The Match Day is a significant milestone in the lives of medical
students and residents. In the United States, applicants can fall into
one of two categories: either "Foreign Medical Graduates" (FMG) or
"Inside Medical Graduates" (International Medical Graduates, Americans
who went abroad for medical studies). Let us take a look at a few of the
facts and figures rather than coming to a direct conclusion about
whether or not it is difficult for international medical graduates to
get a match into a residency program in the field of surgery. In recent
years, there has been a meteoric rise in the number of people requesting
for residency in the United States.
In 1975, there was no
competition at all because there were more seats available than there
were people applying for them. However, by the year 2012, the situation
had undergone a dramatic shift, and there were about only 24,000 places
available to accommodate 40,000 applicants. More than 2,700 non-US
international medical graduates were given the opportunity to reserve
seats in Post Graduate Year – 1 (PGY-1), and around 160 graduates were
given the opportunity to reserve seats in Post Graduate Year – 2.
(PGY-2). It was intriguing to see how the success rates of US graduates
compared to those of non-US graduates working in international
management positions. According to the figure, there is a direct
correlation between the number of applications submitted and the
percentage of successful matches. The percentage of IMGs whose profiles
were matched in 2003 was 55.7%; this figure fell to 48.9% in 2006 and
then continued to erode, reaching 40.6% in 2012. It is anticipated that
throughout 2016-2017, it would fall even further. It is anticipated that
by the year 2018, the number of medical graduates practicing in the
United States will exceed the number of international medical graduates
competing for vacant opportunities (Newton and Grayson, 2003).
Most
AMGs (American Medical Graduates) do not have to worry about their
residency since more than 90% of AMG match successfully on Match Day.
Those who are still there will quickly be promoted to their new roles.
The medical field might be difficult to break into for international
medical graduates. More than 12,000 international medical graduates
(IMGs) applied for residency in 2015, but only half of them were
accepted. There is no question about the difficulty of entering
residency programs. Entry into residencies like as radiology, surgery,
obstetrics and gynecology, and orthopedics has proven to be challenging
for IMGs. Various authors (Horvath et al., 2005). On the other hand,
Matching is much less difficult in the specialties of internal medicine,
psychiatry, pediatrics, primary care, and neurology.
The major
reason for such a disparity is rooted in the structure of the system
itself and how it operates. In order to successfully complete Steps 1
and 2 of the USMLE, all students are required to attend medical school
in either the United States or Canada. They are also able to participate
in NRMP at the same time. On the other hand, the IMG is required to
wait for around six months after graduation before being accepted into a
residency program.
Another study reveals that fifty percent of
international medical graduates (IMGs) do not succeed in receiving their
residency match, which results in increased numbers of candidates the
next year and so on. (Newton and Grayson, 2003) [citation needed]
When
it comes to the IMG, the Director of the Residency Program has a
different perspective. They define an IMG as a student who departed the
United States to pursue medical education elsewhere because they were
unsuccessful in gaining admission to a medical school in the United
States. They do not have an overly positive attitude toward IMGs. It is
possible that it is agreed that they studied extraordinarily well
overseas; yet, these directors will always place a greater emphasis on
the American quality of medical school, which the IMG's have not
experienced.
Aside from this, there is a widespread misconception
that doctors who have received their training outside of the United
States are unable to communicate effectively with patients in that
country. The lower standard of life that is common in countries outside
the United States is yet another significant element that contributes to
Match's lower success rate. Poor bedside manner in surgery residency
might be legitimately caused by an international medical graduate (IMG).
In most non-Western nations, the practice of conducting in-depth
therapeutic consultations with individual patients is not the norm.
However, this is the norm in the United States, where patients are kept
fully informed on every facet of their treatment, including the
specifics of their medications and any other relevant information. Even
though a patient undergoing surgery is making a significant choice and
should have both the positives and negatives of the procedure
communicated with them in advance, this is not the standard practice in
many other nations.
International medical graduates are
discouraged from applying to residency programs in the United States by
directors of residency programs. This is done for a variety of reasons,
including those listed above. IMGs need to put in greater effort,
demonstrate extra credibility, and be able to shine brighter than AMGs
in order to have a chance of getting a crack at the job. It is possible
for an international medical graduate to match in the next terms if they
are able to create a fantastic curriculum vitae, successfully obtain
significant clinical experience in the United States, and acquire
outstanding letters of recommendation.
The unfortunate reality is
that it is becoming increasingly difficult, year after year, for
graduates of internal medicine programs to find a residency position in
surgery or even in other specialties. However, at the same time, the
number of AMGs is growing as well, making this an ideal environment for a
competition to determine the most qualified candidate.
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