Conscripting Doctors - Next logical step

[Sulaco]

You can have an FMG with a board score of 240 and a US grad with 230 and the US grad gets first dibs--it's an active policy of discrimination against US citizens with an FMG label. US grads ultimate fear is that FMG's (even if they are Americans) will accept lower pay and larger loads compared to them. Too many doctors I've worked with expressed those unfounded fears. Originally the Caribbean lagged far behind their US counterparts in board scores but the gap has significantly closed in recent years, especially in top tier schools where the difference is negligible. In fact, St. George's USMLE Step 1 averages are higher than US DO schools.

My dad has been a Professor of Neurology at several major medical schools, graduated from one of the top medical schools in the world, board certified in Neurology, as well as practicing medicine for the last 25 years or so.
To say doctors are "scared" of Caribbean trained doctors is true, but not for the reasons you're laughably asserting.
On an almost universal level, the Caribbean trained docs have been far less knowledgeable and capable then American doctors trained at quality schools.
In real world clinical and hospital environments, it's not even close.

 

[TerryMathews]

I've elaborated upon my reasoning and answered all of your questions in other posts, but you seem to be conveniently ignoring them.

Link it then because I sure don't see it Dean Wormer.

 

[Victorian Gray]

Its the inevitable direction once you start down the slippery slope and keep tilting it.

Other than pie in the sky nonsense, if you want to increase access and reduce costs at the same time you are going to have to increase supply, alot.

...snip...

This is why alot of these systems cause massive shortages or surpluses depending on which brand of poor execution is carried out. Canada has imaging shortages. I wonder that flavor or shortage and overcapacity is heading to us via the ACA.

Umm, just what are these "imaging shortages" that Canada is supposed to be experiencing?

 

[OverVolt]

Umm, just what are these "imaging shortages" that Canada is supposed to be experiencing?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653696/

The first sentence?

 

[Slew Foot]

My dad has been a Professor of Neurology at several major medical schools, graduated from one of the top medical schools in the world, board certified in Neurology, as well as practicing medicine for the last 25 years or so.
To say doctors are "scared" of Caribbean trained doctors is true, but not for the reasons you're laughably asserting.
On an almost universal level, the Caribbean trained docs have been far less knowledgeable and capable then American doctors trained at quality schools.
In real world clinical and hospital environments, it's not even close.

I, myself was a professor of Anesthesia at a major University in CA, and we wouldnt even give a sniff to anyone not from a US medical school. If I can fill my class with top tier students from UC Med Schools, Harvard, Stanford, and the like, why would i pick someone from Buttfuckingstan regardless of what their USMLE score is?

 

[5150Joker]

My dad has been a Professor of Neurology at several major medical schools, graduated from one of the top medical schools in the world, board certified in Neurology, as well as practicing medicine for the last 25 years or so.
To say doctors are "scared" of Caribbean trained doctors is true, but not for the reasons you're laughably asserting.
On an almost universal level, the Caribbean trained docs have been far less knowledgeable and capable then American doctors trained at quality schools.
In real world clinical and hospital environments, it's not even close.

Who cares what your dad did? He's a dinosaur. I'm in the field right now and see it everyday. You're an idiot if you think there's a huge difference between practicing Caribbean and US grad physicians in their respective specialties. In fact you probably were treated by a Caribbean grad at some point and didn't even know it. The training is exactly the same with US and Carib grads and the USMLE score gap is minimal between the top Carib schools and US medical schools. So where is the difference coming from? That's right, nothing but ego and fear projected by some US grads.

P.S. Back in my core clinical rotation days while working alongside US grads, we had an OB/GYN attending ask us how much blood a woman loses during menses. His (US med student) answer? 2 liters. I was so impressed by the quality of US graduates with his answer.

 

[TheVrolok]

The students that get through USMLE are every bit as qualified as a US educated medical student.

Passing the USMLE does not mean equivalency as a student. It means they both passed a board exam based on scientific knowledge. What range of scores? How competitive? etc. etc. There are numerous American grads who pass the USMLE who don't end up matching for residency spots because it isn't only about board scores.

In fact, the top tier Caribbean schools send all their students to train at the same hospitals as the US medical schools.

I'm quite aware as I've seen many, many Caribbean students in Miami. The difference is apparent. Are there some Caribbean students who are as strong as, or stronger, than US students? Certainly. But the average is certainly not the same. Argue as much as you want against "the man" the is the AMA (I definitely don't care much for the organization), but there is some solid ground for pushing back against the Caribbean schools.

In fact, St. George's USMLE Step 1 averages are higher than US DO schools.

Had to chuckle a bit at this part, do you think that's because the majority of DO students are taking the COMLEX rather than the USMLE and your sample size is garbage?

Who cares what your dad did? He's a dinosaur. I'm in the field right now and see it everyday. You're an idiot if you think there's a huge difference between practicing Caribbean and US grad physicians in their respective specialties. In fact you probably were treated by a Caribbean grad at some point and didn't even know it. The training is exactly the same with US and Carib grads and the USMLE score gap is minimal between the top Carib schools and US medical schools. So where is the difference coming from? That's right, nothing but ego and fear projected by some US grads.

So are we, and having spent a number of years in Miami I've seen many, many Caribbean students/grads and my anecdotal evidence is in complete opposition to yours. We could bicker back and forth with, "Well, my experience is..." but you may as well stop presenting yours as fact and blaming the bogeyman.

 

[Oric]

Why not import english speaking doctors ?

 

[Sulaco]

Who cares what your dad did? He's a dinosaur. I'm in the field right now and see it everyday. You're an idiot if you think there's a huge difference between practicing Caribbean and US grad physicians in their respective specialties. In fact you probably were treated by a Caribbean grad at some point and didn't even know it. The training is exactly the same with US and Carib grads and the USMLE score gap is minimal between the top Carib schools and US medical schools. So where is the difference coming from? That's right, nothing but ego and fear projected by some US grads.

P.S. Back in my clinical rotation days while working alongside US grads, we had an OB/GYN attending ask us how much blood a woman loses during menses. His (US med student) answer? 2 liters. I was so impressed by the quality of US graduates with his answer.

He's a dinosaur, yet is still on faculty as a professor at a major medical school, sees patients in clinic and in the hospital, and has more experience in his little finger than anything you've done thus far? Gotcha.

Sorry, not looking for a pissing match, but if you're idea is to support your views (which it looks like are being dismantled by more than a few members here) with anecdotal evidence, it's simply trumped ten fold by those with vastly greater knowledge and experience in the field than you have. Sorry.

 

[PhoKingGuy]

Who cares what your dad did? He's a dinosaur. I'm in the field right now and see it everyday. You're an idiot if you think there's a huge difference between practicing Caribbean and US grad physicians in their respective specialties. In fact you probably were treated by a Caribbean grad at some point and didn't even know it. The training is exactly the same with US and Carib grads and the USMLE score gap is minimal between the top Carib schools and US medical schools. So where is the difference coming from? That's right, nothing but ego and fear projected by some US grads.

P.S. Back in my clinical rotation days while working alongside US grads, we had an OB/GYN attending ask us how much blood a woman loses during menses. His (US med student) answer? 2 liters. I was so impressed by the quality of US graduates with his answer.

Curious to what your qualifications are.

Current third year med student, have already seen my fair share of idiot carib med students. Its well known they are a lower rung of student, and its true. You'll get a good one every once in awhile but its rare.

Its easy to get a good board score when your whole curriculum is based around step 1 prep from day 1. Their clinical knowledge/practical knowledge is laughably bad.

I'll even go one step further, I'm a DO student and did clinical research my second year of school. The docs I worked with preferred me to scrub in to assist them over the 4th year carib students there at the time, they stated it was not a common occurrence for that to happen.

 

[5150Joker]

Fourth year, in the middle of interviews. Will be doing IM. The genius I talked about was a DO student from Midwestern.

 

[Fern]

Care to elaborate? How are the businesses burdened by insurance concerns? Is it every nation or just one or two nations and their particular idiosyncratic systems?

There's not a whole lot of difference. The only one I can think of is that the foreign companies under single payer don't have to call around once every few years to get the best rates etc. There's no haggling with the govt.

But the foreign companies pay a crap ton of money for employees' HC. They also have to sign their employees for coverage etc. The difference is that instead of the sign up being with a private insurer they sign up employees with the govt. agency. Just like here, you have to be issued an insurance card etc.

And just like here your HI coverage is linked to your employer (or at least it was when I lived and worked in Europe).

So, there was really no difference.

IMO, the big differences in HC all lie elsewhere (e.g., physicians make a decent but modest salary, medical school is basically free, physicians aren't independent businesspersons bearing risk by taking out big loans for medical equip etc, and you can pretty much forget litigation etc.). The system is very very different on the provider side.

Fern

 

[TheVrolok]

Fourth year, in the middle of interviews. Will be doing IM. The genius I talked about was a DO student from Midwestern.

A single comment from a single dumb kid? I've heard completely ridiculous things come out of the mouths of DO students, MD students, FMG students, DO attendings, MD attendings, FMG attendings. I've also heard/seen great medicine from DO/MD/FMG students/attendings. An anecdote here or there is worthless.

I'm in the field right now and see it everyday.

P.S. Back in my clinical rotation days.

Fourth year, in the middle of interviews.

Back in your clinical rotation days? As opposed to being currently in your clinical rotation days?

 

[5150Joker]

I'm on Swype so it's a pita to type on an s2. Back during cores when we were lumped together. And exactly my point, you made sweeping generalizations based on your anecdotal experience with Caribbean students. Granted there's plenty of morons but I've met more than my share of DO student that I thought knew less than the PA students.

 

[TheVrolok]

I'm on Swype so it's a pita to type on an s2. Back during cores when we were lumped together. And exactly my point, you made sweeping generalizations based on your anecdotal experience with Caribbean students. Granted there's plenty of morons but I've met more than my share of DO student that I thought knew less than the PA students.

I thought your point was that the AMA was fighting equally competent Caribbean grads? Now your point is "anecdotal evidence is BS" and your statements about Caribbean grads are just as worthless as ours? All while you spend time condescending DO students after trying to speak from a position of authority suggesting you weren't simply another med student? Sounds to me like you're just full of shit with a chip on your shoulder.

 

[5150Joker]

I thought your point was that the AMA was fighting equally competent Caribbean grads? Now your point is "anecdotal evidence is BS" and your statements about Caribbean grads are just as worthless as ours? All while you spend time condescending DO students after trying to speak from a position of authority suggesting you weren't simply another med student? Sounds to me like you're just full of shit with a chip on your shoulder.

The AMA is biased against FMGs, you'd have to have your head in the sand to say otherwise. And my point was your anecdotal experience as a 3rd year DO isn't anymore valid than the one I posted. Some surgeon lets you scrub in over other Caribbean students you work with and somehow you think you're better than them? Talk about a condescending attitude. Yeah holding and retracting is tough work. I never hid the fact that I'm at the tail end of being a med student, check my profile, its clearly listed.

 

[TheVrolok]

The AMA is biased against FMGs, you'd have to have your head in the sand to say otherwise. And my point was your anecdotal experience as a 3rd year DO isn't anymore valid than the one I posted. Some surgeon lets you scrub in over other Caribbean students you work with and somehow you think you're better than them? Talk about a condescending attitude. Yeah holding and retracting is tough work. I never hid the fact that I'm at the tail end of being a med student, check my profile, its clearly listed.

You must be confusing me with someone else, I never said anything about scrubbing in. Might want to read up.

Never hid the fact? Certainly obfuscated? Or are you saying that, "back in my clinical days" doesn't imply you're currently not in your clinical days?

Oh, we've also changed Caribbean grads to all FMGs? I work with quite a few FMGs (mostly from Pakistan, Napal, Nigeria, and India where I'm at) and they're great.

Of course the AMA is biased against Caribbean grads, what I'm saying is that the bias isn't necessarily unfounded as the average Caribbean grad is less competitive than the average domestic grad. It's really simple unless you think the Caribbean schools are significantly easier to get into and at the same time are producing better quality grads?

 

[5150Joker]

You must be confusing me with someone else, I never said anything about scrubbing in. Might want to read up.

Never hid the fact? Certainly obfuscated? Or are you saying that, "back in my clinical days" doesn't imply you're currently not in your clinical days?

My mistake, got you mixed up with Phoking. I mentioned I was on the s2, it was a simple oversight when swyping. "Back during my core clinical days", happy? :sneaky:

Oh, we've also changed Caribbean grads to all FMGs? I work with quite a few FMGs (mostly from Pakistan, Napal, Nigeria, and India where I'm at) and they're great.

Last I checked, Caribbean grads are FMGs. And the AMA is biased against them all, Caribbean or otherwise. Recently US med schools in the NY region have felt threatened by them (Caribbean schools) because they're locking in hospitals for clinical spots and outspending them. They have also went crying to the AMA to help them out.

Of course the AMA is biased against Caribbean grads, what I'm saying is that the bias isn't necessarily unfounded as the average Caribbean grad is less competitive than the average domestic grad. It's really simple unless you think the Caribbean schools are significantly easier to get into and at the same time are producing better quality grads?

I've clearly pointed out that the top Caribbean schools produce higher quality grads vs their lower counterparts but the disparity is not even close to what is being talked about here--especially once they hit residency. However, contrary to some people's misguided opinions, they aren't spoon fed USMLE material. The top schools also produce the bulk of Caribbean grads and they the are ones that have been targeted due to their numbers and representation. I mentioned St. George's specifically as an example where their grads are on par with US allopathic grads and outscore osteopathic averages. Yes Indian/Pakistani FMG's are great, as long as you can understand them.

 

[fskimospy]

There's not a whole lot of difference. The only one I can think of is that the foreign companies under single payer don't have to call around once every few years to get the best rates etc. There's no haggling with the govt.

But the foreign companies pay a crap ton of money for employees' HC. They also have to sign their employees for coverage etc. The difference is that instead of the sign up being with a private insurer they sign up employees with the govt. agency. Just like here, you have to be issued an insurance card etc.

And just like here your HI coverage is linked to your employer (or at least it was when I lived and worked in Europe).

So, there was really no difference.

IMO, the big differences in HC all lie elsewhere (e.g., physicians make a decent but modest salary, medical school is basically free, physicians aren't independent businesspersons bearing risk by taking out big loans for medical equip etc, and you can pretty much forget litigation etc.). The system is very very different on the provider side.

Fern

Oh god is this wrong. Basically look at any major company's HR department. A huge portion of their work is devoted to managing the company health plan. There is enormous overhead that is replicated in every business.

Not to mention that the 'crap load' of taxes they pay for health insurance is much less than what we pay here. Single payer is an enormous competitive advantage for foreign companies. They live in countries that use logic to drive health care choices instead of blind faith in the market. Hell, even their conservatives aren't nutty enough to not accept single payer.