The Foreign Underclass in American Medicine

Dear Dr.Shafqat:

I am an American and a recent graduate from a foreign medical school. I agree with everything you have written and am impressed by how well you have presented this issue.

I have a website whose purpose is to act as a sounding board for FMGs and also to expose the prejudices that FMGs face especially from organizations such as the ECFMG. I would like your permission to include your article in my website. The webaddress is http://www.maxpages.com/bestdoctors



Sincerely,

Daniel R. Klages

as a recent graduate of medicine from TURKEY, i completely disagree about the policy of the U.S. government.i have been studying die hard to succeed in U.S.M.L.E.,and have the confidence to pass them.

as a recent graduate of medicine from TURKEY, i completely disagree about the policy of the U.S. government.i have been studying die hard to succeed in U.S.M.L.E.,and have the confidence to pass them.

I am a foreign medical student and a US citizen and wondering why one of the requisites of the ECFMG us that the university be listed in the World Directory of Medical Schools, my university is excellent and after all it is the student who forms himself as a physician and not the university, the univeristy serves only as a meer guide of discussion.

Mauricio Pinto

Universidad Nuestra Senora de La Paz

Nicely written article. No profession is immune from ``double standards`` practiced here. Relentless persuit of 2nd generation will make a dent in the system at the end. Meantime, all strugles and contributions by FMGs will keep the drive alive and will be the inspiration to the young ones.

all the information and writer`s perception about the problem is correct,but I think it is pretty old and can do no good about the present situation of FMGs still trying to pay a fortune with their odd jobs to appear in the exam.While people with a far less credential doing all kinds of healthcare jobs.There is no place in american healthcare for a foreign doctor whatsoever.I wish american could use those foreign doctors who are in this country doing odd jobs thanks to the red- tape

It certainly is an article well written and echoes the sentiments of many IMG`s aspiring to get into a residency program in the U.S. I am one of them.I have passed USMLE Steps 1,2 and 3.

I have always wondered why the U.S. does not stop the USMLE exams for IMG`s when they are so keen on not taking in an IMG if they can help it. It must be because of the huge profits they reap in with the exam fees that the IMG`s keep paying and re-paying(when they don`t pass in the first attempt)

Re: SS

(“...I don’t dispute that desi physicians ON THE AVERAGE are worse than US physicians...”)

This is my only contention. No more. It would, similarly, be reasonable to say that, on the average, an MBA from Harvard is ‘superior’ to an MBA from Tuskegee University in Montgomery, Alabama. This is not a statement on the ethnic inferiority of Alabamians. Indeed, it is true that “exceptionally brilliant Tuskegee MBAs will always outshine sub-average Harvard MBAs.” But perhaps this is too restrictive a statement and you could say that I am “selling the Tuskegee MBAs short.”

I think we are essentially in agreement, only I don’t seem to share your ‘passion’ about this issue and therefore we have a ‘semantic divergence’.

It would be purely a semantic argument if, for example, a brilliant and successful Alabamian working at a prestigious Wall Street firm stood up for the rights of fellow Southerns and stated that, “Tuskegee MBAs who are manifestly better than the majority of Harvard MBAs are not a rarity. There are many, many Tuskegee MBAs who can, will and do outshine not only ‘sub-average’ Harvard MBAs but also average and superior ones.”

The fact is that when Wall Street recruiters are going through their applications’ list, they will have a natural bias in favor of sending interview calls to Harvard MBAs in preference over Tuskegee MBAs. There are going to be many cases where justice will not be served and a deserving Tuskegee MBA will be overlooked in favor of a Harvard MBA.

That many Tuskegee MBAs are also poor rural Alabama Blacks is an unfortunate coincidental. To turn it into a racist argument is taking things a little too far.

...SR

Great article, Saad. And your replies to others are ones I fully agree with.

Even though I agree with you that it is prejudicial to comment on the `lower quality` of desi-docs as a dogmatic statement, because indeed some excellent physicians are produced at desi med schools, but the awkward fact still remains that the `quality of training` in desi med schools ON THE AVERAGE (AK excluded) is poor. The harm of the 70s and 80s has only half-heartedly been partially-reversed. The fact still remains that the resource starved desi institutions with politicized faculty recrument simply do not match the standard of the US med schools.

Even the entry requirments of desi schools (again AK excluded) are woefully inadequate. An FSc is almost like high school. The average US med school entering student has four more years of college, surely that should account for something. It would have to, by definition, reflect in a haigher quality `product` because the `raw materail` is of a higher grade. So you have a higher grade of `raw material` being `processed` in better funded higher quality institutions and the `product quality` is going to reflect that ON AVERAGE. Compare to this an `imported product` that was `processed` in poorer institutions which took in lower grade `raw material` in the first place. This is a `no-brainer`.

Cry racism and prejudice all you want, scream for `affirmative action for FMGs if you will, the fact is simple and straight forward that the desi FMG does not have a snowballs chance in hell compared to the US grad. This, of course, is true for the aggregate. Exceptionally brilliant FMGs will always outshine sub-average US grads, but that is not the discussion.

...SR

I just have one question . If Pakistani Doctors are so good, why do they fail so much in USMLE ?
Exceptions are DR`s from Agha Khan University. I think the problem is the dimenishing requirement for FMGs and poor quality of our doctors whether from any place in Pakistan to compete for these positions. Result is that these few positions are going to graduates of other countries. This is a fact. What is the solution?

1. What ever was missed during 5 year commando traing/medical training program in Pakistan, make up for that here by working smart. I used the word commando traing, our medical colleges are controled by political parties, and best places for military training.

2. Stop blamming the system. US merit system may be bad but far better than many other countries, including Pakistan, where no discussion can be started without somebody mentioning racsim. Prove is thats why many of us are here.