In choosing a residency what should one look for? No, I’m not going to bore all of us with a lengthy discussion about being a dumb medical student looking for a paycheck (although that will feel mighty good – been almost 3 years since I’ve had a job). What I’m referring to is the evaluations students make of the residents they work with and the decisions to either a) enter that field of medicine, b) apply to that residency program, c) run away screaming.
During every rotation thus far I’ve noted the abundance in foreign med grads (FMG) who occupy the slots at my school’s main teaching hospital. I’ve also noticed that on OB/GYN, which is considered hands down the best program here (although not necessarily by the students), the majority of residents are United States med school grads (USMG). This fact in and of itself speaks volumes of the quality of the other residencies.
Now, nothing against FMG’s, but there is certainly something to be said about any program who can’t staff their residency positions without 75% of their residents coming from other areas of the world. In fact, the majority of residencies will rank USMGs before they’ll consider an FMG. Got it, G?
When looking at the recent NMRP data from the last batch of newly minted docs some variables are evident that would appear to weaken this post. For instance, some of the primary care fields like family med skew the results a bit. Less USMGs are entering this field which leaves it wide open for FMG's to get into American medicine. Despite these outliers, however, the program(s) that consistently relies heavily on FMG’s in order to have a functional program warrants a serious consideration by any medical student (US or F) towards the training being doled out.
Certainly FMG’s are necessary to help level out the physician decline in this country. Rural areas desperately require physicians who are willing to work in less than stellar conditions with less pay. Often times FMG’s are the only ones to do so. But when considering a place for potential employment, I stronly suggest evaluating their creed of residents. More then 30% made up from FMG makes me nervous. With that being said, I would never apply to the current school that will confer to me my MD. And that is quite sad.