Why are so many non US IMG filling residency spots?

[Animalcules]

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.

Unless they have a Green Card, they typically do as the J1 visa requires them to either go back to their home country or work several years in underserved areas to get a waiver for this requirement.

---

Members don't see this ad.

 

[Small Cell Carcinoma]

The answer is simple. They are more qualified. Period.

So in your opinion for a PGY1 spot at malignant community hospital primary care residency that many of us IMGs are destined for, a objectively more qualified FMG should take the spot over a barely qualified American? You seem to think both candidates will make crummy doctors anyway and that they are gunning for undesirable positions so why can't the American citizen get the spot first? It is really astonishing to me how someone could find this morally acceptable. Both applicants are undeniably capable of becoming competent physicians. It really blows my mind that others don't see the unfairness in suggesting that a FMG be given a spot over an American.

On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic.

 

[Animalcules]

Free markets within a country, protectionism internationally. It's not a contradiction.

It sure is. That's not how the world works anymore.

 

[Splenda88]

Unless they have a Green Card, they typically do as the J1 visa requires them to either go back to their home country or work several years in underserved areas to get a waiver for this requirement.

Not a big deal to spend 3 yrs in an underserved location while making 300k+/yr...

 

[Animalcules]

So in your opinion for a PGY1 spot at malignant community hospital primary care residency that many of us IMGs are destined for, a objectively more qualified FMG should take the spot over a barely qualified American? You seem to think both candidates will make crummy doctors anyway and that they are gunning for undesirable positions so why can't the American citizen get the spot first? It is really astonishing to me how someone could find this morally acceptable. Both applicants are undeniably capable of becoming competent physicians. It really blows my mind that others don't see the unfairness in suggesting that a FMG be given a spot over an American.

On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic.

The FMG beats out the unqualified US-IMG. I doubt they will get the spot over the barely qualified IMG. You act like there is a level playing field. There is not. We are talking Caribbean moonshine versus Lagavulin. It's not unfair. I have no idea what I'm buying into when I drink Caribbean moonshine. I may end up blind and with gout. I will let your Step 1 knowledge figure this one out.

 

[Animalcules]

Not a big deal to spend 3 yrs in an underserved location while making 300k+/yr...

Show me that contract please. They are worked to hell and are payed well below market value. A lot of FMG also don't want these jobs. They come her to work in academia and do research.

 

[IMGASMD]

Caribbean moonshine versus Lagavulin.

Where does pruno fit in?

 

[Splenda88]

Show me that contract please. They are worked to hell and are payed well below market value. A lot of FMG also don't want these jobs. They come her to work in academia and do research.

Can't show you these contracts because I dont have them. That is what a couple of them told me... I only saw one contract of one who will be working 18 12hr shift per month close to Nashville for 405k/year with a 20k sign-on bonus

 

[Small Cell Carcinoma]

Show me that contract please. They are worked to hell and are payed well below market value. A lot of FMG also don't want these jobs. They come her to work in academia and do research.

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

 

[7331poas]

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

The bill that needs to be brought before congress is the one preventing carribean programs from exporting their product into the United States.

 

[Lawpy]

this is next level. A carribean medical student complaining that medical students from other countries (not Caribbean) are getting residency spots.

This sounds very self serving. If you asked me, no foreign medical students (including carribean) should be getting spots.

It should be USMD -> DO -> debate about the rest.

Yeah I agree. It's also interesting that this thread went to 5 pages when this post here directly and effectively answered the question.

 

[Medic741]

The bill that needs to be brought before congress is the one preventing carribean programs from exporting their product into the United States.

A bill needs to be passed that prevents the fed from throwing millions into the Caribbean dumpster fire through offering subsidized student loans to Carribean students.

 

[mrbreakfast]

ou act like there is a level playing field. There is not. We are talking Caribbean moonshine versus Lagavulin. It's not unfair. I have no idea what I'm buying into when I drink Caribbean moonshine

This beautiful metaphor summarizes the argument pretty well. Caribbean programs aren't the best of the non-US med schools. Compared to the big foreign programs, they're likely among the worst.

A bill needs to be passed that prevents the fed from throwing millions into the Caribbean dumpster fire through offering subsidized student loans to Carribean students.

Agreed, considering I believe the stat is the average Caribbean enrollee doesn't even graduate, let alone become a practicing MD.

 

[jurassicpark]

So in your opinion for a PGY1 spot at malignant community hospital primary care residency that many of us IMGs are destined for, a objectively more qualified FMG should take the spot over a barely qualified American? You seem to think both candidates will make crummy doctors anyway and that they are gunning for undesirable positions so why can't the American citizen get the spot first? It is really astonishing to me how someone could find this morally acceptable. Both applicants are undeniably capable of becoming competent physicians. It really blows my mind that others don't see the unfairness in suggesting that a FMG be given a spot over an American.

On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic.

"On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic." THIS is from your very FIRST post " If it were not for them, every US citizen AMG or IMG would have a spot. "

 

[Small Cell Carcinoma]

The bill that needs to be brought before congress is the one preventing carribean programs from exporting their product into the United States.

And it is exactly this kind of arrogant condescending thinking that is preventing any process from being made on this thread.

 

[DrWhozits]

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

Then go bring it up to the public. You may have a shot in the current political climate.

But unfortunately for you, I think there would be way more support for American schools, not American citizenship. I think you underestimate the public’s stigma toward training in the Caribbean.

 

[Small Cell Carcinoma]

"On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic." THIS is from your very FIRST post " If it were not for them, every US citizen AMG or IMG would have a spot. "

Yeah but since an almost negligible number of AMGs go unmatched/unemployed, it isn't the main thing I was trying to draw attention to.

 

[chaim123]

And it is exactly this kind of arrogant condescending thinking that is preventing any process from being made on this thread.

Actually that touches on another important issue - why do US federal education dollars get funneled to Caribbean schools so that most students can drop out or never match? It would make much more sense to keep the money here in the US and support education here, for those who can make it in USMD and USDO schools.

 

[radsisrad]

It sure is. That's not how the world works anymore.

Non sequitur.

 

[Mass Effect]

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.

Because you're a US AMG. We know what education you got. We know what we're getting. Likewise, a US-IMG and an FMG with the exact same experience/status should be on an equal playing field and I think most agree that the US-IMG should get the spot. Where there's disagreement is in a US-IMG with sub-par stats and a superstar FMG. The FMG should get the spot. US IMG has a foreign degree. FMG has a foreign degree. So US-IMG = FMG, and let the best candidate win.

So in your opinion for a PGY1 spot at malignant community hospital primary care residency that many of us IMGs are destined for, a objectively more qualified FMG should take the spot over a barely qualified American?

Yes.

You seem to think both candidates will make crummy doctors anyway

The person you talked to never said any such thing. Why are you making stuff up?

It really blows my mind that others don't see the unfairness in suggesting that a FMG be given a spot over an American.

It blows my mind that you think a barely qualified American should become a doctor over a stellar FMG.

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

Again, you're not going to make headway invoking Trump here. He does exactly what you've been doing -- hyperbole with zero to back it up. Any "rational person in Congress" would have to look at all the facts -- a student who couldn't get into an American school, goes to a diploma mill that allows him 7 chances to pass with sub-par scores versus a superstar from India and I would bet they'd go with the candidate from India, unless they're xenophobic. Also, this is absolutely not the first thread "ever addressing this on SDN." More hyperbole. I'm understanding why Trump seems to be your hero.

 

[Mass Effect]

And it is exactly this kind of arrogant condescending thinking that is preventing any process from being made on this thread.

Actually, what's preventing progress in this thread is the blatant hyperbole and refusal to accept facts.

 

[DrWhozits]

Because you're a US AMG. We know what education you got. We know what we're getting. Likewise, a US-IMG and an FMG with the exact same experience/status should be on an equal playing field and I think most agree that the US-IMG should get the spot. Where there's disagreement is in a US-IMG with sub-par stats and a superstar FMG. The FMG should get the spot. US IMG has a foreign degree. FMG has a foreign degree. So US-IMG = FMG, and let the best candidate win.



Yes.



The person you talked to never said any such thing. Why are you making stuff up?



It blows my mind that you think a barely qualified American should become a doctor over a stellar FMG.



Again, you're not going to make headway invoking Trump here. He does exactly what you've been doing -- hyperbole with zero to back it up. Any "rational person in Congress" would have to look at all the facts -- a student who couldn't get into an American school, goes to a diploma mill that allows him 7 chances to pass with sub-par scores versus a superstar from India and I would bet they'd go with the candidate from India, unless they're xenophobic. Also, this is absolutely not the first thread "ever addressing this on SDN." More hyperbole. I'm understanding why Trump seems to be your hero.

“This is the biggest thread on this in the history of SDN. So big. The biggest. No on has ever had a thread like this. I have many, many friends that tell me they’ve never seen a thread like this.”

 

[Small Cell Carcinoma]

Actually that touches on another important issue - why do US federal education dollars get funneled to Caribbean schools so that most students can drop out or never match? It would make much more sense to keep the money here in the US and support education here, for those who can make it in USMD and USDO schools.

Well why don't we try to focus on those of us who are nearing completion our medical education rather than those of us who were unsuccessful doing so. Oh and a good number drop out of stateside schools especially DO ones too

 

[Aslanim]

Honestly, the days of med school not being free in the US are probably numbered.

 

[DrStephenStrange]

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

Never thought Trump and rational could be in the same sentence.

 

[Dantes]

So in your opinion for a PGY1 spot at malignant community hospital primary care residency that many of us IMGs are destined for, a objectively more qualified FMG should take the spot over a barely qualified American? You seem to think both candidates will make crummy doctors anyway and that they are gunning for undesirable positions so why can't the American citizen get the spot first? It is really astonishing to me how someone could find this morally acceptable. Both applicants are undeniably capable of becoming competent physicians. It really blows my mind that others don't see the unfairness in suggesting that a FMG be given a spot over an American.

On another note, I am not trying to bring US AMGs into this debate. I have no idea how this thread has gotten so off topic.

This thread is going in circles. Why do you think it's unfair? It's already tough for FMGs to match here. Americans are given first dibs. This already happens. IMGs still match if they have good board scores and grades. It seems you want even fewer FMGs than there already are because they aren't home grown. We disagree because we want to attract top talent, period. Even state schools with a bias in the US take stellar out-of-state students. The system you're advocating for already exists. It seems you just want it skewed more towards one end of the spectrum.

 

[DrStephenStrange]

Well why don't we try to focus on those of us who are nearing completion our medical education rather than those of us who were unsuccessful doing so. Oh and a good number drop out of stateside schools especially DO ones too

DOs have had a stable 96% graduation rate over 6 years. Definitely not like the Caribbean.

 

[nimbus]

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.

When the non citizen is better qualified.

 

[DrWhozits]

When the non citizen is better qualified.

I’m all for open debate, but this isn’t something that anyone will be able to convince @Small Cell Carcinoma otherwise.

This is a fundamental difference in his/her interpretation of the world.

 

[nimbus]

OP needs to realize that many of the FMGs who train here are people who would have attended a T10 USMD school if they had the good fortune to be born here. I have several FMG family members and they are some of the smartest and hardest working people I know. I’m an immigrant myself, a USMD and I attended a T10 school. My friend is a retina surgeon. She graduated pi beta kappa, summa cum laude from an Ivy undergrad and also an ivy med school. Her father is an FMG cardiologist who graduated from University of Aleppo, then trained at no name places in Cleveland and Detroit. Had he been born here, I’m sure he would easily have gained admission to a USMD school.

 

[Neopolymath]

God I love this thread. Inject it into my veins.

OP is paying one of two intelligence taxes and hates the cost. He either couldn't even get into the bad DO schools or didn't apply to them. Both situations should be punished thoroughly.

For a Trumper, you should know/love Americans are harsh. Well, the harsh truth is we don't want dumb Americans treating our families. It goes against the origins of the American dream to turn down foreigners who are often superior so Johnny 25 MCAT McKnight can pursue his dream of being a doctor against all reason. End lending to these programs and solve this problem. Stop letting these poor Americans fall prey to Carib schools.

 

[Small Cell Carcinoma]

This thread is going in circles. Why do you think it's unfair? It's already tough for FMGs to match here. Americans are given first dibs. This already happens. IMGs still match if they have good board scores and grades. It seems you want even fewer FMGs than there already are because they aren't home grown. We disagree because we want to attract top talent, period. Even state schools with a bias in the US take stellar out-of-state students. The system you're advocating for already exists. It seems you just want it skewed more towards one end of the spectrum.

Yes this is what I am saying. I feel it needs to be more skewed towards the other end of the spectrum. The same way it is for out of state and international med school applicants. This should be no different.

 

[ndafife]

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.

You willingly chose to leave this country and now you want special treatment to come back?

 

[DrStephenStrange]

OP needs to realize that many of the FMGs who train here are people who would have attended a T10 USMD school if they had the good fortune to be born here. I have several FMG family members and they are some of the smartest and hardest working people I know. I’m an immigrant myself, a USMD and I attended a T10 school. My friend is a retina surgeon. She graduated pi beta kappa, summa cum laude from an Ivy undergrad and also an ivy med school. Her father is an FMG cardiologist who graduated from University of Aleppo, then trained at no name places in Cleveland and Detroit. Had he been born here, I’m sure he would easily have gained admission to a USMD school.

To add to that one of the smartest and humblest person I know is an Interventional Cardiologist and faculty at my DO school. He graduated from Ghana, and went to IM residency and fellowship at NYU. I'm pretty sure if he wasn't on another level in his country he wouldn't have gotten into a NYU residency program. And now, he's paying it forward by teaching us, medical students, the knowledge and clinical skills we need, paying taxes, and also by being one of the best doctors in the town I'm at.

 

[Small Cell Carcinoma]

God I love this thread. Inject it into my veins.

OP is paying one of two intelligence taxes and hates the cost. He either couldn't even get into the bad DO schools or didn't apply to them. Both situations should be punished thoroughly.

For a Trumper, you should know/love Americans are harsh. Well, the harsh truth is we don't want dumb Americans treating our families. It goes against the origins of the American dream to turn down foreigners who are often superior so Johnny 25 MCAT McKnight can pursue his dream of being a doctor against all reason. End lending to these programs and solve this problem. Stop letting these poor Americans fall prey to Carib schools.

That is extremely out of line for you to say. You do not know me or what circumstances led me to need to go abroad for medical training. But if you feel so strongly that I am to be punished for things out of my control, why don't you say the same for FMGs on the basis that they were not born in this country?

 

[gyngyn]

Leave the president out of this thread and do not attack the intelligence of someone with whom you disagree.
Thanks.

 

[Animalcules]

And in the process directly prevent thousands of American citizens from getting those jobs. Trump or any rational person in congress would sign a bill regulating this in a heartbeat. It just needs to be brought to the public's eye since no one seems to really bring it up. I even think this may be the first thread ever addressing this on SDN.

Oh please, do you really believe the MD-PhD from Ireland is taking away your residency spot at Hopkins? American universities are the best research institutions in the world because they recruit the best - independent of country of origin.

 

[catnip12]

Regardless, and I gain no pleasure it emphasising this, but yet I feel that it is still a point that you don’t yet grasp fully, or refuse to come to terms with, which is.... that America does not owe you a residency spot, or care for the circumstances that pushed you (or your peers) to an offshore medical school.

It’s just the truth. The only thing you can do at this point, is to go through the match process with your best possible application. The rest are forces far larger than you can control at this time. Whether or not you find it fair.

That is extremely out of line for you to say. You do not know me or what circumstances led me to need to go abroad for medical training. But if you feel so strongly that I am to be punished for things out of my control, why don't you say the same for FMGs on the basis that they were not born in this country?

 

[Dantes]

Yes this is what I am saying. I feel it needs to be more skewed towards the other end of the spectrum. The same way it is for out of state and international med school applicants. This should be no different.

But it already is! Squeezing out a few more top FMGs will not drastically change your chances. Focus on doing you. If Caribbean schools paid more attention to improving their status like DO schools have the past few decades that could change. But as it stands they have a predatory and profit-first reputation.

 

[Neopolymath]

That is extremely out of line for you to say. You do not know me or what circumstances led me to need to go abroad for medical training. But if you feel so strongly that I am to be punished for things out of my control, why don't you say the same for FMGs on the basis that they were not born in this country?

If someone literally held a gun to your head forcing you to go to the Caribbean then you should be contacting the police not ranting online as @Goro would say.

 

[olabrador23]

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.



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.

you sound like a fair and pro-merit guy. I am pro-merit too.

Some assume that non-US FMG are superior to U.S. IMG. I say, prove it via standardized testing.

But I guess you did not know this, USMLE - I finally passed! after failing 3 times (some failed Step 6-7 times and still matched).

Please do tell me how is that a meritocracy again? or is it "protectionism" for U.S. students?

In U.S. med school admission, out-of-state students compete for the left-over from in-state students for state medical schools too. Those states say they want to spend their tax money and save those seats for their own people. Nobody seems to have any problem.

Have you heard the proposal for Steps going P/F by the end of this year (2019)? After Steps is going P/F, it will be 100% that U.S. IMG will pick up the left over of AMG. What people are going to be measured on? The schools they went to? The people they know or write them LORs or make calls for them? Is it not "protectionism" for U.S. MD/DO then? or still a meritocracy you say?

U.S. IMG have already only been able to pick the left-over of U.S. MD / DO, no matter how good they are. So how should that any different for U.S. IMG vs non-US IMG?

Many want those "super star" FMG ranked over U.S. IMG. Fine. But the same people would want those "super star" FMG ranked over U.S. MD/DO and take their spots too? Guess not.

Again, I am very for a merit-bases system with no exception with no regards to who you are, where you go to school, age, sex / gender, nationality, religion, etc. Everyone should have to prove themselves via standardized testing to show that they are qualified and be ranked against others to compete for residency spots. I am all for attracting world's talents to this country and they need to prove themselves in the process along with everyone else.

But I think it is very hypocritical of the people who so quickly criticize the U.S. IMG who wants to residency spots for Americans / U.S. citizens only. It is alright to "protect" U.S. MD/DO but it is not ok to protect U.S. IMG over non-US? I guess they forgot to look at themselves in a mirror.

It is common sense that when you are in another people house, you play by their rules. You are at the mercy of the landlord. It is their house, their money, therefore their decision to whether to let you eat or not or the food you could eat. The house owner should decide that and rightfully so. As examples, many countries do NOT let a foreign trained physicians (citizen or not) to ever practice in their country (e.g. Hongkong). I think Congress should have a bill and vote for a law to decide on this matter as how to spend tax money on medical residency / training programs and who would be eligible for and/or preferred to receive this funding / training spots, etc.

 

[DrWhozits]

That is extremely out of line for you to say. You do not know me or what circumstances led me to need to go abroad for medical training. But if you feel so strongly that I am to be punished for things out of my control, why don't you say the same for FMGs on the basis that they were not born in this country?

How is that out of your control? YOU chose to go there. The “Syrian Refugee” that you referenced earlier didn’t chose to be born in Syria...

 

[ExploringOptions]

Not someone in the medical field. I am in psychology. Been reading this thread with interest and amusement. I 100% would prefer a FMG over a Caribbean one just like I won’t go see a psychologist who got their degree online or at Argosy. You aren’t owed a damn thing because you are American. You weren’t up to snuff for US or non/Carib med schools. You aren’t up to snuff to be my doctor. The xenophobia on here makes me angry you’ll be a doctor at all. Seems like you’d have trouble treating patients different than yourself. But maybe you can get a spot as Trump’s personal physician! I have a feeling you’d get on well together.

 

[Mass Effect]

you sound like a fair and pro-merit guy. I am pro-merit too.

Some assume that non-US FMG are superior to U.S. IMG. I say, prove it via standardized testing.

But I guess you did not know this, USMLE - I finally passed! after failing 3 times (some failed Step 6-7 times and still matched).

Please do tell me how is that a meritocracy again? or is it "protectionism" for U.S. students?

In U.S. med school admission, out-of-state students compete for the left-over from in-state students for state medical schools too. Those states say they want to spend their tax money and save those seats for their own people. Nobody seems to have any problem.

Have you heard the proposal for Steps going P/F by the end of this year (2019)? After Steps is going P/F, it will be 100% that U.S. IMG will pick up the left over of AMG. What people are going to be measured on? The schools they went to? The people they know or write them LORs or make calls for them? Is it not "protectionism" for U.S. MD/DO then? or still a meritocracy you say?

U.S. IMG have already only been able to pick the left-over of U.S. MD / DO, no matter how good they are. So how should that any different for U.S. IMG vs non-US IMG?

Many want those "super star" FMG ranked over U.S. IMG. Fine. But the same people would want those "super star" FMG ranked over U.S. MD/DO and take their spots too? Guess not.

Again, I am very for a merit-bases system with no exception with no regards to who you are, where you go to school, age, sex / gender, nationality, religion, etc. Everyone should have to prove themselves via standardized testing to show that they are qualified and be ranked against others to compete for residency spots. I am all for attracting world's talents to this country and they need to prove themselves in the process along with everyone else.

But I think it is very hypocritical of the people who so quickly criticize the U.S. IMG who wants to residency spots for Americans / U.S. citizens only. It is alright to "protect" U.S. MD/DO but it is not ok to protect U.S. IMG over non-US? I guess they forgot to look at themselves in a mirror.

It is common sense that when you are in another people house, you play by their rules. You are at the mercy of the landlord. It is their house, their money, therefore their decision to whether to let you eat or not or the food you could eat. The house owner should decide that and rightfully so. As examples, many countries do NOT let a foreign trained physicians (citizen or not) to ever practice in their country (e.g. Hongkong). I think Congress should have a bill and vote for a law to decide on this matter as how to spend tax money on medical residency / training programs and who would be eligible for and/or preferred to receive this funding / training spots, etc.

Look, the people going IMG know what they're getting themselves into. You can argue about playing by the rules of the landlord, but what you leave out, is we already are. The PDs are the landlord and we play by their rules. Congress has no say here and proposing legislation will bring out everyone from PDs, the ACGME, and the AMA all against the diploma mill that is Caribbean schools. You can try it all you want, but I guarantee Carib grads will be worse off for it.

Hell, even @Small Cell Carcinoma , the creator of this thread, discouraged posters from going Carib last summer due to the sub-par education/knowledge. That alone is enough to convince me that legislation from non-physicians has no place in this arena.

 

[Lawpy]

That is extremely out of line for you to say. You do not know me or what circumstances led me to need to go abroad for medical training. But if you feel so strongly that I am to be punished for things out of my control, why don't you say the same for FMGs on the basis that they were not born in this country?

What? Dude you chose to go to Caribbean. It was definitely under your control and you made the bad decision. Your anti-FMG rants are irrational.

 

[DrWhozits]

you sound like a fair and pro-merit guy. I am pro-merit too.

Some assume that non-US FMG are superior to U.S. IMG. I say, prove it via standardized testing.

But I guess you did not know this, USMLE - I finally passed! after failing 3 times (some failed Step 6-7 times and still matched).

Please do tell me how is that a meritocracy again? or is it "protectionism" for U.S. students?

In U.S. med school admission, out-of-state students compete for the left-over from in-state students for state medical schools too. Those states say they want to spend their tax money and save those seats for their own people. Nobody seems to have any problem.

Have you heard the proposal for Steps going P/F by the end of this year (2019)? After Steps is going P/F, it will be 100% that U.S. IMG will pick up the left over of AMG. What people are going to be measured on? The schools they went to? The people they know or write them LORs or make calls for them? Is it not "protectionism" for U.S. MD/DO then? or still a meritocracy you say?

U.S. IMG have already only been able to pick the left-over of U.S. MD / DO, no matter how good they are. So how should that any different for U.S. IMG vs non-US IMG?

Many want those "super star" FMG ranked over U.S. IMG. Fine. But the same people would want those "super star" FMG ranked over U.S. MD/DO and take their spots too? Guess not.

Again, I am very for a merit-bases system with no exception with no regards to who you are, where you go to school, age, sex / gender, nationality, religion, etc. Everyone should have to prove themselves via standardized testing to show that they are qualified and be ranked against others to compete for residency spots. I am all for attracting world's talents to this country and they need to prove themselves in the process along with everyone else.

But I think it is very hypocritical of the people who so quickly criticize the U.S. IMG who wants to residency spots for Americans / U.S. citizens only. It is alright to "protect" U.S. MD/DO but it is not ok to protect U.S. IMG over non-US? I guess they forgot to look at themselves in a mirror.

It is common sense that when you are in another people house, you play by their rules. You are at the mercy of the landlord. It is their house, their money, therefore their decision to whether to let you eat or not or the food you could eat. The house owner should decide that and rightfully so. As examples, many countries do NOT let a foreign trained physicians (citizen or not) to ever practice in their country (e.g. Hongkong). I think Congress should have a bill and vote for a law to decide on this matter as how to spend tax money on medical residency / training programs and who would be eligible for and/or preferred to receive this funding / training spots, etc.

This argument seems to come up a lot. Students are not just standardized test scores. Their truly is more to a persons application than just the one score.

The system we have is still a meritocracy with some caveats. Where you go to school is 100% part of your application and thus your merit. If it helps, being a USMD is an A. DO is a B. USIMG a C. And FMG a D (these last two are probably arguable)

You can overcome that grade by having a good score, but it is a part on your application. Trying to boil everyone down to board scores does a massive disservice to the quality of education, particularly in the clinical years.

I’m a DO student, and in no way would I argue that my school should be looked at the same way as Harvard or Hopkins or hell, U of Random State. But boards and research and the like give me the opportunity to potentially earn (again, meritocracy) a spot despite a knock on my application being from a DO school.

“Common sense” would dictate that if some one from another country can do enough to overcome the negative of FMG on his/her application then they have earned the spot.

If you are still reading...
The point about states doing this is non-sense. They literally do what the US does right now. Favoring instate applicants (citizens or US students) over out of state applicants (FMGs). No one is crying about the way that system works, just as no one should be crying about the way the national system works.

 

[Goro]

The bill that needs to be brought before congress is the one preventing carribean programs from exporting their product into the United States.

Cutting off access to loans should suffice.

 

[MSTP18]

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.

You have been trained in the American healthcare system by an LCGME accredited medical school guaranteeing that you have had certain knowledge, exposures, and experiences while the other has not. That is not meaningless.

you sound like a fair and pro-merit guy. I am pro-merit too.

Some assume that non-US FMG are superior to U.S. IMG. I say, prove it via standardized testing.

But I guess you did not know this, USMLE - I finally passed! after failing 3 times (some failed Step 6-7 times and still matched).

Please do tell me how is that a meritocracy again? or is it "protectionism" for U.S. students?

In U.S. med school admission, out-of-state students compete for the left-over from in-state students for state medical schools too. Those states say they want to spend their tax money and save those seats for their own people. Nobody seems to have any problem.

Have you heard the proposal for Steps going P/F by the end of this year (2019)? After Steps is going P/F, it will be 100% that U.S. IMG will pick up the left over of AMG. What people are going to be measured on? The schools they went to? The people they know or write them LORs or make calls for them? Is it not "protectionism" for U.S. MD/DO then? or still a meritocracy you say?

U.S. IMG have already only been able to pick the left-over of U.S. MD / DO, no matter how good they are. So how should that any different for U.S. IMG vs non-US IMG?

Many want those "super star" FMG ranked over U.S. IMG. Fine. But the same people would want those "super star" FMG ranked over U.S. MD/DO and take their spots too? Guess not.

Again, I am very for a merit-bases system with no exception with no regards to who you are, where you go to school, age, sex / gender, nationality, religion, etc. Everyone should have to prove themselves via standardized testing to show that they are qualified and be ranked against others to compete for residency spots. I am all for attracting world's talents to this country and they need to prove themselves in the process along with everyone else.

But I think it is very hypocritical of the people who so quickly criticize the U.S. IMG who wants to residency spots for Americans / U.S. citizens only. It is alright to "protect" U.S. MD/DO but it is not ok to protect U.S. IMG over non-US? I guess they forgot to look at themselves in a mirror.

It is common sense that when you are in another people house, you play by their rules. You are at the mercy of the landlord. It is their house, their money, therefore their decision to whether to let you eat or not or the food you could eat. The house owner should decide that and rightfully so. As examples, many countries do NOT let a foreign trained physicians (citizen or not) to ever practice in their country (e.g. Hongkong). I think Congress should have a bill and vote for a law to decide on this matter as how to spend tax money on medical residency / training programs and who would be eligible for and/or preferred to receive this funding / training spots, etc.

One place where your comparison with state med schools breaks down is that I, having never worked or lived in TX will never pay TX taxes. Even if I were admitted and went to medical school in TX, I would still probably not pay taxes to TX as my residency would likely remain with my home state. The FMG who is working in the USA for residency will pay taxes to the USA. If I went to TX for residency, I would pay taxes to TX.

Also, no one is saying that ANY US MD/DO person should get a spot before anyone else regardless of red flags, etc. What OP is arguing for is that the US-IMG, no matter how many times they failed courses, got put on probation, what have you, gets a spot ahead of ANY FMG. That's absurd.

I'll repost Mass Effect because they summed it up so well.

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.

...

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.

 

[Splenda88]

You have been trained in the American healthcare system by an LCGME accredited medical school guaranteeing that you have had certain knowledge, exposures, and experiences while the other has not. That is not meaningless.

Well, OP is kind of making the same argument... He is an American who speaks the language and understands the culture very well so why shouldn't he has a leg up over an FMG with an accent and has never lived in the US? By the way, I am an AMG with an accent so nothing against people who speak with an accent.

 

[Small Cell Carcinoma]

Well, OP is kind of making the same argument... He is an American who speaks the language and understands the culture very well so why shouldn't he has a leg up over an FMG with an accent and has never lived in the US? By the way, I am an AMG with an accent so nothing against people who speak with an accent.

Exactly. People here are really making me out to be some sort of xenophobe when that isn't the case at all. I have no problem with immigration and allowing immigrants access to jobs here. What I have a problem with is them threatening the livelihood of American citizens when they don't have any real basis on being here in the first place. If they want to be a doctor here so badly they should immigrate here like everyone else, work in a related field for several years, gain citizenship, show an actual commitment to this nation, and then try to match. I would have no problem with that scenario at all.