Australian orthopaedic resident married an American girl

Hi,

I'm a current othopaedic registrar (AKA 'resident' in American lingo) at a top hospital in Australia but am looking to relocate to the US as I recently married an American girl (from Boston) who is keen to settle in the States.

I took all the USMLE exams and with very little prep scored in the high 230's for all parts and am fully ECFMG accredited.

I'm a good resident, have published extensively and would otherwise be on the path to a very successful career as an orthopaedic surgeon in Australia but as mentioned above, I have personal life factors that are encouraging a relocation to the States. The frustrating thing though is that when I applied via the Match last year I was hauled into the "IMG" category even though I'm from first world english speaking country with a far superior medical system to that of the USA.

If there are any program directors out there keen to get a really good resident onto their program please email me for further details.

Australian ortho resident.
[url=mailto]ilansemail@yahoo.com[/url]

slamming our health care system is not a smart way to try and gain anyone's favor. for better or worse, all non-American schools are viewed with intense suspicion, even those in offshore carribean territories. 230's on the boards are at best average for U.S. grads applying to ortho and will not open any doors for you. just trying to be realistic. good luck, you will need it.

agree with above. crapping on someone's house and then asking to be invited in, is never a good strategy. an fmg is an fmg irrelavent of your "superior" english speaking skills. this is a very difficult specialty with extremely large egos and even more sensitive. so check your attitude and tone when approaching the application arena and be prepared for a difficult and frustrating road ahead. there is an orthopaedic surgeon(FMG) i know who took his USMLE and scored also in the 230s, but after years of research and applying, settle to be a orthopaedic physician assistant. that being said, i wish you all the luck in the world as i could not find a more satisfying specialty to practice medicine

You guys need to relax. His comment about the "far superior" medical system may have been a bit arrogant but does not deserve the ridiculous slam on IMG's. The nauseating attitude that you need to be a superstar to match into orthopedics is a falsehood perpetrated by those within orthopaedics who want to perpetuate the self-congratulatory "I-Matched-in-ortho-so-worship-me" attitude. I know several idiots who have matched in ortho, who are far from stellar, and cannot operate their way out of a paperbag if their life depended on it. I'm sure there are many out there. Heck you two could be one of these people. There are surgeons in other areas of the world with technical skills that would make any American see double...in spine world with which I am most familiar, check Juergen Harms in Germany who really has no equal, Suk in Korea and SEVERAL other Asian spine surgeons with technical skills you'd be hard-pressed to match in our precious US of A. So let's not be so provincial.

Here Here!!! What many fail to realize is that it is way harder for people in foreign countries to go into medicine. They basically are groomed from the age of 14 to become physicians, and in many countries are finished with med school, by the age of 24. Most foreign medical students have far superior "book knowledge" and can function without the crutches of having all this fancy shmancy technological equipment. Anyway, the point is that unless you are racist then we all agree all peoples are about as intelligent as each other. I dont know the exact percentages, but if 0.5% of the population in the US become physicians, then for example the 0.2% of those in other countries that become physicians are overall smarter than the general pool of US grads.

Anyway, the Australian system,( I really dont know) probably does provide better health care, heck any system that can provide health care to more than only 60% of the populaton must be better. Besides the US was built on immigrants. You look at some of the most respected people in academia, many are foreign. America does so well because it draws the best talent from all countries, and those that do immigrate generally are willing to bust their butt to get the job done and in doing so become the best of the best.

Being the son of an immigrant I have come to see a man go from janitor to a successful millionaire many times over that in turn provides jobs that feed 20 other families.

Anyway my point is don't be a jerk, the bloke just posted a message on a board, that may have been somewhat arrogant but all surgeons have to have some degree of arrogance otherwise they would be behind the mayo passing instruments, or on the other side of the curtain passing gas(no offense to anesthesiologists).

I can understand both sides of the issue here. The comment that Australia's health care system is far superior is arrogant. But the belief that you have to be a super special FMG to make it in a US residency is a bit arrogant itself. But that said, I think that we need to understand the issue as a whole. What I am about to write is my understanding of how the system works. If I am wrong, please correct me. Also, I am sorry for being long-winded.

The issue of accepting FMGs to US residencies is not necessarily one of intelligence or expertise. In fact, it is a financial issue. In a simplified explanation, the funding for the education of resident education comes from Medicare. This is a program that is paid for by US citizen tax dollars. For the sake of being a devil's advocate, why should US citizens pay for other country's doctors to be educated? Taxpayers in the UK, France, India, Germany, etc are not paying to educate the vast majority of American doctors. In my opinion, this is where the main obstacle is met. I'm not exactly sure if a program gets a certain amount to fund X number of residents a year or if a program has X number of spots and that the training of US medical grads will be covered but the program must come up with extra cash to train FMGs. Either way, training FMGs places an extra strain on the program, so why not favor US medical grads? It is easier for the program. It's the path of least resistance.

I want to refute a point that Whatnow made earlier. He/She said that as a whole, FMGs are smarter. I believe that the comment that it is harder to be accepted to medical school in the US that it is in other countries is flawed. The AMA fights hard to keep enrollment in US medical schools at a steady number. This keeps demand high for doctors and therefore keeps reimbursement and salary high. I have spoken to several FMGs who state that it is much easier to enroll in medical school and I have had several friends who have done rotations in other countries as well. Specifically, one told me of a hospital in Brazil where the residents saw 1-2 patients a day. They were responsible for blood draws, transport of the patient to and from imaging studies, performing the studies, prepping the patient for surgery, etc. Why? Because the local medical school, in a city of approximately 1 million people, graduated roughly 1000 MD's per year. I graduated from a school in a city of 1.5-2 million in a state of roughly twice that population. The state as a whole graduated about 250 doctors a year combined between all medical schools. This dichotomy shows that the Brazilian market was saturated and because of this the doctors were relegated to lab tech, x-ray tech, transporter, RN, and MD. I don't know about you, but I went to school to be a doctor.

Are there FMGs out there that are as smart as the average US medical grad? Hell yes. Are they as a whole smarter? I can't answer that. Do they deserve a fair shake? I believe so. I think that the laws and restrictions in this country make it hard to train here if you are an FMG. You have to be a "superstar" to be accepted to a competitive residency, not because most FMGs are inferior, but because funding is based on US tax dollars and the possibility that foreign medical schools may be over-saturated. Because of this, the bias has to be slanted towards the US medical grad (I am not saying that foreign medical education is lacking, but if so many doctors are graduating, then you have to question what screening process is enforced in making them MDs. In the US, we know what this process is. In other countries we do not. Some countries may have higher standards. Some may be lower. How do we know the difference? USMLE scores can be a yardstick, but many people are good test takers. Does that truly level the playing field? It leaves a little bit of a dilemma, eh?).

I know a lot of FMGs and am impressed by many of them and am similarly impressed with a similar number of US medical grads. Just because someone graduates from a school in another country doesn't mean they are inferior; it just means that they don't come with the ease of funding of US medical grads. An application should be viewed as a whole and the funding process should be altered. But until that happens, the benefit of the doubt has to be given to US medical grads.

I wish Ozortho all the luck in the world. You may have an uphill battle, but it is one worth fighting. Keep it up. You didn't deserve the attacks that you received on this forum.