Letter To Lou Dobbs

CNN ^ | 02/25/2005 | Lou Dobbs

[OKIEDOC]

LOU DOBBS TONIGHT QUICKVOTE Should doctors who graduate from foreign medical schools be licensed to practice in the United States?

[OKIEDOC]

Dear Lou Dobbs

Lou Dobbs Tonight

I can guess that many American citizens would say no to more foreign doctors . However, there is a very big question to be considered..

Just were do all those doctors come from that work in places where American graduates will not venture? Places like rural America, inner city and ghetto hospitals.

All graduating foreign doctors before they can be certified by the Educational Commission for Foreign Medical Graduates have to pass the same United States Medical Licensing Exams (USMLE) as do those who graduate from American medical schools. Qualified foreign doctors practicing medicine in the United States go through a very expensive, rigorous and time consuming process to get into the worst of residencies. These doctors just as the American graduates must complete from 3 to 7 years in a residency. This is regardless of whether or not they have completed that same residency education in a foreign country.

Most non-university-affiliated residencies such as those found in community based hospitals can not attract the American medical graduate (AMG). Currently the United States medical schools graduate something over 15,000 students each year. There are currently opening's each year for 20,000 plus residency positions. The 20,000 plus figure, still does not generate enough qualified doctors to fill Americas needs each year. The situation on lack of qualified doctors is getting worse, not better. To get the required American trained doctors the United States would have to lower their medical school standards. I am sure that would be a hard sell to most Americans.

The testing percentage point difference between FMG's and AMG's is less than one percent for those passing the USMLE's. The foreign medical applicant jumps through many more hoops to become a doctor in the United States than do their AMG counterparts. Most have to learn a new foreign language English and prepare for the exams by studying medical books written in English. By the time, the FMG reaches a residency program in the USA he or she has spent an amazing amount of time and money getting there. Perseverance is the word for these hard working individuals.

Yes, we could adopt the current prohibitive requirements that Canada has placed on foreign doctors. Canadian laws are so prohibitive that there are places in Canada where the local population goes with out any medical care. The situation is getting so bad in places like Toronto that doctors are resigning in mass rather than work under the strain of a prohibitive system. Many Canadians who can afford medical care go South to the United States to receive a better grade of medical treatment.

I have read estimates that if the United States decided to adopt Canada's prohibitive measure's it would take more than 12 to 20 years to make a turn around. Consider this, the average medical student takes four years as an undergraduate, then 6 to 7 years in a graduate medical school and then another 3 to 7 years in residency specialization. All of this just to hang a sign out front advertising that you now practice medicine and are willing to pay exorbitant insurance rates.

I would hope that you would consider both sides before making a decision as to whether or not foreign doctors should practice in this country. Better still ask you personal doctor what he or she thinks.

Sincerely

Okiedoc

[Mr. Bird]

I assume from your screen name that your a physician. I believe the question harbors many complexities. With fierce competition for every patient dollar, hospitals must weigh the benefits of adding more foreign-trained physicians to staff. Patient satisfaction scores, which will soon be published so that the consumer can find not only who is providing quality care but who is providing quality service, are highly dependent on such issues as cultural competencies and clear, effective communications.

A rising foreign population of docs in a community hospital could have a negative impact, sending more patients from secondary markets to larger, tertiary care institutions. While that would certainly strengthen acute care hospitals' bottom line, it would increase the already staggering pressures on throughput and bed management.

I think a simpler solution would be for the AMA to expand the number of med school slots for foreign students seeking to stay in the U.S. to practice. There is no dearth of qualified foreign students eager to come here, and we still have the best medical education apparatus in the world. They would gain a level of "Americanization", and would learn the business of U.S. medicine.

As you indicate, a foreign-trained doc already can eventually practice here; let's keep that process as is and increase the pool of those trained in America.

[OKIEDOC]

Thanks for your comments.

I only posted this to point out the inaccuracies found in Dobbs story. Yes I could go for training foreign students or even expanding U.S medical schools. However, as you say that takes time, lots of time.

I believe that America is slowly approaching a crisis concerning the number of available physicians.

Socialized medicine as proposed by most liberal lawmakers will not and has never worked.

I believe the hospital money argument that you pose was used also in Canada to cut back on IMG's entering their residency programs. However, as with most government programs they went overboard trying to fix the problem. Their prohibitive requirements are now costing the Canadian people a lack of medical care.

I can not see a time when foreign physicians will not be allowed into this country to pursue a medical license. If that were to happen, I predict pure calamity.

We already have some foreign students graduating from U.S medical schools. These students usually do not go to the inner cities or rural areas to work.

We could adopt Cuba's socialist heath system and mandate that graduates go to certain areas to work.

Alternatively, we could just raise the average resident salary, to more than minimum wage, for the number of hours worked.

Of course, the higher salaries might cause many community hospitals to close their doors for lack of funds.

I agree with you that something needs to be done before it is to late.