Petition to Address Residency Shortages

[Baller MD]

One thing I don't understand is why there are residency programs filled solely with foreign med grads.

Y?

If you ask AAMC or OP, it is because there is a shortage of residency spots. Makes perfect sense right? /sarcasm

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[jw3600]

Fair, but the tone in your posts is unnecessary. I don't care if you want to correct someone, there's a way do it without being a jerk. I'm wrong, you're right ,oh wise one. Now lets stop arguing amongst ourselves about midlevels (it's what they want us to do)




Fixed. I agree with you, but lets not act like most people aren't on their side.

STFU already.

 

[Psai]

Have a bad day at work champ?

I mean if you want to be a jerk about it some would argue that the term "mid-level" is derogatory:

https://www.ena.org/SiteCollectionDocuments/Position Statements/AANPNPConsensusStatement.pdf

lol stop googling terms and posting random links as if they're relevant

"These terms further confuse the healthcare consumers and the general public, as they are vague and are inaccurately used to refer to a wide range of professions. The term “midlevel provider” (mid-level provider, mid-level provider, MLP) implies that the care rendered by NPs is “less than” some other (unstated) higher standard. In fact, the standard of care for patients treated by an NP is the same as that provided by a physician or other healthcare provider, in the same type of setting."

The amount of cognitive dissonance and just straight up lies is just astounding.

 

[sazerac]

One thing I don't understand is why there are residency programs filled solely with foreign med grads.

Y?

Because they are run by PDs who themselves were foreign med graduates. It's a way of paying it forward and showing solidarity with those who come behind you. You see this behavior in mid and top level residencies too.

Sure there might be better candidates out there if the PD took the time to look, but if you're satisfied with your interns year after year, why change?

 

[cbrons]

Because they are run by PDs who themselves were foreign med graduates. It's a way of paying it forward and showing solidarity with those who come behind you. You see this behavior in mid and top level residencies too.

Sure there might be better candidates out there if the PD took the time to look, but if you're satisfied with your interns year after year, why change?

In most cases they're not run by foreign PDs.

 

[jw3600]

lol stop googling terms and posting random links as if they're relevant

"These terms further confuse the healthcare consumers and the general public, as they are vague and are inaccurately used to refer to a wide range of professions. The term “midlevel provider” (mid-level provider, mid-level provider, MLP) implies that the care rendered by NPs is “less than” some other (unstated) higher standard. In fact, the standard of care for patients treated by an NP is the same as that provided by a physician or other healthcare provider, in the same type of setting."

The amount of cognitive dissonance and just straight up lies is just astounding.

That....that....that is not actually written somewhere....

 

[jw3600]

We're not "implying it". We're stating it.

 

[NickNaylor]

We're not "implying it". We're stating it.

Do you disagree with the statement? If so, why?

 

[jw3600]

Do you disagree with the statement? If so, why?

Not exactly sure what you're asking, but I think that the term mid level provider does clearly (and accurately) state that the care will be "less than" some other stated (by me: Physician) standard. This is not necessarily a bad thing. If you have a complicated tax filing one year, you hire a CPA and a JD/LLM in tax. If you worked at subway 40 hours a week with no dependents, file at HR&Block. Their product is inferior but will be good enough. You acknowledge and then accept the risk that comes with that choice.

 

[emt409]

Agreed. More than 10,000 PGY1 spots were not filled by US Seniors in the 2015 match. Despite all the AMA/AAMC fearmongering about lack of residency spots, too many new allopathic schools opening etc... there are plenty of spots for US allopathic grads. It is true that non-US allo's will probably feel more of a squeeze as the new batch of med schools starts graduating.

You have no idea what you are talking about. Unmatched US Senior with an MD/PhD from a top 25 school. There are almost no unfilled slots. Even in prelim surgery.

 

[jw3600]

You have no idea what you are talking about. Unmatched US Senior with an MD/PhD from a top 25 school. There are almost no unfilled slots. Even in prelim surgery.

Do you know the figures for how many are in your position? When I see unmatched numbers, my impression is that it is pre SOAP and late offers. I do not think I have ever seen the number of applicants who, when it's all said and done, have no residency spot, even a prelim.

Edit: Good luck to you. What is your school recommending?

 

[DermatoFIGHT]

The shortage is of residencies that people are actually interested in. Reality, people do not want to go into primary care when they graduate with 300,000-400,000 in loans to never be able to pay off their debt.

I think graduates from a US medical school should have first option at residencies seeing they pay into the U.S. system handsomely through taxes, loan interest, and working in the USA.

 

[famoussquamous]

lol stop googling terms and posting random links as if they're relevant

"These terms further confuse the healthcare consumers and the general public, as they are vague and are inaccurately used to refer to a wide range of professions. The term “midlevel provider” (mid-level provider, mid-level provider, MLP) implies that the care rendered by NPs is “less than” some other (unstated) higher standard. In fact, the standard of care for patients treated by an NP is the same as that provided by a physician or other healthcare provider, in the same type of setting."

The amount of cognitive dissonance and just straight up lies is just astounding.

lol you do realize that's an official quote from The American Academy of Nurse Practitioners right? It's not just some "random" quote, as asinine as you may find it.

 

[Psai]

lol you do realize that's an official quote from The American Academy of Nurse Practitioners right? It's not just some "random" quote, as asinine as you may find it.

There's something wrong with the way you read and analyze information

 

[famoussquamous]

There's something wrong with the way you read and analyze information

Why don't you direct some of that anger at the people actually saying this stuff instead of the messenger, chief? All I'm saying is "mid-levels" don't consider themselves to be mid-levels.

 

[jw3600]

Why don't you direct some of that anger at the people actually saying this stuff instead of the messenger, chief? All I'm saying is "mid-levels" don't consider themselves to be mid-levels.

And most politicians don't consider themselves to be scum bags. Has zero bearing on them being so. Your identity in this world is not some completely self derived concept.

 

[Freddie Mercury]

You have no idea what you are talking about. Unmatched US Senior with an MD/PhD from a top 25 school. There are almost no unfilled slots. Even in prelim surgery.

I'm not sure if you're being sarcastic, but whatever, I'll humor you if so. Even after accounting for DO's/FMG/IMG etc, there were still more than 1000 PGY1 spots that went unfilled. What's funny is you mention prelim surgery, which had over 400 spots go unfilled.

 

[Psai]

Why don't you direct some of that anger at the people actually saying this stuff instead of the messenger, chief? All I'm saying is "mid-levels" don't consider themselves to be mid-levels.

You thought a nursing assistant was a mid level

 

[famoussquamous]

You thought a nursing assistant was a mid level

I meant nurse but used the wrong abbreviation, my bad. I'll go back and change the typo. You knew what I was trying to say, next time just say "I think you meant to say nurse instead of nursing assistant" and leave it at that.

 

[Wordead]

The shortage is of residencies that people are actually interested in. Reality, people do not want to go into primary care when they graduate with 300,000-400,000 in loans to never be able to pay off their debt.

I think graduates from a US medical school should have first option at residencies seeing they pay into the U.S. system handsomely through taxes, loan interest, and working in the USA.

I agree with you to an extent, but what about the american people? Don't they deserve the best people going into medicine? How will the USA remain great in medical innovation without talent? Frankly, there are several IMGs that I've met that I'd rather work and be treated by than the dreck of my class.

Your reasoning is akin to to arguing that everyone should buy american cars because it supports american jobs and is patriotic. No, I have no interest in your dog**** car because it costs a ton of money and is an inferior product, regardless if it's an American product.

 

[W19]

I agree with you to an extent, but what about the american people? Don't they deserve the best people going into medicine? How will the USA remain great in medical innovation without talent? Frankly, there are several IMGs that I've met that I'd rather work and be treated by than the dreck of my class.

Your reasoning is akin to to arguing that everyone should buy american cars because it supports american jobs and is patriotic. No, I have no interest in your dog**** car because it costs a ton of money and is an inferior product, regardless if it's an American product.

The American car industry is NOT supported by tax payers (oh well until Barack Hussein and Bush bailout in the case of GM), so we should not compare the two... Med school in here is not like an 'inferior product' as you are trying to allude to... Also, what you think about your classmates is practically irrelevant.

About the American people 'deserve the best people going into medicine'... please give me a break! We have nurses practicing medicine...

 

[SouthernSurgeon]

The American car industry is NOT supported by tax payers (oh well until Barack Hussein and Bush bailout in the case of GM), so we should not compare the two... Med school in here is not like an 'inferior product' as you are trying to allude to... Also, what you think about your classmates is practically irrelevant.

About the American people 'deserve the best people going into medicine'... please give me a break! We have nurses practicing medicine...

Med schools in the US aren't inferior, but some grads might be.

Residency is subsidized by the taxpayers, in order to provide future healthcare providers for those taxpayers. That doesn't mean US med students are entitled to residency slots.

The system is already so heavily stacked against FMGs, as of right now they have to be superstars to "beat out" a US grad for a spot. There doesn't need to be any more protectionism for US students. There should always be a role for the best and the brightest to succeed even if they didn't happen to be born here.

Edit because I just noticed this...seriously with the Barack Hussein? I can't tell if you are just an idiot who repeats every dumb thing he hears, or if you're a troll.

 

[ASD2019]

The American car industry is NOT supported by tax payers (oh well until Barack Hussein and Bush bailout in the case of GM), so we should not compare the two... Med school in here is not like an 'inferior product' as you are trying to allude to... Also, what you think about your classmates is practically irrelevant.

Huh? It is completely a legit comparison b/c the point is that both GM workers and AMGs pay taxes into the US tax system so we should favor them (DermatoFight's opinion). Residencies already greatly favor AMGs. No one said AMGs are inferior. The point is that some FMGs are superior to some AMGs. The american people shouldn't be devoid of this superior service, provided by the brighter FMG ,simply b/c some dude successfully finished a school located in the US. And I would also add that many of the FMGs who land a residency spot in the US, ultimately end up practicing here simply b/c of pay (so they are essentially contributing to the US tax system as much as their AMG peers).

 

[path or no path]

what residency shortage? tons of IMG already match, do you want more IMG to match than AMGs?

Amen. What's the point in increasing # of residency spots if for example ~ 50% of IM spots are taken by IMGs.

 

[path or no path]

What happened to the pharmacists?

WAAAY oversaturated job market, kind of like pathology, people have a really hard time finding good jobs in a desirable location

 

[DermatoFIGHT]

I agree with you to an extent, but what about the american people? Don't they deserve the best people going into medicine? How will the USA remain great in medical innovation without talent? Frankly, there are several IMGs that I've met that I'd rather work and be treated by than the dreck of my class.

Your reasoning is akin to to arguing that everyone should buy american cars because it supports american jobs and is patriotic. No, I have no interest in your dog**** car because it costs a ton of money and is an inferior product, regardless if it's an American product.

I understand what you are saying but If the American people want talent then the system shouldn't be setup to scare away the talent. When you systematically rip apart the medical profession to make it so much burden with little to no reward, the talented ones are those who say no thank you. The fools too blinded by their Pre-Med outlooks continue forward. The current climate is what robbed America of talented physicians from primary care. When you have loans that accumulate $25,000 in interest alone a year.

I have seen FMG come to the USA and do residency training only to leave back to their country when done. Doesn't that screw the American people? If American grads face monster debt, maybe there should be a buy in for FMG to contribute back to the system. It is hard to say there is no right answer because the system is setup so poorly overall and cannot ignore the evils that the medical schools are doing.

 

[W19]

Med schools in the US aren't inferior, but some grads might be.

Residency is subsidized by the taxpayers, in order to provide future healthcare providers for those taxpayers. That doesn't mean US med students are entitled to residency slots.

The system is already so heavily stacked against FMGs, as of right now they have to be superstars to "beat out" a US grad for a spot. There doesn't need to be any more protectionism for US students. There should always be a role for the best and the brightest to succeed even if they didn't happen to be born here.

Edit because I just noticed this...seriously with the Barack Hussein? I can't tell if you are just an idiot who repeats every dumb thing he hears, or if you're a troll.

Why make the exception for Caribbean students then? Don't tell me PDs know how 'University of [insert] School of Medicine' work in every single country in the world...

How do we know that these FMG wont go back to their country of origin?

 

[DermatoFIGHT]

WAAAY oversaturated job market, kind of like pathology, people have a really hard time finding good jobs in a desirable location

the pharmacy job market is a result of that profession's incompetent leadership and willingness to accept this by pharmacists. Same leaders year after year with no progress or real advancement. They took advantage of a false need in pharmacy created by rapid pharmacy openings by corporations undercutting the independents. Laws were changed by corporate lobbyists to then create a supersaturation leading to their downfall. This is a big warning sign to medicine if physicians do not wake up and stop selling out to the big hospitals/corporations. Pharmacy had a big problem, their profession was dominated by women the type that have kids and work part-time. The large majority of women that did not work part-time and weren't real fighters to protect the profession. When hours started being cut or their husband's jobs were lost, they re-entered the pharmacy workforce adding to saturation.

You reap what you sow

Why make the exceptions for Caribbean students then? Don't tell me PDs know how 'University of [insert] School of Medicine' work in every single country in the world...

How do we know that these FMG wont go back to their country of origin?

Force them to give up a kidney to transplant recipients to do residency in USA...... it would show great determination on their part to the PD. :-D

 

[ASD2019]

I understand what you are saying but If the American people want talent then the system shouldn't be setup to scare away the talent. When you systematically rip apart the medical profession to make it so much burden with little to no reward, the talented ones are those who say no thank you. The fools too blinded by their Pre-Med outlooks continue forward. The current climate is what robbed America of talented physicians from primary care. When you have loans that accumulate $25,000 in interest alone a year.

I have seen FMG come to the USA and do residency training only to leave back to their country when done. Doesn't that screw the American people? If American grads face monster debt, maybe there should be a buy in for FMG to contribute back to the system. It is hard to say there is no right answer because the system is setup so poorly overall and cannot ignore the evils that the medical schools are doing.

I think you are being a little bitter and overly exaggerating. Yes we all agree that debt sucks! The point is that the system already affords a great deal of protection to AMGs. If you can get through med school and get close to decent board scores, you are essentially guaranteed a residency spot as an AMG. However, as a FMG to get anything (including the leftovers) you really have to prove your competency. Now the portion of FMGs we are discussing is those who are scoring higher than a significant number of AMGs. Why should their merits be ignored simply b/c someone else graduated from a US school?

There is anecdotal evidence for almost anything in this world, but I would argue that most FMGs stay upon completing their training simply b/c they would make a fraction of what they make here if they were to go back. But for arguments sake, I don't think it is a bad thing if some of them choose to go back. As the leader of the world, I think we have a huge responsibility towards global health. Not only for the sole reason of helping others, but for our own selfish gains. If we can train someone here who will go back to their country to improve their public health infrastructure, then that means .01% less chance of Americans seeing some deadly bug in their backyard (I'm all for that). And we can go on and on about how they could produce research that ultimately benefits some Americans.....

 

[ASD2019]

Why make the exception for Caribbean students then? Don't tell me PDs know how 'University of [insert] School of Medicine' work in every single country in the world...

How do we know that these FMG wont go back to their country of origin?

You should honestly try comprehending prior to posting. I would suggest rereading posts a few times to help with comprehension.

 

[DermatoFIGHT]

I think you are being a little bitter and overly exaggerating. Yes we all agree that debt sucks! The point is that the system already affords a great deal of protection to AMGs. If you can get through med school and get close to decent board scores, you are essentially guaranteed a residency spot as an AMG. However, as a FMG to get anything (including the leftovers) you really have to prove your competency. Now the portion of FMGs we are discussing is those who are scoring higher than a significant number of AMGs. Why should their merits be ignored simply b/c someone else graduated from a US school?

There is anecdotal evidence for almost anything in this world, but I would argue that most FMGs stay upon completing their training simply b/c they would make a fraction of what they make here if they were to go back. But for arguments sake, I don't think it is a bad thing if some of them choose to go back. As the leader of the world, I think we have a huge responsibility towards global health. Not only for the sole reason of helping others, but for our own selfish gains. If we can train someone here who will go back to their country to improve their public health infrastructure, then that means .01% less chance of Americans seeing some deadly bug in their backyard (I'm all for that). And we can go on and on about how they could produce research that ultimately benefits some Americans.....

Being an "accepted" medical student, I hope someone reads you back your personal statement when you are working as a resident and have experienced the current system first hand.

 

[Goro]

If I may lean in with an aside, being a car guy....BMWs, Toyotas, Hondas, Hyundai, etc are built right here in the USA. The plant where Toyota Tundras are built is in Princeton, IN which I used to pass it each time I'd go visit my in-laws.

For the foreseeable future, residency slots will outnumber bodies to fill them.

Huh? It is completely a legit comparison b/c the point is that both GM workers and AMGs pay taxes into the US tax system so we should favor them (DermatoFight's opinion). Residencies already greatly favor AMGs. No one said AMGs are inferior. The point is that some FMGs are superior to some AMGs. The american people shouldn't be devoid of this superior service, provided by the brighter FMG ,simply b/c some dude successfully finished a school located in the US. And I would also add that many of the FMGs who land a residency spot in the US, ultimately end up practicing here simply b/c of pay (so they are essentially contributing to the US tax system as much as their AMG peers).

 

[PL198]

WAAAY oversaturated job market, kind of like pathology, people have a really hard time finding good jobs in a desirable location

I'm so sick of hearing about a desirable location. People think it's their god given right to work in LA.... Who knew that the location where many people would want to live would be competitive? You mean other people want to live there too?

I see this stuff so often " No jobs in Boston, LA or Miami, specialty xyz sucks"

 

[W19]

You should honestly try comprehending prior to posting. I would suggest rereading posts a few times to help with comprehension.

I guess it does not help too much when English is one's third language

 

[W19]

Most FMG spend more than 2 months studying for these boards...

 

[BDUS]

Most FMG spend more than 2 months studying for these boards...

I don't think spending more time studying for something translates to higher score. It's not easy to sit and study for months on end. You start forgetting the details you studied a month or two ago. IMO

 

[Baller MD]

I don't think spending more time studying for something translates to higher score. It's not easy to sit and study for months on end. You start forgetting the details you studied a month or two ago. IMO

 

[67552931811]

Nvm: don't care enough.

 

[pathologyDO]

I don't think spending more time studying for something translates to higher score. It's not easy to sit and study for months on end. You start forgetting the details you studied a month or two ago. IMO

 

[BDUS]

If you read the second 2 lines that was my explanation. There has to be an optimum amount of study time before you begin to forget things you have studied in the beginning. Too little or too much can be detrimental to score

 

[W19]

It is something that is repeated again and again in SDN, so everyone (or most) believes it... You are telling me that you never heard about the 'law' of diminishing return that SDN invented about step1....

 

[pathologyDO]

If you read the second 2 lines that was my explanation. There has to be an optimum amount of study time before you begin to forget things you have studied in the beginning. Too little or too much can be detrimental to score

Thanks, but it was a rhetorical question.

 

[pathologyDO]

It is something that is repeated again and again in SDN, so everyone (or most) believes it... You are telling me that you never heard about the 'law' of diminishing return that SDN invented about step1....

Puhleese.


There is a difference between what we talk about here on sdn as point of diminishing returns, and having an entire year longer to study. One argues that around what, 4-5 weeks of intense prep we begin to retain less and start forgetting what we learned closer to t=0. However, comparing 4 vs 6 weeks is nothing like comparing 4-6 weeks and 12 months. By going through material slowly for an entire year and using resources like FC or Q banks to keep your knowledge fresh it is inevitably going to be easier for you to master the material than someone who has a small fraction of the time.

 

[W19]

Thanks, but it was a redundant question.

What? You meant to say a 'rhetorical' question.

 

[pathologyDO]

What? You meant to say a 'rhetorical' question.

 

[W19]

Puhleese.


There is a difference between what we talk about here on sdn as point of diminishing returns, and having an entire year longer to study. One argues that around what, 4-5 weeks of intense prep we begin to retain less and start forgetting what we learned closer to t=0. However, comparing 4 vs 6 weeks is nothing like comparing 4-6 weeks and 12 months. By going through material slowly for an entire year and using resources like FC or Q banks to keep your knowledge fresh it is inevitably going to be easier for you to master the material than someone who has a small fraction of the same amount of time.

I know that...

 

[W19]

Huh!

 

[pathologyDO]

I know that...

Then you must not have understood the point of my meme

 

[W19]

@pathologyDO I am not following on that one, I guess... Anyway, my brother in-law whose med school education is completely different from ours, spend a whole year studying for step1 and score in the 99% percentile and he acknowledged that if he spent 6-8 weeks studying for it, he would have never passed it...

 

[pathologyDO]

@pathologyDO I am not following on that one, I guess... Anyway, my brother in-law whose med school education is completely different from ours, spend a whole year studying for step1 and score in the 99% percentile and he acknowledged that if he spent 6-8 weeks studying for it, he would have never passed it...

Fair enough!

And yes, it doesn't surprise me one bit that he would score very well. Congrats to him for doing so well