Petition to Address Residency Shortages

[68PGunner]

The funding comes from Medicare to provide caretakers for Medicare beneficiaries. Not to provide protection for US students.

There is already a huge innate advantage for US students built in.

I agree with you. I see your point when there wasn't enough US med grads for residency slots. However, the landscape had changed drastically in the past decade when more and more US grads are unmatched.

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[68PGunner]

You score a 34 on the MCAT get into a US School, I score a 29 and go onto SGU. I then achieve a 250 on my step 1 test, you score a 220 we are both US Citizens, but you feel I shouldn't have a shot at residency. Sounds like a problem in our system

Dude, a 29 mcat will get you into a do/md school even in today competitive environment. You just didn't apply broadly enough.

 

[laricb]

Dude, a 29 mcat will get you into a do/md school even in today competitive environment. You just didn't apply broadly enough.

That wasn't the point. Just because one student makes it into a US School it doesn't make him the better candidate when it comes to residency. There are many more steps one needs to achieve before we reach our goal. Grades, Steps 1 and 2, clerkship, etc That was what I meant by get your feet wet.

 

[68PGunner]

You dont think there are any foreign grads that are better than the matched americans, much less the unmatched ones? Yes, some of the unmatched are those with unreasonable expectations but there are plenty of people who simply should not have a spot.

Sure there are always exceptions to the norm. But, we don't deviate from making national policies that have the best interest of the American public especially when their tax money is used to fund these training slots.

 

[68PGunner]

That wasn't the point. Just because one student makes it into a US School it doesn't make him the better candidate when it comes to residency. There are many more steps one needs to achieve before we reach our goal. Grades, Steps 1 and 2, clerkship, etc That was what I meant by get your feet wet.

So that applicant should only target US med schools. What is the problem? The argument is that admission to US med school is tough. I disagree with that premise considering the average stats for some low do schools.

I'm a fan of pushing our prospective students to US med sschools because I know that the tuition money will be used to add jobs in the US.

Double whammy!

 

[Wordead]

Sure there are always exceptions to the norm. But, we don't deviate from making national policies that have the best interest of the American public especially when their tax money is used to fund these training slots.

You still don't get it. The best interest of the american public is to take the best students that foreign medical schools have to offer, not prioritize the worst american students.

 

[Ace Khalifa]

I'd rather have a super smart foreign-born doctor treat me or my family members than an idiot American doctor who somehow matched. Being American means jacksh** if you're not competent. The xenophobic presence here is laughable.

 

[laricb]

So that applicant should only target US med schools. What is the problem? The argument is that admission to US med school is tough. I disagree with that premise considering the average stats for some low do schools.

I'm a fan of pushing our prospective students to US med sschools because I know that the tuition money will be used to add jobs in the US.

Double whammy![/QUO

I'd rather have a super smart foreign-born doctor treat me or my family members than an idiot American doctor who somehow matched. Being American means jacksh** if you're not competent. The xenophobic presence here is laughable.

He is now just trying to get under our skin, He wont admit it but he better get it now...

 

[68PGunner]

You still don't get it. The best interest of the american public is to take the best students that foreign medical schools have to offer, not prioritize the worst american students.

I agree with you. Perhaps I wasn't making my proposal clear about the SOAP part:

I definitely think that competent unmatched US med grads should be prioritized over their foreign counterparts. At the end of the day, PDs still need to be mindly of standards and patient safety. If a PD feels that all of the US med grads to his program during the SOAP process are unqualified, that person certainly has the right to reject all of the applicants and open his training slots to fmg. However, I seriously doubt that all of our unmatched US med grads are unqualified to practice medicine.

 

[laricb]

I agree with you. Perhaps I wasn't making my proposal clear about the SOAP part:

I definitely think that competent unmatched US med grads should be prioritized over their foreign counterparts. At the end of the day, PDs still need to be mindly of standards and patient safety. If a PD feels that all of the US med grads to his program during the SOAP process are unqualified, that person certainly has the right to reject all of the applicants and open his training slots to fmg. However, I seriously doubt that all of our unmatched US med grads are unqualified to practice medicine.

Thank god we have many PD's that are either IMG or FMG that aren't biased.

 

[68PGunner]

I'd rather have a super smart foreign-born doctor treat me or my family members than an idiot American doctor who somehow matched. Being American means jacksh** if you're not competent. The xenophobic presence here is laughable.

That super smart foreign physician wouldn't have an issue getting accepted to a US med school. You guys are just trying to counter my points with baseless assumptions.

 

[laricb]

That super smart foreign physician wouldn't have an issue getting accepted to a US med school. You guys are just trying to counter my points with baseless assumptions.

That super smart foreign physician wouldn't have an issue getting accepted to a US med school. You guys are just trying to counter my points with baseless assumptions.

Yea, they probably couldn't get a 34 on the MCAT

 

[68PGunner]

Yea, they probably couldn't get a 34 on the MCAT

I'm pretty sure you wrote this post considering yourself as a prime example. I hate to burst your bubbles but you are probably not that intelligent. Among top schools like the Ivies, there is no shortage of foreign students with great gpas and mcats.

Considering that the stats required to get into a low do school can be as low as 3.0 and 23-25 mcat, your points are unvalid.

 

[laricb]

I'm pretty sure you wrote this post considering yourself as a prime example. I hate to burst your bubbles but you are probably not that intelligent. Among top schools like the Ivies, there is no shortage of foreign students with great gpas and mcats.

Considering that the stats required to get into a low do school can be as low as 3.0 and 23-25 mcat, your points are unvalid.

Ill talk to you next year when I obtain my residency in EM....

 

[68PGunner]

Ill talk to you next year when I obtain my residency in EM....

Let me know and I will send you a box of chocolates to your place, commending you for your hard work. I'm a fan of people overcoming challenges due to hard work and dedication. These values are what make this country the greatest place on earth.

 

[laricb]

Let me know and I will send you a box of chocolates to your place, commending you for your hard work. I'm a fan of people overcoming challenges due to hard work and dedication. These values are what make this country the greatest place on earth.

Guys like you made me work harder and I Thank You.

 

[Mad Jack]

FAIL.

It's a privilege to be a part of this country and to practice medicine here. When you and your ancestors haven't done anything to contribute to this country, you should be thankful of leftovers.

Many of the best doctors I worked with at a top IM program were foreign medical graduates- Oxford, Cambridge, whatever the hell the name of that top med school in India is, etc. This is America. We want the best and brightest the world has to offer, not to be a bunch of protectionist dinguses.

 

[68PGunner]

Many of the best doctors I worked with at a top IM program were foreign medical graduates- Oxford, Cambridge, whatever the hell the name of that top med school in India is, etc. This is America. We want the best and brightest the world has to offer, not to be a bunch of protectionist dinguses.

Assuming other things being equal, are you telling me that you would rather have a fmg with 240 step scores over a us med grad with 230 step scores? I respectfully disagree.

 

[Mad Jack]

You still don't get it. The best interest of the american public is to take the best students that foreign medical schools have to offer, not prioritize the worst american students.

This is exactly why I oppose any measures for "DO equality" or "US MD and DO graduates first" that the AOA puts forward, despite my being a DO student. The best positions should go to the best students, and that should be prioritized as PDs fit.

 

[Bryan O’Blivion]

The few US grads that failed to match that I have known, known of, or read about all had significant academic or personal difficulties. For the average US medical student who applies consistent effort, the odds of matching somewhere in something are pretty favorable.

There are a lot of ways physician performance can suffer, and this is usually multifactorial, but complacency is certainly not good. A little bit of fear and hunger can make you push yourself a bit. I don't think the profession would benefit from a guarantee of training despite consistent poor performance.

Working with residents from other countries, I found them to be hard working and smart, with a realistic and objective view of the world. Keeps me feeling pretty grateful. That can be easy to lose sight of, so it's good to be reminded of from time to time.

 

[Mad Jack]

Assuming other things being equal, are you telling me that you would rather have a fmg with 240 step scores over a us med grad with 230 step scores? I respectfully disagree.

It's never that simple. Step scores are only a part of the picture- an important part, but not even close to the only part. I'd rather take a FMG with 8 first author pubs and a 230 than a US MD with 2 first author pubs and a 230. Many of the FMGs and IMGs we take are usually researchers, accomplished specialists, or other very talented individuals. I'd rather have a foreign overachiever than a stateside slacker.

 

[68PGunner]

This is exactly why I oppose any measures for "DO equality" or "US MD and DO graduates first" that the AOA puts forward, despite my being a DO student. The best positions should go to the best students, and that should be prioritized as PDs fit.

I don't necessarily agree with extreme measures that would jeopardize patient safety. However, as recipients of federal money, PDs need to consider the public interest and prioritize competitive US med grads over fmgs. The next question is then how do we draw the lines.

If we use statiscal analysis, we can then draw the lines by only admitting fmgs over US med grads with stats that are 2 standard deviations over their U.S. counterparts. These data are easily available.

 

[Mad Jack]

I don't necessarily agree with extreme measures that would jeopardize patient safety. However, as recipients of federal money, PDs need to consider the public interest and prioritize competitive US med grads over fmgs. The next question is then how do we draw the lines.

If we use statiscal analysis, we can then draw the lines by only admitting fmgs over US med grads with stats that are 2 standard deviations over their U.S. counterparts. These data are easily available.

The taxpayers are getting a physician either way, so it really doesn't matter whether that physician is foreign or domestic. As a Medicare recipient someday (as that is where the public money comes from), would you prefer an American physician, or the best physician possible, regardless of their nationality?

 

[68PGunner]

It's never that simple. Step scores are only a part of the picture- an important part, but not even close to the only part. I'd rather take a FMG with 8 first author pubs and a 230 than a US MD with 2 first author pubs and a 230. Many of the FMGs and IMGs we take are usually researchers, accomplished specialists, or other very talented individuals. I'd rather have a foreign overachiever than a stateside slacker.

I think we are sharing the same sentiments. However, our main difference is probably the lines being drawn.

I am not in favor of opening all of our training slots to fmgs especially when we have equally competitive applicants at home.

 

[68PGunner]

The taxpayers are getting a physician either way, so it really doesn't matter whether that physician is foreign or domestic. As a Medicare recipient someday (as that is where the public money comes from), would you prefer an American physician, or the best physician possible, regardless of their nationality?

As a future patient, I would want the best patient care from the best available physician. However, where do you draw the lines that the fmg is superior to his or her us counterpart?

I respectfully disagree that it doesn't matter whether the physician is foreign or not. I know for sure that the native applicant has been paying tax -- a portion that is a part of Medicare. I also know that his of her ancestors have made some contributions to this country. So, my question then becomes why should I open the opportunity to practice in this country to fmgs when we have equally competitive applicants at home.

Personally, I consider the opportunity to practice in this country a privilege that needs to be earned. We shouldn't open our residencies to all fmgs when the diffefences between fmgs and U.S. med grads are not statistically significant.

 

[Mad Jack]

As a future patient, I would want the best patient care from the best available physician. However, where do you draw the lines that the fmg is superior to his or her us counterpart?

I respectfully disagree that it doesn't matter whether the physician is foreign or not. I know for sure that the native applicant has been paying tax -- a portion that is a part of Medicare. I also know that his of her ancestors have made some contributions to this country. So, my question then becomes why should I open the opportunity to practice in this country to fmgs when we have equally competitive applicants at home.

This is America. We believe in the ability of the individual to define themselves, not on success by birthright and ancestral lineage. We're a nation of immigrants. And most of those American applicants have paid hardly, if any, taxes- most are young people that have worked part time, low-wage jobs at best, their entire life's contributions to the tax base are less than what a physician contributes in an entire year. If we're just going by who's paying taxes, we'd be better off grabbing some of those Brits that graduate as doctors at 22- they could finish a FM residency at 25 and beat out even the youngest of American graduates by a good four years, contributing thousands more in those extra working years.

The application is not equally open. Foreign graduates are heavily scrutinized, and PDs know how to sort the chaff from the wheat. We don't need government regulations to ensure that only the best of the best get in, such ideas are nonsense.

 

[Slack3r]

As a future patient, I would want the best patient care from the best available physician. However, where do you draw the lines that the fmg is superior to his or her us counterpart?

I respectfully disagree that it doesn't matter whether the physician is foreign or not. I know for sure that the native applicant has been paying tax -- a portion that is a part of Medicare. I also know that his of her ancestors have made some contributions to this country. So, my question then becomes why should I open the opportunity to practice in this country to fmgs when we have equally competitive applicants at home.

Personally, I consider the opportunity to practice in this country a privilege that needs to be earned. We shouldn't open our residencies to all fmgs when the diffefences between fmgs and U.S. med grads are not statistically significant.

When has the 20-something year old, first generation American student who went from HS-->undergrad-->med school paid any taxes?

 

[W19]

I don't necessarily agree with extreme measures that would jeopardize patient safety. However, as recipients of federal money, PDs need to consider the public interest and prioritize competitive US med grads over fmgs. The next question is then how do we draw the lines.

If we use statiscal analysis, we can then draw the lines by only admitting fmgs over US med grads with stats that are 2 standard deviations over their U.S. counterparts. These data are easily available.

Over 2 stdv dude! Average step1 now is 23o and the stdv is around 20... You are talking about FMG applicants with 270+ score... You definitely won't find many.

 

[68PGunner]

When has the 20-something year old, first generation American student who went from HS-->undergrad-->med school paid any taxes?

But their parents have been paying tax to the Medicare fund and made contributions to this country. How do you explain to these parents that have paid tax by opening training slots to fmgs and making their sons and daughters jobless especially when the US applicant is equally competitive?

I have no doubt that some PDs are doing the right things by weighing these factors into consideration. However, there are some PDs that just open our door to fmgs when the diffefences are insignificant. For me, these PDs need to be kept in check by the proper authorities.

 

[W19]

Don't worry @68PGunner, Trump will solve that issue....

 

[68PGunner]

Over 2 stdv dude! Average step1 now is 23o and the stdv is around 20... You are talking about FMG applicants with 270+ score... You definitely won't find many.

That fmg can go into family med to help alleviate the physician shortage in underserved communities then. Nothing in life is ever perfect. Practicing family med in the US beats practicing oncology in India.

 

[Baller MD]

Many of the best doctors I worked with at a top IM program were foreign medical graduates- Oxford, Cambridge, whatever the hell the name of that top med school in India is, etc. This is America. We want the best and brightest the world has to offer, not to be a bunch of protectionist dinguses.

Yeah but we are also draining other countries of the best minds so that we can care for an obese population over here?

 

[Mad Jack]

But their parents have been paying tax to the Medicare fund and made contributions to this country. How do you explain to these parents that have paid tax by opening training slots to fmgs and making their sons and daughters jobless especially when the US applicant is equally competitive?

I have no doubt that some PDs are doing the right things by weighing these factors into consideration. However, there are some PDs that just open our door to fmgs when the diffefences are insignificant. For me, these PDs need to be kept in check by the proper authorities.

You do realize one of the largest founding principles of this country was that individuals were to not be judged based upon the station of their ancestors, right? That we kind of had a huge push to move away from that system of inherited privilege and have a nation where individuals could define themselves, where the son of a murderer could become a Senator, an orphan could become a physician, an immigrant that came from nothing could become the leader of a multibillion dollar corporation, etc etc?

This isn't the nation of unearned privilege and consolation prizes. This is America. We don't reward you for where your parents came from. We reward you for being good at what you do. We give you what you earn and what you deserve. And if you're kicking around with a bunch of red flags at the bottom of your US MD class and we've got some guy clamoring to get into this country with groundbreaking cancer research from Pakistan that would give his firstborn to get into even the lowest of community IM residencies, well then that talented guy gets the job, not the screw up that happens to have citizenship.

 

[Mad Jack]

Yeah but we are also draining other countries of the best minds so that we can care for an obese population over here?

I can't hear you, I'm too busy caring about America and the freedom is too loud.

Seriously though, if other countries can't incentivize their physicians to stay, that isn't our problem. This is a global world. There's ways for countries to incentivize (and even force) physicians that train here back if they want to use them, but that is none of our concern. We do what we can to get the best doctors, and they do what they can to keep them.

 

[68PGunner]

You do realize one of the largest founding principles of this country was that individuals were to not be judged based upon the station of their ancestors, right? That we kind of had a huge push to move away from that system of inherited privilege and have a nation where individuals could define themselves, where the son of a murderer could become a Senator, an orphan could become a physician, an immigrant that came from nothing could become the leader of a multibillion dollar corporation, etc etc?

This isn't the nation of unearned privilege and consolation prizes. This is America. We don't reward you for where your parents came from. We reward you for being good at what you do. We give you what you earn and what you deserve. And if you're kicking around with a bunch of red flags at the bottom of your US MD class and we've got some guy clamoring to get into this country with groundbreaking cancer research from Pakistan that would give his firstborn to get into even the lowest of community IM residencies, well then that talented guy gets the job, not the screw up that happens to have citizenship.

Dude I actually agree with you about the founding foundations that make this nation great. We just disagree on where to draw the lines. Obviously, in your example, the Indian applicant should get the job. Again, this is an extreme scenario with statistically significant difference with a no brainer decision. However, in real life, the differences are usually not that significant and require authoritative lines in order for PDs to make the proper decision when federal money is used to fund these training slots.

 

[Mad Jack]

Dude I actually agree with you about the founding foundations that make this nation great. We just disagree on where to draw the lines. Obviously, in your example, the Indian applicant should get the job. Again, this is an extreme scenario with statistically significant difference with a no brainer decision. However, in real life, the differences are usually not that significant and require authoritative lines in order for PDs to make the proper decision when federal money is used to fund these training slots.

Actually, the differences are usually pretty profound. At some programs, they'll get 1000 apps for 20 slots, and 900 of those apps will be FMGs. Out of those 900, you'll get some crazy high stats from a few. I was reading about a guy with a 260 Step 1/272 Step 2 that only got 3 interviews out of over 150 applications as an IMG, for instance. That gives you an idea of how hard it is for even a very, very highly scoring candidate to get an interview- the ones we do end up interviewing and keeping are often far and away above the US grads they're competing with at a given institution, if they win out. We don't need government interference in our match process, there would be massive unintended consequences that you, as a premed that likely has minimal teaching hospital experience, cannot even come close to fathoming. The process works, trust me. PDs are smarter than me, or you, or our ******ed government when it comes to picking the best doctors for their training program.

 

[Baller MD]

I can't hear you, I'm too busy caring about America and the freedom is too loud.

Seriously though, if other countries can't incentivize their physicians to stay, that isn't our problem. This is a global world. There's ways for countries to incentivize (and even force) physicians that train here back if they want to use them, but that is none of our concern. We do what we can to get the best doctors, and they do what they can to keep them.

Dude, they're only over here because of the money. A lot of them come from third world countries.

 

[Wordead]

Dude I actually agree with you about the founding foundations that make this nation great. We just disagree on where to draw the lines. Obviously, in your example, the Indian applicant should get the job. Again, this is an extreme scenario with statistically significant difference with a no brainer decision. However, in real life, the differences are usually not that significant and require authoritative lines in order for PDs to make the proper decision when federal money is used to fund these training slots.

Im not sure if you're just a troll or have just crossed from naive premed to full on idiot. You want the government to dictate who gets residency spots?

 

[68PGunner]

Actually, the differences are usually pretty profound. At some programs, they'll get 1000 apps for 20 slots, and 900 of those apps will be FMGs. Out of those 900, you'll get some crazy high stats from a few. I was reading about a guy with a 260 Step 1/272 Step 2 that only got 3 interviews out of over 150 applications as an IMG, for instance. That gives you an idea of how hard it is for even a very, very highly scoring candidate to get an interview- the ones we do end up interviewing and keeping are often far and away above the US grads they're competing with at a given institution, if they win out. We don't need government interference in our match process, there would be massive unintended consequences that you, as a premed that likely has minimal teaching hospital experience, cannot even come close to fathoming. The process works, trust me. PDs are smarter than me, or you, or our ******ed government when it comes to picking the best doctors for their training program.

Then in your opinion what contributes to 5-8% of our us grads going unmatched while slots are being filled by fmgs?

 

[Mad Jack]

Dude, they're only over here because of the money. A lot of them come from third world countries.

I don't care why they're here. I care about whether they are good at what they do or not. Deep down, when you talk to your classmates, at least half of them are mostly in it for the money. And you know what, who cares? That's them exercising their rights and their freedom to pursue life, liberty, and happiness as they see fit.

 

[68PGunner]

Dude, they're only over here because of the money. A lot of them come from third world countries.

That's probably the truth with nobody willing to admit to it.

 

[68PGunner]

I don't care why they're here. I care about whether they are good at what they do or not. Deep down, when you talk to your classmates, at least half of them are mostly in it for the money. And you know what, who cares? That's them exercising their right to pursue freedom to pursue life, liberty, and happiness as they see fit.

Why are we opening our door to everyone to pursue these liberties in this country when they and their ancestors have done nothing to this country? Why are we using federal money to promote such practice in the first place?

 

[Mad Jack]

Then in your opinion what contributes to 5-8% of our us grads going unmatched while slots are being filled by fmgs?

That doesn't include the SOAP. After the SOAP, >99% of MD and DO graduates obtain training.

And, in my opinion, those are people that reached too hard or didn't apply to enough programs. Every single person I've ever talked to that didn't match either had:

1: Major red flags (multiple failures in med school, failed boards, IAs, repeating years, etc)
2: Only applied to one moderately or highly competitive specialty (you can apply to all the ortho programs in the world, you ain't gettin' in with a 210)
3: Ranked too few programs (if you only ranked 5 programs, you shouldn't be surprised if you didn't match)
4: Only applied in a geographically competitive area (if you only applied in NYC, you screwed yourself, sorry)

 

[Mad Jack]

Why are we opening our door to everyone to pursue these liberties in this country when they and their ancestors have done nothing to this country? Why are we using federal money to promote such practice in the first place?

Because we want the best and brightest the globe can offer if we want to be the best nation in the world. And stop bringing up ancestors- no one gives a damn about your ancestors. You didn't perform their accomplishments, they did. You get no credit for their work, just as they get no credit for yours. Each man and woman makes their own way.

 

[W19]

That doesn't include the SOAP. After the SOAP, >99% of MD and DO graduates obtain training.

And, in my opinion, those are people that reached too hard or didn't apply to enough programs. Every single person I've ever talked to that didn't match either had:

1: Major red flags (multiple failures in med school, failed boards, IAs, repeating years, etc)
2: Only applied to one moderately or highly competitive specialty (you can apply to all the ortho programs in the world, you ain't gettin' in with a 210)
3: Ranked too few programs (if you only ranked 5 programs, you shouldn't be surprised if you didn't match)
4: Only applied in a geographically competitive area (if you only applied in NYC, you screwed yourself, sorry)

Where do you get that stats? Is that a pure guess?

 

[68PGunner]

Im not sure if you're just a troll or have just crossed from naive premed to full on idiot. You want the government to dictate who gets residency spots?

No. The issue is that PDs need to be cognizant of the American public interest when making their decisions since their programs are being funded by federal money. These measures are here to protect the public tax payer interest. It's very similar to the instate vs outstate status when it comes to med school admission. Nobody is whining about it. I don't understand why we can't outline measures that prioritize competitively US med grads. Continuing with the status quo by doing nothing is straight up ignorant.

 

[Mad Jack]

Where do you get that stats? Is that a pure guess?

All I know is my DO school's stats, as well as a few of the other schools' stats provided by the AOA. All DO schools have greater than 98% placement post-SOAP. Any school that has lower than that gets a warning, and a second warning can cause their class size to be cut. I can't speak to the ACGME side of things, but I'd logically assume that they do at least as well as us on the DO side.

 

[68PGunner]

That doesn't include the SOAP. After the SOAP, >99% of MD and DO graduates obtain training.

And, in my opinion, those are people that reached too hard or didn't apply to enough programs. Every single person I've ever talked to that didn't match either had:

1: Major red flags (multiple failures in med school, failed boards, IAs, repeating years, etc)
2: Only applied to one moderately or highly competitive specialty (you can apply to all the ortho programs in the world, you ain't gettin' in with a 210)
3: Ranked too few programs (if you only ranked 5 programs, you shouldn't be surprised if you didn't match)
4: Only applied in a geographically competitive area (if you only applied in NYC, you screwed yourself, sorry)

If your data is from an unbiased source, I would agree with you that the current system is working.

 

[Wordead]

Why are we opening our door to everyone to pursue these liberties in this country when they and their ancestors have done nothing to this country? Why are we using federal money to promote such practice in the first place?

By your reasoning, those who have contributed more to this country, ie have had families in the country for longer periods of time, should get priority admission to medical school and residencies.

Also you realize that just last page you said that there are plenty of great foreign students at ivies that should apply to US medical schools? They havent paid anything in taxes either, but somehow you're okay with them becoming physicians. Baffling.

 

[68PGunner]

By your reasoning, those who have contributed more to this country, ie have had families in the country for longer periods of time, should get priority admission to medical school and residencies.

Also you realize that just last page you said that there are plenty of great foreign students at ivies that should apply to US medical schools? They havent paid anything in taxes either, but somehow you're okay with them becoming physicians. Baffling.

It's because they are statically superior to their US counterparts. I'm all for providing the best patient care for our people. However, I'm not in favor of opening a blind door to everyone especially when there are equally competitive US grads.

The issue is not as black and white as you are making it out to be.