Why practice in the USA?

[gtb]

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I'm a US medical student rotating through clerkships in my 3rd year of medical school. I've encountered a small number of IMGs who have already graduated from their programs and are now performing audition rotations in various hospitals. One question I've wanted to ask is, "Why do you want to practice medicine in the US?" Politeness prohibited me from inquiring in person, so I ask this online instead.

I keep reading and hearing in media that America is the equivalent of evil in the world. That the American healthcare system is inherently cruel in its denial of services for certain individuals. That Americans are arrogant, stupid, insensitive, and rude. So why do some physicians in other countries work so hard and jump through so many hoops attempting to come to America and practice medicine?

Thanks in advance for your sincere answers.

 

[Gary]

I think the 5 Cs would be a good answer: Car, Credit Card, Cash, Club membership and Condominiums

 

[bts4202]

I am an american who left teh country to get my medical education. I want to come back for two reasons. A) I love my home and B) America is one of the only places where I will make enough money to pay back the $200K loan that I took for school!!

 

[redshifteffect]

Originally posted by gtb
I'm a US medical student rotating through clerkships in my 3rd year of medical school. I've encountered a small number of IMGs who have already graduated from their programs and are now performing audition rotations in various hospitals. One question I've wanted to ask is, "Why do you want to practice medicine in the US?" Politeness prohibited me from inquiring in person, so I ask this online instead.

I keep reading and hearing in media that America is the equivalent of evil in the world. That the American healthcare system is inherently cruel in its denial of services for certain individuals. That Americans are arrogant, stupid, insensitive, and rude. So why do some physicians in other countries work so hard and jump through so many hoops attempting to come to America and practice medicine?

Thanks in advance for your sincere answers.

Though i can't speak from personal experience I can say that I've spoken to many IMGs and most of them tell me that they had no idea what it would be like to practice there before they came. They always hear rumours about how good America is from the media and their friends and family members...and then when they actually go there it is completely different from what they started.

Another thing I have heard is that there are too many doctors in some countries...so it's tough for people to get a job.

BTS, There are other countries where you could get a job (if you weren't from St.Chris) where you could pay off ur 200K debt...

 

[bts4202]

Originally posted by redshifteffect

BTS, There are other countries where you could get a job (if you weren't from St.Chris) where you could pay off ur 200K debt...

What country doesn't allow docs with senegalese degrees?

Even so, there is no place that I have been to or heard of that pays docs as well as the US does. If you find one let me know, but I know the docs in the UK make crap. They say so themselves. I don't know how it is down under, but most places are WAYYY behind America. I know a Ortho/trauma surgeon in london making 50,000 pounds a year from NHS. He works with insured patients on the side and gets another 60,000 or so/year. Thats a total of 110,000 pounds = $180,000 a year for a ORTHOPEDIC/TRAUMA SURGEON. Plus, don't forget about the kind of taxes people have to pay in a socialize society (socialized healthcare, etc). Trauma surgeons in the US make over $300,000/year easily. Are UK docs starving... NO, are they doing as well as US docs... Hells NO.

 

[redshifteffect]

Originally posted by bts4202
What country doesn't allow docs with senegalese degrees?

Even so, there is no place that I have been to or heard of that pays docs as well as the US does. If you find one let me know, but I know the docs in the UK make crap. They say so themselves. I don't know how it is down under, but most places are WAYYY behind America. I know a Ortho/trauma surgeon in london making 50,000 pounds a year from NHS. He works with insured patients on the side and gets another 60,000 or so/year. Thats a total of 110,000 pounds = $180,000 a year for a ORTHOPEDIC/TRAUMA SURGEON. Plus, don't forget about the kind of taxes people have to pay in a socialize society (socialized healthcare, etc). Trauma surgeons in the US make over $300,000/year easily. Are UK docs starving... NO, are they doing as well as US docs... Hells NO.

With ur sengalese degree i doubt u will be able to practice in Australia...though in Australia it's much better than the UK Or Canada. The average salary here in Tassie for GPs that i've seen is about 200,000 Australian, while most specialists are making 500,000 +

Compare that to the average cost of medical education here (5 years @ 6000 per year = 30,000...u'll make that back in internship)

 

[gtb]

It's different for a US citizen that went to medical school in another country. Your family is here, your culture is here, and you're just coming home to work and to live. I'm curious why people from other nations and other cultures have a desire to practice medicine in the United States.

 

[bts4202]

Originally posted by gtb
It's different for a US citizen that went to medical school in another country. Your family is here, your culture is here, and you're just coming home to work and to live. I'm curious why people from other nations and other cultures have a desire to practice medicine in the United States.

You may have a more difficult time getting that info on here since the vast majority of posters are US/ Canadian citizens who have traveled abroad for med school rather than vise versa.

 

[Stephen Ewen]

There are some fair amount of people on the boards who are non-US citizens, so give it a bit of time.

To reply to a question about where physicians salaries are comparable to the U.S., I understand (from a physician friend who did med school at King Fasal in Saudi Arabia) that a U.S. or U.K. trained physician can make comparable in gov hospital centers in Saudi Arabia, though the hours can be pretty gruelling.

 

[Purifyer]

Originally posted by gtb
"Why do you want to practice medicine in the US?"

Honestly the only reason I would want to touch the US with a 10 foot barge poll would be i) Money.

Other reasons medical graduates from 1st world countries might have (imo)

- dissatisfaction with country of origin (eg. social policy, racial issues, personal issues[eg. break up with fiance, divorce, parental death])
- some perception that it is easier to actually become a specialist/doctor in the US compared to their home country.
- perhaps some americo-philes feel that the US is the hub of medical knowledge
- Brain drain - some people simply feel that the grass is greener on the other side.
- Life plans... eg. married to an American

 

[pitman]

For non-1st-World, some common factors are the high standard of living in the US (beyond a simple $ comparison) and relative social/political/educational freedom & equality compared to much of the rest of the world.

-pitman

 

[PTCA]

Originally posted by gtb
I'm a US medical student rotating through clerkships in my 3rd year of medical school. I've encountered a small number of IMGs who have already graduated from their programs and are now performing audition rotations in various hospitals. One question I've wanted to ask is, "Why do you want to practice medicine in the US?" Politeness prohibited me from inquiring in person, so I ask this online instead.

I keep reading and hearing in media that America is the equivalent of evil in the world. That the American healthcare system is inherently cruel in its denial of services for certain individuals. That Americans are arrogant, stupid, insensitive, and rude. So why do some physicians in other countries work so hard and jump through so many hoops attempting to come to America and practice medicine?

Thanks in advance for your sincere answers.

Sorry man, I am really not sure that it was politeness that prohibited you from asking
I think that you should stand by your opinion if you strongly believe in it. No one would be offended if you presented an unbiased, well-documented case about why you think their presence in the US constitutes a contradiction. I think that deep down you know that they would be quite right to dismiss your remarks as irrelevant.
Very few of the media all over the world are proclaiming that the US is Evil.
And this occurs almost exclusively in countries with which the US has some sort of political rivalry (like countries already named Evil by the US president).
The American health system creates certain problems for patients not doctors (doesnt it?) And anyway, is this something believed only by foreigners? Havent you met any Americans who believe that? Are these Americans anti-American? Should they leave? Do they want a change (regardless of what you think the effect would be) in order to hurt the US or do they think a change would actually help? I mean,arent those who face problems under the current system, Americans? How come all these anti-American foreigners are concerned about them? Anyway I am not sure personally if a change is needed and I think that you will find (if you actually ask, instead of making assumptions about their beliefs), that most of non US FMGs are against a change because (unless they come from Canada or maybe Scandinavia) they have witnessed the flaws of their own systems. American opponents of the system tend to be more idealistic about the matter.
Come on, you have probably read that US foreign policy is arrogant. Which large-scale respected media have portrayed Americans in general as stupid, insensitive, and rude? In Britain for example the stupid-American cliche is used for comedy, but this is no different in its nature than other cliches used both in Britain and in the US about lets say the French.
The US foreign and health policies are not the US. While inquiring about that, you should also ask them who their favorite writer is, who is their favorite actor? who is their favorite filmmaker? Who is their favorite musician? What do they think about institutions like democracy, the freedom of the press, the independent justice system?
Not all non-US fmgs stay (their visa is for the most part temporary) .So many know that they might never make big money practicing as specialists in the US. They think that the educational experience alone is worth it and they only end up taking home superior training, not $$. Another great appeal in my opinion is that the US system gives you a relatively fair chance. Sure, you are a 3rd class candidate to begin with, but you know where you stand. If you score high and look like a decent candidate on your interview you know that certain doors will open for you. (This might sound insignificant to you because you take it for granted, but you would be surprised at the lack of such consistency that you might come across in some countries, even ones own)
Finally, it is also a challenge. Certain counties dont have a licensure exam system. If you graduate you are a doctor. So a system that provides a basic evaluation of your skills and knowledge allows you to monitor the quality of your work in med school by international standards. Many instructors encourage their students to get involved in the usmles process specifically for that reason.
Keep an open mind (and thus live up to a positive cliche about Americans I have come across).

 

[Stephen Ewen]

Very interesting discussion. Let me add something to the mix.

Not meant to be guilt manipulation here, as the facts alone are powerful all by themselves:

At about 341 persons per physician in the total US in comparison to, say, 57,000 persons per doc in Burkina Faso, non-US medical practice most definitely has its very good reasons. Many other examples could be given.

Here is a four year old thread (!), now part of SDN's Big Guide, that some might find interesting: http://www.studentdoctor.net/guide/mission/index.html

There are many organizations the world over that facilitate every sort of person imaginable of every persuassion to serve the very underserved of our world, and since this sort of thing is one of my fortes, I like very much discussing it if anyone is game. 🙂

 

[pitman]

Originally posted by Stephen Ewen
Very interesting discussion. Let me add something to the mix.

Not meant to be guilt manipulation here, as the facts alone are powerful all by themselves:

At about 341 persons per physician in the total US in comparison to, say, 57,000 persons per doc in Burkina Faso, non-US medical practice most definitely has its very good reasons. Many other examples could be given.

Here is a four year old thread (!), now part of SDN's Big Guide, that some might find interesting: http://www.studentdoctor.net/guide/mission/index.html

There are many organizations the world over that facilitate every sort of person imaginable of every persuassion to serve the very underserved of our world, and since this sort of thing is one of my fortes, I like very much discussing it if anyone is game. 🙂

Damn, I thought I was well ebugecated, even on the 3rd World, but don't recall every having heard of Burkina Faso (tho' have a vague memory of Upper Volta!).

I will be doing 3rd World medicine, but aside from a few anecdotes and plans to go back to Haiti, I hadn't thought much about logistics. Things are a bit hectic now with xmas and moving to Australia, but I'll soon be milking you, Stephen, for info on routes/programs/etc. -- but aren't you leaving SDN soon for Haiti??

-pitman

 

[gtb]

Back to the original question. What exactly is the appeal of practicing medicine in America.

PTCA's venting had several points I identified.
1.) A direct quote, "the educational experience alone is worth it and they only end up taking home superior training." So from this do others consider American post graduate training to be quite good?
2.) A fair chance to compete based on merit (I'm paraphrasing this one.)
3.) A standardized system of evaluating quality of care through boards and licensure.

 

[Purifyer]

Originally posted by gtb
Back to the original question. What exactly is the appeal of practicing medicine in America.

PTCA's venting had several points I identified.
1.) A direct quote, "the educational experience alone is worth it and they only end up taking home superior training." So from this do others consider American post graduate training to be quite good?
2.) A fair chance to compete based on merit (I'm paraphrasing this one.)
3.) A standardized system of evaluating quality of care through boards and licensure.

Gtb... from just reading your posts... maybe you should be taking these issues up with your local psychiatrist instead of SDN... you sound as though you have some serious issues to work through. Careful though... I hear the field is full of IMGs 😉

 

[gtb]

I'm suprised at the open hostility in response to genuine curiosity. I'm not the least disturbed that people from around the world come to study and to live in the US. And I'm not concerned that somehow my own career success is likely to be diminished by physicians from other countries practicing here. I'm just interested in what makes the US medical system worth all the hassles of USMLE Step 1/2/3, the costs of interviewing, and the hurdles of immigration.

Respectfully curious,
GTB

 

[Miklos]

Originally posted by gtb
Back to the original question. What exactly is the appeal of practicing medicine in America.

PTCA's venting had several points I identified.
1.) A direct quote, "the educational experience alone is worth it and they only end up taking home superior training." So from this do others consider American post graduate training to be quite good?
2.) A fair chance to compete based on merit (I'm paraphrasing this one.)
3.) A standardized system of evaluating quality of care through boards and licensure.

As a USIMG abroad, I have met a number of fellow medical students and physicians from Europe who wish to come to the US for postgraduate training. I would agree that the three points (above) constitute significant reasons why they would want to go through the hurdles required to gain a residency.

As I am familiar with a number of the European healthcare systems, I will elaborate on those. In the Southern and Eastern parts of Europe the healthcare systems (IMHO) suffer from two or three problems:

1) An insane hierarchy, where connections count much more than skills or attitude.
2) Lack of money, especially when it comes to funding postgraduate education or high-tech medicine.
3) An oversupply of bright young physicians earning a pitance.

These factors make the US a very attractive place to pursue postgraduate education, as it is one of the very few places that keeps the door open (somewhat) to FMGs. A motivated FMG with good English skills (another reason, as English is becoming the universal language) who is willing to plunk down some money for USMLE's, ECFMG registration, etc... has a good chance at a residency making much more money than they could back home. Additionally, the skills and knowledge they acquire are widely respected back home and allow them to get a better place in the hierarchy upon returning.

Those coming to the US from Western European countries have similar reasons, except that their health systems (for the most part) operate on a much higher level than the impoverished Southern and Eastern ones.

Interestingly, I have met a number of FMGs who desire to come to the US, though they claim to despise the American system and keep telling me how much better (more humane, etc..) their own country is. (Often, these people have never set foot in the US and all their knowledge comes from the media or rumors!)

My answer to this is quite simple. If that country is so great, why does it not provide decent opportunities to its medical graduates?

BTW, Purifyer: I have met plenty of Kiwi's abroad (mostly in the UK) who have abandoned New Zealand's health system in search of better pay and opportunity.

Miklos

PS I do not think that asking is rude. I think that most FMGs will be quite open with you in telling you about their motivations.

 

[Purifyer]

The above post was meant in jest but I seem to have come across wrong. I was just amused that gtb needlessly repeated out of context some of JTCAs 'post', then seemed to put on the 'innocent act'.

Anyway, sorry if it offended 😉

 

[UCLAMAN]

Originally posted by gtb
I'm a US medical student rotating through clerkships in my 3rd year of medical school. I've encountered a small number of IMGs who have already graduated from their programs and are now performing audition rotations in various hospitals. One question I've wanted to ask is, "Why do you want to practice medicine in the US?" Politeness prohibited me from inquiring in person, so I ask this online instead.

I keep reading and hearing in media that America is the equivalent of evil in the world. That the American healthcare system is inherently cruel in its denial of services for certain individuals. That Americans are arrogant, stupid, insensitive, and rude. So why do some physicians in other countries work so hard and jump through so many hoops attempting to come to America and practice medicine?

Thanks in advance for your sincere answers.

I can't speak for other nations but I'd imagine there are quite a few countries out there in the same predicament. I will compare the Philippines to the US, being Pilipino and having experienced healthcare there.

As bad as things are with out healthcare system it is nothing compared to the philippines. Their hospitals don't even have half the technology and resources we have here. Gloves are hard to come by. My aunt is an ob/gyn there and treats boxes of gloves like gold. In the US I have 4 unopened boxes stashed in my locker for anatomy lab. I use em like water and can ask for more for free if I desire. Ultrasound gel? Also like gold to them. Cheap here. Imagine performing surgery without any suction. Can't see jack. They go through operations without suction in the Philippines because the hospital's suction pump broke and they have no money to get it repaired or purchase a new one. Those are just a few examples. Bottom line...the hospitals are poor.

Training...old school. Med students get crapped on by their superiors. If you think getting pimped in an American med school is bad you would be screwed in the Philippines. Residency programs here pride themselves in how little scutwork they allow their residents to do. If you train in the Philippines, get ready for scutwork galore in addition to being a good physician.

The nation itself is poor. The streets of the US are paved with gold compared to the Philippines. Walk into any supermarket, any Best Buy, and car dealership, any shopping mall. Look around you. 3/4's of the things you see aren't available in the Philippines or are so expensive that only the president can afford it. You want healthcare denial? EVERYONE in the Philippines doesnt have enough money to receive healthcare. The uninsured population here is nothing compared to the percentage of the population there that doesn't receive healthcare and in some cases may have never received proper healthcare. I'm amazed that some people have lived so long without adequate healthcare.

You need to realize how lucky you are to be living in such a great nation, let alone practice medicine in it. Things aren't exactly like this in other parts of the world.

As bad as things may seem here, its really just a drop in the bucket compared to other places. And yes, jumping through all those hoops is well worth the trouble for those who are capable of jumping through them.

 

[redshifteffect]

Originally posted by Miklos
As a USIMG abroad, I have met a number of fellow medical students and physicians from Europe who wish to come to the US for postgraduate training. I would agree that the three points (above) constitute significant reasons why they would want to go through the hurdles required to gain a residency.

As I am familiar with a number of the European healthcare systems, I will elaborate on those. In the Southern and Eastern parts of Europe the healthcare systems (IMHO) suffer from two or three problems:

1) An insane hierarchy, where connections count much more than skills or attitude.
2) Lack of money, especially when it comes to funding postgraduate education or high-tech medicine.
3) An oversupply of bright young physicians earning a pitance.

These factors make the US a very attractive place to pursue postgraduate education, as it is one of the very few places that keeps the door open (somewhat) to FMGs. A motivated FMG with good English skills (another reason, as English is becoming the universal language) who is willing to plunk down some money for USMLE's, ECFMG registration, etc... has a good chance at a residency making much more money than they could back home. Additionally, the skills and knowledge they acquire are widely respected back home and allow them to get a better place in the hierarchy upon returning.

Those coming to the US from Western European countries have similar reasons, except that their health systems (for the most part) operate on a much higher level than the impoverished Southern and Eastern ones.

Interestingly, I have met a number of FMGs who desire to come to the US, though they claim to despise the American system and keep telling me how much better (more humane, etc..) their own country is. (Often, these people have never set foot in the US and all their knowledge comes from the media or rumors!)

My answer to this is quite simple. If that country is so great, why does it not provide decent opportunities to its medical graduates?

BTW, Purifyer: I have met plenty of Kiwi's abroad (mostly in the UK) who have abandoned New Zealand's health system in search of better pay and opportunity.

Miklos

PS I do not think that asking is rude. I think that most FMGs will be quite open with you in telling you about their motivations.

I think it really depends on what motivates u...if it's money then from what I'm hearing the US seems to be the place to go. But there are other countries out there (ex. Canada,Australia even NZ to some extent) where they work less but get a very good pay for that country. I don't really envy US docs at all...u work way more hours than other western countries...

 

[Stephen Ewen]

Originally posted by pitman
Stephen...aren't you leaving SDN soon for Haiti??

On-ground activity in Haiti is on hold for a while with me. I am right now working/living on a Micronesian island and will be for quite some time...and we do indeed have Net access here. 🙂

 

[pitman]

Originally posted by Stephen Ewen
On-ground activity in Haiti is on hold for a while with me. I am right now working/living on a Micronesian island and will be for quite some time...and we do indeed have Net access here. 🙂

Damn you! Living out my fantasies like that...which island, Pohnpei? I'll be in Brisbane soon, hope to do part of my 3rd year in Brunei, and will certainly be exploring micronesia/polynesia/indonesia/malaysia as much as time permits over the next 4 years.

Doin' anthropology work, or missionary?

-pitman

 

[Miklos]

Originally posted by redshifteffect
I think it really depends on what motivates u...if it's money then from what I'm hearing the US seems to be the place to go. But there are other countries out there (ex. Canada,Australia even NZ to some extent) where they work less but get a very good pay for that country. I don't really envy US docs at all...u work way more hours than other western countries...

Redshifteffect,

I do not know how familiar you are with the Canadian health care system and its problems.

First of all, the Canadian physicians work just as much as their counterparts in the US. (The only exception to this might be surgery, where the US system seems to pride itself on working their residents to death.)

As you say, the pay is good once you are a specialist. However, as the taxes are significantly higher than in the U.S., your take home is significantly less. We could argue about quality of life (U.S. vs Canada), but I think that might be a topic for another thread or forum. As is the funding of the health system and the expectation of the Canadian population (US quality health care at a single payer price). Nevertheless, a very significant number of Canadian physicians cross the border in search of better opportunities every year.

Worse, there is a shortage of physicians in Canada, especially in certain specialites and provinces. Instead of addressing the problem as the US does, by keeping the door open to FMGs, especially as far as postgraduate positions are concerned, Canada overtly discriminates against FMGs by only allowing them to compete in the 2nd iteration of CaRMS after having them jump through many hoops as each province sees fit (I will not detail them here. See the CaRMS site at www.carms.ca for details)

Any properly motivated FMG sees through this quite easily. Why spend thousands of dollars to prep for Canadian immigration and Canadian exams, when the match rate in the 2nd iteration http://www.carms.ca/stats/stats2003.htm#imgs2nd was 10.7% last year?

Contrast that to the NRMP, http://www.nrmp.org/res_match/tables/table2_2003.pdf Non-US Foreign Graduates, active applicants matched PGY1 where 55.7% matched and in addition many prematched or scrambled for a position.

Also, consider the raw number of positions attained through the two matching systems. In Canada, a grand total of 67 IMGs matched last year. In the U.S., 2799 Non-US FMGs matched [and that does not count those who prematched or scrambled (2102 positions left unmatched for the scramble); in truth, no such opportunity exists in Canada (28 unfilled positions after 2nd iteration!)] The ratio of successful matches through the programs is nearly 42:1, much more than would be expected based on population differences where the ratio is roughly 10:1.

Though AMGs are preferred to FMGs at the overwhelming majority of U.S. programs; a FMG with command of the English language, good USMLE scores and the motivation necessary to succeed HAS A DECENT SHOT at a good residency in the U.S.

Where else on the planet is this the case?

Re: Australia and New Zealand. I do not know what the situation is 'down under'. However, I repeat...I have met plenty of Kiwi's abroad looking for better pay.

Miklos

 

[redshifteffect]

Originally posted by Miklos
Redshifteffect,

I do not know how familiar you are with the Canadian health care system and its problems.

First of all, the Canadian physicians work just as much as their counterparts in the US. (The only exception to this might be surgery, where the US system seems to pride itself on working their residents to death.)

As you say, the pay is good once you are a specialist. However, as the taxes are significantly higher than in the U.S., your take home is significantly less. We could argue about quality of life (U.S. vs Canada), but I think that might be a topic for another thread or forum. As is the funding of the health system and the expectation of the Canadian population (US quality health care at a single payer price). Nevertheless, a very significant number of Canadian physicians cross the border in search of better opportunities every year.

Worse, there is a shortage of physicians in Canada, especially in certain specialites and provinces. Instead of addressing the problem as the US does, by keeping the door open to FMGs, especially as far as postgraduate positions are concerned, Canada overtly discriminates against FMGs by only allowing them to compete in the 2nd iteration of CaRMS after having them jump through many hoops as each province sees fit (I will not detail them here. See the CaRMS site at www.carms.ca for details)

Any properly motivated FMG sees through this quite easily. Why spend thousands of dollars to prep for Canadian immigration and Canadian exams, when the match rate in the 2nd iteration http://www.carms.ca/stats/stats2003.htm#imgs2nd was 10.7% last year?

Contrast that to the NRMP, http://www.nrmp.org/res_match/tables/table2_2003.pdf Non-US Foreign Graduates, active applicants matched PGY1 where 55.7% matched and in addition many prematched or scrambled for a position.

Also, consider the raw number of positions attained through the two matching systems. In Canada, a grand total of 67 IMGs matched last year. In the U.S., 2799 Non-US FMGs matched [and that does not count those who prematched or scrambled (2102 positions left unmatched for the scramble); in truth, no such opportunity exists in Canada (28 unfilled positions after 2nd iteration!)] The ratio of successful matches through the programs is nearly 42:1, much more than would be expected based on population differences where the ratio is roughly 10:1.

Though AMGs are preferred to FMGs at the overwhelming majority of U.S. programs; a FMG with command of the English language, good USMLE scores and the motivation necessary to succeed HAS A DECENT SHOT at a good residency in the U.S.

Where else on the planet is this the case?

Re: Australia and New Zealand. I do not know what the situation is 'down under'. However, I repeat...I have met plenty of Kiwi's abroad looking for better pay.

Miklos

There is no doubt that Canada isn't perfect...and it's true that Canadians work harder than other countries like Australia but I still dont' think they work as hard as Americans. The amount of work put in by US docs is probably the highest of most other Western countries.

As for Canada and it's physican shortage there is no doubt that Canada has a dire shortage of docs and at the same time they aren't doing enough to recruit FMGs but the reason is that unlike the US they can not afford the residency positions....they simply do not have the money in the public health care system.

Thus they have developed alternate means of recruiting physicans - one such method is being tested in Ontario and involves recruiting licensed physicans who are already established in pratice in other countries to undergo a series of pratical evaluations but no actual written exams and no repeatition of their residency.

So arguably that is a more fair system since it's allowing doctors who have already established themselves in practice the chance to be integrated fairly quickly within the Canadian without having to repeat an entire residency again.

As i said before the US probably has the most fair system to get into as an FMG but that doesnt' mean its' the best place to practice...unless money is the only motivating factor.

Now as for Kiwis i dont' personally know their situation but in general from what i have seen Australians work a lot less than North Americans and they definitely get paid more than Canadians...and they manage to maintain a very good lifestyle. To me that's much more important than any monetary compensation....

 

[Miklos]

Originally posted by redshifteffect
There is no doubt that Canada isn't perfect...and it's true that Canadians work harder than other countries like Australia but I still dont' think they work as hard as Americans. The amount of work put in by US docs is probably the highest of most other Western countries.

I disagree. I have seen the same q4 on-call schedules for med. students, interns and residents and same q8 on-call schedules for attending physicians in Canada as in the U.S. Further, the shortage of physicians, especially rurally and in certain specialties means that those practicing must make up for the shortage.

As for Canada and it's physican shortage there is no doubt that Canada has a dire shortage of docs and at the same time they aren't doing enough to recruit FMGs but the reason is that unlike the US they can not afford the residency positions....they simply do not have the money in the public health care system.

I am sorry, but I don't buy that argument. I understand that certain Canadian provinces are recruiting foreign specialist physicians as they need them due to an acute shortage. These physicians will hit the low six figures (Canadian) immediately.

Conversely, I believe that the salary and benefits paid to a postgraduate trainee (say C$60k/year) is a small drop in the bucket compared to the work they complete during their residency. The hospital system in North America (both US and Canada) depends on their indentured servitude. The easiest way to increase the supply of doctors in the Canadian system would be to strategically increase the number of postgraduate training positions, especially for IMGs. With regard to the Canadian budget problems, I think that is a topic for another thread.

Thus they have developed alternate means of recruiting physicans - one such method is being tested in Ontario and involves recruiting licensed physicans who are already established in pratice in other countries to undergo a series of pratical evaluations but no actual written exams and no repeatition of their residency.

So arguably that is a more fair system since it's allowing doctors who have already established themselves in practice the chance to be integrated fairly quickly within the Canadian without having to repeat an entire residency again.

With regard to this, I have two points.

1) Are you aware of the restrictions placed upon such physicians? I do not know the parameters of the Ontario program, but other provinces do the best they can to limit such physicians to practicing in the hospital and not independently (e.g. where the money is at). Such a system can hardly be considered fair.

2) Most US States and Canadian provinces try to recognize each other's postgraduate training. The countries of the EEC recognize each other's postgraduate training (for the most part). With exceptions few and far between most places will require you to either complete residency or social service if coming from one system to another. I'm not saying it is good, but that is the way it is. In the U.S., established docs can apply to the particular specialty board to have their residency reduced.

As i said before the US probably has the most fair system to get into as an FMG but that doesnt' mean its' the best place to practice...unless money is the only motivating factor.

Now as for Kiwis i dont' personally know their situation but in general from what i have seen Australians work a lot less than North Americans and they definitely get paid more than Canadians...and they manage to maintain a very good lifestyle. To me that's much more important than any monetary compensation....

There is an axiom in politics: "People vote with their feet." Or, if you would like me to put it in another way; Everyone acts in their own perceived self-interest.

Despite what you have said, FMGs come to the U.S. They come like the other immigrants in search of opportunities that are unavailable to them anywhere else. I think that this speaks for itself.

Miklos

 

[FionaS]

Roll on European Working Time Directive...

We may earn less, but we work less too 😀

Or at least, it's slowly getting that way.

I may do some of my training in the US at a much later stage - reason - just like to see what it's like over there. Couldn't ever live there though, your whole philosophy on life just feels wrong(not bad, just wrong for me).

 

[Miklos]

Originally posted by FionaS
Roll on European Working Time Directive...

We may earn less, but we work less too 😀

Or at least, it's slowly getting that way.

I may do some of my training in the US at a much later stage - reason - just like to see what it's like over there. Couldn't ever live there though, your whole philosophy on life just feels wrong(not bad, just wrong for me).

Fiona,

Correct me if I am wrong, please. If I understand your post, you have never been to the U.S., but you pass judgement on the 'whole American philosophy on life'?

Miklos

 

[BellKicker]

Originally posted by gtb
"Why do you want to practice medicine in the US?"

Thanks in advance for your sincere answers.

Short answer: I married one of you guys.

Long answer: It's a nice place with great training. They speak English there, which is a big deal. (I'd have a hard time going to Germany or France or most other places). I'm from a small country and had never intended on staying there my whole career. Who knows where I'd gone if fate hadn't decided for me? More money? I'm still not sure about that one; at least per hour most specialties make more here.

 

[FionaS]

Correct me if I am wrong, please. If I understand your post, you have never been to the U.S., but you pass judgement on the 'whole American philosophy on life'?

Well, I've never worked in the medical system in the US, but I have been to the US a few times. 😉

 

[FunnyLookingKid]

Originally posted by gtb
I'm a US medical student rotating through clerkships in my 3rd year of medical school. I've encountered a small number of IMGs who have already graduated from their programs and are now performing audition rotations in various hospitals. One question I've wanted to ask is, "Why do you want to practice medicine in the US?" Politeness prohibited me from inquiring in person, so I ask this online instead.

I keep reading and hearing in media that America is the equivalent of evil in the world. That the American healthcare system is inherently cruel in its denial of services for certain individuals. That Americans are arrogant, stupid, insensitive, and rude. So why do some physicians in other countries work so hard and jump through so many hoops attempting to come to America and practice medicine?

Thanks in advance for your sincere answers.

this is a great post. number one it illustrates the absurdity of the printed media. anybody that writes that the USA is the "evil of the world" is the equivalent of an anencephalic, or a liar.
Where do you read this?

I have the perspective of an American that attended a caribbean school, and worked in England ( well I did my 3rd year of med school there, not worked---but I saw how it worked)
I have a lot of respect for the British doctors, and their abilities. They are some really really smart people. However, their system is dysfunctional.
If you want to be a surgeon, the odds are stacked against you !
Talk about indentured servants
Man--first do a year or more of house officer jobs--where you might be little more than a glorified medical student/ nurse assistant/lab tech.
An IV falls out in the middle of the night--call the "house dog" to restart it. Forget that crap !
I mean talk about meaningless scut ! Drawing freaking pre-op labs ( and running them to the lab )
What a total waste of your degree. Not to mention the pay is so rediculously low that most house officers live in paltry on-site housing the equivalent of a college dorm room.
Then you work for several years climbing up the ladder, passing some REALLY difficult exams.
I knew an Iraqi guy that was working there. Brilliant!
But he wasn't British and they kept failing him on the oral portion of the part 2 of the Membership exam. I know there is bias in who passes and who fails.
Then you basically have to wait for somebody to die or for them to build a new job, to get a job as a consultant ( attending )
I worked with a number of Irish docs, when I was a neonatal fellow. They were on faculty at a US medical school. Had lots of great publications ( had also worked for years at various Irish and British hospitals before coming to America and doing a fellowship ) and there were maybe 1 or 2 jobs opening up a year in Ireland for a neonatologist ! ( somebody either retired or died )
----and the job usually went to somebody that they knew. Screw qualifications. Nepotism is king

so that's the job market angle.
Then there is the money in America as well as the quality of life which we are used to

I am not trying to sell life in America to anybody. By the numbers of people waiting in line to come here and work, I think the answer is obvious.

IMO, the training programs for residents and fellows is superior to any other place on earth in terms of the comprehensive nature and speed of the training programs that we have here.
you can also achieve autonomy and freedom to work where and how you want like no other place on Earth.

 

[Miklos]

Amen.

 

[theodore]

Just to steer things up a bit, I'd like to make a couple of remarks.
First of all, I don't think that you have to have lived in a country in order to judge it, or possibly put a general label on it. For example, do I have to have been in the States to know that the lifestyle of residents is totally hectic? No, because I DO know that when you have to work for 86,or 90, or 100 hour weeks, you have hardly anytime for doing anything but sleeping. Plus, I know that 90% of the American students in my school do NOT want to return to the States, simply stating that "life is much better" in Europe. As for the waiting lines, I can tell you (and I 'm a living example of that) that the main reason people come to the States isn't money. It's a lack of alternatives(as in my case),or the desire to learn medicine in the Mecca of medicine. Money can be a factor only when you have serious reasons to stay in the States after your training(which anyway is exceptionally difficult nowadays). They're not taking FMG'S just for taking them. These are people that have passed hard exams,will work very hard, and will get paid virtually nothing. Don't tell me that getting 2000-2500$ per month (about half of which will go for the rent) for 14 hour days is a good deal,bc it's not.
Where do I see that America is the mother of all evil? Nowadays, I read it everywhere. The critical point here is to isolate American foreign policy from the American public's view on that matter. I can't put the public and the government on the same side, when I see for example the former deciding on a war, and the latter expressing its opposition with some of the greatest demonstrations worldwide. Human beings are very sensitive to power, and they tend to misuse it when they have too much of it. The race doesn't matter, as long as there are 46 chromosomes and a lot of power,99% of the cases, this power will be misused.
I sensed a hint about racial issues in the UK. Well,I'm sure that many Middle East citizens aren't even given the chance to step foot on US ground despite having passed the necessary examinations. I know of a couple of personal examples. And a couple of weeks ago,the American authorities decided that Greek citizens (the only ones among EU citizens) are required to give fingerprints and be photographed upon entering the US. All this in the name of terror prevention, with which I , as a Greek citizen, have absolutely no connection, either geographically or politically or ideologically (for those who don't know, the trial of the only terrorist organization we had in Greece was completed just last month. Let alone that they had 20 victims in 30 years of action, compared to the 3000 of the 9-11, or that half of the murders were of political nature, with victims directly or indirectly involved in the survival of the junta in Greece in the 70's,compared to the totally random victims of 9-11). Up to now, I thought that the relationships of two countries were based on the formal position of their governments, but in this case we have a pro-American government being asked to give firgerprints and photos of its citizens.What I mean is that every event has two sides, and learning about just one of them can't give the whole picture. I'm not more against the Iraq war than I am against Alexander the Great's invasion in Asia "in the name of civilization". Who asked these people if they wanted to become "civilized"? If an "x" person kills a "y"person bc "y" killed "x"'s father,who had killed"y"'s mother, who's right and who's wrong -if you can say there's any right in killing someone?
And forgive me, but I,as a Greek, can't take advice about human rights and the value of human life and about terrorism from someone that establishes the legal of death penalty,or faces criminality by giving everyone the right to carry guns. Seriously, are there people that believe that the only way to prevent harm is by giving the ability to harm back??

 

[Miklos]

Originally posted by theodore
Just to steer things up a bit, I'd like to make a couple of remarks.
First of all, I don't think that you have to have lived in a country in order to judge it, or possibly put a general label on it. For example, do I have to have been in the States to know that the lifestyle of residents is totally hectic? No, because I DO know that when you have to work for 86,or 90, or 100 hour weeks, you have hardly anytime for doing anything but sleeping. Plus, I know that 90% of the American students in my school do NOT want to return to the States, simply stating that "life is much better" in Europe.

Theodore,

I think that your premise is wrong. Let me tell you where I see a clear difference between Europe and the U.S.; medical students, as well as interns and residents in the States are given much more responsibility than their equivalents in Europe (and thereby are able to learn). Yes, North American students/interns/residents work more hours (up to 86 hours/week averaged) than their European equivalents (limited to 56 hrs a week as of this year in the EU), however they are also part of a team providing medical care. In Europe, students/interns/residents spend a lot of their time either doing pure scutwork better suited to nurses or spending their time kowtowing to their professors, both of which are pure wastes of time. The feudal medical hierarchy is alive and well in Europe. In North America, it is a rarity, as people don't have time for it. As you haven't been in the U.S., you simply don't know, because there is only one way to find out.

As far as 90% of Americans not wanting to return, I have a hard time believing that...

As for the waiting lines, I can tell you (and I 'm a living example of that) that the main reason people come to the States isn't money. It's a lack of alternatives(as in my case),or the desire to learn medicine in the Mecca of medicine. Money can be a factor only when you have serious reasons to stay in the States after your training(which anyway is exceptionally difficult nowadays). They're not taking FMG'S just for taking them. These are people that have passed hard exams,will work very hard, and will get paid virtually nothing. Don't tell me that getting 2000-2500$ per month (about half of which will go for the rent) for 14 hour days is a good deal,bc it's not.

Gross income for an intern is $37,000 a year. A pittance, I agree, as take home is around $2,500 a month. Spending $1,200 a month on rent though is excessive in most parts of the country (outside of NYC, Boston, San Francisco, Chicago and other overpriced areas). BTW, the pay of a junior UK house officer is roughly the same by direct currency exchange. But, the prices for everything are much higher in Britain. Also, once you receive your license in the US during your residency, you have the chance to 'moonlight' (earn money on the side). You can't do that in the UK (only one employer). However, your point is valid. Though, were else will an FMG have a chance to get a first rate post graduate education? Also, an FMG can get board qualified in record time compared to other places. Re: staying; Please remember that it is even more difficult for an American to get a work permit in Europe and I will not mention how difficult it is for an American to try and get post graduate education in Europe. Bottom line is that the U.S. is the most welcoming place for FMGs.

Where do I see that America is the mother of all evil? Nowadays, I read it everywhere. The critical point here is to isolate American foreign policy from the American public's view on that matter. I can't put the public and the government on the same side, when I see for example the former deciding on a war, and the latter expressing its opposition with some of the greatest demonstrations worldwide. Human beings are very sensitive to power, and they tend to misuse it when they have too much of it. The race doesn't matter, as long as there are 46 chromosomes and a lot of power,99% of the cases, this power will be misused.

Typical knee-jerk European anti-americanism. Truth is that Europe is geo-politically weak, and weakness corrupts just as much as power. Europe cannot intervene anywhere, so it resorts to appeasement and carping. One of the bloodiest dictators has been removed from power with a minimum loss of life. What do Europeans do? Complain...

I sensed a hint about racial issues in the UK. Well,I'm sure that many Middle East citizens aren't even given the chance to step foot on US ground despite having passed the necessary examinations. I know of a couple of personal examples. And a couple of weeks ago,the American authorities decided that Greek citizens (the only ones among EU citizens) are required to give fingerprints and be photographed upon entering the US. All this in the name of terror prevention, with which I , as a Greek citizen, have absolutely no connection, either geographically or politically or ideologically (for those who don't know, the trial of the only terrorist organization we had in Greece was completed just last month. Let alone that they had 20 victims in 30 years of action, compared to the 3000 of the 9-11, or that half of the murders were of political nature, with victims directly or indirectly involved in the survival of the junta in Greece in the 70's,compared to the totally random victims of 9-11). Up to now, I thought that the relationships of two countries were based on the formal position of their governments, but in this case we have a pro-American government being asked to give firgerprints and photos of its citizens.What I mean is that every event has two sides, and learning about just one of them can't give the whole picture.

Greece has completely lost control of its borders and no Greek government seems to want to do anything about it. Guess what? As a consequence, the U.S. requires visas of Greek citizens. Greece is not eligible for the Visa Waiver Program, until it does something about its borders. Stop complained about the U.S. and complain to the Greek government.

The fact that you support a terrorist organization is scary...especially when you read your next paragraph.

I'm not more against the Iraq war than I am against Alexander the Great's invasion in Asia "in the name of civilization". Who asked these people if they wanted to become "civilized"? If an "x" person kills a "y"person bc "y" killed "x"'s father,who had killed"y"'s mother, who's right and who's wrong -if you can say there's any right in killing someone?
And forgive me, but I,as a Greek, can't take advice about human rights and the value of human life and about terrorism from someone that establishes the legal of death penalty,or faces criminality by giving everyone the right to carry guns. Seriously, are there people that believe that the only way to prevent harm is by giving the ability to harm back??

As the Romans said: "Si vis pacem, para bellum!"
Human nature hasn't changed, I am afraid.

IMHO, there is a war between Islamic fundamentalists and the West. I know which side I want to win. As a Greek, you should as well. Or would you care for a return to Islamic rule? After all, Greece only regained its independence pretty recently.

With regard to the American legal system, it is something for better or worse unique to America. However, I will give you a justification for using the death penalty: the Soham murders in Britain.

 

[IMGforNeuro]

hi guys,
Lets come to the main topic as to why IMGs come to the US.
I am from India just like most foreign born med grads so i can certainly give reasons why IMGs like me come to the US.
Let me start by saying that the US is the most liberal country to accept foreign doctors.
In India there are over 100 med schools. The competition to get residency is immense , something like 40 or 50 to one spot.
Many people who are unable to compete the residency spots try the usmle . There are many who get lured into usmle for the 'glamour ' aspect of a US residency which has a lot to do with discovery channel. Many people come here for MONEY. There are many who are pursuing int med or peds in India and come to the US to do these residencies. Majority people who compete and get surgical or competitive fields do not come here because the quality of residency training in India , believe me is equal to the best in any part in the world. There is great patient exposure and clinical variety. The institute i was pursuing my neurosurg residency , AIIMS is among the best in asia and has every expertise in every field and there are many other such places. It was only when i came to the US that i compared residency training in both countries. This goes without saying that every country has outstanding , good , average and bad med schools.
I have now concluded that med education and residency is almost equal everywhere. The US is lucrative because of standard of living. But doctors in India too have a very good life. Many FMGs from India realize this when they come to the US and then compare.
Most people who come here from my country , do so for int med or peds , etc.
There are many who are not able to get residency in india and try to get it in the US of course in places as bronx.
WHY don't these people go back? Firstly because they have to move back to a different system which adds to the struggle. These people have already struggled to jump from one system to the other and a similar attempt will be difficult. Some of these people who have had good subspeciality fellowships are able to move back . But any person without subspeciality exposure will find it difficult because people trained there are very smart and have a lot of clinical exposure.
Then many of these also realise that their residency training will get them a job in primary care here , whereas in India they will have to compete with many others.
Finally i would like to add that surgical subspecialities are very good in india with much less malpractice liability.
HOWEVER , I respect america for its liberal atmosphere , but i also have respect for many of my colleagues in india for their capabilities and job satisfaction.
Just to bring to your notice that many surgical specialists perform a greater variety of procedures there and also make good money.
Most neurosurgeons in US do not perform many procedures because of liability issues whereas in India they do a greater variety of procedures.
With the recent surge in economy and insurance sectors they are likely to flourish. The Apollo group of hospitals is the third largest health care system in the world and the largest outside the US.
Now regarding the overall health sector , it goes without saying that the US has a much bigger healthcare sector , also because of the insurance.
This is the broad picture of nonUS FMGs from India.

 

[theodore]

Miklos my friend, you are quite well informed,but u r missing a couple of important points. I highly doubt that asking for fongerprints-photographs has anything to do with Greece's questionable borders. It's clearly because Greek terrorism was ended just recently, and some its victims were American citizens(mainly officials). But if it did have anything to do with that, the last government that should punish Greece for that is the US government. Especially after Clinton's public statement that he feels sorry for the American support of the Greek Junta, a fact that couldn't be more directly involved in the invasion of Cyprus and the Turkish occupation that followed since then. Or the endless support Turkey has enjoyed from the US on pretty much every issue, just so they keep giving to the US a way to the Middle East. You have to understand that the weapons industry is one that has a huge impact on the American industry and the American foreign policy. These are people that rule goverments and end governments, if they want to. And it does hurt me as a Greek citizen that my country has to give around 10% of its GDP(3 times more than the European average), just bc it happens to be next to one of US's favorite pals.
I don't want an Islamic rule. I don't want an American rule. I don't want a European rule. And I mainly don't want war. The more concetrated the power is, the higher the chances are for going into wars(bc the strong side won't risk much). The more distributed the power is, the less the chances for going into war (because noone will risk going against an opponent about as strong as he is). I don't believe any huge power is a benign power, as American politicians are claiming for America. When a single country with 5%of the planet's population is spending in military equipment as much as the rest 95% of the planet put together, you figure what may happen if this power falls in the wring hands (if it's not in the wrong hands already).
As for the Indian friend, he said more or less what I said. Money is one of the reasons one would go to the US, but it s for sure not the only, and in some cases not even the main reason.

 

[Miklos]

Miklos my friend, you are quite well informed,but u r missing a couple of important points. I highly doubt that asking for fongerprints-photographs has anything to do with Greece's questionable borders. It's clearly because Greek terrorism was ended just recently, and some its victims were American citizens(mainly officials).

Theodore,

With regard to the visas, I am afraid you are mistaken. Greek citizens have required visas to the U.S. for as long as I can remember. I believe that Greece, even after entry to the EU, did not receive visa waivers.

For participation in the visa waiver program see http://travel.state.gov/how_a_country_qualifies.html

Several issues with Greece pop-up...

Passport security

A country must have a machine readable passport (MRP) program in place in order to qualify for VWP participation.
In addition, VWP candidate countries must demonstrate that adequate safeguards against fraudulent use of their passports are in place, including proper storage of blank passports and sufficient screening of passport applicants.
Consideration will also be given to the ease with which host country citizenship can be obtained.

Border controls

VWP candidate countries must demonstrate that effective border controls are in place for all territory under their control.
Factors taken into consideration include the thoroughness and consistency of entry checks as well as the extent to which the country's territory is used as a transit point for alien smugglers.

Law-enforcement cooperation

The degree to which host country law enforcement agencies cooperate with U.S. counterparts as well as international entities such as Interpol will be considered.
The Attorney General, in consultation with the Secretary of State, must evaluate the nominee country's interest in enforcement of U.S. immigration laws, and the existence and effectiveness of extradition agreements with the U.S., including extradition of its own nationals who violate US laws.
The Attorney General must submit a report to Congress on the country's qualification for designation that includes an explanation of a favorable determination.

Security concerns

Any security concerns that could be raised by a country's admission into the VWP program will be considered.

Please don't be insulted, but I think that Greece flunks the following tests:

-Passport Security. I have heard from Greeks that countries outside the EU scrutinize their passports and even make them take language tests to prove that they are Greek. This makes me doubt the security (and ease) by which Greek passports are obtained.

-Border Controls. I think we both agree that there is precious little of this in Greece.

-Law enforcement cooperation. Until the 17 November terrorists were finally caught, there was precious little. It seemed that the terrorists had "protection" from someone in the Greek government.

-Security Concerns. I hope that the Olympics succeed, but I would not put any money on them.

I think that you should seriously take a closer look at what the Greek government is (not) doing, before placing the blame on the U.S.

Re: Greece v. Turkey. I think that this is a discussion best left for another forum. I hope that the two sides will someday begin to cooperate, but the only thing they seem to agree on is that everything is the fault of the U.S. This, in spite of the fact that they have a history with each other that predates the states by a couple of hundred years, or that their cultures (apart from language and religion) have many similarities. Well, we shall see what happens in Cyprus.

Miklos

 

[theodore]

I m not talking about the visa demands., I m talking about the Greek citizens being the only in the EU to be asked for fingerprints-photogrtaphs upon entering US.
Passport control: Greece is the land of opportunity in the Balcans. This is the reason Greek passports are so popular,and at the same time so suspicious, wherever you go. I was in Croatia last year, along with my American gf and two Norwegian friends. The clerks at the borders only glanced at the outside of my company's passports,while at the same time they checked mine inside out three times. They told me the reason is the one I mentioned above. Not that we can't do anything about it, but at least it's not that we are considered dangerous.
Border controls: I don't think Greece has less control of its borders than the average European country. W

 

[theodore]

Especially if you consider that the whole Balcans want to migrate there. We have 1 million of immigrants working and living in Greece, at a time that the Greek population is just 10 million.
Law enforcement: I could rumble about the reasons behind 17N's longevity for hours. Let's just mention that this was a group of 15 people, while in neighbouring Italy there was a multithousand organization, which in fact is still alive and well. I didn't see any restrictions upon Italian citizens, so this can't be used as an excuse.
Security: This is why the "preemptive strikes"that Bush is rumbling about is a bad thing. In the post Iraq era, any country can be faulted without evidence for harbouring terrorists. Greece has done everything possible to prevent terrorist actions during the Olympics. But we have to understand that when someone is willing to give his life for killing a couple of others, we can't possibly prevent it from happening. Give a solution to these people's problems(for starters, give a solution to the palestinian issue) and they will stop commit suiciding. Now you tell me, if a crazy radical islamist decides to bathe with gasoline and puts himself on fire next to a gas station in a major traffic road, what can u do to prevent it from happening, and most impotrtantly, can u be blamed as a partner in his action?
Greece VS Turkey: I don't have to say much. If I have to defend my country on that, then all sense of democracy and peace is gone, and I don t want to believe that this is happening. Clinton, still being president admitted US involvement in the Greek junta. Cyprus was free and for absolutely no reason and without any warning it was occupied next day and ever since with US blessings. One UN resolution was enough for US to justify attack to Iraq(and it did, even without that one resolution!!), but there are 30 something resolutions condemning the Turkish occupation in Cyprus and yet nothing is done. This is the ultimate double standard, hypocritic behaviour. So no, not everything is US's fault, but on this matter, it's nothing but US's fault. They created the mess, and for 30 years they've been supporting it.

 

[Miklos]

Originally posted by theodore
I m not talking about the visa demands., I m talking about the Greek citizens being the only in the EU to be asked for fingerprints-photogrtaphs upon entering US.
Passport control: Greece is the land of opportunity in the Balcans. This is the reason Greek passports are so popular,and at the same time so suspicious, wherever you go. I was in Croatia last year, along with my American gf and two Norwegian friends. The clerks at the borders only glanced at the outside of my company's passports,while at the same time they checked mine inside out three times. They told me the reason is the one I mentioned above. Not that we can't do anything about it, but at least it's not that we are considered dangerous.
Border controls: I don't think Greece has less control of its borders than the average European country. W

Theodore,

Re; Visa. It is the same thing. Unless Greece as a country (!)participates in the Visa Waiver Program, its citizens as well as all other those of all other countries that do not participate in the VWP must be fingerprinted. I cannot explain it any better than that. Call your elected representatives and ask them why Greece does not participate in the VWP.

Re; passports. Au contraire. If Greece easily (or corruptly) issues passports, every Greek passport bearer will pay the price...

Re; border controls. No other EU country has as many illegal immigrants as Greece by population percentage...how many of those 1m immigrants are legal?

Miklos

 

[Miklos]

Originally posted by theodore
Especially if you consider that the whole Balcans want to migrate there. We have 1 million of immigrants working and living in Greece, at a time that the Greek population is just 10 million.
Law enforcement: I could rumble about the reasons behind 17N's longevity for hours. Let's just mention that this was a group of 15 people, while in neighbouring Italy there was a multithousand organization, which in fact is still alive and well. I didn't see any restrictions upon Italian citizens, so this can't be used as an excuse.
Security: This is why the "preemptive strikes"that Bush is rumbling about is a bad thing. In the post Iraq era, any country can be faulted without evidence for harbouring terrorists. Greece has done everything possible to prevent terrorist actions during the Olympics. But we have to understand that when someone is willing to give his life for killing a couple of others, we can't possibly prevent it from happening. Give a solution to these people's problems(for starters, give a solution to the palestinian issue) and they will stop commit suiciding. Now you tell me, if a crazy radical islamist decides to bathe with gasoline and puts himself on fire next to a gas station in a major traffic road, what can u do to prevent it from happening, and most impotrtantly, can u be blamed as a partner in his action?
Greece VS Turkey: I don't have to say much. If I have to defend my country on that, then all sense of democracy and peace is gone, and I don t want to believe that this is happening. Clinton, still being president admitted US involvement in the Greek junta. Cyprus was free and for absolutely no reason and without any warning it was occupied next day and ever since with US blessings. One UN resolution was enough for US to justify attack to Iraq(and it did, even without that one resolution!!), but there are 30 something resolutions condemning the Turkish occupation in Cyprus and yet nothing is done. This is the ultimate double standard, hypocritic behaviour. So no, not everything is US's fault, but on this matter, it's nothing but US's fault. They created the mess, and for 30 years they've been supporting it.

Theodore,

I'm not going to pick up the debate on this one. I think that it is best if we agree to disagree.

Miklos

 

[theodore]

I agree. And I coud accept being wrong (partlly or completely,doesn't matter) for any of the topics you brought up, except for the Cyprus issue. Because it's just way wrong.

 

[PTCA]

Originally posted by Miklos
Theodore,

With regard to the visas, I am afraid you are mistaken. Greek citizens have required visas to the U.S. for as long as I can remember. I believe that Greece, even after entry to the EU, did not receive visa waivers.

true,
My concern is slightly different. Is the distinction between countries requiring a visa and countries not requiring one, valid anymore?Quite a few EU citizens are held in guantanamo as terrorism suspects (all of non visa requiring nationalities). Quite a few of the 9-11 terrorists flew, resided, and studied in the EU and europe in general. I think that the US should check all nationalities or none at all.

Originally posted by Miklos

Please don't be insulted, but I think that Greece flunks the following tests:

-Passport Security. I have heard from Greeks that countries outside the EU scrutinize their passports and even make them take language tests to prove that they are Greek. This makes me doubt the security (and ease) by which Greek passports are obtained.

Not exactly, the issue is not the ease by which the passport is obtained. Greek passports were until recently easy to forge ( that type is still in circulation and are particularly popular within the eastern European organized crime circuit). I think this is truly the main problem.

Originally posted by Miklos

-Security Concerns. I hope that the Olympics succeed, but I would not put any money on them.

Well other Americans have! I understand that. Australians, Americans and Israelis have undertaken the contracts for the security of the 2004 Olympics. So a potential failure would hardly be solely a Greek one.

Originally posted by Miklos

-Border Controls. I think we both agree that there is precious little of this in Greece.

Greece is a gateway for illegal immigrants in Europe. I understand that the problem is not negligent controls at the borders. The main issue is that the island complexes are hard to inspect. So there is a lot of border hoping going on, just like along the US-Mexican borders. The control for those who actually cross the borders legally is regulated and inspected by the EU, so it cannot be exceptionally negligent. (I think about 80% of Greece?s 1 million immigrants have now a legal work permit. I guess that they mast have been subjected to some sort of control and background checks before they were granted this recognition.)

Originally posted by Miklos

-Law enforcement cooperation. Until the 17 November terrorists were finally caught, there was precious little. It seemed that the terrorists had "protection" from someone in the Greek government.

I read recently about this in the British press. The general belief in the British media seems to be that there was mutual distrust between Greek authorities and the CIA rather than intentional non-cooperation. The Scotland Yard became involved after the group assassinated a British diplomat and they imply that their intervention actually solved this. The Greek authorities had in fact, in the past, persecuted suspects that the CIA had fingered, but there were no convictions as the evidence available was insufficient. The Greek government accused the CIA of providing inaccurate info and the CIA accused the Greek government of lack of political will to crack down on the group. The British intelligence preety much uncovered the actual perpetrators. The only one of those arrested in the recent crack down, who had been recognized by the CIA in the past, was reacquitted.

 

[deleted36260]

Originally posted by Purifyer
Honestly the only reason I would want to touch the US with a 10 foot barge poll would be i) Money.

Other reasons medical graduates from 1st world countries might have (imo)

- dissatisfaction with country of origin (eg. social policy, racial issues, personal issues[eg. break up with fiance, divorce, parental death])
- some perception that it is easier to actually become a specialist/doctor in the US compared to their home country.
- perhaps some americo-philes feel that the US is the hub of medical knowledge
- Brain drain - some people simply feel that the grass is greener on the other side.
- Life plans... eg. married to an American

I love the passive American hate on this board. Perhaps some would simply like to live here 🙂

 

[theodore]

By the way, I just happened to see Tenet saying that the CIA never claimed to the US government that there was clear evidence of WMDs in Iraq. And G.W saying that "we didn't find what we expected to find". Just bc I brought up the issue of "benign power" in one of my posts... They guy has done the damage, I hope that at least the American public will sent him back to his ranch. Go go J.F.K!!

 

[deleted36260]

Originally posted by theodore
By the way, I just happened to see Tenet saying that the CIA never claimed to the US government that there was clear evidence of WMDs in Iraq. And G.W saying that "we didn't find what we expected to find". Just bc I brought up the issue of "benign power" in one of my posts... They guy has done the damage, I hope that at least the American public will sent him back to his ranch. Go go J.F.K!!

Wrong thread buddy.

 

[Purifyer]

Originally posted by phatmonky
I love the passive American hate on this board. Perhaps some would simply like to live here 🙂

I try to restrain my complete disdain for America as I believe it is impolite to discuss such views in mixed company. Sometimes I let slip 😉

My post was a brutally honest reflection of my opinions however, and if you removed the subjective intonation, it is completely fair and true as well.

As for wanting to live in the US? As I said, the only reason I would want to would be money. I felt sympathy for America, along with the majority of the world on September 11. It amazes me that in the space of two years the country has succeeded in turning world opinion completely against it.

But I try very, very hard to realise one point. For every overbearing, completely ignorant American that quite frankly gets what they deserve from the muslim world, there are ten perfectly decent people who swear under the same flag.

 

[BellKicker]

Originally posted by Purifyer


I felt sympathy for America, along with the majority of the world on September 11. It amazes me that in the space of two years the country has succeeded in turning world opinion completely against it.

So true. On 10-11 the big French Newspaper Le Monde had one message on their front page in massive letters:

"We are all American"

I've never had that many people talk to me that day, saying how bad they felt, wanting to know how my relatives dealt with it. I'm not even American, my wife is (and 50% my kids).

Two years later I tell everyone my wife is Canadian. Seriously. I'm so sick of the negative reactions and predictable arguments.

 

[deleted36260]

Originally posted by BellKicker


Two years later I tell everyone my wife is Canadian. Seriously. I'm so sick of the negative reactions and predictable arguments.

That's such a shame that the Canadians are now going to get credit for, what I'm sure is, your lovely wife.

 

[BellKicker]

LOL. Yeah, we're really influencing geopolitical coolness with this.