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Author Topic: Get a medical degree but cannot find a residency/job  (Read 274 times)

MillCreek

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Get a medical degree but cannot find a residency/job
« on: February 23, 2021, 06:16:44 AM »

https://www.seattletimes.com/nation-world/i-am-worth-it-why-thousands-of-doctors-in-america-cant-get-a-job/

Here in the United States, after graduating from medical school, you must complete a residency in order to get licensed.  Residency slots are funded by the Federal Government, and there have been calls for years to increase the number of slots. There are more medical school graduates than there are residency slots, so every year, a few physicians do not match up.

There are many foreign medical schools that are the equal or superior to those in the United States.  A graduate of most foreign medical school in Canada, the UK, Singapore, Japan, most of Western Europe and some other schools throughout the world will generally have no trouble in qualifying for a residency slot in the US, assuming they want to practice here.

Then you have the medical schools in the Caribbean. They are held in disdain by the US medical establishment and you will have a lot of problems getting a residency slot. The majority of students at those schools did not qualify for admission to a US/Canada/Europe medical school and many of the graduates are not at the same level of competence and training when they finish medical school.

Even if the number of residency slots magically expanded overnight, these foreign medical school graduates from the Caribbean are still going to be at the bottom of the selection process.  Their best bet is to seek an alternative route to licensure, such as Arkansas or Missouri, or to look at practicing in another country.  Anyone who went through the admission and schooling process and now claims they were unaware of the residency issue is either fooling themselves or a dolt.

This is no different than graduating from a non-ABA approved law school; you will find it difficult to find a state willing to let you take the bar exam.  But a lawyer who does not pass the bar/is licensed has better career prospects than a physician who cannot get a medical license.

Edited to add: I have known many people who practiced as physicians in their home country, and cannot qualify for licensure under the different licensure standards in the USA.  They end up working as physician assistants, research jobs or the like.
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MillCreek
Snohomish County, WA  USA


Quote from: Angel Eyes on August 09, 2018, 01:56:15 AM
You are one lousy risk manager.

Ben

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Re: Get a medical degree but cannot find a residency/job
« Reply #1 on: February 23, 2021, 06:25:10 AM »

Edited to add: I have known many people who practiced as physicians in their home country, and cannot qualify for licensure under the different licensure standards in the USA.  They end up working as physician assistants, research jobs or the like.

https://youtu.be/2wcI10CNuxU
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WLJ

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Re: Get a medical degree but cannot find a residency/job
« Reply #2 on: February 23, 2021, 06:35:12 AM »

The article in a nutshell. To increase diversity we must lower our standards.
Never Underestimate The Power Of The Stupid Side

dogmush

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Re: Get a medical degree but cannot find a residency/job
« Reply #3 on: February 23, 2021, 07:49:03 AM »

Are the standards in the Caribbean schools lower, or are American Med schools (and Dr.'s) indulging in a "not trained here" kind of thing, or some combination?

I could see either, or both, happening.

Kingcreek

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Re: Get a medical degree but cannot find a residency/job
« Reply #4 on: February 23, 2021, 07:59:37 AM »

Is there some of the same for APNs and PAs?
My niece finished her schooling and worked low wage as a LPN or CNA for 9 months in a nursing home while she waited for clinical assignment to finish whatever they call the residency part. Maybe because she is a straight A white girl from Minnesota worked against her. Or maybe some specialties are saturated?
What we have here is failure to communicate.

MillCreek

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Re: Get a medical degree but cannot find a residency/job
« Reply #5 on: February 23, 2021, 08:03:08 AM »

Are the standards in the Caribbean schools lower, or are American Med schools (and Dr.'s) indulging in a "not trained here" kind of thing, or some combination?

I could see either, or both, happening.

Probably some of both, but the Caribbean medical schools have much lower standards for admission and generally produce a lower qualified physician. As a residency director, you would be hard-pressed to give a precious residency slot to one of these graduates instead of someone who graduated from a respected school in the US or Canada.
_____________
Regards,
MillCreek
Snohomish County, WA  USA


Quote from: Angel Eyes on August 09, 2018, 01:56:15 AM
You are one lousy risk manager.

MillCreek

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Re: Get a medical degree but cannot find a residency/job
« Reply #6 on: February 23, 2021, 08:10:11 AM »

Is there some of the same for APNs and PAs?
My niece finished her schooling and worked low wage as a LPN or CNA for 9 months in a nursing home while she waited for clinical assignment to finish whatever they call the residency part. Maybe because she is a straight A white girl from Minnesota worked against her. Or maybe some specialties are saturated?

Probably not on the discrimination.  I am guessing that your niece did her ARNP at one of the newer online-only/low residency programs.  There are scads of those programs out there and they are often looked upon dubiously due to the lack of actual hands-on patient experience.  The student is often responsible to find their own externship and get the necessary clinical practice necessary for licensure. With COVID, a lot of those externship opportunities have dried up. The more classic ARNP program at a medical/nursing school builds patient experience/clinical practice into the teaching process early on, so by the time the student finishes, they have much more hands-on experience and are a better clinician.
_____________
Regards,
MillCreek
Snohomish County, WA  USA


Quote from: Angel Eyes on August 09, 2018, 01:56:15 AM
You are one lousy risk manager.

Kingcreek

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Re: Get a medical degree but cannot find a residency/job
« Reply #7 on: February 23, 2021, 09:01:20 AM »

the newer younger medical doctors that seem to rotate in and out of our rural hospital system are almost all non-domestic (what is the current PC word for foreign?)
What we have here is failure to communicate.

BobR

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Re: Get a medical degree but cannot find a residency/job
« Reply #8 on: February 23, 2021, 09:31:30 AM »

the newer younger medical doctors that seem to rotate in and out of our rural hospital system are almost all non-domestic (what is the current PC word for foreign?)

I always called them what they are, FTDs. Foreign Trained Doctors. Although I am sure they weren't too happy with that label either.  ???


bob

BobR

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Re: Get a medical degree but cannot find a residency/job
« Reply #9 on: February 23, 2021, 09:36:08 AM »

Probably not on the discrimination. I am guessing that your niece did her ARNP at one of the newer online-only/low residency programs.  There are scads of those programs out there and they are often looked upon dubiously due to the lack of actual hands-on patient experience.  The student is often responsible to find their own externship and get the necessary clinical practice necessary for licensure. With COVID, a lot of those externship opportunities have dried up. The more classic ARNP program at a medical/nursing school builds patient experience/clinical practice into the teaching process early on, so by the time the student finishes, they have much more hands-on experience and are a better clinician.

I will second that.To think you can sit at home and learn how to be an Advanced Practice Nurse is absurd. Many times you get a Bachelors RN who after a year or so of patient care decide they want to be an ARNP so they go find an online program that will take anyone because they can. All on-line and then maybe 150 hours of clinical and they get to sit the boards and if lucky enough to pass then they get to hunt for a job. Many end up at a Doc in the Box for experience. Then they find a practice that may take them. I have always been leery of those programs, I have seen what they produce at times.

bob

Hawkmoon

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Re: Get a medical degree but cannot find a residency/job
« Reply #10 on: February 23, 2021, 10:17:50 AM »

I've been reading for years that there is a growing shortage of physicians in the United States. I would seem that if we don't have enough doctors, "the system" should be able to absorb as many medical school graduates as the schools can spit out. But I guess if the shortages are in places like East Bumbernuts in the wilds of flyover country, there aren't any hospitals there that can provide slots for residencies. I assume the residencies are all (or mostly) in large hospitals in major metropolitan areas.

I know most of the doctors in the specialty clinics at my VA hospital are residents "on loan" from the medical school in the next city. They are mostly pretty good but it is annoying that by the time I've seen a specialist a few times and developed a doctor-patient relationship, the doctor's residency is completed and I have to start all over with a new one.

Hawkmoon

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Re: Get a medical degree but cannot find a residency/job
« Reply #11 on: February 23, 2021, 10:22:17 AM »

the newer younger medical doctors that seem to rotate in and out of our rural hospital system are almost all non-domestic (what is the current PC word for foreign?)

PC? Dunno. "Foreign" works for me (unless you prefer "alien" or "third world").

I'll hazard a guess that the woke term would be something like "inter-cultural." I'm sure I'm not the first to notice that PC terms generally seem to be aimed at obfuscating what they really mean.

MillCreek

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Re: Get a medical degree but cannot find a residency/job
« Reply #12 on: February 23, 2021, 10:23:28 AM »

^^^Plus, after they finish their residency, a lot of clinicians don't want to move out to East Moosejaw to practice.  They prefer a more urban or suburban practice environment where they have the patients, the technology, the colleagues, and a job for their spouse/partner.  It takes a special sort of clinician to practice out where little of that may be available.
_____________
Regards,
MillCreek
Snohomish County, WA  USA


Quote from: Angel Eyes on August 09, 2018, 01:56:15 AM
You are one lousy risk manager.

Hawkmoon

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Re: Get a medical degree but cannot find a residency/job
« Reply #13 on: February 23, 2021, 10:29:50 AM »

Where is Dr. Quinn, Medicine Woman, when we need her most?

Ben

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Re: Get a medical degree but cannot find a residency/job
« Reply #14 on: February 23, 2021, 10:38:59 AM »

^^^Plus, after they finish their residency, a lot of clinicians don't want to move out to East Moosejaw to practice.  They prefer a more urban or suburban practice environment where they have the patients, the technology, the colleagues, and a job for their spouse/partner.  It takes a special sort of clinician to practice out where little of that may be available.

The medical outfit covered by my insurance had a small office in my little town run by a PA. They shut it down last year and combined it with one of their other rural offices about 40 minutes from me, mostly setup to serve the underserved hispanic community there. I went there once last year to do some bloodwork that had already been setup by the closed office in my town. It was a Charlie Foxtrot.

At this point, I can drive the same distance and instead of going to a tiny hole in the wall, go to one of their main, modern, medical facilities.
"I'm a foolish old man that has been drawn into a wild goose chase by a harpy in trousers and a nincompoop."

BobR

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Re: Get a medical degree but cannot find a residency/job
« Reply #15 on: February 23, 2021, 01:55:58 PM »

^^^Plus, after they finish their residency, a lot of clinicians don't want to move out to East Moosejaw to practice.  They prefer a more urban or suburban practice environment where they have the patients, the technology, the colleagues, and a job for their spouse/partner.  It takes a special sort of clinician to practice out where little of that may be available.

That is for sure. When I worked for the Indian Health Service, just a bit past East Moosejaw in Browning Montana getting docs there was a constant challenge. At the time the IHS would provide 20K a year toward paying off school loans for docs that would brave the wilds (area and patients).

We would also get some sketchy docs, also some pretty sketchy ones at the VA. When the salary is limited due to government pay scales it is hard to get docs to accept it when they can make substantially more across town in a real hospital. ;)

bob

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Re: Get a medical degree but cannot find a residency/job
« Reply #16 on: February 23, 2021, 02:05:23 PM »

Where is Dr. Quinn, Medicine Woman, when we need her most?

Or "Doc" Adams? (Gunsmoke)
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Fly320s

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Re: Get a medical degree but cannot find a residency/job
« Reply #17 on: February 25, 2021, 04:19:08 PM »

Or "Doc" Adams? (Gunsmoke)

Would you accept Doc Hollywood?
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