The carib schools are toast!

[Guinea]

Glad to see SGU is taking the lead in this. Publishing their actual data shows confidence in their education programs! They are trying to stand out from the rest of the caribbean crowd. Deep down, I knew they would have to be much higher than the IMG average of 48%.
IMO, SGU simply produces a better medical graduate than the AVERAGE caribbean med school.

According to the SGU website:
First time Step 1 pass rate is about 85%
Match rate for SGU students in this years match is 80%

IF I WAS A PROSPECTIVE STUDENT, and I thought I could love primary care medicine, then SGU is a safe bet to get a good education, spend some time abroad, and be fairly certain you will Match.

rlxdmd

SGU is an expensive choice for someone who just wants to do primary care though. It's $200,000 for just tuition alone at current rates. Add housing, transportation and interest, it's about $285,000 by the time you graduate. That's assuming no additional tuition hikes (fat chance) and a conservative 7% interest rate on all unsubsidized loans.

A first year non-match rate of 32% (1 - 85%*80% = 32%) is pretty darn high for someone who just walloped nearly $300k.

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[dtwalrus]

SGU is an expensive choice for someone who just wants to do primary care though. It's $200,000 for just tuition alone at current rates. Add housing, transportation and interest, it's about $285,000 by the time you graduate. That's assuming no additional tuition hikes (fat chance) and a conservative 7% interest rate on all unsubsidized loans.

A first year non-match rate of 32% (1 - 85%*80% = 32%) is pretty darn high for someone who just walloped nearly $300k.

1) 80% for SGU in the Match this year, the number given by the dean, seems pretty accurate given the general feedback from students in the match. However, two things, that 80% was for US citizens at SGU,. Canadiens, Brits and other FMGs didn't fare quite as well. Also, it should be noted that 80% is a dip by SGU standards, so there might be some truth to the narrowing window of opportunities, even at the top schools in the Caribbean.

2) Also, 80% doesn't take into account prematch or scrambling residencies (which, let's face it, is a regular part of the residency process for many Caribbean students) Taking into account those two factors, it could be closer to 90% of US citizens at SGU who participated in the match (granted, that's not everyone considering the very real attrition rate) will have a residency next year. Those numbers haven't come out yet...

And Guinea: $200,000 is expensive, yes, but it's a fairly useless argument when it comes to the Caribbean option. $200,000 might scare away potential Tufts students in favor of another, less expensive US school. But if it's a choice between $200,000 to go to arguably the best, and safest option in the Caribbean, or giving up on a lifelong dream, well, that's no choice at all. In fact, given the sacrifices students in the Caribbean already have to make to achieve a career in medicine, I can't imagine why you'd think money would be a factor. If you've ever met any of these students who have left family and loved ones, left the comforts of home or even a developed nation in general, if you've ever met any one with that much desire to practice medicine, you would know that telling them $200,000 is not in any way suddenly going to open their eyes and convince them to do accounting or something or other...

And could you explain to me how you came up with that 32% non-match rate. Not very good at math, I'll admit, but I always thought 80% match + 10% (prematch and scramble) = 90% with residencies. Doesn't that leave only 10% = non-match?

 

[cpants]

1) 80% for SGU in the Match this year, the number given by the dean, seems pretty accurate given the general feedback from students in the match. However, two things, that 80% was for US citizens at SGU,. Canadiens, Brits and other FMGs didn't fare quite as well. Also, it should be noted that 80% is a dip by SGU standards, so there might be some truth to the narrowing window of opportunities, even at the top schools in the Caribbean.

2) Also, 80% doesn't take into account prematch or scrambling residencies (which, let's face it, is a regular part of the residency process for many Caribbean students) Taking into account those two factors, it could be closer to 90% of US citizens at SGU who participated in the match (granted, that's not everyone considering the very real attrition rate) will have a residency next year. Those numbers haven't come out yet...

And Guinea: $200,000 is expensive, yes, but it's a fairly useless argument when it comes to the Caribbean option. $200,000 might scare away potential Tufts students in favor of another, less expensive US school. But if it's a choice between $200,000 to go to arguably the best, and safest option in the Caribbean, or giving up on a lifelong dream, well, that's no choice at all. In fact, given the sacrifices students in the Caribbean already have to make to achieve a career in medicine, I can't imagine why you'd think money would be a factor. If you've ever met any of these students who have left family and loved ones, left the comforts of home or even a developed nation in general, if you've ever met any one with that much desire to practice medicine, you would know that telling them $200,000 is suddenly going to open their eyes and they'll decide to do accounting or something or other...

And could you explain to me how you came up with that 32% non-match rate. Not very good at math, I'll admit, but I always thought 80% match + 10% (prematch and scramble) = 90% with residencies. Doesn't that leave only 10% = non-match?

He is factoring in the USMLE pass rate of 85%. 1 * .85 pass * .80 + .10 get residencies = .765. 76.5% of passing seniors will end up with a residency. If you include attrition rates that will go even lower. For SGU I believe 7% drop out (6-7% transfer to US schools)--that makes the percentage of first-year matriculants eventually achieving residency only 71%). It is important for premeds considering the Carib option to consider all of these factors. If you only include people who make it through with a passing USMLE, the match rate appears pretty high. But the reality is that a large chunk of matriculants at SGU will fall by the wayside somewhere along the way. That is why the investment can by pretty risky. If you look at an entering class, 29% of them will not achieve residency. And SGU is the cream of the Caribbean crop, these numbers will look pretty dismal at some of the lesser options.

 

[relaxedMD]

Price is not the issue when you are pursuing medical education. Its about becoming a doctor.
When the US option isnt there, then there are a handful of good international options, SGU being one of them. I think these international schools are well established and have excellent training programs in place. Ten years from now, they will continue to produce good grads that consistently match at or near the rate of their US counterparts.

As for the price:
Many of the private med schools in the US and a handful of state med schools charge 50000/yr tuition. Similar to SGU's match list, many of their grads enter IM, Peds, and FM.
US grad or US IMG, hefty loan amounts arent steering new grads away from primary care.

rlxdmd

 

[dtwalrus]

He is factoring in the USMLE pass rate of 85%. 1 * .85 pass * .80 + .10 get residencies = .765. 76.5% of passing seniors will end up with a residency. If you include attrition rates that will go even lower. For SGU I believe 7% drop out (6-7% transfer to US schools)--that makes the percentage of first-year matriculants eventually achieving residency only 71%). It is important for premeds considering the Carib option to consider all of these factors. If you only include people who make it through with a passing USMLE, the match rate appears pretty high. But the reality is that a large chunk of matriculants at SGU will fall by the wayside somewhere along the way. That is why the investment can by pretty risky. If you look at an entering class, 29% of them will not achieve residency. And SGU is the cream of the Caribbean crop, these numbers will look pretty dismal at some of the lesser options.

Why would you factor in USMLE pass rate into a match rate? Isn't it apples and oranges? In fact, I would imagine that the 15% that don't pass the USMLE's on the first attempt comprise a significant portion of the 20% left in the cold on match day. Shouldn't the math work the other way, and we can say that those that pass the boards on the first attempt at SGU match at a >80% rate while the overall match rate, including those that failed a USMLE exam, for those that entered the match = 80%.

And yeah, there's absolutely no argument when it comes to percentage of incoming class that will end up with a residency. It's not by any means 90%. Bottom line, if you didn't get into a US school you better ask yourself whether it's because you're capable, but just not competitive at a US school for whatever reason, or if you're just flat out incapable of living up to the demands of medical school. Ultimately, the match rate for capable students coming down to SGU is probably very high, and thus definitely worth the investment.

 

[cpants]

Why would you factor in USMLE pass rate into a match rate? Isn't it apples and oranges. In fact, I would imagine that the 15% that don't pass the USMLE's on the first attempt comprise a significant portion of the 20% left in the cold on match day. Shouldn't the math work the other way, and we can say that those that pass the boards on the first attempt at SGU match at a >80% rate...

And yeah, there's absolutely no argument when it comes to percentage of incoming class that will end up with a residency. It's not by any means 90%. Bottom line, if you didn't get into a US school you better ask yourself whether it's because you're capable, but just not competitive at a US school for whatever reason, or if you're just flat out incapable of living up to the demands of medical school. Ultimately, the match rate for capable students coming down to SGU is probably very high, and thus definitely worth the investment.

Didn't realize that was only the first-attempt stat. The overall pass rate should be used, to factor in risk of not being able to pass the boards. I don't know what that is. I am sure first-attempt passers have a lot more success than multiple-attempt passers, just as they do from US schools.

I think the point is just that as someone considering the option, you need to have the perspective to consider the risk that you won't end up being a doctor. It's all well and good to consider the match rate for people who end up being eligible and applying for the match, but that skips over a lot of time and money spent.

You are right. If you are the person who is able to make it, then it is definitely worth the investment, and visa versa.

 

[dtwalrus]

Didn't realize that was only the first-attempt stat. The overall pass rate should be used, to factor in risk of not being able to pass the boards. I don't know what that is. I am sure first-attempt passers have a lot more success than multiple-attempt passers, just as they do from US schools.

I think the point is just that as someone considering the option, you need to have the perspective to consider the risk that you won't end up being a doctor. It's all well and good to consider the match rate for people who end up being eligible and applying for the match, but that skips over a lot of time and money spent.

You are right. If you are the person who is able to make it, then it is definitely worth the investment, and visa versa.

Ah, I get it. I agree, any potential applicant to the Caribbean must be fully aware of the fact that even at the very best schools, the percentage of US citizens who begin year 1 and match after year 4 is significantly lower than 80% listed match rate, and the percentage of non-US citizens is very much lower than 80%. (Canadiens are a case unto themselves, since many are very qualified (3.6+, 30+) but just face a very difficult application process in general, both to get into med school and into residencies).

If you just didn't have the ability to succeed enough to get into a US med school, there's probably a better chance that you'll be in the jobless 20% than the succesful 80%...and just as much in debt.

The Caribbean isn't for the incapable, it's for the exceptional few who are capable but, for whatever reason, are not competitive.

 

[hanky1982]

McGillGrad, you spend so much time defending your position and your school that it must get tiring. One question, why didn't you go DO?? Look, I was one of those kids wasn't about the whole OMM thing, and so is pretty much 95% of my class. We take one class a week (2 hrs a week) so we can be "DOs." I don't have to (at least I haven't yet) had to justify anything, and as an added bonus, we have a much larger number of residency programs to pick from (DO and MD)... (making assumption that the student is qualified). Point being, do you get tired of having to justify your position and your institution, and what do you think the impressions will be of IMGs in the next few years.

 

[HCE]

I wouldn't be surprised if residency spots did increase....but I don't think it's a guarantee because remember, increasing the number of residency spots costs money, and it's money from the federal gov't, primarily. It would likely be cheaper to increase the number of PA's and NP's, so I wouldn't be surprised if the US gov't chooses to go that route.

I'm not sure that most residency programs will prefer US IMG with 90+ on the USMLE over US grads with 80's USMLE either. I know some of them do, but for others they are looking more to protect their own (i.e. some of the state schools and their residency programs) and/or for people who are native to their states and/or likely to stay there to practice. Some people and some programs just tend to tar all Carib grads with the same brush too, which really isn't fair - some of it I think is just bias and thinking the Carib grads weren't "good enough" to get into a US school, but some of it is based on their experiences with seeing doctors trained in some of the store-front diploma-mill type Carib schools that used to exist, and still do to some extent.

I think we'll see the competition for residency spots ratcheted up in the next few years, and I do think it's likely to get hard for FMG and US IMG's to get a spot. The people with the 99 USMLE scores likely won't have to worry about getting spots any time soon, though it will be harder to get the specialties they want. I agree it will get harder for US allo and US DO grads, too.

I agree with your sentiments here. I do think residency spots will increase but, if health reform comes to fruition as recently proposed, emphasizing prevention, treatment vs. procedures as a means of reimbursment, insurance for all Americans, etc., I would expect the major growth in residency positions to be in primary care fields. If this happens, competition will increase dramatically for the shrinking specialties vs. primary care. Additional programs that would encourage people to go into primary care positions (read "tuition reimbursement") would shift somewhat the competitiveness of the specialty fields. In other words, your chosen speciality will be more indicative of your chance to match vs. your AMG/IMG status. If in fact a big emphasis on primary care is coming as I expect, increased DO residency positions would make sense, given those schools' historical emphasis on primary care fields.

 

[McGillGrad]

McGillGrad, you spend so much time defending your position and your school that it must get tiring. One question, why didn't you go DO?? Look, I was one of those kids wasn't about the whole OMM thing, and so is pretty much 95% of my class. We take one class a week (2 hrs a week) so we can be "DOs." I don't have to (at least I haven't yet) had to justify anything, and as an added bonus, we have a much larger number of residency programs to pick from (DO and MD)... (making assumption that the student is qualified). Point being, do you get tired of having to justify your position and your institution, and what do you think the impressions will be of IMGs in the next few years.

OMG, you have no idea how tiring it gets. There's nothing left of the poor equine to beat.

I think a DO is a fine option. I just don't want to be a DO. I'm Canadian and it is not an option in Canada (although recognized).

It is human nature to judge others on every possible level, but it is also natural to focus on the person once you have sufficient contact with him/her.

So, IMGs will probably be disparaged by those who have little experience with them and accepted on a case-by-case basis by the rest.

Like I have always said, opening more spots in US MD and DO schools will allow students who would otherwise go to the Caribbean stay in the US and the ones that really lose out are the ones with the lowest stats or least motivation.

 

[cpants]

OMG, you have no idea how tiring it gets. There's nothing left of the poor equine to beat.

I think a DO is a fine option. I just don't want to be a DO. I'm Canadian and it is not an option in Canada (although recognized).

It is human nature to judge others on every possible level, but it is also natural to focus on the person once you have sufficient contact with him/her.

So, IMGs will probably be disparaged by those who have little experience with them and accepted on a case-by-case basis by the rest.

Like I have always said, opening more spots in US MD and DO schools will allow students who would otherwise go to the Caribbean stay in the US and the ones that really lose out are the ones with the lowest stats or least motivation.

I think for the most part the discrimination will die down after residency. No one really cares where you went to med school years down the road.

 

[Guinea]

But if it's a choice between $200,000 to go to arguably the best, and safest option in the Caribbean, or giving up on a lifelong dream, well, that's no choice at all. In fact, given the sacrifices students in the Caribbean already have to make to achieve a career in medicine, I can't imagine why you'd think money would be a factor. If you've ever met any of these students who have left family and loved ones, left the comforts of home or even a developed nation in general, if you've ever met any one with that much desire to practice medicine, you would know that telling them $200,000 is not in any way suddenly going to open their eyes and convince them to do accounting or something or other...

Well said.
But when we are talking about an investment the size of a mortgage, it's good for people to seriously sit down and think hard about whether they will succeed. We don't need the subprime of Caribbean students any more than we need subprime mortgages.

SGU has annual class size of 800, and the match list they publish has only about 450 people.

 

[dragonfly99]

I think it would be really scary and bad to have 200-250k of student loans and not have a good way to pay that back. I guess some students drop out in first year, so they have less to pay back, but I really wonder what happens to all these people who drop out.

I think if you are not a good standardized test taker and thinking of going to the Caribbean, you better rethink that. IMHO people who don't make in the high 20's on the MCAT are probably at risk of not doing so hot on the boards...well at least mid 20's MCAT if not high 20's-30's. Also, if your study skills were poor in undergrad and that caused your GPA to be low, or you just honestly can't stomach the long hours of studying and sitting in class up to 6-7 hours/day, then seriously think about whether med school is for you.

p.s. With the increased number of DO students entering DO schools in the US, it's hard for me to believe the DO's won't increase their residency spots. If they don't, they'll probably end up with more unmatched students in a few years, and it would be bad for morale and PR of their schools to have that situation.

 

[Lokhtar]

Many DO residencies already go unfilled, especially in primary care as students opt for MD residencies.

 

[howelljolly]

I think it would be really scary and bad to have 200-250k of student loans and not have a good way to pay that back. I guess some students drop out in first year, so they have less to pay back, but I really wonder what happens to all these people who drop out.

I think if you are not a good standardized test taker and thinking of going to the Caribbean, you better rethink that. IMHO people who don't make in the high 20's on the MCAT are probably at risk of not doing so hot on the boards...well at least mid 20's MCAT if not high 20's-30's. Also, if your study skills were poor in undergrad and that caused your GPA to be low, or you just honestly can't stomach the long hours of studying and sitting in class up to 6-7 hours/day, then seriously think about whether med school is for you.

.

This is the rationale for the US government deciding that Americans who go to these Caribbean schools should not be able to get federal or student loans any more. Because, too many of the students who did have loans didnt have the means to pay them back.

So, at this point, only the older 3 or 4 schools offer loans at a decent rate...maybe. Some of the other schools can set you up with essentially what amounts to a private loan at an astronomical interest rate. Some of the other schools send you to a loan shark.

A sizable number of people will do anything just to become an MD. Im not sure why that is.

 

[dtwalrus]

This is the rationale for the US government deciding that Americans who go to these Caribbean schools should not be able to get federal or student loans any more. Because, too many of the students who did have loans didnt have the means to pay them back.

So, at this point, only the older 3 or 4 schools offer loans at a decent rate...maybe. Some of the other schools can set you up with essentially what amounts to a private loan at an astronomical interest rate. Some of the other schools send you to a loan shark.

A sizable number of people will do anything just to become an MD. Im not sure why that is.

Whether or not the loans are at a decent rate is debateable, but the Big 3 offer loans at the exact same rate as US schools...because the US gov't sets Stafford and Grad Plus Rates...at least that's my understanding.

 

[howelljolly]

Whether or not the loans are at a decent rate is debateable, but the Big 3 offer loans at the exact same rate as US schools...because the US gov't sets Stafford and Grad Plus Rates...at least that's my understanding.

Yeah, thats what Im calling decent. The second tier schools are offering loans with interest rates of 12%

 

[tantrum]

I agree with your sentiments here. I do think residency spots will increase but, if health reform comes to fruition as recently proposed, emphasizing prevention, treatment vs. procedures as a means of reimbursment, insurance for all Americans, etc., I would expect the major growth in residency positions to be in primary care fields. If this happens, competition will increase dramatically for the shrinking specialties vs. primary care. Additional programs that would encourage people to go into primary care positions (read "tuition reimbursement") would shift somewhat the competitiveness of the specialty fields. In other words, your chosen speciality will be more indicative of your chance to match vs. your AMG/IMG status. If in fact a big emphasis on primary care is coming as I expect, increased DO residency positions would make sense, given those schools' historical emphasis on primary care fields.

This is a very optimistic view of healthcare reform. Congress cannot even agree on any budget so I doubt there will be significant reform (just window dressing). Residency positions are funded via Medicare and all these deficits will mount in the next few years. Medicare will be in a deeper red as you can already see in the cuts to physician reimbursements. I doubt we will see a big increase in the number of primary care residencies.

 

[HCE]

This is a very optimistic view of healthcare reform. Congress cannot even agree on any budget so I doubt there will be significant reform (just window dressing). Residency positions are funded via Medicare and all these deficits will mount in the next few years. Medicare will be in a deeper red as you can already see in the cuts to physician reimbursements. I doubt we will see a big increase in the number of primary care residencies.

Tantrum, I don't disagree with you. You'll see I used the word "if" often. I'm not however ready to throw in the towel on whether it will happen, given the Obama teams' insistance that reforming healthcare is a key piece of economic recovery, and given the apparent cooperation from the dreaded insurance companies. So, with a big "if", I don't see how health care can be reformed as is being discussed without a huge increase in the number of primary care physicians. And given the cost of medical education, there is no way anywhere near enough folks will choose the primary care fields without major tuition assistance/reimbursement.

 

[dragonfly99]

I don't see how health care can be reformed as is being discussed without a huge increase in the number of primary care physicians. And given the cost of medical education, there is no way anywhere near enough folks will choose the primary care fields without major tuition assistance/reimbursement.

An alternative to increasing the number of primary care docs would be to just try to use NP's and/or PA's in their place to deliver primary care. Nobody knows if this will happen or not, but I am afraid that may be what happens, particularly if the gov't assumes a larger and larger role in health care. They will like this idea because they can pay an NP or PA less than a physician.

 

[howelljolly]

An alternative to increasing the number of primary care docs would be to just try to use NP's and/or PA's in their place to deliver primary care. Nobody knows if this will happen or not, but I am afraid that may be what happens, particularly if the gov't assumes a larger and larger role in health care. They will like this idea because they can pay an NP or PA less than a physician.

...until the NPs lobby for pay equal to PCPs

 

[pruritis_ani]

As somebody who interviews and ranks applicants yearly, let me be clear...

AMG over IMG in almost every case. period. i have been involved in many discussions where an AMG actually failed a step was being considered for a position, while offshore grads in the high 90s on all steps were not even interviewed.

truly, if the numbers of US training positions increase, then IMGs will be largely pushed aside, except in very rare cases.

the good news would be that with the increase in seats, many of us would not have to ever go offshore.

i am an offshore grad myself, i have worked with a great many wonderful offshore grads. but, the reality is that most programs will still choose an inferior AMG. unfair? maybe. but, not matter how much we tell ourselves that we are special, our qualifications are unique, that we can outcompete a US grad, the reality is rapidly changing.

my program does not even interview IMGs anymore, except in very rare cases. this from a program that has recently filled entire classes with IMGs!

the winds of change are a blowin....

 

[McGillGrad]

N=1

but thanks for the input

Considering that you had a criminal record before medical school, I find it hilarious that you would be spouting off all of this jazz.

You think that you might be BSing a bit since your program accepted you as an offshore with a criminal record...and now they don't even interview IMGs? The search fxn is a bitch, huh?

As somebody who interviews and ranks applicants yearly, let me be clear...

AMG over IMG in almost every case. period. i have been involved in many discussions where an AMG actually failed a step was being considered for a position, while offshore grads in the high 90s on all steps were not even interviewed.

truly, if the numbers of US training positions increase, then IMGs will be largely pushed aside, except in very rare cases.

the good news would be that with the increase in seats, many of us would not have to ever go offshore.

i am an offshore grad myself, i have worked with a great many wonderful offshore grads. but, the reality is that most programs will still choose an inferior AMG. unfair? maybe. but, not matter how much we tell ourselves that we are special, our qualifications are unique, that we can outcompete a US grad, the reality is rapidly changing.

my program does not even interview IMGs anymore, except in very rare cases. this from a program that has recently filled entire classes with IMGs!

the winds of change are a blowin....

 

[RussianJoo]

hahahaha


that's a great find!!!!

 

[NAVYLABTECH08]

this is a simple thing to understand.

A. Obvious physician shortage now and expected to be worse come 2016
B. Solution is to increase students in med school to have more available docs come the future
C. If residency slots do not increase, the problem remains the same.
D. Hence, if seats increase==> more docs==> MUST HAVE MORE RESIDENCY SPOTS

* The problem is not IMGs, the problem is not enough docs in general and how to get more.

Remember, it is not the medical school that makes the doctor, but the residency/fellow spot.

*if anything, caribbean schools will just increase their enrollments to keep up with the trend in US because those schools are business markets first and education sites second.

* The true problem will be the physician salary. Two large problems lume that could decrease physican salaries.

#1: universal healthcare
#2: Drastic increase in physicians will dilute the market (ie like in denistry) and will end up with docs working less hours or more competition leading to decreased sales.

JMO!

 

[pruritis_ani]

N=1

but thanks for the input

Considering that you had a criminal record before medical school, I find it hilarious that you would be spouting off all of this jazz.

You think that you might be BSing a bit since your program accepted you as an offshore with a criminal record...and now they don't even interview IMGs? The search fxn is a bitch, huh?

ummmm...what?

talk about irrelevent. am i to understand that your position is that what I am saying cannot be relevent because i had a misdemeanor when in college? interesting position. however, I have found that most people resort to personal insults when they have lost a debate. i guess you are there.

also, if you are stating that since my program must be so god awful to accept somebody like me....well, the fact that they are not even interviewing IMGs at a program like this should be a bit of a warning! we are certainly not Hopkins, but we are a solid middle of the road program....let me tell you the trend of our residency classes...when I interviewed, we were 80% offshore, with all of the rest DOs with the exception of 1 MD from McGill, of all places...my class was 33% US MD and 66% IMG. since that class we have not matched a single IMG. starting this year, we no longer interview IMGs, period. none. nada. our criteria for US students? pass the boards, graduate medical school, no fails on steps. so, your position of "well, I have better scores than those silly US grads" doesn't hold any water when the programs start setting the ERAS filters to not even LOOK at IMG applications.

trust me when I say this situation is not unique to our program, hospital or specialty. well, you don't have to trust me, I could care less. however, if I were still in my offshore school, that would be worrisome. in fact, i would NEVER go offshore today and assume the debt. i would go US DO, or be a plumber. i love what i do, but it is getting tougher to take the road that i was so lucky to get in on.

my N is actually far >1, as I am a member of several comittees in my hospital, and am involved in the ranking/matching process for all specialies. additionally, i serve on a national board, with a focus on medical education in my specialty. you don't have to listen, but you can be sure that i get my information from my direct experience, as well as my communications on a national level.

the reality is that position numbers are likely to be static, as there is no funding for more post graduate positions. the reality is that US medical schools (allopathic and DO) are significantly increasing numbers. and, the reality that you refuse to see is that US grads are nearly always preferred to offshore grads, regardless of step scores.

let me know how the match goes for you. and, remember, i have nothing to gain by BSing. i post what i know, but i do hope the best for all of you. and, by all means, i could certainly be wrong with my predictions. but, it sounds to me like you are basing your position on what you hope is the case, and i am basing my position on actual varied experience, in the real world of post graduate medical education and national politics.

 

[pruritis_ani]

this is a simple thing to understand.

A. Obvious physician shortage now and expected to be worse come 2016
B. Solution is to increase students in med school to have more available docs come the future
C. If residency slots do not increase, the problem remains the same.
D. Hence, if seats increase==> more docs==> MUST HAVE MORE RESIDENCY SPOTS

* The problem is not IMGs, the problem is not enough docs in general and how to get more.

Remember, it is not the medical school that makes the doctor, but the residency/fellow spot.

*if anything, caribbean schools will just increase their enrollments to keep up with the trend in US because those schools are business markets first and education sites second.

* The true problem will be the physician salary. Two large problems lume that could decrease physican salaries.

#1: universal healthcare
#2: Drastic increase in physicians will dilute the market (ie like in denistry) and will end up with docs working less hours or more competition leading to decreased sales.

JMO!

the problem is that residency spots are not likely to increase. simply put, there is no funding. and, if you expect the government to justify funding in excess of the US med student output, you may be unpleasantly surprised. all the US medical school lip service is to increase access to health care. nope, they want to increase enrollment to increase money. there may be a slight increase in position numbers as hospitals and programs add spots over the cap (which is nice and profitable too), but there can't be a huge increase in residency position numbers by this method.

the latest talk about further decreasing resident work hours has really brought the issue of funding to light. the fact is, the government is pretty clearly against further funding of residency positions. this makes the hours issue untenable, as they would need a LOT more docs to cover only 60 hours a week, as well as to cover the extra length of training that would come from this. so, it would appear to me that the best hope for offshore grads is to pray for shorter work hours and longer training programs, as that would lead to a neccesary increase in residency positions that would far outpace the US medical school growth....but, my guess is that this is a pipe dream for now.

my estimation is that US output will closely approach the available slots. thus, the few remaining residency positions will be fought over by IMGs.

i think the biggest problem will be for offshore schools. basically, the numbers will add up to the same amount of doctors training, but US schools will simply have to accept more people, and will take that supply from the offshore schools. offshore schools will have a lot more difficulty recruiting when match rates plummet.

hopefully, many of the folks on this board will now wind up in US MD or DO programs. but, the reality is that in the near future it will be more difficult as an offshore grad.

 

[tantrum]

Medicare is already in the red and will be bankrupt by 2017. There will be SOME increase in residency spots but not enough to accommodate IMG's. There might be some spots left but based on the projection by 2016, I doubt whether there will be a thousand spot left for IMG's.

 

[dragonfly99]

Nobody really knows what is going to happen w/the number of US residency spots. There is a bill in Congress right now I think that proposed to life the "cap" on residency positions. Who knows if it will pass. Even if it does, that won't create more residency spots...just the possibility of them.

Just because the gov't doesn't have money for stuff doesn't mean they won't spend money on it. Just b/c we have a big nat'l debt, I wouldn't rule out creation of more residency spots.

I do agree that 50k/year tuition is very, very steep for somebody who plans to do primary care, or might be forced into primary care. The gov't has created an income-based repayment scheme on student loans, though (at least for the time being) so your payments would be controlled while you are doing residency. Such a high amount of debt will put a dent in your future lifestyle, however...and I don't just mean no mansion and no fancy cars. I'd think long and hard about spending that amount of money, especially if you don't have family/parents chipping in. But it would still be better to pay 50k/year for a real medical school, vs. 20k-30k/year for some of the shady Caribbean med schools.