Doctors with foreign medical degrees-what do you think?

[luv2sparkle]

I have been looking for a new family practice doctor for our family. In my general area we have three major medical groups. One associated with a large teaching hospital, one that is just it's own group that is pretty big, and one that is smaller but still associated with a good hospital.

In researching the doctors for the smallest group I noticed that none of the doctors went to medical school in the US. All of them did a residency here however. If find this a little disconcerting and was wondering what everyones thoughts on this were.

I like the smaller group. The major teaching hospital is great but very impersonal. There is a lot of red tape with that group although there is good access. In going there I have felt that sometimes you can get lost in the shuffle.

The second large group is a nightmare. We have been with them for my husband and sons but have never actually seen a regular GP because in order to see one you have to have an initial 2 hour appointment or they wont see you. You have to make the appointment at least 6-8 months in advance and something always comes up. What the heck, who wants to do that anyway.


What do you think about Dr. educated in the West Indies or other small countries?

 

[JulieN]

Honestly, being a doctor is not THAT hard. For most routine things, PAs and NPs are very effective. US med schools do not graduate enough physicians for the future demand, with the ACA and our aging population.

I can't see it making any difference for the vast majority of people.

 

[Laila619]

I don't know, I'd probably prefer a US educated doctor if given the choice.

 

[kenny]

It depends on the country.
There must be countries with standards as high as, or higher, than the US.

I have two friends now living in the US who were doctors in Nicaragua.
Here they are not doctors.
They told me that here in the US their education is not considered good enough to get a license to practice medicine in the US. (Their words)

I assume there must be a list of quality of education by country.

 

[Dancing Fire]

I don't know, I'd probably prefer a US educated doctor if given the choice.

Me too.

 

[kenny]

I realize this NY Times link answers a different question (ranking health care system by country) but ...

http://www.nytimes.com/2007/08/12/opinion/12sun1.html?pagewanted=print&_r=0

"Seven years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations.
France and Italy took the top two spots; the United States was a dismal 37th.
More recently, the highly regarded Commonwealth Fund has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data.
Its latest report, issued in May, ranked the United States last or next-to-last compared with five other nations — Australia, Canada, Germany, New Zealand and the United Kingdom — on most measures of performance, including quality of care and access to it.
Other comparative studies also put the United States in a relatively bad light."

 

[madelise]

you mean physicians with degrees from the philippines, india, or the carribean? they're still drs. it's a rigorous process to test to be able to practice within the states. i wouldn't let which hospitals they're affiliated with make the choices, though. if you get admitted, you're prob going to have a different admitting/attending doctor(s) for your stay, and that's outside of your regular physician's control/workload.


if that group all have legal right to practice, their university of origin shouldn't be an issue.

however, i should probably add that you might not want to shove your whole family into one practice? keep the kids in pediatric care, and yourself/hubby with an internist? yourself maybe even under direct primary care of an ob gyn?

 

[luv2sparkle]

Thank you all for your thoughtful replies! My concern was really not what hospital they were affiliated with. We just live close to a well known teaching and trauma center. They are great but the medical center is big and impersonal.

I guess I was wondering what the reason US citizens go to these small countries for Med School. Can they not get in here, or is the cost less and that is the reason. Is a Dr. better trained here? What is the level of science in other countries? I just don't know.

I was just surprised that every Dr. in this small group went to med school some where other than the US.

I like a small group better than a massive one. We have a HMO/PPO plan, so if I wanted an ob I could go to one as a PPO. My youngest is almost 17 so he really doesn't want to go to a pediatrician anymore. I was was thinking of switching three of us to one Dr. He also is just a couple miles from my house since we have been driving back to the mountain community we lived in prior to here to our dr.there.

 

[smitcompton]

Hi,

If the Dr. graduated from a foreign medical school, he still must pass an exam to do his internship and residency here in the US.
If he trained at a good teaching hospital his training ought to be good. If they don't meet the hospital standards they are let go.
Each year you are accepted all over again. So ask them where they got their training. Their medical license is on line in most states, along with their medical history shown where they practice.

A large teaching hospital is good for serious stuff. You can always get a referral if needed from your family doctor if you need to utilize the big hospital.

I would choose a group near my home. If you don't like them, change to the other.

Annette

 

[Ninna]

Thank you all for your thoughtful replies! My concern was really not what hospital they were affiliated with. We just live close to a well known teaching and trauma center. They are great but the medical center is big and impersonal.

I guess I was wondering what the reason US citizens go to these small countries for Med School. Can they not get in here, or is the cost less and that is the reason. Is a Dr. better trained here? What is the level of science in other countries? I just don't know.

I was just surprised that every Dr. in this small group went to med school some where other than the US.

Both. DH was in that pool years back when he was wait-listed at BUSM and wasn't going to pay almost full tuition to GWUSM. He liked St. Kitts in the Caribbean, a state of the art med school with better chances of residency program acceptance in the US.
He also had 50% chances of acceptance at Ross [Dominica] for almost half the price in the US at 9% acceptance.

Since I'm aware of the challenges that International doctors have to successfully match into residency programs here, I would not have a problem being their patient but, I would check them out first just to make sure they weren't trained in the Balkan region

 

[MakingTheGrade]

As an MD myself in residency, I would say the residency program is more important to me than the medical school. Recently I was talking to a pediatric fellow who said when she's looking into pediatricians for family, she prefers docs from good residencies. Medical school isn't quite as relevant as residency in terms of making sure a doc is good at their chosen specialty since residency is really where you get more of your clinical experience and training.

In terms of why us citizens go overseas, there are potentially a lot of reasons, and yes, the general conception is that those schools are less academically competitive. However, it doesn't mean they can't train good docs. I went to a top ten med school, I have a close friend who went overseas and is now in training towards family med. I would trust him in a heartbeat, the reason he struggled with applications to med school was more related to him choosing the wrong major in college that hurt his GPA rather than his intellectual competence and ability, and med school applications in large part is a numbers game. But he did really well once in med school and got into a great residency.

 

[MakingTheGrade]

Honestly, being a doctor is not THAT hard. For most routine things, PAs and NPs are very effective. US med schools do not graduate enough physicians for the future demand, with the ACA and our aging population.

I can't see it making any difference for the vast majority of people.

I think it's totally true that for the routine things, you don't need the extensive MD training. But where a solid medical education becomes important is in recognizing when something that seems innocuous and perhaps routine is actually something potentially dangerous and deserves more investigation and attention. I.e. Teenager with bone pain, 99% of the time is just growing pains or stress fractures, but a good doc asks the right questions to make sure it isn't something much more serious. And docs who are trained in high volume residencies that see more of the "zebras" and rare cases, might have better instincts when something doesn't smell quite right.

 

[luv2sparkle]

Thanks Ninna and Making the Grade, that is just the kind of info I was hoping to get from pricescopers! There is one Dr. I really like and he has some good reviews but I was so thrown off by everyone having an out of country education. All had pretty recognizable residency programs, or at least places I felt comfortable with. I will feel much better choosing him with this feedback from people who know much more about this than I!

 

[justginger]

I realize this NY Times link answers a different question (ranking health care system by country) but ...

http://www.nytimes.com/2007/08/12/opinion/12sun1.html?pagewanted=print&_r=0

"Seven years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations.
France and Italy took the top two spots; the United States was a dismal 37th.
More recently, the highly regarded Commonwealth Fund has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data.
Its latest report, issued in May, ranked the United States last or next-to-last compared with five other nations — Australia, Canada, Germany, New Zealand and the United Kingdom — on most measures of performance, including quality of care and access to it.
Other comparative studies also put the United States in a relatively bad light."

This was my first reaction, before I realized the question pertained to Americans who chose to leave the country for an education. Having experienced the systems through close friends in each country, I am of the opinion that the level of continued learning post-graduation is much more intense in Australia. And being located near SE Asia, we get a lot of Indian, Sri Lankan, Thai doctors. And you know what? They're bloody brilliant! Just because they have strong accents or make grammatical errors, people disregard them as stupid. They're not. Chances are they only started learning English in their late teens/early 20s (at the same time they were at medical school!), and it may well be their third or fourth language. With the exception of one Sri Lankan doctor who was horrible, every collaboration I've had with foreign-born and educated Australian doctors have been extremely good.

Maybe those American students left the country to be educated elsewhere because they thought another country's education system would be better for them.

 

[AGBF]

Until I got fairly deeply into reading this thread I forgot that my own internist of many years went to medical school outside the United States. He was one of many people of my generation who did not get into a medical school in the United States. He opted to go to one in a Spanish speaking country. I had friends who went to medical school in Italy and in France, but my internist was not a friend. I met him when we were both in our 30's and he was already a practicing physician in Connecticut.

I am fairly savvy about doctors. I really do a lot of due diligence when looking for a specialist or a surgeon. That I have stayed with my internist for so many years speaks to the quality of the medicine he practices. He is thorough; smart; and also has a very kind, empathic "bedside manner". I know that he keeps up with medical training and always seems on top of things that are evolving in medicine. His Caribbean medical school didn't do him any harm.

AGBF

 

[mjr1]

This is a very interesting topic. It is hard to get into an American medical school. It is expensive to go to medical school-no matter where you go. Every school looks at the WHOLE student, not just their grades. That being said, most people who live in the US and are educated in the US choose to go to an American school if they can get in. I know of 1 or 2 friends over the years who chose schools in their parents native country as they had family there and spoke the language which can be big issues to deal with when going to a foreign med. school. Some foreign students choose to transfer to American schools after their second year. Their diploma only reflects the school they graduated from. Many foreign meds do a 5th year at an American school before they match for their residency. Residency spots have now become much more competitive. All of that being said, an American who seeks a medical education OUTSIDE the US must REALLY REALLY REALLY want to study medicine. Maybe their grades weren't perfect, or maybe the school was looking for something else (I had a friend turned down at Hopkins because the minority quota was filled)-at any rate it can be very challenging to attend medical school outside of the US and someone who goes that route is usually very "called" to the profession. Having a true calling to a profession like that usually makes a very caring committed physician. My 2 friends who both started their education in Grenada are wonderful doctors who I would gladly have take care of me. I never discount a foreign grad. I am much more interested in how they treat me as a patient and how we are able to communicate.

 

[CJ2008]

As an MD myself in residency, I would say the residency program is more important to me than the medical school. /quote]

(Sorry for the the threadjack sparkle) but how do you find out what residency program a doctor was in?

 

[rosetta]

As someone who has been educated at some fine schools in the UK and other "western countries" I would STRONGLY advise you not to harbour any prejudices against foreign medical graduates. Their post-graduation training is a much more important indicator of their overall ability and competence. In fact, I would argue that in some specialties, foreign doctors have much more experience due to more exposure to the endemic diseases of their countries.

 

[anners11]

I agree that it's much more important where the physician trained for residency than where they went to medical school. The other important thing to look at is board certification, which is the golden seal of approval. To me, that's far more important than where someone went to medical school. Knowing that someone is board certified in their stated specialty tells you that they have a medical license, they successfully completed residency training in an ACGME approved residency (and met requirements for foreign grads to be accepted into that residency) and that they have passed an examination showing that they have adequate knowledge in their specialty. Additionally in most specialties there are re-certification requirements that include a certain amount of CME and also re-certification after a designated period of time.

You can go to the American Board of Family Practice website http://www.theabfm.org or the American Board of Internal Medicine http://www.abim.org to get more information on the requirements for obtaining and then maintaining board certification.

I think you can also verify a physicians board certification on the websites as well.

 

[luv2sparkle]

Until I got fairly deeply into reading this thread I forgot that my own internist of many years went to medical school outside the United States. He was one of many people of my generation who did not get into a medical school in the United States. He opted to go to one in a Spanish speaking country. I had friends who went to medical school in Italy and in France, but my internist was not a friend. I met him when we were both in our 30's and he was already a practicing physician in Connecticut.

I am fairly savvy about doctors. I really do a lot of due diligence when looking for a specialist or a surgeon. That I have stayed with my internist for so many years speaks to the quality of the medicine he practices. He is thorough; smart; and also has a very kind, empathic "bedside manner". I know that he keeps up with medical training and always seems on top of things that are evolving in medicine. His Caribbean medical school didn't do him any harm.

AGBF

I think this is true for the Dr. I am considering as well, Deb. He has a video on the medical groups website and speaks of the time he takes with patients really listening to them. That is so unlike the Dr. I have now, who barely listens to anything you say and is very eager to prescribe meds when they are not entirely necessary (IMHO). I would rather take a holistic approach for some things and take as little meds as possible. She at one point encouraged my brain injured son to smoke as a way to deal with stress, which I could not believe and has precipitated my desire to switch. We had stayed with her primarily because since her office is considered rural, we have more options in procuring treatment for his needs within our HMO.

 

[luv2sparkle]

As an MD myself in residency, I would say the residency program is more important to me than the medical school. /quote]

(Sorry for the the threadjack sparkle) but how do you find out what residency program a doctor was in?

In the medical group I am considering, each Dr. has a profile which lists all of their education and where they did their residency. Also, in the video I spoke of in response to Deb's post, he mentions the hospitals he has participated in studies in. He mentions UCLA and Chicago and did get his undergrad at Berkley.

 

[luv2sparkle]

There seems to be a shift. In the past, at our large teaching hospital I have seen a lot of students from other countries who came to study in the US to obtain medical degrees. They stayed here and worked with the large group. This is the first time I have noticed so many Drs.
who were americans who went to other countries to obtain degrees. It might not be new, maybe it is just the first time I have noticed.

The daughter of a good friend is just now completing her medical school training this May. This girl is crazy smart and from the time she was about three years old, she wanted to be a doctor. I remember her carrying around a little toy medical bag as a tiny tot. So funny, lol.
She had a very difficult time getting into medical school due to one grade that was a B+ in her undergrad work. I could hardly believe that any school would turn down Sarah. She ended up going to school in Denver before transferring back here. So I guess, I shouldn't be that surprised.

 

[luv2sparkle]

As someone who has been educated at some fine schools in the UK and other "western countries" I would STRONGLY advise you not to harbour any prejudices against foreign medical graduates. Their post-graduation training is a much more important indicator of their overall ability and competence. In fact, I would argue that in some specialties, foreign doctors have much more experience due to more exposure to the endemic diseases of their countries.

I agree with you totally. I think it was the fact that EVERY doctor in this group was educated in another country. I don't think I would have given it much thought if that hadn't been the case. It started me thinking about the why of it. I don't think it would have prevented me from choosing this Dr. after doing as much research as I can about it. He not only sounds like a great doctor but also just a good man.
I could be off on that last part considering what people post about themselves on the internet but that is also important to me. Caring and giving. He seems to give back to the community and is involved. I like that.

 

[MakingTheGrade]

As an MD myself in residency, I would say the residency program is more important to me than the medical school. /quote]

(Sorry for the the threadjack sparkle) but how do you find out what residency program a doctor was in?

In the medical group I am considering, each Dr. has a profile which lists all of their education and where they did their residency. Also, in the video I spoke of in response to Deb's post, he mentions the hospitals he has participated in studies in. He mentions UCLA and Chicago and did get his undergrad at Berkley.

Yeah, most docs will have their residency listed in their credentials online.

I think the most important part is finding a doc your family is comfortable with, someone who you feel listens to you and who you trust.

 

[rubyshoes]

Ha! I don't know any Indian person living in the US who would go to an American-educated Dr when we could go to Indian Drs practicing here. Becoming a Dr in USA is not that hard, you have to be smart and be prepared to pay big bucks for tuition. Becoming a Dr in India? You better be a freakin' genius. The competition is intense and the education grueling. I was educated in India (not a Dr) and I can tell you the Math and Science taught in American schools is a joke. What is considered 'advanced' here is par for the course in the Indian educational system. Just see how much American students lag behind world scores in education. It's always Asian countries coming out ahead. Just because you're a Dr here, doesn't automatically mean you're brilliant. But if you're a Dr who studied in India, you definitely are. I have many friends here who are Indian Drs with med degrees from India who did further studies here as well as residency etc and they told me getting educated here was a breeze compared to India. That says a lot to me.

My best friend in India is a Radiologist and her husband is an Oncologist. They live a very cushy life and her husband comes to Chicago every other year for conferences. I asked her why they don't consider moving here and she said she is afraid of racism. Post 9/11 America is not a safe place for brown-skinned people depending on where you live. A big metropolis, sure. A small no-name town, not a good idea.

She also told me about the large number of flight attendants who come to the dermatology dept of her hospital. Apparently these American flight attendants fly into India, go get their Botox etc done for a fraction of the cost, and fly back home. Medical tourism.

The foreign doctors who are willing to come here despite the upheaval, potential racism, people questioning their caliber just because they have a funny sounding name and accent, and dealing with a litigious society to boot, they do so because they can make TONS of money here. In India, you're competing against other Drs for the same small pool of jobs at the same hospitals. The US is much larger and with its aging population desperately needs more Drs so American hospitals are willing to pay handsomely for foreign doctors. It's a win win.

I don't know anything about doctors from nations other than India or USA. I would assume they have some basic level of competence to pass exams here and get licensed but I'd rather stick to what I know is an excellent pool of Indian doctors.

http://yaleglobal.yale.edu/content/indian-doctors-help-fill-us-health-care-needs

 

[rubyshoes]

I just read some of the other responses and although I am wary of Caribbean-educated doctors, I find it interesting what other posters said about schools in Grenada/St Kitts and how the doctor in question may have been turned away for reasons like their major etc. I always assumed it was because they weren't smart enough but I guess that is not always true. Well, I learned something.

 

[amc80]

My gut reaction would be to go with a US educated doctor, even if that's completely unreasonable. I always look at the education and residency of a doctor I am researching. Unfortunately, most doctors in my area went to the local med school which really isn't a great school. My grandfather was the Dean of Pathology there and even he said it wasn't great, ha.

 

[Chewbacca]

This has never even crossed my mind! I have been attended to by many doctors who I am positive had medical degrees from countries other than my own.

 

[icekid]

Honestly, being a doctor is not THAT hard. For most routine things, PAs and NPs are very effective. US med schools do not graduate enough physicians for the future demand, with the ACA and our aging population.

I can't see it making any difference for the vast majority of people.

Wow, I would love to know what makes you so qualified to make that offensive statement. Are you a physician, Julie? I do not believe so. That is... audacious, to put it mildly.



On the topic at hand, there are good and bad "foreign medical graduate" doctors as there are good and bad "american grads."

In general, it is much (much) easier to get into a Caribbean medical school than an American allopathic school. As stated above, people with foreign degrees still must do residency training in the US in order to work here. They do not tend to get into the more competitive residencies, though. (Extremely rare to be a foreign grad resident where I trained)

Having one B+ during undergrad will NOT keep an otherwise great candidate from attending medical school. That is crazy. (and who on earth would tell her she did not get in due to that one grade?!?!) "Choosing the wrong major" would also rarely keep one from becoming a physician, though clearly some schools/majors are more challenging than others.

All that said, I would certainly allow a good physician with American training to take care of my family no matter where their medical school degree was attained.

mjr- Out of curiousity, how would your friend know they were turned down by Johns Hopkins due to a filled minority quota? Having trained there, I am fairly certain they would not announce that sort of thing IF it were true.

 

[luv2sparkle]

It actually did, Icekid. The competition was so fierce it brought her grade point average down just a wee bit.she graduated from Pepperdine in pre med and didnt get accepted to her school of choice. Eventually she got in to another school. Why would I lie?