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 Residency for IMGs blog: Videos for Internship  



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  #1

Dear members,

I am the Assistant Program Director for an Internal Medicine Residency program who has guided and mentored many IMGs through the residency application process. I welcome you to visit my blog, Internal Medicine Residency for IMGs http://im-for-imgs.com/

Also free educational Videos for Internship/Residency can be found here www.youtube.com/user/Kenne...hBChristopher?feature=mhee
Sample posts include:
Observerships List
IM Program List
Discrimination against IMGs in the Match
Pre-Match offers
Interviewing tips
Even excellent scores are no guarantee
What to do if you don’t match

The purpose of the blog is to share my thoughts, opinions and advice with those who are applying to residency programs. If you have a question that you would like to see answered, feel free to email me at kennethbchristopher@gmail.com.







Edited by IMforIMGs on Mar 08, 2012 - 8:39 PM. : updated blog content



  #2

I have an issue with this statement and will hit you back when I get some time. In some cases it may be true but I've a perspective on it to share --
"Students at the medical school where I work take 2-4 weeks to study for the step 1. Their average is about 225. Most AMGs (to be) study about the same amount of time. Compare that to the individual who really studies for the exam for two focused years and completes thousands of questions – he gets a 225 as well. One cannot really compare the two applicants as they are not the same. Four weeks is not the same as 2 years of study. Lets look at the clinical skills exam, everyone passes except about 15% of the IMGs. The AMGs don’t prepare, the IMGs do. Thus the CS is not a helpful way to distinguish between candidates. Few AMGs take the Step 2 exam and those that do don’t focus on it. IMGs again study for long periods of time. Again not a great comparison."


  #3

This statement however is 100% noteworthy and I completely agree -- "If you match, work hard to get your fellowship then no one will care where you went to medical school."

Also, kudos to your blog -- it contains information that is of great service to many who lack any measurable similar opportunity for career advancement in their home country.


  #4

wellsaid trimidoc but what is astonishing and troubling to understand is despite i know an IMG who even didnt clear his cs yet diagnosed a hypocalcemic fit here in US and advised the patient to take over the counter medication while the patient was sent back home from the ER with prescription of tylenol for pain...no proper exam done...rest assure the history was partially taken...is this the standard of exams and scores?

 


  #5

@trinidoc,

AMG discharged patient with serious hypercalcemia today....

I did not prepare for the CS and definitely did not take years to prepare for steps, sitting at home and studying...

AMGs do focus on step 2, I really don't know who told you that they do not.

People in med school lie about time it took them to prepare for exams. It's common in every med school in the world.  At the end they never studied for more than 2 weeks, or more than few hours here and there. Because they are just so brightwink

 

Shit happens...everywhere..and to everyone...

 


  #6

grin listen guys, If we send an AMG in my country right now, and ask him to study for the clinical knowledge boards, in I can guarantee you he will need 3 years, not just 2!


  #7

I just have a few points --
(1) the time from graduation for many IMGs is spent working in their home countries, not dedicated studying for usmle steps.
(2) many developing countries do not have working schedule regulations that are comparable to the US -- 36hrs working straight still exists
(3) if you get a scholarship from your home country, you have to work at least 3yrs of government service
(4) the IMGs who fail CS do so because English is not their 1st language or because they have thick accents -- & from a US persepctive this is fair, since Americans need to understand what you say!
(5) one cannot generalize that since a person has YOG > 2-3yrs that the time was spent solely on USMLE because they weren't in a "home residency" -- the reason we are applying to the US is because home residencies do not exist or because sub-specialty simply does not exist.

Just some thoughts!


  #8

yes I believe there is discremination againest IMG for many reasons stated above. I cant blame a PD for making what he thinks his best shot..one specific program I know (I have an insider there ) told me that they send automated rejection to all IMGs except if the IMG know someone inside,,, all their IVs were sent to AMGs ... I know that doesn`t apply to all programs ofcourse ,, but the idea is AMG takes the upper hand no matter what their scores are... and i think all IMG should be aware of the fact that in few years AMG will take over. our money is always welcomed for sure,,but not us anymore confused


  #9

The best advice for non perfect candidate,,get USA experience in a hospital that have residency programs ,, they will know you and might pass the filters.


  #10

@trinidoc,

People do not fail CS only because of the accent..Sometimes they don't fake smiles up to American standards. Not that I failed it, but I have come to know few IMG's very bright and fluent in English, who just did not repeat enough of "Ohhh I am sorry to hear that Mrs. so and so" spiced with lots of fake smiles and fake worry...


Edited by doctor4usmle on Dec 03, 2011 - 9:03 PM

  #11

I've found very interesting Dr Kenneth Christopher's blog. It's important that people inside the establishment come forward and share information about mechanisms on how they operate. For more politically significant matters we call them insiders or whistle-blowers, and they play TRULY important roles uncovering big lies, corruption, or simply unfair practicies inside the system. In that regard, Dr Christopher and people like BBB are to be congratulated. I don't know his motivation for sharing this information but I venture myself to guess that he also sees with some suspicion how things currently work. I believe this is a step toward a bigger awakening that will take time, as we mature, as we debate and find ways to digest & tease out the vast amount of contradictory information.

Many things are revealing in Dr. Christopher's blog.

First, he shares information on how important is to pay attention to little details during interview day. Anything that annoys him during that day, it's likely to be taken as a longterm characteristic of the applicant given the shorttime window of interaction with him. Little things could either jeopardize or enhance applicant's chances of being ranked favorably. For example, Dr. Christopher puts several examples of 'planting a [unfavorable] image into his brain' like a candidate knocking on his door while he's already talking to somebody else (ways to avoid such impasse could involve using goggles capable of seeing across doors, or taking pills of Kryptonite like Superman). Just kidding smiling face On a more positive and serious perspective, is the fact that Dr Christopher reveals to us that such whimsical practices do take place. BBB had already told us months ago that PDs strive to make new residents 'fit' with residents already in the program. It suggests that there are residents who 'don't fit'. Interesting concept in & out of itself. I'd like to read more on the subject. Bottomline: there are whimsical criteria that play a critical role after the 'objective criteria' submitted through ERAS. This is an important contribution as many of us might think PDs are fair judges.

Second, his blog doesn't allow comments. That's understandable. He might receive too many, or offensive ones, and filtering those could take a huge amount of his time. So it's wise to deny comments in his blog while receiving feedback in somebody else's blog thus outsourcing the filtering task. That's actually advantageous because it allows a higher level debate to take place in a open and more visible forum like Prep4Usmle. Great!. Let's dive in!

Now, getting to the matter of things, Dr. Christopher shares with us a document from the Association of American Medical Colleges (AAMC). Thanks Dr Christopher. This is a good thing. We need information at this level. We need fact-based information that tell us the implications for our careers. Please read his blog as his post does say critical things and Dr Christopher does a good job summarizing it and providing perspective ( im-for-imgs.com/2011/11/21/...ational-medical-graduates/ )

Assuming you've read his post and attachments, you can continue. If you haven't, please do spend time reading his post as he's discussing VERY important things for our profession and for those IMG physicians who like me, want to get postgraduate training in the U.S.


(I'll continue later...just for the sake of suspense? No. It's because I'm busy and I want to see if enough people are open for debating the many important things he discusses which in my view haven't sparked enough participation). If anybody wants to start the discussion, please do so. Please avoid ad hominems. Thanks.


  #12

hyvee wrote:
yes I believe there is discremination againest IMG for many reasons stated above. I cant blame a PD for making what he thinks his best shot..one specific program I know (I have an insider there ) told me that they send automated rejection to all IMGs except if the IMG know someone inside,,, all their IVs were sent to AMGs ... I know that doesn`t apply to all programs ofcourse ,, but the idea is AMG takes the upper hand no matter what their scores are... and i think all IMG should be aware of the fact that in few years AMG will take over. our money is always welcomed for sure,,but not us anymore confused


it is obvious that discrimination against IMGs exists and this is necessary, the purpose of being a citizen in a country is to receive certain benefits that non-citizens cannot. it's the basis of the world. even in Trinidad, there was an Indian IMG doing an observership in Internal Medicine at my hospital. similarly, even Trinidadian graduates from Cuba must sit and pass PLAB (UK) before being allowed to do internship. it is up to IMGs to be up to mark and even exceed the mark set by AMGs -- it is up to us to justify placement in a residency, to enhance it if we can and at a baseline to "fit in".

standards are put in place for a reason, so that every US patient is guaranteed the same treatment across the board. it is very creditable of the US to allow IMGs to apply to their programs by just doing the same exams an AMG would. in canada, many IMGS have to repeat med school rotations to even qualify to write MCCQE (a practice now discontinued). even so, most IMGs in Canada have government funding from their home country in an exchange program. the US is one of the few places in the world that actually funds it's own IMGs across the board.

this practice, given the economic turn taken in the US, seems to be heading to a close. 40% reduction in GME funding in 2012 = limited IMGs at best. pros vs cons are weighed as in every country. however, there are benefits to having diversity in residencies, as i witnessed 1st hand from the several international med students at my university. i am hopeful for an IM placement, and if i do match -- i will make every effort to justify my place and encourage excellence in my fellow residents as well, AMG or IMG.

if i don't match, i am not at a loss -- USMLE's are quality exams and the knowledge reinforced/learnt will not go to waste. good luck to us all and please continue to lend your views!



  #13

sadly trinidoc,,i agree on every word you said,,it is an open market and certain requirment are enforced.... even more sad that it is still sold to us as undiscrimination enveiroment,,,land of dreams and all those hallucinations,,, it might be easier if you are still back home and don`t match may be no harm done,,,but if you are alllready in USA ;this is home to you and this is your carreer and u have no other option but to be here and find a spot for yourself, what other options anyone can have? start all over again in PA or nursing school ,, which BTW don`t accept any of our degrees,,they have their own policies,,,
I hope u match trinidoc. I read many of your posts,, u are always helping and have positive attitude,, good luck to everyone in this agonising market.


  #14

...continued.

The following points are apparent to me:

-Too few doctors. Apparently the motivation behind increasing the number of American medical graduates is because... there are or there will be a shortage of doctors. A simple observation at our forum suggests otherwise. We know there are many American IMGs needing residency spots. Are they enough to supply the market? I don't know, but being American they should be given preference for their citizen status. Now, we know those vacancies can be filled short-term with current IMG applicants: there are about 10 more IMGs per residency spots available. So the pool of IMGs is huge. So the question is: why neither of these 2 pools are being exhausted?.

At this point, the discussion usually splits into 2 arguments.

1-Quality: it goes this way "American IMGs who didn't score high enough or have attempts are implied to be not that good, and so top scoring IMGs should replace them". It's like saying: "a child who doesn't walk at one year of age shouldn't be allowed to walk at all because he has too many attempts or didn't score high enough during his first attempts". I'm actually tired of this argument of quality based on a few points in computer tests that have very little to do with actual practice of Medicine in a complex environment.

2-The second argument deals with the remainder of IMGs. Why isn't the vast excess of IMGs used to fill up the extra need for physicians? At this point it gets political: Somebody could say...we just want American-born doctors...'cause that's what we want. Or somebody could say: we just want 50/50 or 70/30(American/IMGs). Regardless of that, it's important to recognize that the AAMC made a decision in 2006 to recommend a 30% increase in medical student enrollment and so it favors the "100% American-born". Now in 2011 we are reading a 2008 document that in fact, >85% of medical schools are acting accordingly, and so the target to fill all residency spots with mostly American medical seniors should be attained in 2014-2019 (for easy remembering, the same year that Obamacare kicks in). That of course leaves all us IMGs out of the loop, as Dr Christopher correctly points out.

At this point it's useful to phrase a question: Does it mean that IMG acceptance is going to decrease to the point of disappearance? Is this supposed to free market? The one that regulates itself? It doesn't look like that, but one thing is true: This is policy. A decision has been made. We're already surfing on its wave. The remainder is to find out why, who benefits, what's the goal and what we IMGs have to do. We need to develop a plan.

To be continued....


Edited by xenopus on Dec 04, 2011 - 9:48 AM

  #15

...continued.


Why?

Why switching to all American physicians?

What about the 1986 ECFMG document advocating for more IMGs to get postgraduate medical education in the U.S.? ( http://www.sendspace.com/pro/dl/65y8x4 )

-Does it mean ECFMG goals were achieved?
-If so, when will the ECFMG publish a "Need to Shrink the Program"?
-Or does it mean money is running out?
-Or somebody simply said: “We just want to train American doctors with American money and that’s it. Period”.

Why the switch to all American physicians?

Well, I can't answer why. So far all I've read is Dr. Christopher’s blog and attachments. That's too little to figure out why, we need more documents. Hopefully these will come forward upon further digging. However, I can speculate. Speculating is one of most fascinating things. It stimulates the imagination, it allows you to fly and reach places you've never been, meet people you wouldn’t otherwise meet.

Bear with me on this one. The United States population is one of the most acritical populations. A country of sheep. People in this beautiful republic have enjoyed liberties not available to others, thanks to the strong enactment of a very good Constitution and progressive laws passed during the Roosevelt administration (New Deal of 1933). This has allowed them to rest on their laurels and almost never exercise their democracy. Their democratic muscle is severely dystrophic and atrophic by now. The only reminiscence of freedom are sentences like “I live in a free country, I can say what I want (politics & religion) but because I recognize you don’t agree with me, I just shut up”. And that’s why people in elevators, meetings, parties, and any other social gatherings, they just re-circulate the same bullshit that everybody agrees on usually about consumerism and hedonism while avoiding thorny topics of ‘politics and religion’ and not asking questions. Meanwhile powerful groups have infiltrated the government. And so the beautiful republic has morphed into an Empire, an empire that takes the best of the republic and uses it for the benefit of a few around the world. And people still don’t know it. I tried to write the many reasons and supporting evidence on how people in the U.S. decided to become sheep, but 'realized this topic deserves a book on its own. So for the sake of simplicity and without any intention to offend, just let me point out a fact: Most of the people in America are sheep (or everywhere else for the matter).

Now let’s turn to a more novel issue. From Dr. Christopher’s blog we know that the number of American applicants will be roughly the same number as the number of residency spots available. Although a more fact-based document is needed, we could expect that the probability of matching for American applicants will continue to be high, while decreasing odds will be faced by IMGs. So the role of postgraduate residency programs will be an easy one. As residency spots can be filled completely with American medical student seniors, discarding IMGs is as easy as the click of a mouse. So the question is:

What will the responsibility of postgraduate programs be?

In my view, it will become a like a beauty pageant. All of applicants are equally qualified, all of them will pass the Clinical Skills test, their USMLE scores will be roughly average with minimal studying, their language skills will be superb, their perspectives will be as standard as any of the schools they come from, their views will be roughly as sheepish as households they come from. So what’s the role of residency Program Directors and faculty? PDs and faculty will just have to continue doing what they’re currently doing but in a greater scale: They’ll have to choose the most beautiful, the most articulate, the tallest, the thinner, the blonder, the brownest, the shortest, the most experienced, the most this, the most that. But at the same time, the biggest responsibility will be faced by graduate admission committees who admit young college graduates into medical school. As medical schools increase their enrollment numbers, those graduate committees will become the true gatekeepers and so the bottleneck is set at an earlier stage. From then on, it’s like a going through a pipe. You’ll get safe at the other end. Just hold on tight.

(To be continued...)


Edited by xenopus on Dec 09, 2011 - 7:57 AM. : spelling errors

  #16

hyvee wrote:
sadly trinidoc,,i agree on every word you said,,it is an open market and certain requirment are enforced.... even more sad that it is still sold to us as undiscrimination enveiroment,,,land of dreams and all those hallucinations,,, it might be easier if you are still back home and don`t match may be no harm done,,,but if you are alllready in USA ;this is home to you and this is your carreer and u have no other option but to be here and find a spot for yourself, what other options anyone can have? start all over again in PA or nursing school ,, which BTW don`t accept any of our degrees,,they have their own policies,,,
I hope u match trinidoc. I read many of your posts,, u are always helping and have positive attitude,, good luck to everyone in this agonising market.


thanks for the support .. but don't worry, a home is where your heart is & it cannot be restricted to a country that rejects you/your ability. this will compromise your happiness and i'm sure even you don't match (which i sincerely hope you do) that something will open up for you. open your mind to the other options around the world and get some working experience/salary. the options are there and if in these new places you find personal and job satisfaction, then you've found a home!

@ xenopus -- quite the philosopher! another perspective, what can be done for "home countries" to encourage their graduates to stay and not pursue US training? india is the new economic powerhouse, yet the majority of IMGs are from there ... even a small country like Trinidad & Tobago (1.3 million people) invested close to half a billion dollars (6.4 TT = 1 USD) to bring John Hopkins across to develop cardiology facilities and hospital management training. in the end, only 5 or so cardiologists will emerge (one of whom is an Indian IMG who did IM in US and married a Trini girl so now is a citizen) -- because funding was limited to 4-5yrs -- but still major improvements in infrastructure, protocols and education were seen.

check the youtube link: http://youtu.be/xoK7QM78oic

so my point, there are 2 sides of the coin. and it's not the US responsibility to develop or provide opportunities to IMGs -- it is their country's duty. however, when opportunities are limited, we have no choice but to go the US. that said, what efforts has India made to provide for dual citizenship? once these IMGs get US GC/citizenship -- they are lost to the home country and have to revoke Indian citizenship. shouldn't some policy be created to bring them back? or if not, at least to ensure that not only certain areas have high level medical care and training?

The Caribbean is made up of very small countries, and yet still many efforts are made to encourage educational standards and improvement. I suggest that as fast the US follows the European Union to exclude foreign medical grads, the rest of world should start networking resources to maximize home grown specialists, if not through training in their specific country but through inter governmental arrangements with highly developed countries to do so.

Meantime, I am no politician and I'm just trying to match like the rest of you ... so right about now that's the focus. If one day I am in a position where I can help develop medical care in needful areas/regions, then this discussion becomes a reality. In the meantime, I will bravely go to my interviews in the "under-served" areas of the US -- and hopefully spend the next 3yrs providing quality care to the "developing" parts of the USA.

So good luck guys!! I will never match in JHU but at least I had the privilege of going to lectures and seeing patients with the Hopkins teaching staff. I never asked any one of them for an LOR, although offered, because at the end of the day I got LORs from only people who I worked under ... so at least my limited interviews are from places that genuinely want me as a resident vs a "token" interview to find out about JHU in the Caribbean. let's hope it works out....




  #17

Thanks trinidoc for your comment and link. I wasn't aware about all the important things you tell us about JHU partnering with the government of TT, the huge amount of cash spent on this, the huge prevalence of diabetes (DM2) and other chronic diseases. It's interesting that the output of that partnership doesn't look that great. Please feel free to share more information.

At first glance several things come to mind. What kind of healthcare has TT? Single payer? Managed Care? Hybrid? Other. This is important because I want to know who's responsible for that US$0.5 billion. I was just wondering if the TT government was approached by an economic hitman (see from min 1:30 http://www.youtube.com/watch?v=e0JCJ4pIFEw ). Just a hypothesis, hopefully I'm mistaken.

I'm also trying to match and we'd better do it quick. The door is already closing. GL to you. Please keep bringing your perspectives.

EDIT:
Please take a look at the explanation for Managed Care





Edited by xenopus on Dec 05, 2011 - 11:28 AM. : Half billion + ManagedCare

  #18

Quo bono? Who benefits?

OK. So far we have tons of sheep either domestic or imported, at the end it doesn’t matter, sheep is sheep and all we want is wool. The Managed Care system under Obamacare forces physicians & hospitals to run at their highest efficiency. The reason is huge amounts of money get trapped in Private Insurance firms, so whatever trickles down has to be taken. Doctors and hospitals are like worms feeding on honey that leaks out through the crevices of a big container. Whatever honey leaks out, those outside have to make the most of it. And that’s why we become as efficient as possible. Quickly smiling, draping, rapidly addressing the main complaint, running a differential diagnosis in a matter of minutes, if the patient has a second chief complain it’ll have be addressed on a second visit. Switching rapidly to a 2-question Review of Systems, rapidly running through PAM-HUGS-FOS-SODA and then doing some small talk during hand-washing. Start physical examination, do a 3-minute complete neurological examination and if not, only focus on relevant systems, God helps you if you miss something, give standard recommendations, give diagnostic impression, answer questions, shake hands and get the hell out of there because you’ll have to type or record your full clinical report, focus on positives, relevant negatives, review scribblings, prioritize your diagnoses and quickly decide your standard plan consisting of non-invasive and invasive tests. You have 5 min to rest while nurses are parking another patient in the room for you. If you feel like in an assembly line, don’t worry because that’s exactly what it is. You’re being paid per head, per capita. Per patient. You belong to an industry, one that tries to capture every bit of honey that leaks from the crevices of a big container. The more patients you see, the more money you make. The sheeper you are, the more honey you lick. And everything is gonna be just fine.

Since Obama is going to save the world, you might ask if Obamacare is such a big difference. The main difference is that before you could ‘go naked’, i.e., you could skip buying health insurance if you couldn’t afford it or didn’t want to buy it. Under Obamacare you have to buy. That’s the universal mandate: you have to buy. If you don’t have money, taxpayers will help you buy it. And so taxpayers will help you enrich the coffers of private health insurance companies (take a look at some www.ehealthinsurance.com/he...ealth-insurance-companies/ )

But we were asking: Who benefits from closing doors to IMGs while getting the best of our American youth?

Certainly booksellers and subscriber services like First Aid, Kaplan, Usmle World and others will possibly see their market shrink. Even the ECFMG will probably close its doors. Man, they were so good!. I’ll miss them. I’ll miss the long wait lines when calling. I’ll miss their convoluted language just to describe something as easy as a first time application. I’ll keep my eyes open when they publish a document about the need to shut down the program they strived to expand for many years. Hopefully they'll tell us openly the risks of sponsoring foreign physicians in a progressively shrinking market. For those new applicants ECFMG should say, as nemrac once suggested to warn saying something like this with uppercase “YOU ARE ABOUT TO APPLY TO A LONG AND EXPENSIVE PROCESS OF BEING CERTIFIED WITH THE FINAL PURPOSE TO PURSUE POSTGRADUATE MEDICAL TRAINING IN THE U.S.; DUE TO THE ALMOST NULL PROBABILITY OF BEING ACCEPTED, YOU HAVE TO ACKNOWLEDGE THAT YOU WISH TO PROCEED EVEN IF WE WARN YOU THAT THE ODDS ARE AGAINST YOU. ARE YOU SURE YOU WANT TO PROCEED? CLICK HERE FOR YES. CLICK HERE FOR NO”.

Those above will probably close their doors.

But who will thrive?

It’s well accepted that a good chunk of money in the so-called ‘health care industry’ gets stuck in private insurance health companies (PHICs). This is a fact, please go and check it for yourself. On the other hand, physicians and doctors are failing (providers). A good example is St Vincent Hospital in NYC, but there are many more. Patients, employers and government are either about to go bankrupt or are stretched to the max. So if we had to guess which powerful actor remains capable of moving the tides in the ‘health care industry’ we'd point to the private insurance companies. Their stock is traded in Wall Street and their profits are reciprocal to their expenses (the latter aka Medical Loss Ratio -paying doctors, office visits, surgeries or paying for any health care delivered, or simply their administrative overhead (www.youtube.com/watch?v=qd6...d6GTgUlNWs&feature=related ).

If PHICs arm-wrestle with doctors & hospitals for money, one way to succeed is...to destroy doctors or join them. The joining part is actually beneficial for everybody like the Veterans Administration where doctors, patients and government all belong to the same team. However, team-playing is not the purpose of Private Health Insurance Companies (PHICs). They serve their own capital, they serve their investors. And so they’ll choose to destroy health providers. The destruction part is a bit slow but is happening per the St Vincent Hospital example above. One way to speed this up is by competing directly with physicians by opening their own medical schools. This is a simple way by which private health insurance companies (PHICs) can decrease their medical loss ratio. Because Obamacare will force PHICs to cover for currently denied ‘preexisting conditions’, PHICs need to become more efficient. By opening their own medical schools, PHICs can train their own doctors, they can teach them their most minimal health care practices, they can do research and establish such practices as scientific knowledge to be applied everywhere else. They can even have their own medical journal so their papers never get rejected. They can for example consider ‘medically unnecessary’ certain expensive imaging tests, they might prove transplants too risky, they might change medical algorithms, protocols and guidelines. With time and several iterations of this model, they can bring down all independent medical practices in the country. They can turn doctors from ‘sheep’ to ‘workhorses’. It’s just a matter of time, but to get there they need to make sure all future physicians graduate from American medical schools. Because once inside insurance company-owned medical schools & hospitals, students go like through a pipe. They’ll get safely to the other side, just they need to hold on tight. For Americans medical seniors getting to residency will be a breeze, it could be an exciting one too like a beauty pageant. And Program Directors will wait for them with open arms. PDs will exercise their little bit of power by ranking candidates according to their most capricious criteria. And everything will be just fine.

However, the first medical schools & hospitals to fall prey are those on the market and anything on the market has a price tag. Many PRIVATELY OWNED universities and hospitals will be the first targets of investor capital (read PHICs).

You might want to refute my hypothesis. Please do so, one way could be: Is there any PHIC money behind the AAMC recommendation? Who is backing up such recommendation? Who benefits? Quo bono?

At this point, you could ask, is all of the above Xenopus wild and unchecked imagination? Or does this have any connection with reality? You’ll have to give me a few days or weeks to look for health insurance companies that own medical schools. I encourage you to do some research yourself and we’ll compare our findings later. Most likely, refuting this hypothesis will take 10-20 years. Once those years have passed, nobody will remember this hypothesis advanced today.

Summary. I explained that the strongest actors in the system are currently PHICs, they’ll possibly control educational policy from a distance, but once it becomes favorable, they’ll buy educational & training centers on the market, they’ll compete out doctors & hospitals and slowly lead them to bankruptcy with the final purpose to control the whole system. IMGs will be left out. In the short-term, young American medical students will enjoy a more favorable market but in the long run PHICs are likely to exert complete control over their lives in education, healthcare and insurance. We still need to see what Big Pharma will do, as well as those on the margin.

The next topic: What can I do?

(to be continued…)


Edited by xenopus on Dec 09, 2011 - 8:06 AM

  #19

Please watch video
http://www.youtube.com/watch?v=H18iESwwGOQ
Focus on the question asked at 2:20 min and from then on.



  #20

@nemrac,

If we send AMG to any country and ask them to FIRST learn the language (oh boy, learning another language -how is that possible?!), adjust to the new environment, laws, rent or buy apartment, buy a car etc. etc. and pass the boards, they would shoot themselves (after suffering manic depression and being on pills for ADHD and what not)...

 

But, AMGs do not need go to any other country, because training is the best here, in their country. So they are very blessed...

But sometimes it's fun to imagine people we know here, being in another country and finding their waywink

 

 

nemrac wrote:
grin listen guys, If we send an AMG in my country right now, and ask him to study for the clinical knowledge boards, in I can guarantee you he will need 3 years, not just 2!



Edited by doctor4usmle on Dec 05, 2011 - 11:00 AM




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