Residency Matches with Foreign Medical School Education

[jdaasbo]

I would also like to state that in contrast to Celiac Plexus, i would prefer to work with dedicated and smart people regardless of the degree. To "prefer not to work with DOs or FMGs" is pure hubris and ignorance. I have met just as many jokers from U Chicago and UCSF as I have from SABA, CCOM, and All India Medical College.

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[Celiac Plexus]

Originally posted by jdaasbo
I would also like to state that in contrast to Celiac Plexus, i would prefer to work with dedicated and smart people regardless of the degree. To "prefer not to work with DOs or FMGs" is pure hubris and ignorance. I have met just as many jokers from U Chicago and UCSF as I have from SABA, CCOM, and All India Medical College.

Yeah well, I also said that my position might change once I get to residency and beyond when I get a chance to evaluate DOs, and FMGs firsthand...

 

[Goofy]

I'm certainly not saying that foreign trained physicians are somehow inferior.

I am. It may seem lousy to say, and I certainly don't consider myself prejudice, but IMG's are inferior in the sense that they largely receive subpar and substandard medical education.

I agree that in a free market, may the most qualified applicant get the job.

I agree on this point, but not in the same vein that you probably suggest. For me, the 'most qualified' doesn't necessaryily include those with the highest scores. There are any number of FMG's who have stellar board scores for example. Many of them have already completed advanced medical training in foreigns countries. Many of them have spent in excess of a year preparing for these beatable exams. This hardly proves 'qualification.' One of the most important meters of qualification is country where the medical education was received. So in that sense, the 'most qualified' should get the job.

there's a glut of physicians in the US and the US currently spends more money on health care than any other nation in the world.

You are dead wrong on this point. Next time do a little research before offering claptrap lies. It sounds like you have been indoctrinated into federal spin that has produced a dire medical shortfall. What you erroneously categorize a 'glut' is actually one of the greatest and most critical shortages of physicians in years.

Post graduate training in the US is a gov't policy issue that needs to be addressed.

If you say so.

Generous to the point of potentially bankrupting the US economy through funding of entitlements programs (Title 13 and 19) which acount for >20% of US taxpayer dollars and growing every year.

This is more idiotic conjecture that has absolutely no basis in reality. Federal funding for residency training is certainly 'generous' but it is a rather large step to convey it is 'potentially bankrupting the us economy.' You are confusing health care spending and residency funding two entirely different things.

 

[neilc]

hey kleb, what evidence do you have that says US med schools are better at teaching medicine??? that makes no sense to me...

which countries are subpar? england? france? spain? italy? south africa? ireland? australlia? germany? czech republic? i don't think so. they teach the same basic science, they teach the same clinical skills, in fact they may do it with less dependance on technology, or over a longer period of time...

if you look at it, medical education is basically divided into to parts the world over:basic science and clinical medicine...as for basic science, there are many schools the world over with dedicated faculty specializing in each of the basic science...these guys know the anatomy, the physiology, the pathology just as well as the guys in the states. as a matter of fact, my anatomy prof went and gave some lectures at US med schools...so, it seems clear that the US system and the Us med schools have no special advantage there.

clinical education is a bit different in the US, but i don't agree that it is better. basically, in the US students are given a bit more clinical responsibility a bit earlier...but, i don't see that as a result of or resulting in a better education. maybe a quicker one, but i am not sure about that either. i think when you look at doctors across the world, when they graduate from med school and complete the training required for specialization, they know medicine pretty well. especially when you look at europe/australia/america, the differences are pretty few...but, i don't see a place where there is uniformly bad education of doctors. maybe a lack of a med school, or a lack of doctors, but i think you would need to show some evidence of poor training in order to make such a statement.

the us has no magic method, no special abilities which make medical education its specialty. look at research. breakthroughs come from all over the place. the us has no monopoly. in fact, the US schools are new to the medical education game. many of the schools in europe have been around since the 1500's and earlier.

financial and patriotic reasons are a totally different conversation, however, and i don't even want to get involved in that one! there are lots of reasons people want to come here, and i think that seeking a better quality of education has lmuch ess to do with it than seeking a better quality of life.

i love my country as much as the next guy, but i am aware of the fact that many other countries can do many things (including medical education) at least as well as the US. and me or my family was sick, there are doctors the world over that i would trust with their or my care.

best of luck!

 

[great north]

Well this discussion is rather interesting to me as a Canadian, in particular the comments of "Klebsiella" who apparently champions the notion that american medical education is the "gold standard" in the world where schools such as McGill, Oxford, Cambridge, Universita di Pisa, Agha Khan University and God knows what other schools on earth not to mention perhaps even some Carribean medical school provide don't provide a "gold standard of medical education"...Is your world view as jaded as your view of american medical education, if so perhaps you ought to travel the world man, and see that indeed there is a world of high/highest quality medical education beyond america. Lord knows in Canada we see your medical education as being rather sad where evaluations based on multiple choice exams seem to be the norm. Consider that at McGill, I have been told, that a question on one of their anatomy final exams was..."describe the knee", Well what is your answer mate...come on your the "Gold standard"....start with osteology, musculature, innervation and vasculature and string along function and perhaps related pathology to make your point. I am rather grateful to your country for providing me the opportunity of studying medicine as getting into a canadian medical school is the equivalent of being accepted into one of your "ivy league" schools...Oh, by the way I am studying medicine at Ross University, a for profit carribean school, unlike AMERICAN MEDICAL SCHOOLS which teach medicine to the drum beat of Hippocrates's teachings and the betterment of of human kind (american only of course), where profit is a four letter word. I sincerely hope to see the best and brightest in the medical profeesion when I start clinicals in the US. After all at Ross we learn witchcraft and how to sacrifice cattle for preventive medcine. Furthermore, we are all very willing to do your bidding as the country FP/peds/IM (no subspecialty of course) where no one else dare go......I hope I have not hurt anyone's feelings but............I would rather do an opthalmology residency in Georgia(the country) and end up practicing in Nigeria giving people sight than have to deal with ignorance....after all medicne is God's work on earth...or are we all here because of the love of dead american presidents and german engineering .

Regretfully Yours,

a FMG (boohooooooooohoooooooooooo)

 

[El Duderino]

I would venture to guess that the number of physicians in Denmark is significantly lower per capita than in the US.

Doctors per 1000 inhabitants (1999 OECD numbers):

Denmark: 3,4
United States: 2,8

It is true, however, that the US is the undisputed world champion when it comes to health care spending - almost twice as much per capita as most other OECD countries.

On the other hand, I don't think that a couple of thousand FMG's coming to the US for residencies (most of them on J1 visas AFAIK) are the ones to blame.

 

[BellKicker]

El duderino...... Thanks, buddy. It's nice when someone actually takes time to support my outrageous claims!

 

[abu barney]

No post has yet substantiated the hollow claim that US medical education is "superior" than a foreign medical education. Yeah, the US has *some* of the best hospitals and most cutting edge research, but the vast majority of med schools are really not that impressive. There is this misconception that all foreign med grads go to carribean schools, and that all of them went there since they didn't get into a US med school. The vast majority of international med students had to bust some serious ass to get into the med schools of their respective countries. Most of them were in the top .1% in grades in the country (NOT an exaggeration), and most of them would be in Hopkins or Harvard if, by virtue of God's will, or pure chance, they were born in the US and grew up in the US educational system. Many med students I met in the US during my rotations were not impressive in the least, except for their capability to talk a lot of baseless smack, and certainly not uncomparably superior to foreign students and grads. But the US still provides the best environment for the self-motivated, and generously rewards the hard working professionally, and quite frankly, economically also. So please don't give other hard working students this crap by claiming that someone at *cornell* is somehow inherently superior or has received superior education solely because the name of his med school is *cornell* and not agha khan, or cairo, or vienna (and i'm sure there are a lot of bright and nice people at cornell). Please back up your hollow claims, specifically "Klebsiella", on how US education is so undeniably superior to every other competent and productive medical systems elsewhere. I fail to see any logic in your bigoted, yes bigoted "arguments" (arguments tend to make sense), so please explain to us all why you're so damn intrinsically good.

And BTW, I've seen grads from the U of Baghdad do an excellent good job working at my school's hospital, equally as competent as the grads I seen working in US schools.

Are US grads favored over IMGs when applying to residency? No question about it. Is it fair? Hell yeah. Is it because US grads are "superior" to IMGs? Bull$hit. It's because US grads are better tailored to the system, and are more comfortable working within the confines of the American system, and understandably so.

 

[valdas]

quote:
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Originally posted by rtk

The only reason that non-US citizens and foreign trained physicians can even get residency training in the US is that they are allowed to by law. And the irony is, US tax payers pay their salary. Interesting also that an FMG doesn't pay income taxes on their 35-40K resident salary while they are here in training.


From this it could appear that the poor US tax payers should pay to some Guattemalian for his holiday trip abroad. The truth is: residents are CHEAP labour forse and every hospital is in great need for this slavery. There is not enough crazy americans to do that. I think that everyone !!!! would be amazingly happy with FMG's if they would leave the country after finishing their residencies and never compete with AMG in already overcowded labour market. No way... This country is great for its EQUAL opportunities to everyone.

 

[drusso]

Originally posted by pba


As for D.O, I dont understand it. i dont know what it means. i dont know what the difference is (even D.O.s dont beleive in manipulations), and i dont know why they dont just convert them to M.D schools so it would be less confusing for me (as i am not that smart and get confused easily).
-pba

Well, let me relieve you of the burden of your ignorance: Osteopathic physicians are fully-licensed physicians and surgeons who are also trained in manual medicine. Done. I know that might be mindbending to understand, but that's all there is to it.

As for not believing in the value of manipulation---I think that most DO's in fact do use manipulation selectively in those cases they feel it might be appropriate. Also, DO schools do not convert to MD schools because what would be the point? There would be nothing gained by making such a switch.

 

[El Duderino]

DO schools do not convert to MD schools because what would be the point? There would be nothing gained by making such a switch.

Well, for one you wouldn't have to waste time explaining what DO means to the ignorant.

I think that the conversion would be of benefit. If nothing else, to make it easier for patients. If the degrees are technically the same, why shouldn't they have the same name?

As far as manipulation is concerned, it does not seem to be important enough to warrant distinguishing doctors who have learned it from those who who have not. Similarly, some medical schools will teach you how to do procedures that others won't.

 

[Global Disrobal]

I'm impressed by the comments posted by my fellow IMG's. I must stress however that there is no rationale in replying to the non-sense rhetoric from the likes of Klebsiella. Do your studying and let your practice of medicine speak for itself.

For me, the USMLE, rotation grades, and all other standardized forms of evaluation are not the means for comparison with our US Graduate counterparts. The bottom-line is you and your performance while in practice. The "Superior" physician will always stand out regardless of where they came from, where they graduated from, or whether they are D.O. or M.D..

Lastly to our beloved Klebsiella who is under the mistaken impression that grandiloquency will make him appear smarter than others:

My friend, anyone can pull out a dictionary and start using unnecessary jargon in their posts, however it is the substance of their material that shows their maturity and intelligence. You lack both. All I can think of, while reading your words is:

"A little ignorance and ego can go a long way..."



Best of luck to all and especially to our friend practicing the "superior" medicine!

 

[orthodude]

D.O is a equal but separate degree than M.D. Osteopathic profession is a distinct profession. Our philosophy and approach to the patient makes us different. Manipulation is just an extra tool for us. We work side by side with our M.D. counterparts in every possible specialty that you can name. Just because we are minority, we will not change our profession. Osteopathic medicine is becoming increasingly popular. As a matter of fact, two new schools are starting from next year. So, we ain't going anywhere.

 

[orthodude]

I agree that the guideline for patient management may be similar. However, medicine is not as black and white as it seems to be. Guideline are just some general recommendations, and we revise them many times. A guideline for treating MI today may not be there tomorrow.A physician still has room to modify/add to the general guidelines. I know it's confusing to understand the practical implication of Osteopathic medicine since we do almost exactly the same thing as others. Lets take an example of a COPD patient. A D.O. pulmonary specialist may not only follow the guideline but also perform or prescribe rib raising manipulation technique to fascilitate patient's breathing. Now, you may say that this will increase the cost of health care, since the coding for manipulation is in addition to the regular office visit. But, the patient will get better soon and it will increase the productivity level.

 

[orthodude]

Here is a good source for osteopathic manipulation treatment in different disorders..."Foundations for Osteopathic Medicine"
by Robert C. Ward (Editor), John A. Jerome (Editor), John M., III Jones. Another good book is "An Osteopathic approach to diagnosis and treatment" by Eillen DiGiovanna and Stanely Schiowitz. I am not sure if Harrison has any passage about manipulation. Since, I am in the middle of the block of exams, I will get back to you about that later on. Even if Harrison doesn't mention manipulative therapy, that doesn't mean anything as Harrison is not a complete source of treatment modality. I don't think I need to cite any data to support the fact that manipulation works in various situation, since insurance companies often pay for these treatments. They wouldn't pay for procedures that haven't been proven. Hope this helps.

 

[Apollyon]

Originally posted by drusso
...US-FMGs who could not gain admission to a US-accredited medical school. Strange days are these...

The most foolish thing is that you are putting your faith in admissions committees, and throwing the baby out with the bathwater - in the US, there are more applicants than spots for med school - whereas, these graduates, after receiving the MD, balk at working where the system needs them (although the system has trained them). Yet, you think that Americans who go elsewhere, and do the jobs that the ones who stay home don't want to do, are of less value? Maybe you haven't actually stepped back, and seen medicine from the point of view of a layman; it doesn't matter AT ALL who the doc is - just as long as the right thing is done.

Just my thought (with multiple lives saved and changed for the better to support me).

 

[neilc]

hey orthodude, just cause insurance pays does not mean there is evidence...lots of chiro treatment gets paid and there is limited evidence beyond musculoskeletal pain tx that supports chiro, at least as far as i understand. i think that reimbursement is consumer driven, not science driven.

it would be interesting to read some studies on osteo manipulation...any links?

thanks!