MDs are MDs ...or not ????

[lola]

if you go back and look, i decided to delete the mumbo jumbo thread i wrote earlier. it is not a good reflection of the kind of person i am, but when i'm mad i sometimes need to just get it out.

i contributed meaningful information to the what's wrong with going to the caribbean thread and was attacked by you. i may not have contributed anything meaningful here, but that's only b/c i already learned from that thread that there is no point in arguing with you.

and by the way, i did not characterize by where you go to school. i characterized you by the content of your previous posts and your eagerness to walk all over people who are making non-inflammatory honest posts.

Originally posted by Skip Intro:
Oh, please. You are sounding more and more like a spoiled little rich girl with each passing post. You like that characterization? Well, I don't like being characterized by people like yourself for choices I made that you know - when it comes down to it - nothing about.

so you think i'm rich, spoiled, and think all foreign med students suck, eh? well... go ahead and read my previous posts on this in the other thread, and i'm sure you'll find you have no basis for your conclusions.

---

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[IRON_DUKE]

I think that it is safe to say that skip intros post was very clear .
and most important was THAT it is backed up by facts , maybe they are facts that all who read this may not like ...........but none the less until we read or get others .........they are the ones that will have to make due .

The original post was intented to make a statement and pose a question at the same time .

Are not MDs.................Medical Doctors , anywhere you travel in the world ?

I wonder how a AMG would feel if he left the USA and was told that his education is sub par and not as good as the country he or she is visiting .

If you know your material , and have studied for real , in the end no matter where you graduate you are a real MEDICAL DOCTOR .

 

[IRON_DUKE]

NOT ADEQUATE ?


I thought that AMGs are over qualified ? Not to start another debate .

And of course maybe you wont be allowed by law to practice , but does that mean that you stop being a MD ? Of course not .

Then there would no sence to J 1 visas and jr. fellowships , etc.....

 

[kittyjuice]

as far as im concerned, if you have to care so much about where you went to school to empower yourself, you are insecure to begin with.

if you have more going for you in life, know how to deal and manage people, have true confidence in yourself, it makes absolutely no difference where you study medicine. especially if you pass your boards with flying colors.

if youre a loser, and you go to Harvard med, ur a loser that graduated from harvard. if youre a cool person, confident in him/herself and had to go to Ross or SGu to fulfill a dream, then you will be the same after you graduate.

people always talk, and will continue to talk. its just natural that some have to resort to cutting others down to empower themselves. is it jealousy? is it insecurity? who cares?

the bottom line is that if you let things like that affect you, then ur a weak person to begin with. you should fix yourself internally.

furthermore, it should be noted that around 30-40% of doctors practicing in the US are foreign docs.

get over it. medicine is merely a career. its a great career that requires you to make sacrifices, but life is more than that.

in short, if you have to empower yourself by putting down someone else ur an insecure loser. if you feel that you are subpar for going to a foreign med school, ur a loser as well. go out and breath the fresh air peoples.

peace

 

[Mr. Z]

No one will win this debate, and it has been done to death. Everyone is entitled to their opinions, and nothing is going to change that. AMG's, FMG's, who cares? Just go do your own thing and remember, really the only person you need to answer to is yourself.

Some unsolicited advice for Iron Duke,

You need to relax with the BOLD AND THE CAPITALS, also give the icons a rest. It really makes your posts annoying to read.
Learn to express yourself with words.

 

[IRON_DUKE]

Mr. Z :


Do I need to put one sugar or two in my coffee ?


KittyJuice :


Cool words .

 

[IRON_DUKE]

COOL .


Good to see an about face .

 

[MacGyver]

It seems like a lot of people are angry that the USA tends to favor its own med students for residency..

My comment is, doesnt every country in the world do this? I dont know of a single nation on planet Earth that gives equal consideration to foreign students as it does to the homegrown variety.

 

[IRON_DUKE]

Well I am an american . I understand that each country should favor its own .

But it should not discriminate against those of us who are also its own , but were not fortunate enough to graduate within her borders .

If I get looked down upon cause I dont know my stuff , then cool . But I dont want to hear jibberish after I pass the boards and sweat it out , that well I had more time to prepare , etc..........

Throw me out if I dont know my stuff .....................but respect me fully if I do .



P.S. Mr. Z :

I did away with lots of the smiles and most of the bold text , anything else you want to proof read for me ?

 

[Med4ever]

I agree, Canada for instance gives preferences for its own doc's. So i agree that America should hold the same preference.

 

[Skip Intro]

There are many Canadian students at Ross as well who intend to return to Canada, or stay in the U.S. if they can (as one student I met recently put it) "marry a boy from the U.S." so they may stay and practice permanently in the U.S.

Between 1988-1996, the number of non-U.S. citizen IMG physicians coming to the U.S. increased 531%. During that same period, the number of U.S. citizen IMG (i.e., natives who did their training abroad) decreased 27%. Approximately 25% of all physicians now practicing in the U.S. are foreign-trained. Many came to the U.S. on J-1 visa with the promise that they would return to their native country after completing their training. Many of them did not fulfill this promise.

http://cogme.gov/rpt11.htm

Please try to understand the distinction between native, U.S.-born citizens who train abroad, and non-U.S.-citizen, J-1 visa participants of residency programs who may or may not fully intend to return to their country, despite what they tell the INS.

Originally posted by lola
if you go back and look, i decided to delete the mumbo jumbo thread i wrote earlier. it is not a good reflection of the kind of person i am, but when i'm mad i sometimes need to just get it out.

You also went back and, in lieu of deleting all of them, changed many of your original statements in other responses. This is extremely disingenuine. This is why I will now capture all of your original comments, that are relevant to my responses, as quotes in my own posts so you can't go back and alter or delete them (as well as make a claim that you "never said that"). Perhaps you should cool down, think about what you want to say, and what point you are trying to make before you recklessly post.

 

[lola]

Originally posted by Skip Intro:
You also went back and, in lieu of deleting all of them, changed many of your original statements in other responses.

Errr... not at all true. I deleted 2 posts where I was pissed off at you... that's all. I don't recall changing any others and am pretty certain I did not.

Maybe it's that when you went back and reread what I wrote, you see that none of it deserves the kind of reaction I got from you.

Watch out!! I just changed this post by adding slashes to the end of the bold/quote tags, so that it would appear correctly on the screen. Oh my GOD! I'm changing everything all around

 

[lola]

Originally posted by Skip Intro:
You also went back and, in lieu of deleting all of them, changed many of your original statements in other responses.

Errr... not at all true. I deleted 2 posts where I was pissed off at you... that's all. I don't recall changing any others and am pretty certain I did not.

Maybe it's that when you went back and reread what I wrote, you see that none of it deserves the kind of reaction I got from you.

 

[IRON_DUKE]

oooooooooooooops , wrong thread .

 

[lola]

Originally posted by IRON_DUKE
oooooooooooooops , wrong thread .

no, not wrong thread. WRONG.

 

[IRON_DUKE]

LOLA :


?

 

[lola]

sorry iron duke... got you confused with skip intro. i had better not delete it, though, cause i may get accused of doing something evil

 

[Skip Intro]

Originally posted by lola
sorry iron duke... got you confused with skip intro.

Wow, I'm surprised. After spending what I'm sure was countless hours poring over this and reflecting on the intricacies of the argument as well as the factual data that was provided - and - after all of your valuable input, careful consideration of the subject matter, and thoughtful input on this topic, you still managed to get the two of us confused.

Originally posted by lola
i had better not delete it, though, cause i may get accused of doing something evil

Thank you for the gross mischaracterization of my statements, as well as your own actions, on this thread. I'd invite you to point out anywhere on any message where I "accused (you) of doing something evil."

Intellectually dishonest? Manipulative? Shooting off at the mouth before engaging the brain? Yes. But, evil is the word you've chosen to associate with what you did. Perhaps you should reflect on that a bit.

 

[lola]

Originally posted by Skip Intro

I'd invite you to point out anywhere on any message where I "accused (you) of doing something evil."

and i'd invite you to point out where i've edited posts. wouldn't you have quoted all the things you disagreed with anyway? so if i did change things, you would find the original version in your posts.

 

[Skip Intro]

Originally posted by lola
and i'd invite you to point out where i've edited posts.

I strongly believe that you went back and changed this post:

- - - - - - - - - - - - - - - - - - -
i believe there are some students in the caribbean who are really arrogant and argumentative. i believe there are some carib students who will not make good doctors. i believe there are some carib students who don't understand logical though processes. i believe this, because i've read your posts on sdn.

07-17-2002 11:12 PM
- - - - - - - - - - - - - - - - - - -

Why do I think this? Because I clearly do not remember you specifically saying that before I responded, and I feel that I would've addressed your arrogance at the time it was relevant. Do I have a way to prove this? No. I'm not an administrator.

So, I'm either wrong, or you're a liar. My bet is on the latter. Either way, you've admitted to deleting individual posts in a thread, which is an incredibly intellectually dishonest thing to do amidst a debate. It's one thing to delete an entire thread that you started if it is irrelevant, going nowhere, and maybe potentially offensive. But in the heat of a continuing debate when people are trying to make valid points... shame, shame, shame on you!

Originally posted by lola
wouldn't you have quoted all the things you disagreed with anyway?

Not necessarily, especially if you changed them afterwards. (DUH!)

Originally posted by lola
so if i did change things, you would find the original version in your posts.

What twisted logic!!???!??!?? You're at Harvard getting your MPH? Are you sure?

 

[lola]

**** off Skip Intro.
I will never delete this, because 100% of me believes you absolutely suck. You are an dingus if I've ever heard one.

 

[lola]

that's
F
U
C
K

 

[lola]

and i don't really f*ing care if i get kicked off of sdn for this. it's well worth it to put you in your place.

 

[lola]

in case you can't remember where your place is it's where your head is stuck in the sand and you're suffocating.
you are a pathetic excuse for a human being.

 

[lola]

Originally posted by Skip Intro



My bet is on the latter. Either way, you've admitted to deleting individual posts in a thread, which is an incredibly intellectually dishonest thing to do amidst a debate.

SO.. for anyone who was missing those deleted posts. you basically get the gist of them from my last few posts.

 

[Skip Intro]

Originally posted by lola
**** off Skip Intro.
I will never delete this, because 100% of me believes you absolutely suck. You are an dingus if I've ever heard one.

Originally posted by lola
that's
F
U
C
K

Originally posted by lola
and i don't really f*ing care if i get kicked off of sdn for this. it's well worth it to put you in your place.

What class! What style! Yes, ladies and gentleman, the purported future of American medical education.



Oh, thank you for putting me in my place, lola. You sure showed me.

 

[lola]

don't think people are taking your side on this skippy. not many agree with you, and those few that do probably go to the caribbean too.
the only reasons people aren't coming out of the woodwork to defend me are:
1. they now how LAME you are from previous interaction with you and know that they can never win an argument with you b/c no matter what they say you will come back with some sort of illogical/twisted response.
2. i've gotten so angry that i'm starting to sound almost as lame as you.
3. they've gotten so lost in all this nonsense that they can't remember what the issue was in the first place.

 

[Skip Intro]

Lola, SDN's own ingenue...

Originally posted by lola
don't think people are taking your side on this skippy. not many agree with you, and those few that do probably go to the caribbean too.

Unsubstantiated claims #1 & #2: I've found in life that people are very comfortable talking from the position of opinions. And, some people are even more comfortable positing other's opinions, in lieu of their own, with the requisite inaccountability inherent in such a cowardly act. Likewise, I don't care who's on my side or not. This discussion has never been about taking sides. This has been about seeing through one's own bias and prejudice. I'm sorry that, through your demonstrated immaturity, you are unable to see that.

Originally posted by lola
the only reasons people aren't coming out of the woodwork to defend me are:
1. they now how LAME you are from previous interaction with you and know that they can never win an argument with you b/c no matter what they say you will come back with some sort of illogical/twisted response.

Unsubstantiated claim #3: I've clearly defended my positions and pointed out the fallacy of your limited thinking. Further, I've backed my arguments with data. Again, don't mistake your inability to follow a logical argument with a failure to construct one.

Originally posted by lola
2. i've gotten so angry that i'm starting to sound almost as lame as you.

I haven't gotten angry at all. In fact, your posts have provided much well-needed amusement for me. And, as far as lame... well, yes, your posts have been lame. As far as your misdirected anger... perhaps you should learn to be a little more tolerant of people challenging you - something you're apparently not used to - and meet those challenges on the merit of the argument as opposed to getting so emotional (i.e., grow up).

Originally posted by lola
3. they've gotten so lost in all this nonsense that they can't remember what the issue was in the first place.

You may be lost, but I don't think the rest of us are. Nonetheless, let me refresh your memory. This is about prejudice and bias, something you've adeptly help me illustrate. MDs are MDs, regardless of where they did their training, if they can prove themselves by passing the medical licensure requirements in the U.S. To expect them to subordinate to arrogant, elitist, ill-informed biggots is the paramount example of the "medical aristocracy" in the U.S. system.

 

[resident Q]

Hi all,

I originally posted this to a different thread, but I thought I'd throw a log on the fire here

Original Question: What is wrong with attending SGU medical school in the Caribbean? Is it really that bad?

I know someone who attended SGU (so I look at these forums every now and then), and I had an opportunity to see SGU up close. [I'm not a med student, thankfully , but around two dozen of my extended family are doctors, mostly in the US, and a few in Europe and the Far East.]

SGU isn't bad at all, the education and cost is comparable to a private US medical school. Most of the students are Americans who didn't get into US med schools, but could have, i.e., their scores and grades were competitive, they got interviews, they just didn't get in. Quite a few were from states where it's notoriously hard to get into medical school, NY and CA, I think. There's also a sizeable minority of international students from a lot of different countries. I think every continent was represented, usually by multiple countries.

It's a real medical school, e.g., I poked my head into an air conditioned lecture hall at midnight on a Friday night and there were a bunch of people studying.

There are drawbacks to attending SGU. Whether or not the drawbacks are serious seems to depend on your situation.

(1) Being in the Caribbean, if you don't like the Caribbean. Developing country issues, humidity, etc. Most were OK with it, but a few really suffered.

(2) Bureaucratic BS - the foreign grads have to deal with the ECFMG, additional requirements from state medical boards, and the logistics of being thousands of miles away from home. More BS, but they dealt with it, some better than others.

(3) The most serious drawback - it is tougher to get really competitive residencies. In the class that I'm familiar with, that just graduated, people who did well were able to get into radiology, emergency medicine, someone got orthopedic surgery, etc. But everyone knew beforehand that it would be harder to get into certain fields, so most pursued -- successfully -- less or moderately competitive residencies, e.g., internal medicine, general surgery, pediatrics, OB/GYN, family practice, anesthesia, psychiatry, etc. They're all in residencies, now; they are all practicing doctors.

If you're thinking about going to SGU, and you know now that you will want a really competitive residency, be warned that you'll have to excel to have a chance. (Kind of an ironic twist - if you're only an average student, then you'll have to go a US school )

There are some people who have lived most or all of their lives in academia, who are acculturated to equate academic excellence to general superiority, and anything less with inferiority. (I know, I grew up in such an environment.) But they're in the minority - but some of them are residency directors for the competitive residencies, or wannabes.

Post-residency, all this IMG stuff doesn't seem to be so much of an issue. As I mentioned at the outset, a lot of my extended family are doctors (some are clinical instructors too), and none of them care where their colleagues went to medical school.

Their collective attitude is more or less that (1) medical science is the same all over the world; (2) they see how doctors do in practice before passing judgment - every single one of them has worked with (and hired - or been hired by) various kinds of foreign grads, who were more than competent and successful, and seen ivy leaguers commit the most bizarre, horrid malpractice - so if they had prejudices, they were corrected by reality; and (3) being able to do medicine comes from experience, e.g., an old nurse is far better than a young doctor (or a grandmother is just as good as a new pediatrician at gauging the level of illness); e.g., if you're sick, don't go to a public hospital in the summertime, because that's when everyone's on vacation, and it's staffed by (ugh!) new interns who don't know what they're doing yet, no matter which medical school they went to.

So that's what practicing doctors think, at least in my family; they seem to be individualists, particularly as they get older.

It's not where you go, it's what you do. Anything else is sheer prejudice and bigotry.

 

[resident Q]

Actually, I agree with Skip Intro, and his series of essays on this subject are the most thoughtful I've seen in about two years of monitoring internet activity concerning the issue.

[flame shields on ]
And I don't think the comparison to racism is out of line. Some of the anti-IMG thoughts are similar to what you can see if you surf over to a racist forum (which I don't recommend).

And that worries me, because I wonder if 30 or 50 years ago, if I would be one of those people advising a black person, or a woman, or another minority not to pursue medicine because of the prejudice they would face.

All that secondary prejudice ... e.g., "I'm not prejudiced, but everyone else is, that's how it is and I'm going along with it"; if we're going to be a great nation, a great people, we can't go along with it.

 

[IRON_DUKE]

THUMBS UP

On the post . The more people contribute the better the discussion has become .

Sure tempers flare , but that is natural . The main thing is to explain your position in terms that are positive for all .

If you think that IMGs stink , well back up your argument with facts .

 

[lola]

Originally posted by Skip Intro
Lola, SDN's own ingenue...
perhaps you should learn to be a little more tolerant of people challenging you - something you're apparently not used to - and meet those challenges on the merit of the argument as opposed to getting so emotional (i.e., grow up).

SDN's own ingenue? another post that displays your arrogant tone.

i think you are the one who needs to learn to be more tolerant when you hear negative views about the caribbean. that's what this whole issue is about. you pounced on me when i stated FACTS -- not my opinions, facts. PEOPLE (and no, i'm not the spokesperson for the populus when i say this -- i have no idea why you think i think i am when "people" does not mean everyone on this earth) have negative views about caribbean doctors. those are the facts. i NEVER said that's how i felt or that's how it should be. you assume i feel that way, because you can't seem to comprehend that people have the ability to understand more than one side of a story, because you don't have thatability.

i think you need to get off your high horse and stop bullying those who are in disagreement with you. i'm fine with disagreement. (by the way, you never really disagreed with anything i said. you turned the things i said around and made things up.) what i'm not fine with is an arrogant bastard who seems to think he's superior to everyone else. we can all plainly see that your not.

as for my immatury. well, your immaturity brought it out of me. aren't you in your 30's? then i think it's time for YOU to grow up.

as for your pages and pages of posts here. frankly, i'm just not that interested, so i have not read them all. [here it comes, he's going to jump all over me for not reading them.] i'm responding to earlier issues i have with you, which i should have taken care of then. you bully people around and force them to give in even though they have valid points.

i am going to "grow up"now, and never respond to you again. there is no reason to waste my time arguing with someone like you. i should have learned this after your first post.

 

[ApacheIndian]

Originally posted by lola

i think you are the one who needs to learn to be more tolerant when you hear negative views about the caribbean. PEOPLE have negative views about caribbean doctors. those are the facts

there is no reason to waste my time arguing with someone like you. i should have learned this after your first post.

I second that lol .

 

[Skip Intro]

Originally posted by lola
as for your pages and pages of posts here. frankly, i'm just not that interested, so i have not read them all. [here it comes, he's going to jump all over me for not reading them.]

Yeah, who's the one who's got their "head buried in the sand"?

If you're not prepared to be questioned on your statements, don't make them publicly in a forum. This is not, as you would casually like to believe, like gossiping around the water cooler where words and innuendo can float away forever. People can and will come back and read what is written here.

And, I don't care what you - or anyone else for that matter - think about me. DO YOU UNDERSTAND THAT! This has never been about me or anyone else personally. You and your ilk have turned it into that. Yet you still want to make this all an argument against me. Talk to the facts, lola. Are you capable of doing that? Several other posters have been - even ones who disagree with me.

You apparently can't do that. So, you go for ad hominem and ignoring clearly stated facts instead. Yes; how lame indeed. Again, who's got their head buried in the sand?

 

[Renovar]

Originally posted by Dr. Cuts


I second that lol .

I "third" that lol...

After reading through (rather painfully at times) the whole argument, I must say your logic needs some serious help. Dude, get a grip and get a life outside of this thread, would ya? Please do us all a favor by lay this friggin topic off... The bottom line is that respect and tribute will be paid to those who are worthy and deserving, nothing else matters in the long run. You can't just talk (or post, by sheer volume) your way to the top - I hope your mom taught you that when you are a kid. Anyone will get their due respect after they walk the walk.

 

[Skip Intro]

Originally posted by Renovar
I "third" that lol...

After reading through (rather painfully at times) the whole argument, I must say your logic needs some serious help. Dude, get a grip and get a life outside of this thread, would ya? Please do us all a favor by lay this friggin topic off... The bottom line is that respect and tribute will be paid to those who are worthy and deserving, nothing else matters in the long run. You can't just talk (or post, by sheer volume) your way to the top - I hope your mom taught you that when you are a kid. Anyone will get their due respect after they walk the walk.

Well, first, I'm in medical school, so you should be able to understand that I have no life... right now. I can't remember the last time I sat down and blew an afternoon watching TV.

Secondly, I can't disagree with you. And, aside from what impressions people may have of me on this forum, I clearly know how to "walk the walk." But, hopefully for those who were paying attention, you can at least begin to see that there is no real basis for the bias. The trouble is that, as has been pointed out, many qualified students aren't even given the chance to walk...

As for your underhanded comments on my logic, well, I guess we are all entitled to our own smelly opinions - although at least a few others were capable of following my logic just fine. So, I don't know if that speaks to you or them. But, unlike others, you read it through. You get at least partial credit for that.

 

[IRON_DUKE]

Nuff said .

 

[Renovar]

Originally posted by Skip Intro


Well, first, I'm in medical school, so you should be able to understand that I have no life... right now. I can't remember the last time I sat down and blew an afternoon watching TV.

Secondly, I can't disagree with you. And, aside from what impressions people may have of me on this forum, I clearly know how to "walk the walk." But, hopefully for those who were paying attention, you can at least begin to see that there is no real basis for the bias. The trouble is that, as has been pointed out, many qualified students aren't even given the chance to walk...

As for your underhanded comments on my logic, well, I guess we are all entitled to our own smelly opinions - although at least a few others were capable of following my logic just fine. So, I don't know if that speaks to you or them. But, unlike others, you read it through. You get at least partial credit for that.

Most people in medical school have no life because they are so busy studying. You are sure the first one to admit that you have no life because you are willing to defend your position to the bitter end on some message board. Hey, that's ok... we all got to do something that make float our boat...

Other than your staunchest ally IronDuke, I dont think too many others disagree with me regarding your logic. This is not the first time other posters have mentioned this. Sure, I read every post on this thread, but I got to say that it's usually the other guys (and not you) who are making more sense in their arguments. If one person says you lack logic, you might say he is BSing, but if multiple others have consistently say that your logic needs help, I think you should look at yourself, and not point your fingers back on someone else.

I am only stating the observation of many others. And I just happen to concur with them. You are entitled to your own opinion on this matter, but so are anyone of us. I am just saying what I think. Treat it with a grain of salt, if that makes you feel betteer.

 

[jayvee]

Originally posted by Annette
•••quote:•••Originally posted by lola:
•please don't flame me for this... again, i'm only answering the question. not necessarily expressing my viewpoints. just expressing what "people" think. •••••Lola, maybe you wouldn't be flamed if you actually thought about what you post. Do you have multiple personalities? If you don't, then how exactly can you express what "people" think? You are only one person. If you have published information about a survey of some kind, please provide a refrence. Otherwise, what you are posting is purely your opinion.

wow. annette, that is probably one of the least interesting things I have ever read. I was so stunned by the lameness of your post, that I couldn't help but reply.

While IronDuke, Resident Q, et al. (annette excluded) all have valid points on the inappropriateness of citing an opinion without reference to a study, I think in this case IronDuke et al. are incorrect. Or at least, if IronDuke et al. are correct, than IronDuke should also be held equally guilty for asking the question in the first place "Why do people view FMG as inferior to AMGs" without citing a source.

Why didn't ironduke cite a source inspite of the second poster (name forgotten) mentioning he had NEVER seen it posted on SDN that a FMG is inferior to an AMG? Because it's pretty much common knowledge (for the reasons outlined by Lola and Resident Q) that the average U.S. med applicant prefers to go to a U.S. school and turns to foreign medical schools as a last resort.

Whether or not this is true would be a great study. Whether FMGs end up with more malpractice suits than AMGs would be another one... but, as I really don't care either way, I'll leave it to you to conduct it.

On the other hand... Lola's responses were equally lame after you guys jumped on her.

-----------
REFERENCES

"In formal academic writing, students are expected to provide citations for all information they have obtained from sources except for what might be classified as "common knowledge.""
(_Harper Row Rules of Citation_, Harper Row, 1982).

 

[Skip Intro]

This is the heart of the entire matter...

Originally posted by Renovar
I am only stating the observation of many others. And I just happen to concur with them. You are entitled to your own opinion on this matter, but so are anyone of us. I am just saying what I think.

What are those opinions based on? Are they based on the actual facts (which I can't seem to find supported in any of the literature or multiple studies that have been conducted on the subject matter), or are they only based on hearsay, gossip, and innuendo? Is carelessly repeating them - or worse - simply believing them without further questioning a valid way of thinking?

Take your thought process a step further. That's what I'm really asking everyone to do.

As far as those who do or do not agree with me or can't (or won't attempt to earnestly try to) follow my logic, I think valid statements have been made not only by IRON_DUKE, but also Annette, Leorl, resident Q, stephew, and a few others which amount to a de facto agreement with my position.

-Skip

 

[IRON_DUKE]

ALLOW ME TO CLARIFY :


You guys jumped on her , in refernce to lola , is not accurate . I disagree with her logic . I would counter her logic or posts , but I would not attack her personally . When I do attack someone and believe me later on I feel it was pointless , is becasue the other person choose that route .

Now again I am not a ROSS med student or for that matter a Carib med student . Therefore me agreeing with SKIP INTRO , has nothing to do with us being a team .

I started the post cause I am sick of reading that AMGs feel they have cornered the PHYSICIAN MARKET . That only AMGs practice real medicine and the rest of the world graduates VOO DOO men and Wizards HARRY POTTER style .

If I am wrong about this , then why are even D.O.s who are also part of the AMG club , also looked down upon ?

ANYWHERE YOU TRAVEL IN THE WORLD , there are real physicians . And not all of them are AMGs . THAT IS A FACT .

And many FMGs go to the USA and do their speciality training , funny thing considering they are inferior , or not real physicians at all .

Will the whole issue be solved because I did this post and SKIP INTRO provided data and others submitted real world experience ?

NO . That is also a FACT .

The guy who is working at John Hopkins , well the naysayers dont know what to make of that . And since they cant find a way to explain that FACT away then they resort to attacking my sanity for even starting this post . Or skips for posting data .

That is also a FACT .

 

[Renovar]

Originally posted by IRON_DUKE
ALLOW ME TO CLARIFY :


You guys jumped on her , in refernce to lola , is not accurate . I disagree with her logic . I would counter her logic or posts , but I would not attack her personally . When I do attack someone and believe me later on I feel it was pointless , is becasue the other person choose that route .

Now again I am not a ROSS med student or for that matter a Carib med student . Therefore me agreeing with SKIP INTRO , has nothing to do with us being a team .

I started the post cause I am sick of reading that AMGs feel they have cornered the PHYSICIAN MARKET . That only AMGs practice real medicine and the rest of the world graduates VOO DOO men and Wizards HARRY POTTER style .

If I am wrong about this , then why are even D.O.s who are also part of the AMG club , also looked down upon ?

ANYWHERE YOU TRAVEL IN THE WORLD , there are real physicians . And not all of them are AMGs . THAT IS A FACT .

And many FMGs go to the USA and do their speciality training , funny thing considering they are inferior , or not real physicians at all .

Will the whole issue be solved because I did this post and SKIP INTRO provided data and others submitted real world experience ?

NO . That is also a FACT .

The guy who is working at John Hopkins , well the naysayers dont know what to make of that . And since they cant find a way to explain that FACT away then they resort to attacking my sanity for even starting this post . Or skips for posting data .

That is also a FACT .

Before I unsubscribe, I just want to wish all of you good luck. Debates and arguments aside, I really wish that everyone who has the heart and the desire to practice medicine will end up fulfilling their dreams.

In response to the above message, this is what i have to say:

The FACT is, real doctors practice everywhere in the world, and not of them are AMG's. True that. But just like America, every country in the world have their own jurisdictions, and train their own doctors through their own accredited medical schools, sanctioned by their government. Therefore in France, the French govt sanctioned their own list of medical schools and train the doctors that serves France, same with England, China, Canada, etc etc. Isn't it safe to say that the French medical school graduates have cornered the French market, etc etc? Isn't it justifiable for the AMG's to feel the same way about America? The truth is, the reason why there are a number of FMG's in this country (and I am not disputing this fact) is that it's relatively easier for foreign graduates to practice in the US, compared to other 1st world nations like Europe and Japan and Canada, in terms of bureaucracy - some countries like Canada wont even allow Canadian citizens who dont train in the LCME accredited med schools to obtain residency positions in Canada, period.

Many FMG's currently in practice now were FMG's from other, 1st world nations who came into the country during the late 60's and 70's when the country needs more doctors than the american medical schools can effectively provide. My classmate's dad, for example, is an Italian medical school graduate with license to practice in Italy, Switzerland and the US. A professor of surgery in my medical school is from Oxford medical school. These doctors are considered FMG's, and some didn't even do their residency in America, but does it mean they are inferior? Of course not. They meet the competition of that country to gain admissions to the med school (and believe me, in all other 1st world nations, it's just as competitive if not more so, than in US), and satisfied the requirements of a first world nation to become a physician in that nation. By the way, there is no discrimination shown to this group of doctors whatsoever.

Now, the second group of FMG's, the ones thats the subject of our discussion, are Americans who graduated from American college, and they can not meet the competition to gain admission to the US medical schools that are accredited by LCME. They typically have lower test scores, lower college grades , or have other things on their personal profiles that are less appealing for admissions to the US schools. They typically choose to attend the for-profit medical schools operated by Americans off shore in the Carribeans, the Phillippines or other non-1st world countries. These schools have questionable admissions standards (in terms of acceptance rate, MCAT's, GPA's, etc), questionable quality of education (ie. faculty to student ratio, students per cadaver, educational facilities, quality of library, etc etc etc), and questionable commitment to the success of students (ie. graduation rate, drop out rate, USMLE fail rate?) and inferior hospital training site compared to the US (ie. most carribean med schools are affliated with non-academic hospitals, most are not accredited by the residency matching process.) I can list a hundred more reasons, and these are facts that are backed up by documented sources. I am not saying the students who graduated from these schools are inferior, but I am saying that the training that this group of FMGs receive is inferior to those received by the AMG in an LCME accredited medical school. Note these are two different statements. And yes, discrimination is shown to this group of FMG's when they apply to residency positions, and beyond. And why wouldn't there be? Just look at the reasons above. I am not saying either it's right or wrong to discriminate, but why such discrimination exist.

Above all, I must say that there must be a few stand-outs who attended carribeans, but managed to perform well and is successful at residency and their medical career. Kudos to them! Everything in life has exceptions, but they are EXCEPTIONS rather than the norm.

 

[Skip Intro]

Renovar:

Do you think there are too few medical schools (allopathic, MD-granting) in the U.S.? Too many? Just the right amount?

(Okay, one more...)

Originally posted by Renovar
Therefore in France, the French govt sanctioned their own list of medical schools and train the doctors that serves France...

Are you familiar with the French system (i.e., how French students are admitted to and proceed through medical school)?

-Skip

 

[Renovar]

Originally posted by Skip Intro
Renovar:

Do you think there are too few medical schools (allopathic, MD-granting) in the U.S.? Too many? Just the right amount?

(Okay, one more...)

Are you familiar with the French system (i.e., how French students are admitted to medical school)?

-Skip

To your 2 questions above:

1. In my opinion CURRENTLY there is just a right amount. However, I think there are too many residency spots waiting to be filled (in the US, the residents are basically cheap labors, that's why every hospital opens up a lot of residency slots). That's why AMA suggested in the near future the number of residency slots tol be decreased from 150% of AMG's to 110% of AMG's, while holding the number of American medical schools and their class size constant (according to 1st AID of USMLE 2002 edition). Note that every state with their own state medical schools will adjust the number of positions as change in the need of their state arise, and as I see it I dont see there will be any major change in any state anytime soon.

2. Yes I am. A collegue of my father is a doctor in France right now. Their system is similar to a lot of countries in the Europe. After 12 years of HS and 1 year of what they term "baccalaureat" they take a government baccaluareat exam, and they choose which field they want to enter, and after such exam, those students who choose healthcare/natural sciences tract will be assigned to medical schools, dental schools, etc. consistent with their performance on the exam as well as their "ranking choice" (similar to the matching process). Medical schools there are 7 years, plus residency length comparable to those in the US. Annually there are 7500-8000 doctors graduating from medical school, while there are more than 80000 people writing the natural/biological sciences baccalaureate, most of whom are in the health-care track and undoubtedly has medical schools in mind.

 

[Skip Intro]

Originally posted by Renovar
1. In my opinion CURRENTLY there is just a right amount. However, I think there are too many residency spots waiting to be filled (in the US, the residents are basically cheap labors, that's why every hospital opens up a lot of residency slots). That's why AMA suggested in the near future the number of residency slots tol be decreased from 150% of AMG's to 110% of AMG's, while holding the number of American medical schools and their class size constant (according to 1st AID of USMLE 2002 edition). Note that every state with their own state medical schools will adjust the number of positions as change in the need of their state arise, and as I see it I dont see there will be any major change in any state anytime soon.

Okay, I'll accept that response as a current assessment. But, that begs a few follow-up questions (in the name of honest discourse, trust me... you are one of the few posters so far who've been able to impress me with your responses and seem much more informed than others).

How will we account for adequate healthcare of the aging demographic in the U.S. over the next 20-30 years (namely the baby-boomers, the front-end of whom are currently in their mid-fifties)? (see this recent link in reference: http://www.ama-assn.org/sci-pubs/amnews/pick_02/prl20121.htm )

Currently, almost 25% of doctors in the U.S. are IMGs. There are currently about 813,770 practicing physicians in the U.S., which means that there are about 203,000 foreign-trained physicians practicing medicine. According to the COGME 8th and 11th reports, the number of physicians entering GME has steadily increased, along with the number of doctors specializing. There is a need for more "generalists" in the U.S., but USMGs students seem unwilling to pursue that training.

Who is going to fill this void?

Should IMGs be recruited solely for these positions, despite the fact that they now tend to pursue similar patterns of specializing? (previously cited)

Will limiting the number of GME positions - essentially forcing most non-U.S. citizen IMGs out - from 140% to 110%, as you suggest (and as the COGME tends to concur), ultimately solve this looming problem?

Again, do we need more medical schools in the U.S.?

Sources:

(1) American Medical Association, Physician Characteristics and Distribution in the US, 2002-2003 Edition Chicago: American Medical Association, 2002

(2) http://cogme.gov/rpt8.htm

(3) http://cogme.gov/rpt11.htm

Originally posted by Renovar
2. Yes I am. A collegue of my father is a doctor in France right now. Their system is similar to a lot of countries in the Europe. After 12 years of HS and 1 year of what they term "baccalaureat" they take a government baccaluareat exam, and they choose which field they want to enter, and after such exam, those students who choose healthcare/natural sciences tract will be assigned to medical schools, dental schools, etc. consistent with their performance on the exam as well as their "ranking choice" (similar to the matching process). Medical schools there are 7 years, plus residency length comparable to those in the US. Annually there are 7500-8000 doctors graduating from medical school, while there are more than 80000 people writing the natural/biological sciences baccalaureate, most of whom are in the health-care track and undoubtedly has medical schools in mind.

From what I understand, this first year is a "come one, come all" type of "prove yourself" period. The competition is stiff, and many students fail to make it further into the program. I have a friend from France (Bordeaux) who wished to pursue his medical education, but failed to match-in to a program. Ironically, he came to the U.S. and completed his Bachelor's degree at University of Colorado (go figure). But, I digress...

Despite the significant difference in cost, is this, in your opinion, different from an off-shore medical program that "weeds out" many students who simply cannot make it - or will never pass USMLE Step I - yet still allows them the chance to become a doctor if they have the intelligence, ability to learn medicine, can pass their course work, and ultimate licensure requirements?

To head-off a potential follow-up argument as to the quality of the programs offered off-shore (in comparison to French government's oversite, as could be argued, which is equivalent to, if not more rigorous than, the LCME's), should the accreditation process of the WHO and/or the individual country where a school resides be considered inferior to the LCME's, despite findings of equivalency, say, by the U.S. DOE?

Sources:

(1) http://www.ocf.berkeley.edu/~issues/spring96/french_doc.html

(2) http://www.rossmed.edu/Medical_Scho.../USDE_Standards/usdoe_approves_standards.html

Let's keep this discussion going, Renovar. Please don't unsubscribe.

 

[IRON_DUKE]

AMGs have the market cornered :


What did I mean by this statement ? Of course I think its ok for Americans to have the market cornered . I am an american , why would I want to practice medicine there if I was not . Granted with the exception that maybe family situations would put me in that spot . Say for example I married a french girl , and she wanted to live in france .

What I am saying about the market being cornered is that , WITHOUT even reviewing a IMGs scores , publications , USMLE scores , etc............. you discard them as being inferior . Now when I say you , I mean the person doing the looking over . Not you who are reading this .

If I get a decent USMLE score , oh well I had more time to study .............. If I got good grades in school , well who knows , the school must have been easier , if I get some decent publications , then maybe my pop is on the board of directors ................ NAYSAYERS always have an explaination of why that american IMG , did well . He was a freak of nature , or an exception to the rule . None have the guts to come out and say ......... COOL the person in question did his work . END OF STORY .

And who is to say that there are not comparable quality medical univeristies outside the USA . Not all foreign medical hospitals diagnose via X RAY anymore , no folks ..........there are up to date technology out here . And I dont have to worry about MAL PRAXIS looming over my shoulder , here you are expected to get down and dirty from day one . In fact med students are expected to attend 20 child births as a MINIMUM , hands on . And yes allow me to tell you , there are standards here too .

Brazil is the mecca for plastic surgery . Look it up . The best techniques come from there . Not so much red tape .

.................................so you can take this with a grain of salt , I dont care . But the fact remains the same , study , work hard and PRAYER .

3 ingredients that wont let you down .

GOD , HARD WORK , STUDY .

 

[BellKicker]

Renovar, you have many good points.

First off, you're so right about the fairness of AMGs being favored. That happens anywhere.

About France vs the US system. Now I'm talking post grad training. I don't know France as well as England, Scandinavia, Germany.

Let me summarize:

US:

Residency right away. Relatively easy to get into some, very hard to get into others. Some people apparently never get one. There is no limbo. I think hospitals would love to hire pre-residency slaves (house officers) but to my knowlege it's not done.

Europe:

House officer years first. These are far more important than grades. People do research during these years. Some residencies are very very hard to get into. You WILL need at least a PhD to get one (or something longer called a doctorate. Don't ask). IMGs have a hard time. The difference is that you can always work years of well-paid house officer positions as you gather points for that residency of your dreams. Obviously, everything takes a lot longer over here, too.

Renovar, on a personal note, that guy who was licensed in Europe and the US, how did he do that?? First off, we are basically licensed anywhere in the EU and many people do their house officer years abroad because the credits transfer home no problem. But how did he manage getting both EU and US? It was my impression that nothing transferred. I know there are loop holes but a full unrestricted license; how did he do that?

Lastly, I was a little shocked when you wrote about the residencies being cut down. I thought there was a doctor shortage in the US. And it's not exactly like the residents have easy hours, so the need must certainly be there for MORE doctors. Are you implying something like house officer years. I don't really know if I would prefer that. It's apples and oranges.

With such a cut-back and no other changes, future IMGs like myself would be in very big trouble.

 

[BellKicker]

Skip Intro, I was trying to read those links but I got stuck. SHOULD be reading about the great world of fungi (gotta love paracoccidioimycoidosis (or whatever)). Can you fill me in on the gist of it.

I've actually considered family practice for a long time. I probably would have chosen that even if I had stayed in my own country. But they talk about an increase in those residencies? Taken from where? If you have read the whole thing can you summarize what it says? Is it bad or good for IMGs? That's what I can't figure out.

Later.

 

[Renovar]

Originally posted by Skip Intro


Okay, I'll accept that response as a current assessment. But, that begs a few follow-up questions (in the name of honest discourse, trust me... you are one of the few posters so far who've been able to impress me with your responses and seem much more informed than others).

How will we account for adequate healthcare of the aging demographic in the U.S. over the next 20-30 years (namely the baby-boomers, the front-end of whom are currently in their mid-fifties)? (see this recent link in reference: http://www.ama-assn.org/sci-pubs/amnews/pick_02/prl20121.htm )

Currently, almost 25% of doctors in the U.S. are IMGs. There are currently about 813,770 practicing physicians in the U.S., which means that there are about 203,000 foreign-trained physicians practicing medicine. According to the COGME 8th and 11th reports, the number of physicians entering GME has steadily increased, along with the number of doctors specializing. There is a need for more "generalists" in the U.S., but USMGs students seem unwilling to pursue that training.

Who is going to fill this void?

Should IMGs be recruited solely for these positions, despite the fact that they now tend to pursue similar patterns of specializing? (previously cited)

Will limiting the number of GME positions - essentially forcing most non-U.S. citizen IMGs out - from 140% to 110%, as you suggest (and as the COGME tends to concur), ultimately solve this looming problem?

Again, do we need more medical schools in the U.S.?

Sources:

(1) American Medical Association, Physician Characteristics and Distribution in the US, 2002-2003 Edition Chicago: American Medical Association, 2002

(2) http://cogme.gov/rpt8.htm

(3) http://cogme.gov/rpt11.htm

Ok, let me try to respond to the first part of your argument:

According to the COGME reports you included, it concluded that:

"Despite the aforementioned uncertainties, current data support a goal that total first-year residency positions be reduced to 110% of 1993 USMGs and that 50% of this reduced number enter practice as generalists. Implementing this recommendation will require fundamental changes in current patterns of GME which should be instituted as rapidly as possible. If this goal is achieved, the nation's physician workforce will more closely correspond to physician requirements early in the next century."

And this drives the crux of the question. Do we need more doctors in this country? According to COGME the answer is no... According to COGME and AMA, they are looking towards pushing more AMG's away from speciality medicine and more into primary care (medicine, ob/gyn, family practice, etc), fields that are traditionally occupied by most FMG's. I must point out that this report is in 1996, and many things have changed since then, and many medical schools as well as the various state governments in the US are now actively encouraging their graduates to pursue a career in primary care, including some of the top institutions. As far as I can see they are on it's way of 110-50-50 as proposed by COGME. Consider the following:

Cornell's Weil Medical College, long considered one of the best med schools in the nation, is pushing 53% of their graduates into primary care in the past 2 years, up from just over 1/3 10 years ago. Case Western is up at 60+%. Similar upward trends can be observed at some of the top private schools such as Northwestern, Wash U and Stanford. Almost every school sees some kind of upward trend in the past few years, even at my medical school where primary care is traditionally looked-down-upon. The proportion of people going into primary care from state medical schools is even more astonishing in recent years. In the past 3 years Penn State has 70-80% primary care matching rates (many of these match-lists are on-line), and that's quite typical of many state schools. Some states (such as PA, NY, OH, and I am sure many others) are offering full scholarship money for medical students to commit into going into primary care, and are attracting many students (including some of my classmates) to go this route. All this, coupled with increasing number of osteopathic graduates as well as increased prominence of NP's and PA's in primary care roles (fittingly so considering we are in the era of the HMOs and their cost-cutting ways), in my understanding, will fill the health care void. True, we need more family docs, geriatricians and internists and less plastic and orthopedic surgeons, but this void are going to be filled from within.

 

[Renovar]

Originally posted by BellKicker
Renovar, you have many good points.

First off, you're so right about the fairness of AMGs being favored. That happens anywhere.

About France vs the US system. Now I'm talking post grad training. I don't know France as well as England, Scandinavia, Germany.

Let me summarize:

US:

Residency right away. Relatively easy to get into some, very hard to get into others. Some people apparently never get one. There is no limbo. I think hospitals would love to hire pre-residency slaves (house officers) but to my knowlege it's not done.

Europe:

House officer years first. These are far more

important than grades. People do research during these years. Some residencies are very very hard to get into. You WILL need at least a PhD to get one (or something longer called a doctorate. Don't ask). IMGs have a hard time. The difference is that you can always work years of well-paid house officer positions as you gather points for that residency of your dreams. Obviously, everything takes a lot longer over here, too.

Renovar, on a personal note, that guy who was licensed in Europe and the US, how did he do that?? First off, we are basically licensed anywhere in the EU and many people do their house officer years abroad because the credits transfer home no problem. But how did he manage getting both EU and US? It was my impression that nothing transferred. I know there are loop holes but a full unrestricted license; how did he do that?

Lastly, I was a little shocked when you wrote about the residencies being cut down. I thought there was a doctor shortage in the US. And it's not exactly like the residents have easy hours, so the need must certainly be there for MORE doctors. Are you implying something like house officer years. I don't really know if I would prefer that. It's apples and oranges.

With such a cut-back and no other changes, future IMGs like myself would be in very big trouble.

According to the Graduate Medical Education council (COGME), in terms of numbers, there is a physician surplus in this country, however, there are shortage of physicians (at the time of the report, 1996) in the fields of primary care, as well as in other underserved or rural areas, and the majority of surplus is in the specialty fields.

Residents in this country have sucky hours, sucky life, and are basically cheap labor workhorse in the health-care system. That's why hospitals love them. That's why hospitals want to have more of them. They help to keep the dollars down and workhours up. But each and every resident become full doctors after residency, which adds to an already over-supply of full doctors practicing in this country. That's why COGME decides to bite the bullet and decrease the number of residency positions. True, it's going to hurt the hospital economics and the HMO's profit margins, but it will, in the long term, stabilize the physician supply in this country.

But what this is going to do, is hurt the FMG's, especially those FMG's who recieved their medical training abroad, but seek US residency positions. To those who train abroad and complete their residency abroad, I personally foresee a smaller problem.

In response to those doctors I mentioned in the post, quite honestly I didn't know the logistics, but suffice to say they came into this country during the 70's, and passed certain examinations and specialty boards required of them at the time and was granted US license to practice. Laws have changed since then, but the new laws only affect the new incoming FMG's, and does not apply to those FMG's who have already attained US license.