Friday, May 4, 2007

Whatup, G?

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.


Old MD Girl said...

The guy who did my mom's craniotomy did medical school in Egypt. I think he may be an exception though.


We had a talk about the FMG phenomenon the other day in med school, and I asked whether the additional hurdles the US has erected to keep the evil job sucking foreigners out (oh excuse me, the terrorists), had in any way had an impact on the willingness of FMGs to practice in this country. Alas, my professor was unable to answer that question. So sad.

I hear that the hurdles are lower now for FMGs than they used to be when they thought we had too MANY doctors in this country. Who knows which direction the political tide will be flowing next month.

Old MD Girl said...

Just out of curiosity, what didn't you like about Rosemary's Baby? Does this have anything to do with your loathing of everything OB/Gyn?

pinkie said...

Um, seeing that you want to go into Anesthesiology, and we don't have that, I'm thinking you have no choice but to apply elsewhere =). But then again, even if we *did* offer it, you would probably run away screaming the opposite way regardless.

Come on, I know deep down inside, Ob/Gyn is growing on you. Think of the babies!!!

Liz said...

hey!!! I'm an FMG!!! I hate my life... ;)

But i am not deterred by those 50-50 odds... I gotta be better than the average FMG, right?? Also, sydney has actual nobel- prize -winning research going on... if all else fails & i feel nervous, i can do one of those pre-match contract thingies...

let's just hope for good board scores. darrow takes his in 2 weeks. holy poop.

Oh and as an aside--acceptions to the rule include many docs i worked with at Cornell Med when i was doing research there--grads from pakistan, india, etc in competitive res spots at a pretty good school.

MedStudentGod (MSG) said...

I do believe I've misrepresented myself and the true meaning of this post...again. What I was trying to convey was NOT that FMGs are terrible doctors, but rather the programs that house more than 50% are suspect - not the docs themselves.

I was trying to elaborate on the fact that it's unfortunate, but very commonplace for FMGs to get stuck having to choose lower tier residency programs because they're foreign. Nothing against FMGs - many that I've worked with are great - barring the communication barrier.

And I didn't like Rosemary's baby because it was just too campy. I laughed at it almost all the way through.

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