Now, a cautionary tale...

[deleted520847]

Anyone know what happened to this doctor?

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[rkaz]

Stories like this really sadden me.

I had 2 friends who chose to go to medical school overseas. One attended one of the 'big 3' Caribbean med schools. She graduated several years ago, but was unable to pass her boards, despite several attempts. She committed suicide this year. Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years, I can only imagine her suffering at being hundreds of thousands of dollars in debt without means to pay off her loans. I wish I knew about her pain, so that I could have reached out to her before it was too late.

Another friend of mine went to India and graduated several years ago. She is back in the US, studying for step 3. Has attempted several times to get into residency and is still trying.

Both of these women are/were highly intelligent, kind-hearted, friendly and beautiful. It took a lot of courage to go overseas, and the path has not been easy.

I also previous thought about going overseas and was accepted to SGU - though ended up going the DO route, and matched into an ACGME psychiatry residency on my first application. I'm now in the middle of residency and licensed in my state. Knowing what I know now, I feel extremely fortunate for the path that opened up for me.

I know it can be easy to judge the person in the original post. Yes, he took the "easy way out" by going overseas and not doing the MCAT. But in the end this way has been so much harder for him than if he just used his initial years to get a solid pre-med foundation, study for the MCAT and matriculate into a US MD/DO school. DO schools at least allow grade replacement, so while it might take some time to gain admission for someone who may not initially have the greatest application, it can be done. I really hope after all of this that there is a solid career path for him so he has the opportunity to make a sustainable living and pay off his loans. I worry for people with these kinds of loans with little way to pay them off, that they might get really desperate and suicide may be seen as the only solution. I really hope for Dr. Bill and other US-IMG's without residencies that they can reach out for help, and not feel beaten down by their personal struggles. Medicine can be a very unforgiving field and it's really sad for people to be in these situations.

 

[the argus]

Stories like this really sadden me.

I had 2 friends who chose to go to medical school overseas. One attended one of the 'big 3' Caribbean med schools. She graduated several years ago, but was unable to pass her boards, despite several attempts. She committed suicide this year. Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years, I can only imagine her suffering at being hundreds of thousands of dollars in debt without means to pay off her loans. I wish I knew about her pain, so that I could have reached out to her before it was too late.

Another friend of mine went to India and graduated several years ago. She is back in the US, studying for step 3. Has attempted several times to get into residency and is still trying.

Both of these women are/were highly intelligent, kind-hearted, friendly and beautiful. It took a lot of courage to go overseas, and the path has not been easy.

I also previous thought about going overseas and was accepted to SGU - though ended up going the DO route, and matched into an ACGME psychiatry residency on my first application. I'm now in the middle of residency and licensed in my state. Knowing what I know now, I feel extremely fortunate for the path that opened up for me.

I know it can be easy to judge the person in the original post. Yes, he took the "easy way out" by going overseas and not doing the MCAT. But in the end this way has been so much harder for him than if he just used his initial years to get a solid pre-med foundation, study for the MCAT and matriculate into a US MD/DO school. DO schools at least allow grade replacement, so while it might take some time to gain admission for someone who may not initially have the greatest application, it can be done. I really hope after all of this that there is a solid career path for him so he has the opportunity to make a sustainable living and pay off his loans. I worry for people with these kinds of loans with little way to pay them off, that they might get really desperate and suicide may be seen as the only solution. I really hope for Dr. Bill and other US-IMG's without residencies that they can reach out for help, and not feel beaten down by their personal struggles. Medicine can be a very unforgiving field and it's really sad for people to be in these situations.

First off, I'm sorry about your friend. Someone taking their own life is always a sad and horrible situation.

But for you to in some way imply that going to a Caribbean school and accruing student loan debt was the reason for her suicide, especially seeing as "Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years," is incredibly cavalier and pretty irresponsible. Not to mention if your friend was a US citizen who went to a big 3 Caribbean school, she almost surely had US federal student loans which would qualify for an income-driven repayment plan. She in no way would be "suffering at being hundreds of thousands of dollars in debt without means to pay off her loans." She would have had to pay 10-20% of her discretionary income towards her loans, which while annoying, is not something that will financially cripple someone for the rest of their lives.

 

[NewHorizons]

First off, I'm sorry about your friend. Someone taking their own life is always a sad and horrible situation.

But for you to in some way imply that going to a Caribbean school and accruing student loan debt was the reason for her suicide, especially seeing as "Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years," is incredibly cavalier and pretty irresponsible. Not to mention if your friend was a US citizen who went to a big 3 Caribbean school, she almost surely had US federal student loans which would qualify for an income-driven repayment plan. She in no way would be "suffering at being hundreds of thousands of dollars in debt without means to pay off her loans." She would have had to pay 10-20% of her discretionary income towards her loans, which while annoying, is not something that will financially cripple someone for the rest of their lives.

But it's also unclear if the victim rationalized it as well as you have. While I agree that suggesting their circumstances may be premature, we also cannot rule it out as a contributing factor... the extent to which it plays a role is probably something we'll never know.

 

[Skip Intro]

While I was on Dominica, two students died.

One guy they found with a needle hanging out of his arm. The other one drifted out to sea during a kayak trip and was never found.

After graduation back in the U.S., another guy in my graduating class whom I knew personally (with his whole future ahead of him) was in his internship in Ohio when he snuck away from his friends, wasn't heard from, and fell off of a dockside pier at a restaurant. He drowned and his body was found several days later.

So, also not to sound cavalier or irresponsible, but some people die. The reasons are varied and, yes, even sometimes preventable.

Did Dr. Bill's situation work out? Who knows? I haven't re-visited his blog. But, I doubt he killed himself. I could be wrong. And, yes, that would be tragic. Nonetheless, the vast majority of people who fail out of school (Caribbean or otherwise) don't commit suicide. Suicide is never a wise solution to any problem. Neither, honestly, are anecdotes at helping predict individual outcomes. They can, however, serve as a warning and wake-up for anyone who thinks that everything is automatically going to work out okay if they just show-up and check-in.

That was my only point of sharing this story originally.

-Skip

 

[deleted718115]

First off, I'm sorry about your friend. Someone taking their own life is always a sad and horrible situation.

But for you to in some way imply that going to a Caribbean school and accruing student loan debt was the reason for her suicide, especially seeing as "Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years," is incredibly cavalier and pretty irresponsible. Not to mention if your friend was a US citizen who went to a big 3 Caribbean school, she almost surely had US federal student loans which would qualify for an income-driven repayment plan. She in no way would be "suffering at being hundreds of thousands of dollars in debt without means to pay off her loans." She would have had to pay 10-20% of her discretionary income towards her loans, which while annoying, is not something that will financially cripple someone for the rest of their lives.

Federal loan - while better than private loans - is still very draconian.
If you put your loans on hold under "unemployment deferment," interests will still accumulate, and deferment is not unlimited. You can only defer up to 2 years in total over the life of your loans.
Income-driven plans subject borrowers to a massive "tax bomb" at the end of 25 years that has to be paid up front. If a person is working a normal job (not making at least $100k/year), there's no way in hell she can pay off that ridiculous "tax".

 

[W19]

If you can't get into US med school and you still want to be a doctor, do the DNP program. That way you can call yourself 'doctor'. You don't have to subject yourself to the uncertainty of attending a Caribbean school...

 

[cassis_Cake]

If you can't get into US med school and you still want to be a doctor, do the DNP program. That way you can call yourself 'doctor'. You don't have to subject yourself to the uncertainty of attending a Caribbean school...

Yes, if your motivation for going to medical school is to call yourself 'doctor' then you should follow this advice...

 

[Skip Intro]

If you can't get into US med school and you still want to be a doctor, do the DNP program. That way you can call yourself 'doctor'. You don't have to subject yourself to the uncertainty of attending a Caribbean school...

You currently cannot introduce yourself as "doctor" to your patients, in most instances, without clarifying that your terminal degree is in nursing. There are laws currently being formulated and advanced in both state legislatures and at the federal level, met with huge resistance from the nursing community, that are in the process of codifying this.

Regardless, most medical staff at hospitals will require that you clarify you are a nurse when interacting with patients and staff, and likely will not extend admitting privileges without physician supervision. And, lastly, you open yourself to potential huge liability if you confuse or mislead a patient into believing that you are a medical doctor, when (in fact) your terminal degree is in nursing and you are not functioning under a license issued from the board of medicine in your state (with all the requisite legal issues).

-Skip

 

[deleted718115]

I find the degree "doctor of nursing" preposterous.

 

[W19]

@Skip Intro DNP will tell you that 'physician' is a trade name that is protected by law--not doctor.

'Regardless, most medical staff at hospitals will require that you clarify you are a nurse when interacting with patients and staff, and likely will not extend admitting privileges without physician supervision.'

I have not seen that.. Sure other medical staff roll their eyes when DNP do that, but most will not approach them about it

 

[Mad Jack]

First off, I'm sorry about your friend. Someone taking their own life is always a sad and horrible situation.

But for you to in some way imply that going to a Caribbean school and accruing student loan debt was the reason for her suicide, especially seeing as "Although I do not know the exact circumstances surrounding her desperation and death as we had not chatted that much in recent years," is incredibly cavalier and pretty irresponsible. Not to mention if your friend was a US citizen who went to a big 3 Caribbean school, she almost surely had US federal student loans which would qualify for an income-driven repayment plan. She in no way would be "suffering at being hundreds of thousands of dollars in debt without means to pay off her loans." She would have had to pay 10-20% of her discretionary income towards her loans, which while annoying, is not something that will financially cripple someone for the rest of their lives.

Until the tax bomb hits. And you're pretty much ineligible for any other loans due to your massive debt to income ratio, regardless of how little you're paying. And then there's the whole wasting several years of your life bit. And the astounding sense of failure you have to live with for the rest of your life, which, in light of certain cultural factors, may as well be social suicide (such a person would pretty much be unable to find a spouse in certain cultures, which can pretty much obliterate their family lives and future). I mean, it's not just about the money, there's a lot that goes into this and you can't really say what was going on, but I guarantee her failing to match had something to do with it.

 

[W19]

Until the tax bomb hits. And you're pretty much ineligible for any other loans due to your massive debt to income ratio, regardless of how little you're paying. And then there's the whole wasting several years of your life bit. And the astounding sense of failure you have to live with for the rest of your life, which, in light of certain cultural factors, may as well be social suicide (such a person would pretty much be unable to find a spouse in certain cultures, which can pretty much obliterate their family lives and future). I mean, it's not just about the money, there's a lot that goes into this and you can't really say what was going on, but I guarantee her failing out had something to do with it.

Wow! How can you guarantee such thing?

 

[Mad Jack]

Wow! How can you guarantee such thing?

Do you honestly think that it would have zero contribution to her suicide whatsoever? Not a bit? I mean, suicide is a multifactorial thing, as anyone who's ever attempted it can attest.

 

[W19]

Do you honestly think that it would have zero contribution to her suicide whatsoever? Not a bit?

I don't know that person or anything about the incident, so making any connection between the two would be just speculation...

 

[Skip Intro]

@Skip Intro DNP will tell you that 'physician' is a trade name that is protected by law--not doctor.

We do not allow (at the multitude of hospitals I have worked in) CRNAs, midwives, or nurse practitioners with DNP or DNAP terminal degrees to introduce themselves to patients as "doctor" in the hospital. This is, in my experience, uniformly adopted at the vast majority of hospitals in the U.S.

Likewise, while they may be able to get away with this if they hang a shingle and open up a solo office somewhere (like chiropractors who call themselves "doctor" but can't prescribe, order certain tests, perform invasive procedures, etc.), I think they should be cautious about ensuring and it would be prudent that their patients understand that they (1) never went to medical school, (2) never did a residency, (3) are not licensed by the board of medicine, (4) may not be able to fully treat the patient's presenting complaint, and (5) that there is a significant chance that they completed their some or the bulk of their "doctorate" through some online course with zero additional clinical contact time. Otherwise, they may find themselves spending an inordinate time in court.

-Skip

 

[W19]

@Skip Intro It's not uniformly adopted... They get away with with by saying: I am doctor [last name], I am your nurse practitioner... But the truth is most patients don't pay attention to the latter part of the sentence once they see someone with a white coat introducing him/herself as doctor...

 

[Skip Intro]

@Skip Intro It's not uniformly adopted... They get away with with by saying: I am doctor [last name], I am your nurse practitioner... But the truth is most patients don't pay attention to the latter part of the sentence one they see someone with a white coat introducing him/herself as doctor...

If you go back to what I originally said...

You currently cannot introduce yourself as "doctor" to your patients, in most instances, without clarifying that your terminal degree is in nursing.

... you will see that we are not in disagreement.

And, I can tell you, that at all the hospitals I have worked at -- from residency to my current place of employment -- they do not introduce themselves as doctor to the patient. If they did, they would not last long. I work with a P.A. who has a PhD in physiology. He absolutely knows it would be career suicide if he dared to introduce himself as "doctor" to any patient. I've even heard him clarify when patients call him "doc" that he's not a medical doctor.

-Skip

 

[W19]

@Skip Intro I got what you said, but I think it is still misleading even if they clarify because most patients won't really pay close attention...

 

[Mad Jack]

I don't know that person or anything about the incident, so making any connection between the two would be just speculation...

A speculation that would be correct 99 times out of 100

 

[W19]

A speculation that would be correct 99 times out of 100

Lol...

 

[deleted520847]

I obviously do not know about the medical profession in the Caribbean but is it possible for these doctors to practice medicine there instead of trying and failing to match several years in a row?

 

[NotAProgDirector]

I obviously do not know about the medical profession in the Caribbean but is it possible for these doctors to practice medicine there instead of trying and failing to match several years in a row?

No. The islands are very small, the schools train 100's of docs, and the foreign students can't work there without visas. And medical school without a residency is not enough to practice.

 

[Seth Joo]

If you can't get into US med school and you still want to be a doctor, do the DNP program. That way you can call yourself 'doctor'. You don't have to subject yourself to the uncertainty of attending a Caribbean school...

Nursing in many ways is a better career than Medicine, you can work in more countries with less red tape than a physician.

 

[tartesos]

Nursing in many ways is a better career than Medicine, you can work in more countries with less red tape than a physician.

That sounds like it came from a nurse.....

 

[tartesos]

No. The islands are very small, the schools train 100's of docs, and the foreign students can't work there without visas. And medical school without a residency is not enough to practice.

To give the perspective of the Dominican Rep( for those who attend UNIBE or UCE, You need to do a "pasantia" which is working in a rural community for a year for about 500 us doll a month in order to obtain a medical license, to then take an exam and compete for a residency spot( Score, publications and location of pasantia( the more remote the better) play a role in your competitiveness ... If you are not very very proficient in Spanish it would be practically impossible.

On top of that, hierarchy in residency is much like military ( standing up when a senior resident walks in the room, because said any senior resident can discipline you with extra work etc. ). It's a tough cookie to swallow.

 

[deleted520847]

On top of that, hierarchy in residency is much like military ( standing up when a senior resident walks in the room, because said any senior resident can discipline you with extra work etc. ). It's a tough cookie to swallow.

yikes!

 

[deleted274002]

It appears he did get one interview this year thus far. I, for one, am pulling for him, if for no other reason other than no one deserves to be a debt slave.

 

[W19]

@SpAnKz89X I do not see that in his blog... I think the system should give him a chance... If NP are practicing medicine and not killing people, I don't think him being a FM doc will do damage to the system.

 

[deleted274002]

@SpAnKz89X I do not see that in his blog... I think the system should give him a chance... If NP are practicing medicine and not killing people, I don't think him being a FM doc will do damage to the system.

It isn't on his blog. I wandered over to "Student Doc" and found he's a top moderator over there. In November, he mentioned that he did get one interview.

http://www.studentdoc.com/phpBB2/viewtopic.php?t=18997

This thread (not the person who started it, but in many of the replies) reminds me why SDN can be an awful place. Self-righteousness masquerading as "tough love". Yes, he's in a tough spot, and yes, his likelihood of matching is very slim, but so many here are tearing him down unnecessarily. People that are comfortably in residency or practice seem to think it's perfectly acceptable for people to become debt slaves if they cannot get into residency. These same people will endlessly complain about malpractice attorneys suing them out of their livelihoods or NP/PAs replacing them as mid-level providers. Am I saying that residency spots should be guaranteed to Caribbean grads? Since they're not guaranteed to ANYONE, let alone Caribbean grads, I would say probably not. However, to make people debt slaves with no way to pay off these loans and no way to discharge them is a crime. I don't care that he went to crappy diploma mills and failed the Steps multiple times. A physician? Probably not. But should he be shackled with this debt that he'll never pay off? Why should anyone be relegated to poverty just because they can't match?

Again, I'm not saying whether he deserves to match one way or another nor am I disputing his many mistakes. I'm just saying 1) don't cast judgments on people for their decisions. We're all a malpractice suit away from never practicing either. People in glass houses should not throw stones and 2) there needs to be a change to the bankruptcy laws so that educational debt like this can be discharged. If you don't want "Dr. Bill" to practice medicine, then fine. Let him start over without having a debt he can never realistically pay in his own lifetime.

FYI, I'm an AMG.

 

[W19]

@SpAnKz89X

It's not a criticism, but many in SDN have not lived in the real world. Medicine attract people from upper middle-class that never hold a job in their life, so a lot of them pass judgment on others based on their narrow experience. The allo forum is notorious for that!

I read part of his blog and I saw he had the opportunity to do an unapproved ACGME internship in PR and I am kind of wondering why did he pass on that... I have a friend who had the same issue, and after two unsuccessful attempts at the match, he did a 2-year unapproved ACGME internship in PR, and was able to get a GP license in PR after year 1.... Then he moved back to the state and get a GP license in one of the many states that would give one a license once you are licensed in any US jurisdiction. My friend is working now in a rural area making the average FM salary + 25k/year loan repayment.

I think that's not a bad deal for people who have trouble matching, but a lot people know about that PR loophole now, so these internships are hard to get...

 

[deleted274002]

Sorry to to revive this old thread, but an update:

http://southerndoccarib.blogspot.com/2016/03/worst-residency-match-ever-2016.html

Dr. Bill didn't match. Poor guy. I hope something works out for him.

 

[Bryan O’Blivion]

Sorry to to revive this old thread, but an update:

http://southerndoccarib.blogspot.com/2016/03/worst-residency-match-ever-2016.html

Dr. Bill didn't match. Poor guy. I hope something works out for him.

It is painful to see, but you should ask yourself if you would want someone with this kind of track record in your residency program. Do you want to be constantly scrutinizing their decisions, making sure that they understand the patient's condition and treatment plan? Do you want to stay late to ensure that they are providing adequate care, reviewing their notes, and then working up their patients on your own? Do you want to volunteer your time to tutor them so that they pass their ITE's? At some point, when you give someone provisional independence, you have to have a basic trust in their ability to interpret basic information and make good decisions, since you won't be there at every moment.

Residency is a steep learning curve, and best suited to people who have a strong foundation of knowledge and have demonstrated a proven ability to learn, especially under time constraints and stress.

I too feel for him, and I am trying not to be self righteous, merely objective, but I do not think that getting a primary care residency position would be ultimately a good thing for him. Like many people, I am sure, part of me thinks: "Why can't this guy get a break?" On the other hand, if he were to match, I think that he would likely end up being dismissed for incompetence, or academic failure. That would not do him any favors. It would also not do his program, fellow residents, preceptors, and ultimately his patients any favors either.

There are accelerated nurse practitioner programs that offer a bridge program for IMGs. This is something he should have considered a few cycles ago.

 

[deleted274002]

It is painful to see, but you should ask yourself if you would want someone with this kind of track record in your residency program. Do you want to be constantly scrutinizing their decisions, making sure that they understand the patient's condition and treatment plan? Do you want to stay late to ensure that they are providing adequate care, reviewing their notes, and then working up their patients on your own? Do you want to volunteer your time to tutor them so that they pass their ITE's? At some point, when you give someone provisional independence, you have to have a basic trust in their ability to interpret basic information and make good decisions, since you won't be there at every moment.

Residency is a steep learning curve, and best suited to people who have a strong foundation of knowledge and have demonstrated a proven ability to learn, especially under time constraints and stress.

I too feel for him, and I am trying not to be self righteous, merely objective, but I do not think that getting a primary care residency position would be ultimately a good thing for him. Like many people, I am sure, part of me thinks: "Why can't this guy get a break?" On the other hand, if he were to match, I think that he would likely end up being dismissed for incompetence, or academic failure. That would not do him any favors. It would also not do his program, fellow residents, preceptors, and ultimately his patients any favors either.

There are accelerated nurse practitioner programs that offer a bridge program for IMGs. This is something he should have considered a few cycles ago.

No, probably not. When I say, "poor guy, I hope something works out for him", I mean to say I hope he finds a mechanism to be able to pay off his student loans. It's more the debt that pulls at my heart strings than anything else.

 

[Skip Intro]

There are accelerated nurse practitioner programs that offer a bridge program for IMGs. This is something he should have considered a few cycles ago.

Hey, this is a great suggestion. I'm not personally familiar with them. I am familiar with the accelerated foreign-M.D -> D.O. pathway that NYCOM offered (at least they did in the past).

Do you have any links? I'm curious now.

-Skip

 

[tartesos]

Hey, this is a great suggestion. I'm not personally familiar with them. I am familiar with the accelerated foreign-M.D -> D.O. pathway that NYCOM offered (at least they did in the past).

Do you have any links? I'm curious now.

-Skip

I didn't know about IMG to do. Interesting.

If you google md to np you will find some programs, there's one in atl, one in Florida and a couple in Nyc that I've heard of from other people.


It's 3 y total, 1 year rn, and 2 years np.




Sent from my iPhone using SDN mobile app

 

[Bryan O’Blivion]

Hi Skip:

The Florida International University program is mentioned in this article that I found by googling: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904828/

I am not going to endorse it, since I know nothing about it, but it superficially seems reasonable for someone in that position. Working in an underserved area as an NP could yield enough of an income for a person to pay back medical loans and still net enough to provide for a family in a reasonable manner. His MD, and RN might be a helpful to him here. It's a way out.

 

[bedevilled ben]

Hey, this is a great suggestion. I'm not personally familiar with them. I am familiar with the accelerated foreign-M.D -> D.O. pathway that NYCOM offered (at least they did in the past).

Do you have any links? I'm curious now.

-Skip

I too was curious. I'm not sure if this is the specific program @Brick Majors was referencing, but this was the first one I came across. This is the only one I found that was specifically targeting IMG/FMGs.

Florida International University Foreign-Educated Physicians Accelerated Combined BSN/MSN

Transitioning From Physician to Nurse Pracitioner

I hope Dr. Bill has fully explored his options at this point. I respect his mental fortitude and perseverance despite questioning his judgment. I was an anxiety-ridden mess on that first day of Match week, I can't imagine going through that process 5 or 6 times.

Edit: I was too slow. Womp.

 

[IslandStyle808]

It is painful to see, but you should ask yourself if you would want someone with this kind of track record in your residency program. Do you want to be constantly scrutinizing their decisions, making sure that they understand the patient's condition and treatment plan? Do you want to stay late to ensure that they are providing adequate care, reviewing their notes, and then working up their patients on your own? Do you want to volunteer your time to tutor them so that they pass their ITE's? At some point, when you give someone provisional independence, you have to have a basic trust in their ability to interpret basic information and make good decisions, since you won't be there at every moment.

Residency is a steep learning curve, and best suited to people who have a strong foundation of knowledge and have demonstrated a proven ability to learn, especially under time constraints and stress.

I too feel for him, and I am trying not to be self righteous, merely objective, but I do not think that getting a primary care residency position would be ultimately a good thing for him. Like many people, I am sure, part of me thinks: "Why can't this guy get a break?" On the other hand, if he were to match, I think that he would likely end up being dismissed for incompetence, or academic failure. That would not do him any favors. It would also not do his program, fellow residents, preceptors, and ultimately his patients any favors either.

There are accelerated nurse practitioner programs that offer a bridge program for IMGs. This is something he should have considered a few cycles ago.

Actually do you feel it was more him being an unknown product than a "dangerous" doctor when he was first applying? He graduated from a non-big 4 school and one would assume the match rates from these schools are much lower. I do believe after his 3rd try he should have threw in the towel. His clinical skills would have been so rusty, if he has not been in any preliminary internship training for that long.

 

[bedevilled ben]

Actually do you feel it was more him being an unknown product than a "dangerous" doctor when he was first applying? He graduated from a non-big 4 school and one would assume the match rates from these schools are much lower. I do believe after his 3rd try he should have threw in the towel. His clinical skills would have been so rusty, if he has not been in any preliminary internship training for that long.

He had a couple of Step failures and had transferred from another unvetted program as well IIRC. He had more red flags than a Chinese military parade.

 

[IslandStyle808]

He had a couple of Step failures and had transferred from another unvetted program as well IIRC. He had more red flags than a Chinese military parade.

Okay gotcha. Makes more sense.

 

[Bryan O’Blivion]

Actually do you feel it was more him being an unknown product than a "dangerous" doctor when he was first applying? He graduated from a non-big 4 school and one would assume the match rates from these schools are much lower. I do believe after his 3rd try he should have threw in the towel. His clinical skills would have been so rusty, if he has not been in any preliminary internship training for that long.

Well, anyone who doesn't learn quickly can be a "dangerous doctor". There are ample opportunities to make serious medical errors in residency, that will fall through the cracks. He doesn't seem dishonest, sneaky, or anything that would make me want to avoid him like the plague, but I can imagine the incredibly wearisome job of being his senior on a busy service. Imagine having to talk over every patient with him, after he interviews them, before he presents them, and making sure he understands the plan. After a week or two, you would begin to resent him, even if he is a nice person. After a while, everybody would be willing to take more call/larger clinic load rather than have to deal with him. I can only imagine the HA for the PD.

It's not that he is an unknown quantity, he's a known quantity. Someone who has failed a standardized assessment of knowledge multiple times. Personally, this is my own gripe, but I don't want anyone with a very low Step 2 ranked, much less a fail. Clinical science is important, it's what we do here. When you become a resident, you become part of a team. You have to think of what you bring to the table. Basically, it is being a trainable learner who can be relied on to complete basic tasks and then more complicated tasks, and develop skills and clinical judgment. And make medical decisions, based on your continually evolving understanding of medical science. It is not about being deserving, at the end of the day, it's about being able to do the job.

This reflects my own personal opinions. Perhaps other people have a more generous viewpoint, but that's how I feel.

EDIT: For clarification, I would add that I personally find residency far more academically challenging than medical school. When you work 12 hours a day, it seems like you return home bereft of the mental energy it takes to learn complex subject matter. That is why it it is really important to have a firm grasp on the fundamentals. If you don't have that, it is MUCH harder. That is why I consider the Steps important.

 

[Bryan O’Blivion]

No, probably not. When I say, "poor guy, I hope something works out for him", I mean to say I hope he finds a mechanism to be able to pay off his student loans. It's more the debt that pulls at my heart strings than anything else.

I agree. I feel like a jerk whenever I write something disparaging about him. He's probably a nice person IRL. I honestly wish him the best. I think that he probably disregarded the advice people gave him over the years.

 

[Skip Intro]

Hi Skip:

The Florida International University program is mentioned in this article that I found by googling: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904828/

I am not going to endorse it, since I know nothing about it, but it superficially seems reasonable for someone in that position. Working in an underserved area as an NP could yield enough of an income for a person to pay back medical loans and still net enough to provide for a family in a reasonable manner. His MD, and RN might be a helpful to him here. It's a way out.

I too was curious. I'm not sure if this is the specific program @Brick Majors was referencing, but this was the first one I came across. This is the only one I found that was specifically targeting IMG/FMGs.

Florida International University Foreign-Educated Physicians Accelerated Combined BSN/MSN

Transitioning From Physician to Nurse Pracitioner

I hope Dr. Bill has fully explored his options at this point. I respect his mental fortitude and perseverance despite questioning his judgment. I was an anxiety-ridden mess on that first day of Match week, I can't imagine going through that process 5 or 6 times.

Edit: I was too slow. Womp.

Yeah, that seems like an interesting program if he'd be willing to go serve somewhere. But, while being a nurse, I'm not sure if he has any practical time as a "doctor" even with his medical degree. He might just want to go to "good-ole" CRNP training at this point, seeing as he's already a nurse. Many people don't even have that option.

But, it's an interesting idea. I wonder if any Carib grads who couldn't get residency and weren't already an allied health professional before going to school there successfully navigated a program like FIU's.

Thanks for sharing. This might help others.

-Skip

 

[Sardinia]

I wonder if any Carib grads who couldn't get residency and weren't already an allied health professional before going to school there successfully navigated a program like FIU's. Thanks for sharing. This might help others. -Skip

 

[hallowmann]

This is a rough thread reread... It seems he's in PR doing one of those unaccredited programs, so I hope whatever is best works out for him.

Sorry to to revive this old thread, but an update:

http://southerndoccarib.blogspot.com/2016/03/worst-residency-match-ever-2016.html

Dr. Bill didn't match. Poor guy. I hope something works out for him.

What's with the fudging the stats? He makes it sound like they rigged it by taking out people who withdrew or did not rank (mostly people who attained positions either before the match, in the AOA match, or one of the other matches like the SF match; people who decided to hold off on residency, OR those that received 0 interviews). How could they possibly include those people as a measure of matching? It would obviously skew the results because those people are removed completely from the matching algorithm to begin with, so why would they be included? Obviously applying is very different than actively participating in the match.

I don't really get how its a way of them "tricking" people nor do I think it comes from a place of malicious intent.

Yeah, that seems like an interesting program if he'd be willing to go serve somewhere. But, while being a nurse, I'm not sure if he has any practical time as a "doctor" even with his medical degree. He might just want to go to "good-ole" CRNP training at this point, seeing as he's already a nurse. Many people don't even have that option.

But, it's an interesting idea. I wonder if any Carib grads who couldn't get residency and weren't already an allied health professional before going to school there successfully navigated a program like FIU's.

Thanks for sharing. This might help others.

-Skip

Its an expensive program. Like $90k in OS tuition alone ($41k for IS) to go through it after completing the 3 pre-reqs (not sure how much that would cost) and taking their exams. So basically going through it would throw on another $100k in tuition and fees (plus living), but at least it would significantly increase their salary. I imagine its worth it for the people that end up working at restaurants or in retail (depending on salary obviously).

I have a family member that is an FMG, far too removed from graduation for the residency app process to be worth it, and he's working essentially as a medical tech making barely enough to support his family (wife, 3 kids, his father and his wife's parents). He's probably as old as this guy is now, but the real problem would be justifying probably $150k-$200k debt and 3 yrs for at most 10-15 more years of productivity as an NP.

 

[W19]

@hallowmann These unaccredited PR programs are somewhat a big loophole that IMG can use... I have a friend who did one after multiple unsuccessful match attempts and he is doing pretty good in the state now. Many states might not want to license you, but if you work for the fed, you need a state license which you got after doing that one year in PR.

My friend got a great job (albeit not in a prime location) making a little bit below average FM salary. The benefits are excellent (even subsidized housing) since the fed has a lot of money to spend.

 

[hallowmann]

@hallowmann These unaccredited PR programs are somewhat a big loophole that IMG can use... I have a friend who did one after multiple unsuccessful match attempts and he is doing pretty good in the state now. Many states might not want to license you, but if you work for the fed, you need a state license which you got after doing that one year in PR.

My friend got a great job (albeit not in a prime location) making a little bit below average FM salary. The benefits are excellent (even subsidized housing) since the fed has a lot of money to spend.

Thanks. I'll throw out the idea to him. He's kind of got a lot on his plate family-wise, so I'm not sure if he'd be able to pack up and go to PR. I'll mention it, but I assume he'd have to learn Spanish? Might be hard enough considering he's ESL to begin with.

 

[W19]

He just have to be conversational cause my friend did not speak Spanish as far as I know...

 

[bedevilled ben]

This is a rough thread reread... It seems he's in PR doing one of those unaccredited programs, so I hope whatever is best works out for him.



What's with the fudging the stats? He makes it sound like they rigged it by taking out people who withdrew or did not rank (mostly people who attained positions either before the match, in the AOA match, or one of the other matches like the SF match; people who decided to hold off on residency, OR those that received 0 interviews). How could they possibly include those people as a measure of matching? It would obviously skew the results because those people are removed completely from the matching algorithm to begin with, so why would they be included? Obviously applying is very different than actively participating in the match.

I don't really get how its a way of them "tricking" people nor do I think it comes from a place of malicious intent.

It's pretty obvious that he's (justifiably) bitter and frustrated with the medical education system, so it's likely a subconscious coping strategy to minimize his personal responsibility for his current situation. If the system is corrupt and set up for people to fail, how can we blame him when he fails? The non-problem is that the system exists because we've collectively decided that there is a minimum level of medical competency required to be allowed to practice with increasing independence as a resident. He has demonstrated numerous times that he lacks this competency with failed classes, failed Step exams, and ultimately an inability to secure a residency despite a half-decade of trying. Additionally, he has exhibited a staggering lack of self-introspection and self-awareness by digging himself progressively deeper in a financial hole, making increasingly risky decisions, and sacrificing his personal relationships on the altar of his unfulfilled dream to become a physician.

The path to physician-hood is a gated one for good reason. As we demonstrate curated competency, whether through MCQ exams or supervised patient interviews/procedures, we are rewarded with increased involvement in our patients' care. With that increased involvement comes increased risk of at best not helping and at worst actively causing harm to people. Real people; not cadavers, not sophisticated SimLab dummies, not patient actors: real people. We want to believe that all it will take is hard work and dedication to achieve all of our lofty goals and dreams. Reality is a harsh & uncaring mistress, though, and sometimes you can do everything right and still have a bad outcome. But that's not the case here. Dr. Bill has demonstrated a pattern of poor medical knowledge and poor judgment while willfully ignoring blatantly obvious risk.

It's a barbed question, but ask yourself honestly: Would you want this physician taking care of your loved one?

As an IMG that recently went through the Match myself, I feel for the guy. It is a harrowing and emotional experience. But this does not represent a failure of the medical education system. It is in fact doing exactly what it is supposed to be doing.