Why practice in the USA?

[Miklos]

---

Members do not see this ad.

Spidey,

I have often visited Canada. Actually, I'm quite fond of the place. (Though it isn't too fond of IMGs)

Nevertheless, I have recently found a pretty strong streak of anti-Americanism. This, despite of American and Canadian similarities.

I am quite aware of the meaning of satire, thank you very much. 😉

Steyn (or the author of the letter) was making fun of the prevalent anti-American attitude present in Canada (especially among the left wing elite). I can't find the entire text at the moment, but it ends with something like: "Do you know how I can get a green card?"

I simply wanted to use the article to point this out to Theodore:

Despite all the left-wing European rhetoric denouncing the US, many Europeans go to great length to get that green card.

Miklos

 

[theodore]

..which brings me up to a previous post of mine: I-and everyone else- reserve the right to argue on a certain country's foreign policy choices, without having to hate the country's population. And I stand by that. I disagree with most of my government's decisions on a daily basis, and I will understand anyone that does the same. I'm sure this doesn't mean I hate Greece, does it?

Bw, I have no intention to become a permanent US resident, but this isn't because of the people, but because of other factors. But this is for another conversation, titled "why train in the States but not stay there for life?"

 

[Spidey]

Originally posted by Miklos

Nevertheless, I have recently found a pretty strong streak of anti-Americanism. This, despite of American and Canadian similarities.

It is fairly common to hear Canadians rag on Bush, but I hope you aren't taking that criticism as anti-americanism so much as anti-Bushism 😛 Most of us (not all) are aware Bush's decisions do not reflect the attitude of all americans.

Once Bush is voted out of office I think you'll find the anti-americanism in many countries will drop considerably.

 

[theodore]

You said it all. I couldn't agree more with you.

 

[Miklos]

Originally posted by theodore
..which brings me up to a previous post of mine: I-and everyone else- reserve the right to argue on a certain country's foreign policy choices, without having to hate the country's population. And I stand by that. I disagree with most of my government's decisions on a daily basis, and I will understand anyone that does the same. I'm sure this doesn't mean I hate Greece, does it?

Bw, I have no intention to become a permanent US resident, but this isn't because of the people, but because of other factors. But this is for another conversation, titled "why train in the States but not stay there for life?"

Theodore,

I had a conversation with an immigrant (very nearly "fresh off the boat") in the U.S. pretty recently.

The guy was a well educated professional who came to the U.S. to work in the high tech sector. He got an H1B visa due to the company's sponsorship along with what most people would consider a very good job. He spent much of the evening bashing the U.S., the president, corporations and American institutions. Went on to call the U.S. foreign policy neo-imperialistic, etc...

So, when I had enough, I politely asked him why he does not leave the country that he so hates and "votes with his feet".

His response: Dead silence....

A piece of advice, if I may. Once you get your residency in the U.S., I would stay away from discussing two subjects unless you know the other party very well: Religion and Politics.

Miklos

 

[Miklos]

Originally posted by Spidey
It is fairly common to hear Canadians rag on Bush, but I hope you aren't taking that criticism as anti-americanism so much as anti-Bushism 😛 Most of us (not all) are aware Bush's decisions do not reflect the attitude of all americans.

Once Bush is voted out of office I think you'll find the anti-americanism in many countries will drop considerably.

Whether you like Bush or not (I don't), Canadians and Europeans alike must come to understand that the job of the U.S. president is to protect his people. No one else, period.

The rest of the world does not get to vote in U.S. elections.

 

[BellKicker]

Oh sure, if this was 14th century Europe.

The leader of the free world has a larger responsibility than just tending to his own country.

 

[neilc]

a larger responsibility, yes. but, his people come first, far ahead of all others. i totally agree with that. bush's job does not directly depend on what the rest of the world thinks about him. and, in fact, the US as a whole generally don't care what the rest of the world thinks. so, as a leader, you can see that his motivation is to make those who vote happy.

but, bush is a weenie. and, i am happy that there appears to be some hope that he will get the boot. a year ago i was sure that this clown would be around for a long time. but, just like his father, he has pretty much blown it for himself. beautiful!

 

[Miklos]

Originally posted by BellKicker
Oh sure, if this was 14th century Europe.

The leader of the free world has a larger responsibility than just tending to his own country.

BK,

I think that we are narrowing down to the source of the friction between the US and some of the 'free world'.

Europeans, especially Western Europeans, feel entitled to a voice in U.S. affairs, as they feel that the American hyperpower (to use a French phrase) affects them more than their own government.

Why?

1) Military might. (No commment necessary)
2) Financial powerhouse (Much of the reason behind the creation of the Euro, as a counterbalance.)
3) R&D/Advertising behemouth (How many products that you use, in someway originated in the U.S.? Hint: What OS runs your machine at this moment?)
4) Cultural superpower. (c.f. those things that Theodore posted about, munching his Big-Mac, drinking his Coke, wearing his Levis, etc..)

As a result, this rankles them.

I believe that Europe is going 'down hill' with the foot stuck on the accelerator. I think that Europeans are increasingly aware of this as well. The good old days of social services for everyone are over, as Europe is essentially being depopulated by demographics. We've discussed my notion of how economics (doesn't) work in Europe.

Now, what would make you more angry than the following scenario:

The situation you've come so accustomed to (the welfare state) is under increasing threat, the US President does whatever he feels like without consulting your leadership (thereby dimishining your importance) and day by day, US power continues to grow as the US has the most dynamic economy on the planet.

What is the average Western European to do?

IMHO, he/she reflexively blames the US.

As Neil points out, Bush simply makes things worse through his (lack of?) style.

Unless Europe can come to grips with the fact that it is no longer the central geopolitical question on the planet (Thank God for that; two WWs were enough!) and that it is increasingly falling behind the times, the US/Western European animosity will continue no matter who is US President.

Miklos

 

[BellKicker]

I agree and I don't.

It's just that in world affairs, what's good for one free, westernized country is usually good for all of them.

I think it's a non-argument to say that Iraq was good for America and not for, say, Canada. That it was good for England but not for Germany. Good for Poland, bad for the Czech Republic, Good for Denmark bad for Sweden.

Iraq could be the best thing that ever happened in the Middle East. Problem is we won't know for 10 years, at least.

 

[BellKicker]

Originally posted by Miklos
BK,

I think that we are narrowing down to the source of the friction between the US and some of the 'free world'.

Europeans, especially Western Europeans, feel entitled to a voice in U.S. affairs, as they feel that the American hyperpower (to use a French phrase) affects them more than their own government.

Why?

1) Military might. (No commment necessary)
2) Financial powerhouse (Much of the reason behind the creation of the Euro, as a counterbalance.)
3) R&D/Advertising behemouth (How many products that you use, in someway originated in the U.S.? Hint: What OS runs your machine at this moment?)
4) Cultural superpower. (c.f. those things that Theodore posted about, munching his Big-Mac, drinking his Coke, wearing his Levis, etc..)

As a result, this rankles them.

I believe that Europe is going 'down hill' with the foot stuck on the accelerator. I think that Europeans are increasingly aware of this as well. The good old days of social services for everyone are over, as Europe is essentially being depopulated by demographics. We've discussed my notion of how economics (doesn't) work in Europe.

Now, what would make you more angry than the following scenario:

The situation you've come so accustomed to (the welfare state) is under increasing threat, the US President does whatever he feels like without consulting your leadership (thereby dimishining your importance) and day by day, US power continues to grow as the US has the most dynamic economy on the planet.

What is the average Western European to do?

IMHO, he/she reflexively blames the US.

As Neil points out, Bush simply makes things worse through his (lack of?) style.

Unless Europe can come to grips with the fact that it is no longer the central geopolitical question on the planet (Thank God for that; two WWs were enough!) and that it is increasingly falling behind the times, the US/Western European animosity will continue no matter who is US President.

Miklos

Sorry, Miklos, I missed your post while posting my own.

All I can say is that you're right but that you're exaggerating quite a bit (as I'm sure you know🙂 ).

No, Europe will never be the center of the world again. I think China is next and then who knows what'll happen. I'm not sure it really bothers people too much, though. I imagine we'll have the highest living standard in the world for quite some time and when it comes down to it that's really what people care about. I'm talking Scandinavia here, not Europe as a whole.

Hey, I'm from tiny Denmark. Whether we bitch about behemoth Germany or America doesn't really matter much. We never had any power anyway.

Okay, must bottle feed screaming baby

 

[theodore]

Originally posted by Miklos
Theodore,

I had a conversation with an immigrant (very nearly "fresh off the boat") in the U.S. pretty recently.

The guy was a well educated professional who came to the U.S. to work in the high tech sector. He got an H1B visa due to the company's sponsorship along with what most people would consider a very good job. He spent much of the evening bashing the U.S., the president, corporations and American institutions. Went on to call the U.S. foreign policy neo-imperialistic, etc...

So, when I had enough, I politely asked him why he does not leave the country that he so hates and "votes with his feet".

His response: Dead silence....

A piece of advice, if I may. Once you get your residency in the U.S., I would stay away from discussing two subjects unless you know the other party very well: Religion and Politics.

Miklos

I don't think I would ever argue about religious or racial issues, not only in the states, but in general. Politics though is another matter. But what you just said comes in contradiction with a previous post of yours (the one about burning the flag). I will be working for the US government, I will be paid by them, I will pay taxes to them, but I won't be free to express my opinion about them. I understand that and kind of respect it,too. But it shows that when you are a guest in a country, you'd better shut up when it comes to criticizing it. Even in a country that gives the right to burn its flag (as you said).

As for the rest of your post, I could never understand this"we helped you, so why are you opposing us" mentality. Someone may go to a country for a number of reasons other than his love for that country. I also know of a very well educated nonUS citizen, living in US for the past 25 years, raising a family there and having a leading spot in an American university, who's counting hours until he returns to his home country. Hasn't he offered to the US? He has.Hasn't he received things back? He has. Won't his kids offer in the feature? They will. Doesn't he have the right to dislike things about the country? Definitely.

I haven't been to the US. Therefore, I don't really care about its internal problems, just like Americans don't really care about Greece's internal problems. Difference is, the US has a leading role in world affairs, thus its decisions do affect me, and that's why I have the right to criticize it.

 

[BellKicker]

I dunno, I'm with Miklos on that one. Why immigrate to a country that you hate?

 

[JoeNamaMD]

Why practice in the USA? The answer is simple, the US is the only country that regularly allows graduates of foreign medical schools to practice medicine. No other country is as open to foreign grads as the USA. Don't tell me about Canada, there are several thousand foreign MDs in Canada driving taxis and delivering pizzas because the Canadian medical authorities will not recognize their degree. And in the rare occasion where Canada allows an FMG to practice they often give favor to graduates of medical schools in Western countries. Discrimination against graduates of medical schools in non-Western countries is very commonplace in Canada. In most of Europe the door is firmly shut to foreigners. The UK allows a small number of FMGs but usually only in General Practice. By contrast, in the US you will see FMGs in EVERY field of medicine from Family Practice to Neurosurgery. In fact one of the top neurosurgeons in the Northeast is an FMG.

As to my own experience, a lot of FMGs tend to have a better bedside manner than USMGs. I used to have an Internist who graduated from Columbia University in New York who was an APATHETIC dingus. I later found an Internist who originally came from India who had far better manners in dealing with patients.

 

[IMGforNeuro]

[By contrast, in the US you will see FMGs in EVERY field of medicine from Family Practice to Neurosurgery.

USED TO , NOW IMPOSSIBLE

 

[theodore]

Originally posted by BellKicker
I dunno, I'm with Miklos on that one. Why immigrate to a country that you hate?

I think we re all smart enough to make the distinction between the politics of a country on certain issues and the general population of the country. I think I've made it clear until now that I have nothing to separate with the random, average Joe. I don't hate the States, but I still don't like the current leadership (hell, even Americans themselves don't like it)!

 

[Stephen Ewen]

Originally posted by JoeNamaMD
Why practice in the USA? The answer is simple, the US is the only country that regularly allows graduates of foreign medical schools to practice medicine. No other country is as open to foreign grads as the USA.

"No other country is as open to foreign grads as the USA."

Of course, you are meaning, "No other [highly developed] country is as open to foreign grads as the USA."

 

[Stephen Ewen]

Originally posted by theodore
I haven't been to the US. Therefore, I don't really care about its internal problems, just like Americans don't really care about Greece's internal problems. Difference is, the US has a leading role in world affairs, thus its decisions do affect me, and that's why I have the right to criticize it.

Very well said, though it is sad that so many of us have little idea of the internal affairs of other countries. I lay a lot of blame for that on the U.S. media, whcih are more stenographers for "official" lines.

Also, I think you'd agree that there is a strong interplay between U.S. domestic affairs and U.S. foreign policy; so, dealing with the latter must also neccessarily entail being somewhat versed on the former.

 

[desperate doc]

Well there maybe several reasons but the bottomline is that practice in US can make a doctor perse financially stable. Also US having high technology with regards to the field of medicine can really attract every doctor for that matter. But for me if you are after the clinical practice or you having a clinical eye and gaining the confidence you need once you're already a doctor, I suggest that you practice in a rural area in the 3rd world countries as they say. I have been practicing as a general practice physician here in the Philippines in one of its rural communities and I find it very emotionally and morally boosting. Imagine yourself healing your patients with no laboratory at all...😕 You will only rely on your history taking and keen physical examination. That i think would be the main ingredient in making a very good doctor a clinical eye and a high tech laboratory.......

 

[BabyPsychDoc]

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.

Is this Ortho guy of yours a consultant? If he is, then he can't be making 50K / year - add AT LEAST 10K to the figure. Then remember that he does not need to pay excruciating malpractice insurance premiums (surgeons I know pay about 300-500 GBP per year, the rest is covered by NHS); nor does he have to pay for health insurance for himself and his family (lets face it, health insurance in the UK is a joke used only by the elderly as a means to jump the queue when it comes to elective procedures. otherwise, you are far better off with the NHS). Taxes do suck, as you have to pay 40% tax on anything earned above 38k/year, and 50% on anything earned above 100k/year (I think, not sure about this last one). Basic tax rate is 22%.

Then think that a British medic goes through an average of 8 year-long postgraduate training, during which s/he works no more than 60 hrs/week on average, and soon this to be reduced further. And, residents' (SpRs') salary starts at 30+ K/year basic plus about 50% oncall supplement - ie, they are overpaid to start with, compared to the US residents.

Bottom line - each country has it's advantages and disadvantages. Graduates of my GP residency have been hired for 70+ K/year - can't be too bad.

 

[Polish RzuR]

Desperate Doc:
I really enjoyed Your post.It's kinda sad for me that about 60% of posts around are bout $$ and Your is rather a event between them.Good "Doctor's eye" like You wrote is something that no cash can balance.Pracitice in such EXTREME conditions is also in my opinion a great way to gain experience sometimes impossible to imagine for people practicing in US or other 1st world countries.Your It is nice to read smth like this 👍

best regards!

 

[Lisa2007]

I´m from Sweden. I have thought about trying to do USMLE so I can go to the US. For me its more about not wanting to stay in my country than anything else and an english speaking country is good for me. Sweden is a great country in many ways, we have good heathcare, studying at the university is free for everyone (still have to borrow money to live and pay for books though) etc. But still many people complain that they don´t get enough from the state. Something that is very swedish is "Don´t think you are better than anyone else". And many people dosn´t seem to think that doctors and other academics should have better pay than they do despite a long education, debt due to studying etc. I think this is very small minded and and to much orientated to the left politicly for my taste. If I put in the effort I want the reward. Oh...I also want to have my morning coffe under a palmtree...winter here is way to cold 😀

 

[Meatwad]

I´m from Sweden. I have thought about trying to do USMLE so I can go to the US. For me its more about not wanting to stay in my country than anything else and an english speaking country is good for me. Sweden is a great country in many ways, we have good heathcare, studying at the university is free for everyone (still have to borrow money to live and pay for books though) etc. But still many people complain that they don´t get enough from the state. Something that is very swedish is "Don´t think you are better than anyone else". And many people dosn´t seem to think that doctors and other academics should have better pay than they do despite a long education, debt due to studying etc. I think this is very small minded and and to much orientated to the left politicly for my taste. If I put in the effort I want the reward. Oh...I also want to have my morning coffe under a palmtree...winter here is way to cold 😀

Haha, palm trees... unfortunately here in America we love to build things, so we pretty much kill every living thing (including palm trees) in sight. So by the time you get here, there will probably be none left. Just a few weeks ago, near my house, they decided to put a huge wall up so people's backyards would be shielded from the pesky noise from a nearby highway. People have lived there for 60 years with that highway noise, and it was never a problem before. However, like I said, we love building and killing. So they ripped down hundreds of trees, and put a big ugly fence up. People just don't realize/care what they are doing to this planet.

 

[Lisa2007]

Haha, palm trees... unfortunately here in America we love to build things, so we pretty much kill every living thing (including palm trees) in sight. So by the time you get here, there will probably be none left. Just a few weeks ago, near my house, they decided to put a huge wall up so people's backyards would be shielded from the pesky noise from a nearby highway. People have lived there for 60 years with that highway noise, and it was never a problem before. However, like I said, we love building and killing. So they ripped down hundreds of trees, and put a big ugly fence up. People just don't realize/care what they are doing to this planet.

If I ever get there I´ll plant my own tree if there´s none left. But thanks for the heads up

 

[combatmedic]

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.

And you base this off what??

CNN??

 

[Repeat]

Good question. 😛

I think the US is a great county, beautiful nature, nice wheater (all depending on the region of course), lower costs for housing, cars etc, a way of living I like. But on the other hand there are a lot of problems like no euthanasia, narrowminded christian-inspired rules, the amount of people without insurance, poverty, crime etc etc.

And with all the tests I have to do to become licensed in the US, even when I have an MD degree from a good university in Europa, it isn't worth the trouble I think...

I think if I would leave my country for another, it's not because I like the other better, but because I like mine less.

 

[Miami_med]

I know a Columbian intern who came here because you have to pay for residency in Columbia, and he didn't have enough money to finish training. He thought $40k for "only" q4 call was awesome. Apparently in Columbia, interns work q4 at the training hospital and moonlight q4 at another hospital to pay for the internship. This of course averages out to q2.

Some people lie about work hours in the US no question, but I think that as far as hours go worldwide, the US is probably in the middle. Europe is at the bottom. 56 hour training weeks for medical residents or 35 hour government imposed wage labor weeks for regular workers are pretty much unheard of outside of Europe and a couple of other countries.

 

[sga430]

I know a Columbian intern who came here because you have to pay for residency in Columbia, and he didn't have enough money to finish training. He thought $40k for "only" q4 call was awesome. Apparently in Columbia, interns work q4 at the training hospital and moonlight q4 at another hospital to pay for the internship. This of course averages out to q2.

Some people lie about work hours in the US no question, but I think that as far as hours go worldwide, the US is probably in the middle. Europe is at the bottom. 56 hour training weeks for medical residents or 35 hour government imposed wage labor weeks for regular workers are pretty much unheard of outside of Europe and a couple of other countries.

psychiatry is not so bad with the hours. think i am averaging about 50 years without the at home call i have (on weekend i do have to round.)

 

[JCYL]

none other than $. 👎