed me.
Your classmates just aren’t good enough. They failed themselves. They should have studied harder and gotten better scores.

I would blame the student not the country.
 

RinShanKaiHo

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I read that the common thinking is that non-US FMGs are top students in their countries while U.S. IMGs went abroad because they mostly are not qualified for U.S. schools (not top students).

I agree with you that U.S. IMGs should be prioritized over non-U.S. as residency spots are funded by U.S. tax payers. There should be laws about this.
Most US tax payers would probably want someone who was top med students in their own country, speak good English, did well on boards to qualify for residency, highly motivated and competent to go through all that hassle to move here to treat them, rather than some of their fellow US people who couldn't get into an MD or DO program and ended up in the islands.
 

Medic741

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The bolded line is exactly what I am trying to draw attention/“debate” about. Most of us US IMGs would be content working at some malignant community hospital program that most others wouldn’t want to be at. However if you look at match data roughly 60% of USIMGs AND 60% of non USIMGs are matching. What this says is that there no priority being given over whether someone is a US citizen or not. Further this also indicates that there are spots available for every US applicant but they are giving some spots to non-US applicants and leaving some Americans unmatched. Why should someone who only trained for a total of 5-6 years in Yemen (who is likely already practicing there) be given a spot that an American who also passed his boards and needs to pay off his loans/work in their own country. There is no reason that 100% of US AMGs/IMGs could not be matching. These foreigners can then go fight over what is left for their shot at the “American Dream”. This would actually be a fair way of approaching things, but it seems to be something that most people don’t want to discuss for some reason.
So don’t go to the Caribbean.

This information about the Caribbean being a terrible career choice and subpar education was available to you before you started your program but somehow thousands of US citizens each year do it anyway.

A great thing about America is you get to make your own decisions and live with the consequences — in this case being at a severe disadvantage at every turn of the medical meritocracy.
 
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OP, ideally you are correct ( baring a passed exam). But you have to realize, making the conscious decision to go Caribbean put you at a disadvantage. A DO med student knows he/she has a tougher/more challenging road if they want to go into a competitive field compared to an MD student. Ideally should it be like that? Idk maybe not, but that’s the way the cookie crumbles. I played D1 football so my chances of going to the NFL were MUCH higher than a D3 college football player. Aren’t we both college football players? Yes. Am I that much better than D3 football players? Probably not, but that’s just the way the system works.
 
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That's because DO schools don't prevent you from taking step 1 if you don't score high enough on an NBME or kick you out or prevent you from applying to DO residencies if you fail to pass step 1.
Also, DO students aren't required to take Step 1 because we have our own equivalent COMLEX. Personally, I took NBME shelf exams for 3rd year, but never had the desire to pay for two sets of boards, so I took only COMLEX. I never even took an NBME Step 1 pre-test. I took COMLEX, did well, matched at my first choice residency (allopathic), and got on with my life. So when the OP says that 100% of DOs didn't take and pass Step 1 before applying to residency, it's true, but that's because it isn't required for us when we have COMLEX.
 
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Most US tax payers would probably want someone who was top med students in their own country, speak good English, did well on boards to qualify for residency, highly motivated and competent to go through all that hassle to move here to treat them, rather than some of their fellow US people who couldn't get into an MD or DO program and ended up in the islands.
Where you got that from? You speak for the whole country? Who are you? I do not see a vote from Congress yet.

I also sense a condescending tone in your post. Island? Did you imply that once they got in to school on the island, they automatically match into residency? Do you know that the doctors from those islands still have to score more than their U.S. counterpart on Steps to prove themselves and earn a spot in their residency programs? They are qualified and earned their places.

You are speaking like those from the island are not highly motivated, do not have to overcome adversity, or are not competent or qualified. How do you think they get licensed?

Do you also protest when state med schools pick in-state students over out-ot-state students? You have any problem with them spending their tax money on their own people? I guess not.

Let's settle that with standardized tests. If you are as good as you believe / say you are, then prove it on the tests. U.S., island, foreign, MD, DO, whatever.

When the results are equal, U.S. get their picks over the non-U.S. It is only right. Period.
 
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Animalcules

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I admire the Trumpian ability to live with internal inconsistency.

The same people that constantly talk about the American Dream and how great free markets are have no problem advocating for absolute protectionism and excluding people they cannot compete with from competition.

Matching is already not an even playing field for FMGs. If it was, my guess is that none of US-IMGs coming back from their Caribbean nightmare would match. I'm not saying that Step scores are the determinant here, but I would argue a well-published cardiology fellow/attending from Ireland is more qualified for the residency spot than you coming back from some scattered rotations on mainland USA just because you have an American accent and paid tuition to a foreign for-profit school that bleeds you dry. You played the lottery, you don't deserve a prize just because you played.

I agree with the argument that countries should make an effort to find jobs for the vast majority of graduates in their programs. This is happening in the US. For foreign students that go to an American medical school, nobody would argue when they match in the US (their playing field is even). If you decided to go to an Irish, English, German, Australian, or Caribbean med school, I would argue the same should be true for you. You should be allowed to practice in the respective country. That's why odds are stacked against the Irish US-IMG and FMG when they come back. Why would anyone deserve a US residency coming back from the Caribbean. That's insane. Open your private practice on one of the islands. If that's not possible, somebody really screwed you over badly.
 
OP
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So don’t go to the Caribbean.

This information about the Caribbean being a terrible career choice and subpar education was available to you before you started your program but somehow thousands of US citizens each year do it anyway.

A great thing about America is you get to make your own decisions and live with the consequences — in this case being at a severe disadvantage at every turn of the medical meritocracy.
Yeah I am well aware of the disadvantages we face as well as the hatred people in this profession have towards us. And I'm not even completely unopposed to them (see some of my other posts on different threads). But when we have our government talking about a "doctor shortage" and simultaneously allowing our training positions to be outsourced to foreign aliens, this I feel is unacceptable. We are one of very few countries (may be the only one actually) the REQUIRES a several year training program after medical school in order to practice medicine. Most other countries just allow graduates to finish medical school and then start practicing/earning. This is a key point that I am not sure others are appreciating. A non-USIMG who doesn't match has other options and a USIMG who doesn't match is completely screwed.
 
OP
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I admire the Trumpian ability to live with internal inconsistency.

The same people that constantly talk about the American Dream and how great free markets are have no problem advocating for absolute protectionism and excluding people they cannot compete with from competition.

Matching is already not an even playing field for FMGs. If it was, my guess is that none of US-IMGs coming back from their Caribbean nightmare would match. I'm not saying that Step scores are the determinant here, but I would argue a well-published cardiology fellow/attending from Ireland is more qualified for the residency spot than you coming back from some scattered rotations on mainland USA just because you have an American accent and paid tuition to a foreign for-profit school that bleeds you dry. You played the lottery, you don't deserve a prize just because you played.

I agree with the argument that countries should make an effort to find jobs for the vast majority of graduates in their programs. This is happening in the US. For foreign students that go to an American medical school, nobody would argue when they match in the US (their playing field is even). If you decided to go to an Irish, English, German, Australian, or Caribbean med school, I would argue the same should be true for you. You should be allowed to practice in the respective country. That's why odds are stacked against the Irish US-IMG and FMG when they come back. Why would anyone deserve a US residency coming back from the Caribbean. That's insane. Open your private practice on one of the islands. If that's not possible, somebody really screwed you over badly.
Living the American Dream means having a path to getting what you want. As I stated earlier even if all residency spots went to all US citizens in the match there would still be spots left to give FMGs a shot at this. I think if anything the similar match rates amongst USIMGs and FMGs shows that it is an even playing field for them currently. This should not be the case.

And your last comment is absurd. No one goes to a place like Grenada intending to practice there, especially from a country like the US. These are business schools that cater to Americans looking to practice at home. We deserve placement because we too passed our board exams, have citizenship, have US clinical experience, speak English properly, actually care about healthcare in this country, and actually have a legitimate reason to be here in the first place. FMGs do not have any of these things and is the entire point of why I made this thread.
 

Ho0v-man

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Living the American Dream means having a path to getting what you want. As I stated earlier even if all residency spots went to all US citizens in the match there would still be spots left to give FMGs a shot at this. I think if anything the similar match rates amongst USIMGs and FMGs shows that it is an even playing field for them currently. This should not be the case.

And your last comment is absurd. No one goes to a place like Grenada intending to practice there, especially from a country like the US. These are business schools that cater to Americans looking to practice at home. We deserve placement because we too passed our board exams, have citizenship, have US clinical experience, speak English properly, actually care about healthcare in this country, and actually have a legitimate reason to be here in the first place. FMGs do not have any of these things and is the entire point of why I made this thread.
You made a bad business decision and think your entitled to a bailout for your irresponsible practices. Wasnt popular 10 years ago. Still ain’t.
 

Animalcules

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foreign aliens
What are you, a non-foreign alien? I really can't see you take care any foreign or undocumented patients.

REQUIRES a several year training program after medical school in order to practice medicine
I don't think this is true.

USIMG who doesn't match is completely screwed
Late awakening. Was this any different four years ago when you decided that you really deserve to practice medicine more than anyone else who got rejected form MD/DO schools and took out the check book to pay yourself back into the game? In most counties, if you don't have the scores, it's "too bad, thanks for playing". Choose another profession. Or if you really want to take care of patients or stay in medicine: nursing, PA, biomedical research. Nobody owes you, you decided to use the medicine equivalent of side door admissions.
 

chaim123

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We deserve placement because we too passed our board exams, have citizenship, have US clinical experience, speak English properly, actually care about healthcare in this country, and actually have a legitimate reason to be here in the first place. FMGs do not have any of these things and is the entire point of why I made this thread.
Are you serious? FMGs do not have any of these things???

Passed boards - check
US clinical experience - maybe
Speak English probably - Good enough to pass STEP in English
Legitimate reason to be here - your opinion
 

DrWhozits

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There’s a lot to unpack here...

Yeah I am well aware of the disadvantages we face as well as the hatred people in this profession have towards us. And I'm not even completely unopposed to them (see some of my other posts on different threads). But when we have our government talking about a "doctor shortage" and simultaneously allowing our training positions to be outsourced to foreign aliens, this I feel is unacceptable. We are one of very few countries (may be the only one actually) the REQUIRES a several year training program after medical school in order to practice medicine. Most other countries just allow graduates to finish medical school and then start practicing/earning. This is a key point that I am not sure others are appreciating. A non-USIMG who doesn't match has other options and a USIMG who doesn't match is completely screwed.
1. What does a doctor shortage have to do with anything? How does not letting foreign doctors in help a shortage?

2. You do realize that America is not the only country in the world with an organized system of medical education right? There are countries all over the world who have their **** figured out.

Living the American Dream means having a path to getting what you want. As I stated earlier even if all residency spots went to all US citizens in the match there would still be spots left to give FMGs a shot at this. I think if anything the similar match rates amongst USIMGs and FMGs shows that it is an even playing field for them currently. This should not be the case.

And your last comment is absurd. No one goes to a place like Grenada intending to practice there, especially from a country like the US. These are business schools that cater to Americans looking to practice at home. We deserve placement because we too passed our board exams, have citizenship, have US clinical experience, speak English properly, actually care about healthcare in this country, and actually have a legitimate reason to be here in the first place. FMGs do not have any of these things and is the entire point of why I made this thread.
Yes, but not for the reason you think. The American dream is about having a path to achieve what you want, I agree. But you are on that path. It’s just not guaranteed.

That would be like me demanding that I be able to get a job in the NFL. I played football in high school! Who cares if I sucked, they should have guaranteed me a spot at a college, because I did all that work! Without a college football spot, the NFL won’t let me play!
 
OP
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What are you, a non-foreign alien? I really can't see you take care any foreign or undocumented patients.



I don't think this is true.



Late awakening. Was this any different four years ago when you decided that you really deserve to practice medicine more than anyone else who got rejected form MD/DO schools and took out the check book to pay yourself back into the game? In most counties, if you don't have the scores, it's "too bad, thanks for playing". Choose another profession. Or if you really want to take care of patients or stay in medicine: nursing, PA, biomedical research. Nobody owes you, you decided to use the medicine equivalent of side door admissions.
If that's what you think fine. Then let me ask you this? What circumstance could possibly make a non-citizen more entitled to job (of any kind) in this country over a qualified citizen? I can't think of any. And I'm sure if you and others on this forum were to put aside your distain for Caribbean med students/grads and actually looked at things rationally you would not be able to think of any others too.
 
OP
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There’s a lot to unpack here...



1. What does a doctor shortage have to do with anything? How does not letting foreign doctors in help a shortage?

2. You do realize that America is not the only country in the world with an organized system of medical education right? There are countries all over the world who have their **** figured out.



Yes, but not for the reason you think. The American dream is about having a path to achieve what you want, I agree. But you are on that path. It’s just not guaranteed.

That would be like me demanding that I be able to get a job in the NFL. I played football in high school! Who cares if I sucked, they should have guaranteed me a spot at a college, because I did all that work! Without a college football spot, the NFL won’t let me play!
Yeah I know its not guaranteed. Up until clinicians I always thought it was because there were less residency spots available then applicants. I thought that if a non-American IMG was accepted to a US residency it was a rare case and was negligible. I had no idea that there are a similar of them getting residency spots as USIMGs.
 
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So don’t go to the Caribbean.
put aside your distain for Caribbean med students/grads
For those premeds reading this thread, this is basically the single take-away from this mess. Do not go to the Caribbean. Period. You will spend four years and enormous effort to realize your clinical education is considered a joke. In reality, your med school clinical education quality is huge. You find that out day one of residency; there are people literally a year ahead of others.

We are one of very few countries (may be the only one actually) the REQUIRES a several year training program after medical school in order to practice medicine
This actually isn't true on either end: other countries have residencies, and you may practice medicine here after completing an internship and nothing else, albeit only in an urgent care PA-like role.

What circumstance could possibly make a non-citizen more entitled to job (of any kind) in this country over a qualified citizen?
...them being better qualified by every metric? You're putting a lot of weight in your citizenship and your island education. The IMGs you're comparing yourself to went to significantly stronger institutes. As you're probably finding out on this thread, people really don't think much of a Caribbean education...


How about this: how would you react to a US citizen whose family lives in India and returned there for med school? They're still a citizen. If you'd take them, how about a non-US citizen who's lived in the states for 10 years and did the same? At what point is someone less worthy than you?
 
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I have mixed feelings about that whole thing... First, I am an AMG (US) and had no problem matching IM in 2018 with mediocre scores (~220/1 and 220+/2)...

As OP alluded to, USMLE was designed as a competency exam just like the dental school exam to practice dentistry. If you talk to a 55+-year-old orthopedic surgeon or a dermatologist, chances are that they would tell you they barely passed the USMLE and these people are great doctors. Nowadays, these people would have settled for IM/FM/Peds, etc... In fact, I was talking to an older (60+) interventional cardiologist (IC) the other day, he does not understand why one needs great USMLE scores to become an IC... He said if things were like that 30+ years ago, he would not be an IC now and yet people think he can walk on water because of how good he is.

On the other hands, I have a few FMG in my program and they are hard workers... and their USMLE scores are > 20 than mine; however, people should also realize that these FMG spend months or even years studying for these exams while us US students have 6-10 wks to study.

In the end, I think US citizens should have priority for residency spots and the remaining spots should be left for stellar FMG...
 
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You are speaking like those from the island are not highly motivated, do not have to overcome adversity, or are not competent or qualified. How do you think they get licensed?
Some of them are qualified, and those usually match. The ones who don't are the ones who have to remediate multiple times, take Step 1 multiple times and in some cases still don't pass until after they graduate med school, and/or fail clinical rotations.

Let's settle that with standardized tests. If you are as good as you believe / say you are, then prove it on the tests. U.S., island, foreign, MD, DO, whatever
That's what the whole thread is about. No one is saying that a US-IMG who excels on coursework, clinicals, and Steps doesn't deserve a spot. What people are saying is that the US-IMG who graduated last in his class, got a 190 on Steps, and remediated 2 clinical rotations doesn't deserve a spot over a superstar FMG just because he's an American citizen. That's the purpose of this thread.

Yeah I am well aware of the disadvantages we face as well as the hatred people in this profession have towards us
It's not toward you as an individual. It's toward the entire for-profit 3rd-world country med schools who take on students just to cash a check and, in the process, take advantage of students' dreams without a care as to how these students will get by if/when they don't match.

But when we have our government talking about a "doctor shortage" and simultaneously allowing our training positions to be outsourced to foreign aliens, this I feel is unacceptable
Yes, there is a doctor shortage, but we want highly qualified individuals caring for patients, no matter which country they're from.

We are one of very few countries (may be the only one actually) the REQUIRES a several year training program after medical school in order to practice medicine Most other countries just allow graduates to finish medical school and then start practicing/earning.
What?? Where did you get that? That's BS. Name the countries that allow this.

Living the American Dream means having a path to getting what you want
You did have a path -- it's called U.S. med schools. It was your choice to discard that path and leave the country for training when there was ample information out there about what a mistake that was. No one owes you a residency just because you're an American.

As I stated earlier even if all residency spots went to all US citizens in the match there would still be spots left to give FMGs a shot at this. I think if anything the similar match rates amongst USIMGs and FMGs shows that it is an even playing field for them currently. This should not be the case
Once you leave the country, you're no longer classified in the same group as USMDs and USDOs when it comes to advanced training. That's just a fact of life and the sooner pre-meds learn this too, the sooner we can get rid of the Caribbean option altogether.
 

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Also, DO students aren't required to take Step 1 because we have our own equivalent COMLEX. Personally, I took NBME shelf exams for 3rd year, but never had the desire to pay for two sets of boards, so I took only COMLEX. I never even took an NBME Step 1 pre-test. I took COMLEX, did well, matched at my first choice residency (allopathic), and got on with my life. So when the OP says that 100% of DOs didn't take and pass Step 1 before applying to residency, it's true, but that's because it isn't required for us when we have COMLEX.
Actually, close to 50% of all DOs take USMLE every year with about a 94% first time pass rate.
 

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If that's what you think fine. Then let me ask you this? What circumstance could possibly make a non-citizen more entitled to job (of any kind) in this country over a qualified citizen? I can't think of any. And I'm sure if you and others on this forum were to put aside your distain for Caribbean med students/grads and actually looked at things rationally you would not be able to think of any others too.
I really wish you'd stop speaking for others. You do it repeatedly and we repeatedly have to tell you you're wrong. One circumstance under which I think a non-citizen is more entitled to a job in this country over a qualified citizen is in the case of a Caribbean med school graduate with poor scores/clinicals versus a stellar FMG. I feel the FMG would be more qualified.
 

DrStephenStrange

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Living the American Dream means having a path to getting what you want. As I stated earlier even if all residency spots went to all US citizens in the match there would still be spots left to give FMGs a shot at this. I think if anything the similar match rates amongst USIMGs and FMGs shows that it is an even playing field for them currently. This should not be the case.

And your last comment is absurd. No one goes to a place like Grenada intending to practice there, especially from a country like the US. These are business schools that cater to Americans looking to practice at home. We deserve placement because we too passed our board exams, have citizenship, have US clinical experience, speak English properly, actually care about healthcare in this country, and actually have a legitimate reason to be here in the first place. FMGs do not have any of these things and is the entire point of why I made this thread.
Alright so just for the sake of argument. Let’s introduce a tiered match system. @Small Cell Carcinoma

in 2019, there were 30,550 positions filled in the match.

So naturally USMDs all get matched because they are the most super American of all. That’s 19,417.

USMDs from past classes trying to match would get spots then accounting for 1,779 spots.

Well then USDOs would come next, because they are still super American but just not quite as good as the USMDs. All of them get spots which is another 7,090. (This does not include some of the AOA applicants who did not apply to any ACGME programs)

Now on to the still American but for some reason chose not to be at an American school. They make up 6,975 applicants, but oh...wait. 19,417 + 1,779 + 7,090 = 28,286.

That means 2,264 US IMGs would get spots. Which is less than 2,997 US IMGs who actually matched in 2019.

If we throw out a meritocracy and just go by our red-blooded “Americanness”, USIMGs still lose. They just lose worse.
^ this says otherwise @Small Cell Carcinoma
 
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NYCdude

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Although OP sounds xenophobic as hell (lol) I have to admit the only thing that irks me is that the foreign docs pay literally nothing for med school and basically earn straight net income when they work here.

They should have to work a few years in low income areas as a payback instead of just gunning for fellowship straight away.
 
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If you talk to a 55+-year-old orthopedic surgeon or a dermatologist, chances are that they would tell you they barely passed the USMLE and these people are great doctors.
This is true - I've posted on SDN about one of my mentors who didn't know he had to take step 1 until the day of the test, and took it with zero prep - but this also underlines the fact that test performance =/= clinical acumen.

I have to admit the only thing that irks me is that the foreign docs pay literally nothing for med school and basically earn straight net income when they work here.
Of course, we're talking about people who are generally in the top 1% in their home country, but you could argue this is an issue with our med school system, not residency. Honestly, the days of med school not being free in the US are probably numbered.
 
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OP
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For those premeds reading this thread, this is basically the single take-away from this mess. Do not go to the Caribbean. Period. You will spend four years and enormous effort to realize your clinical education is considered a joke. In reality, your med school clinical education quality is huge. You find that out day one of residency; there are people literally a year ahead of others.


This actually isn't true on either end: other countries have residencies, and you may practice medicine here after completing an internship and nothing else, albeit only in an urgent care PA-like role.


...them being better qualified by every metric? You're putting a lot of weight in your citizenship and your island education. The IMGs you're comparing yourself to went to significantly stronger institutes. As you're probably finding out on this thread, people really don't think much of a Caribbean education...


How about this: how would you react to a US citizen whose family lives in India and returned there for med school? They're still a citizen. If you'd take them, how about a non-US citizen who's lived in the states for 10 years and did the same? At what point is someone less worthy than you?
I would be fine with the first example. I would object to the second one. But even if that were the case it is likely pretty rare. None of the residents in the IM program I rotated at fit that description either. A vast majority had never even set foot in the US before starting residency. And if it wasn't for their J1 visa or whatever, most of them would leave soon after residency after extracting enough money from our healthcare system.
 
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radsisrad

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I admire the Trumpian ability to live with internal inconsistency.

The same people that constantly talk about the American Dream and how great free markets are have no problem advocating for absolute protectionism and excluding people they cannot compete with from competition.
Free markets within a country, protectionism internationally. It's not a contradiction.
 
OP
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I have mixed feelings about that whole thing... First, I am an AMG (US) and had no problem matching IM in 2018 with mediocre scores (~220/1 and 220+/2)...

As OP alluded to, USMLE was designed as a competency exam just like the dental school exam to practice dentistry. If you talk to a 55+-year-old orthopedic surgeon or a dermatologist, chances are that they would tell you they barely passed the USMLE and these people are great doctors. Nowadays, these people would have settled for IM/FM/Peds, etc... In fact, I was talking to an older (60+) interventional cardiologist (IC) the other day, he does not understand why one needs great USMLE scores to become an IC... He said if things were like that 30+ years ago, he would not be an IC now and yet people think he can walk on water because of how good he is.

On the other hands, I have a few FMG in my program and they are hard workers... and their USMLE scores are > 20 than mine; however, people should also realize that these FMG spend months or even years studying for these exams while us US students have 6-10 wks to study.

In the end, I think US citizens should have priority for residency spots and the remaining spots should be left for stellar FMG...
Yeah and that's another thing actually. We were given 8 weeks to study for step 1 after leaving the island while many FMGs I spoke to took YEARS off the regurgitate what they needed to pass the exams.
 
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Although OP sounds xenophobic as hell (lol) I have to admit the only thing that irks me is that the foreign docs pay literally nothing for med school and basically earn straight net income when they work here.

They should have to work a few years in low-income areas as a payback instead of just gunning for fellowship straight away.
OP probably could have made his point better... I am an AMG (MD) and these people that are saying that OP is unkind is because they are still in the driver seat as US AMG... If the system was based on only merit where someone could sit in India/Pakistan and spend months studying for USMLE and crank out research papers and PD would put them in the same playing field as AMG (US MD), they probably would have a different reaction
 
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Med Ed

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Although OP sounds xenophobic as hell (lol) I have to admit the only thing that irks me is that the foreign docs pay literally nothing for med school and basically earn straight net income when they work here.
When a FMG matches in the US the loser isn't the US, it's the country the doc came from. They made an investment in educating the person and will get nothing back. We just scored someone who can start residency without putting a dime into that individual. It's classic brain drain.

NYCdude said:
They should have to work a few years in low income areas as a payback instead of just gunning for fellowship straight away.
Many do, as jobs that accept J1 visas are typically in less desirable locations.
 

Mass Effect

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Although OP sounds xenophobic as hell (lol) I have to admit the only thing that irks me is that the foreign docs pay literally nothing for med school and basically earn straight net income when they work here.

They should have to work a few years in low income areas as a payback instead of just gunning for fellowship straight away
Would you say the same to US MDs on scholarship who don't have to pay anything and basically earn straight net income?
 

Goro

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If that's what you think fine. Then let me ask you this? What circumstance could possibly make a non-citizen more entitled to job (of any kind) in this country over a qualified citizen? I can't think of any. And I'm sure if you and others on this forum were to put aside your distain for Caribbean med students/grads and actually looked at things rationally you would not be able to think of any others too.
Better training.
Less baggage, especially in making bad choices.
 

Animalcules

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If that's what you think fine. Then let me ask you this? What circumstance could possibly make a non-citizen more entitled to job (of any kind) in this country over a qualified citizen? I can't think of any. And I'm sure if you and others on this forum were to put aside your distain for Caribbean med students/grads and actually looked at things rationally you would not be able to think of any others too.
The answer is simple. They are more qualified. Period.
 
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The answer is simple. They are more qualified. Period.
A lot of them are more qualified than AMG as well.

I am at an IM program that takes AMG with 210+ but they would not look at FMG applicants with USMLE <229, so why should that program pick me with < 220 in step1 over a FMG with 229? On paper, he is more qualified than me.
 
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