Ran across this article on NYTimes on how NY schools are trying to squeeze out Caribbean matriculants/students.
Interesting to see if other states and hospitals will follow NY’s lead or if this is just a storm in a teapot.
Let me know if you guys can’t access it and I’ll cut and paste it.
NYTimes article link
I found the article to be both discouraging and a little scary. So many of primary care physicians come from other locations, American students often opting for the higher paying specialties. It’s great that a place like the carribean exist for those students who have realized their desire to become a physician, but may have not had such a great start in college as an 18 year old! It’s scary to think that hope may be dashed for a lot of people who have tremendous potential, and who would help fill an extreme looming physician shortage! I hope more residency spots will be available in the near future in order to keep pace with growing medical school enrollment.
Dazed
thx a lot for the link. I can’t understand the motivation of the NY Schools. All their slots are full and they pick the best students (among the ones who apply). Their contention is that Caribbean schools are competing for slots? That sounds like a very fallacious argument to me. So if NY schools offer more slots, then students would prefer going to a Caribbean school??? And many students who already go to a Caribbean schools are usually rejected from the US. I really don’t get the issue.
Don’t we need more physicians in the country??? Are there objective measures showing that Caribbean school MDs are not competent? And why not simply increase the number of matriculants (that is the best way to compete with foreign schools).
Or is the competition limited to the clinical slots (and as I understand many hospitals are avoided by NY schools, particularly in difficult and undeserved areas…)
Well I don’t know. But for sure, this is very interesting stuff. Some motivations however are not clear to me.
Surely an interesting read!
I found this another link while looking for more information stated in NY Times article.
http://chronicle.com/article/Students-From -Caribbe…
The comments on this article are informative.
Lately, I’ve been considering applying to a carribean school…Which I think I will do…
I have a GPA 3.43 overall, 3.6 science and what is considered a low MCAT score…I have hundreds of hours of volunteer work for underrepresented, inner city, both in medical setting and community setting, etc.
Im glad to see that St. George and Ross hold true to their claims of placing clerkships…So, I just might be going to the Carribean…next fall…
It is a shame that US medical schools are so closed minded to the fact that they need to expand their class sizes.
On residency match last year, there were over 1000 open slots not filled. We need medical student graduates, especially if they are American citizens that had to go out of the country to gain their MD and have passed USMLE as required.
The article states that there is not correlation between MCAT and USMLE…and US school could very well accept applicants with lower scores. But, they are only concerned about them appearing stringent in their application process, so they only accept people with higher scores and they may not make the best of practicing doctors.
Well, I know I have everything it takes to be an effective practicing physician, except a high MCAT score. But, I am not going to give up…
Carribean here I come…
It’s all about money and arrogance. If there is a doctor shortage that the AMA and these med-schools (US)can keep perpetuating it means more money for them. I am all for keeping unqualified folks out of medicine, that is why there is the USMLE and your board exams. That is why there are tests in Med-school. This is the same stuff I have heard from US schools all my life. Oh you went to this high school, you don’t need to apply to the Ivy League, only those from the right high schools get in. You went to this school for undergrad, oh you won’t get into this grad school. Oh you went to this medical school, you’ll never be a “real” doctor. I am so sicjk and tired of hearing all of the stuff I can’t do because of my past. And here I thought this country was about opening up your future despite your past.
At least, the US remains unique is the sens that despite this conservatism, they remain open more than many developed countries.
I also like that in the US, you have these national exams like MCAT and USMLE that are supposed to be equalizers. However, like every on time exam, it depends on the form of the day. You can be a great photographer, you can still screw up a photograph!
Nonetheless, I find this conservatism to be very selfish. The goal of US med schools (more than any other professional school) should be to answer the need of the population. More doc are needed, I don’t get why little is done to address this shortage…
I do know that 2 years ago American medical schools were all asked to increase their enrollment by 20 percent immediately and work towards doubling their capacity.
Heard this from a dean at UVA’s medical school, but I’m unsure what organization was urging this increase.
Kate
The specific issue that caused a battle between the NY and Caribbean schools was the contract between St. George’s Medical School and the New York City Health and Hospital Corporation (HHC) in August 2008 (http://www.nytimes.com/2008/08/05/nyregion/0 5grenada.html?_r=1). St. George’s would be paying the HHC for the student slots, thus taking away free slots to the NYC medical students. Since HHC runs the largest municipal hospital system with a large percentage of uninsured patients, any money it can make, it grabs
What underlies this all is the lack of availability of clinical rotations and clerkships for medical students overall. Over the past two decades numerous new york city hospitals have closed and/or reduced beds and services, many due to mergers of health systems. Thus clinical opportunity for med students have decrease Yet over the past few years, the number medical schools and the seats in existing medical schools have increased.
The physician shortage grows, push to increase medical students grows, but the facilities to train medical students does not. Thus it is NY medical schools fighting the Caribbean schools for finite resources. This of course misses the real issue that there are not enough medical student slots to train the number of physicians that the United States needs, whether here or overseas.
- Jobusch Said:
Lately, I've been considering applying to a carribean school....Which I think I will do...
I have a GPA 3.43 overall, 3.6 science and what is considered a low MCAT score....I have hundreds of hours of volunteer work for underrepresented, inner city, both in medical setting and community setting, etc.
Im glad to see that St. George and Ross hold true to their claims of placing clerkships...So, I just might be going to the Carribean..next fall..
It is a shame that US medical schools are so closed minded to the fact that they need to expand their class sizes.
On residency match last year, there were over 1000 open slots not filled. We need medical student graduates, especially if they are American citizens that had to go out of the country to gain their MD and have passed USMLE as required.
The article states that there is not correlation between MCAT and USMLE...and US school could very well accept applicants with lower scores. But, they are only concerned about them appearing stringent in their application process, so they only accept people with higher scores and they may not make the best of practicing doctors.
Well, I know I have everything it takes to be an effective practicing physician, except a high MCAT score. But, I am not going to give up...
Carribean here I come...
I have a GPA 3.43 overall, 3.6 science and what is considered a low MCAT score....I have hundreds of hours of volunteer work for underrepresented, inner city, both in medical setting and community setting, etc.
Im glad to see that St. George and Ross hold true to their claims of placing clerkships...So, I just might be going to the Carribean..next fall..
It is a shame that US medical schools are so closed minded to the fact that they need to expand their class sizes.
On residency match last year, there were over 1000 open slots not filled. We need medical student graduates, especially if they are American citizens that had to go out of the country to gain their MD and have passed USMLE as required.
The article states that there is not correlation between MCAT and USMLE...and US school could very well accept applicants with lower scores. But, they are only concerned about them appearing stringent in their application process, so they only accept people with higher scores and they may not make the best of practicing doctors.
Well, I know I have everything it takes to be an effective practicing physician, except a high MCAT score. But, I am not going to give up...
Carribean here I come...
There are approximately 18,000 US-based MD and DO graduates a year for about 26,000 residency slots. So the USA has to import 8,000 PGY-1's a year. Sounds good until you compare the actual data. I did some data analysis on this for the 2009 match data
about 93% of MD seniors get matched
about 70% of DO senior get matched into allopathic
(this is misleading data as it doesn't take into account DO who apply to both and who then go a DO residency which are not reported here match has remained consistent at about 70% for past 5 years)
about 47% of US citizens who go to foreign medical schools get matched (which has dropped from 54% in 2005. This would indicate that the expansion in medical school graduates may be taking a toll on Carib grads already).
about 41% of non-US citizens who apply for residency get matched. (in 2005 this was about 45%, so all grads from Carib medical schools, citizen and non-citizen are losing ground and the spread between citizen and non-citizen is getting thinner)
Ross, SGU and AUC historically have the better rates but I still want to see data from a source outside the school. Not all SGU, Ross, and AUC grads apply for US residency programs. SGU is making a big push into the student market from India.
It also should be noted that many of the non-US Citizen FMG/IMG are not new medical school graduates but physicians who have completed residencies in other countries.
In sum, it still seems from the senior medical school students from off-shore schools who do apply for US based residency programs do have a significantly worse match rate than US based medical school seniors and the rate has been steadily decreasing for the past 5 years.
I am including a link to a previous forum entry on a specific example in matching that goes across MD, DO, and FMG
http://www.oldpremeds.org/fusionbb/showtopic.php?t...
It may be farfetched, but would it be feasible for hospitals/med schools to establish relationships with hospitals/med schools outside the U.S. and Canada in order to train med students? I am talking beyond the Caribbean. Perhaps, as a start, just thinking off the top of my head where there are U.S. military bases?
- gonnif Said:
The specific issue that caused a battle between the NY and Caribbean schools was the contract between St. George's Medical School and the New York City Health and Hospital Corporation (HHC) in August 2008 (http://www.nytimes.com/2008/08/05/nyregion/0 5grenada.html?_r=1). St. George's would be paying the HHC for the student slots, thus taking away free slots to the NYC medical students. Since HHC runs the largest municipal hospital system with a large percentage of uninsured patients, any money it can make, it grabs
What underlies this all is the lack of availability of clinical rotations and clerkships for medical students overall. Over the past two decades numerous new york city hospitals have closed and/or reduced beds and services, many due to mergers of health systems. Thus clinical opportunity for med students have decrease Yet over the past few years, the number medical schools and the seats in existing medical schools have increased.
The physician shortage grows, push to increase medical students grows, but the facilities to train medical students does not. Thus it is NY medical schools fighting the Caribbean schools for finite resources. This of course misses the real issue that there are not enough medical student slots to train the number of physicians that the United States needs, whether here or overseas.
What underlies this all is the lack of availability of clinical rotations and clerkships for medical students overall. Over the past two decades numerous new york city hospitals have closed and/or reduced beds and services, many due to mergers of health systems. Thus clinical opportunity for med students have decrease Yet over the past few years, the number medical schools and the seats in existing medical schools have increased.
The physician shortage grows, push to increase medical students grows, but the facilities to train medical students does not. Thus it is NY medical schools fighting the Caribbean schools for finite resources. This of course misses the real issue that there are not enough medical student slots to train the number of physicians that the United States needs, whether here or overseas.
Somehow the math isn't adding up in my head. If I remember correctly from the article, Medicare pays hospitals for residence programs. So the hospitals are actually making extra money by shaking down the Caribbean schools for their graduates.
I fail to understand why Medicare can not just take that money back and add residence positions. I think taking back the money was mentioned somewhere in the article too but not adding positions. Anyways, something smells funny about the whole wheeling/dealing.
Medicare pays hospitals for RESIDENCY programs, but not, I believe, for medical student clinical training. The article is talking about 3rd and 4th year clinical rotations (although I will concede that they throw the term residency in there occasionally and muddy the waters).
Medical schools cannot just willy-nilly begin taking more applicants. Much planning and facility assessment (and expansion, more than likely) must take place. Is there enough room in the anatomy lab? Do new teaching faculty need to be hired? What kind of clinical load must faculty maintain besides their teaching duties? Etc. etc. etc. It’s not a simple process.
Cheers,
Judy