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Vijay Mehta
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xx AMG vs FMG vs American Born FMG
« Thread started on: Aug 5th, 2010, 10:02am »

There were two types of physicians - American Medical Graduates or Foreign Medical Graduates. For quite some time FMG's were considered much lower than AMG. There are institutions in this country that would not even consider FMG for their training or staff position. However with nearly 25% of physicians from outside USA they are forced to reconsider. However they justify the discriminatory thoughts by saying that AMG's are far superior than FMG. The fact is that some of the top FMG are far superior than some of the AMG and by being so biased these supervisors are doing a dis service to their institutions.

Enter a new group of physicians - American born but foreign trained physicians. The study examines the performance of these three group of physicians. Interesting article. ~ Vijay Mehta


Foreign-Born Doctors Give Equal Care in U.S.
By DENISE GRADY
Published: August 3, 2010

Patients treated by foreign-born doctors who trained in other countries fare just as well as people treated by doctors educated in the United States, a new study has found.

But the results are not as good when the doctor is an American who went to medical school overseas and then returns to practice, the researchers determined. In that situation, patients with heart disease have longer hospital stays and slightly higher death rates.

Graduates of foreign medical schools now make up a quarter of all the practicing doctors in the United States. In order to qualify here, they have to pass a series of rigorous exams and complete residency training. About one-fifth of the foreign-trained doctors in the United States are Americans who studied abroad, often at medical schools in the Caribbean. Most foreign-born doctors in the United States come from India or Pakistan and initially studied medicine in those countries.

The study is being published Tuesday in the August issue of the journal Health Affairs. The first author is John J. Norcini, president of the Foundation for Advancement of International Medical Education and Research, in Philadelphia.

The authors of the study offered two possible reasons the Americans who went to foreign medical schools might not perform as well as doctors trained in the United States, or as well as foreign-born doctors. One is that many of the Americans who study medicine elsewhere do so because their grades and test scores were too low to get into medical school in the United States — so they may be less capable in the first place. Another possibility is that some of the overseas medical schools Americans attend may not be up to par.

There is a doctor shortage in the United States, and foreign doctors have stepped into the breach, particularly in specialties like internal medicine and family practice, which many American students have turned away from in favor of more lucrative specialties like cardiology. In response to the doctor shortage, medical schools in the United States have begun to expand their class sizes, and some new schools have opened. But the number of residency spots is not increasing, so new American graduates may start squeezing out the foreign-born doctors when it comes time to start residencies.

The authors say their findings offer a cautionary note: if schools in the United States lower their standards to fill new spots and begin admitting the kind of American applicants who have been going overseas to study, they may start turning out less competent doctors.

Dr. Norcini said there had been concern about the competence of foreign-trained doctors, based in part on reports in the 1990s of lower test scores and performance ratings. But his study noted that “by the mid-1990s, international medical graduates were outperforming U.S. graduates” on tests in internal medicine.

The researchers set out to evaluate doctors by assessing the health of their patients. They analyzed records from 244,153 hospitalizations in Pennsylvania from 2003-06. All the patients had congestive heart failure or had suffered heart attacks, conditions that are considered a good gauge of the quality of medical care.

The patients were treated by 6,113 doctors. As in the rest of the country, about three-quarters of them were born and trained in the United States. The rest had trained in other countries, and most were foreign-born; about 400 were Americans who had trained overseas.

The patients of foreign-born international graduates had the lowest death rate, 5 percent, and the patients of American doctors trained overseas had the highest death rate, 5.8 percent. Patients of the American born-and-trained doctors fell in the middle, with 5.5 percent.

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Here is my reaction to this article

Well this findings do not surprise me. I was on the admission committee of Texas A & M HSC for 19 years. This gave me unique opportunity to observe metamorphosis from pre med phase - I want to serve the humanity to pre clinical student to clinical student and than on to being a resident and finally practitioner in their field. While some of them maintained the same ranking throughout vast majority moved from the bottom percentile to high percentile and vice a versa.

To me four important characteristics that decides your success or failure as a professional are 1. How much drive are you? 2. How stable is your life? 3. How nerdy are you? (Regurgitation and retention of facts is not necessarily the intelligence but we do name it) 4. What was the place that gave you training?

Those of us who came from India (and I came from one of the lowest ranking med school from that third world country) started with a great disadvantage. However we quickly bridged the gap in span or five to seven years due to having advantage in characteristic number one and two. And many of us surpassed our American born American trained counter parts - had it not been for looking different, sounding different and having the wrong color we would have far surpassed the counter parts. But over all we did extremely well.

While those who were born and brought up here with golden spoon in their mouth and tremendous financial and emotional support from their Desi family did not make the cut to get in US Medical School they started being a different pool than AMG in nerd factor as well as they ended up in a lesser quality educational institution too.

I have personally worked with hundreds of these young men and women. And I am confident that small segment of them are genuinely driven with passion to help humanity and willing to make up the GPA deficiency with sheer hard work. These are going to succeed just as most of us FMG did.

Then there is a large pool of these American Born FMG - who basically lacked the discipline - were driven by their family wanting them to be a doctor or could not find anything better to do. These are the ones who as we follow their path through the life will be the underperforming group.

To all those who are considering the option of going global to get the coveted M. D. behind their name need to do a self assessment and if there is not enough fire in the belly do not waste time and money you can do lot better in some other field.

Most of those overseas medical schools are open thanks to our patronage. May be it is time to put pressure on them to come out clean and tell us exactly what is the track record of their student ten years after entering their schools.

~ Vijay Mehta


One of my well wisher friend asked me - 'aren't you worried that your opinion of AFMG offended a lot of your clients?'

I really do not think so. First of all I do not have clients I have nieces and nephews and I am the well meaning uncle. They all know that it is my signature statement when it is politically incorrect but makes sense.

Second I do not mean to demean them I am simply stating that just as in my generation we were able to overcome the brand name gap by sheer hard work you can do it too. However, you do have to put that extra efforts to get there.

Third, some of them already have realized after spending enormous amount of money and time that it was not what they thought it would be. I like to encourage those to speak up so that future generation who goes to outside medical school do not go thinking that a piece of paper will make them happy.

Overseas med schools would love to paint a rosy picture it is our job to bring out the flip side of the story to bring the balance.

To those whom I offended you feel free to express your anger here or in private emails.
« Last Edit: Aug 5th, 2010, 10:03am by Vijay Mehta » User IP Logged

Greatest threat to Hindu religion comes from Dhongi Baba - Dada - Didi - Swami etc.
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You still go to heaven even if you do not go to Medical School !
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