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Tarshish is cited several times in the Bible. Where was it? Some think India and some Anatolia which is modern Turkey. The general consensus, though, is that it is Tartessos, which was an ancient civilization in what is now southern Spain.
Residency Policy Punishes Good US Doctors — And The Rest Of Us
By Dr. Doug Medina
For years, the Association of American Medical Colleges has predicted the United States will face a large physician shortage, and the coronavirus pandemic may further exacerbate this shortage.
However, there are thousands of qualified U.S. doctors who are unable to practice. Every year, about 1,000 U.S. citizens graduate medical schools in the U.S., but don’t move onto residency at a teaching hospital because they don’t “match” via the National Resident Matching Program (NRMP), the organization that controls this process. Without matching into residency, doctors cannot practice medicine.
I’m one of those doctors ready to help during this current pandemic but can’t. Even though I graduated Georgetown University School of Medicine (GUSOM) in good standing, earning Honors in five clinical rotations, I have not matched into residency.
My path to a top-tier medical school in our nation’s capital started at the University of Colorado where I earned a degree in biochemistry. After college, I received a grant to work at the Ferroelectric Liquid Crystal Materials Research Center in Colorado. My hard work and study ethic helped me score in the 90th percentile on the Medical College Admissions Test (MCAT). I was accepted to GUSOM, which receives about 10,000 applications per year and only selects about 200 candidates.
Since graduating Georgetown in 2011, I passed the United States Medical Licensing Exam (USMLE), Steps 1, 2 and 3. To become a licensed physician, a doctor must pass the USMLE. While I am a nationally licensed physician in the U.S., I cannot practice because I do not have a license number since I don’t have a residency position.
This is happening every year to too many U.S. doctors.
Since 2011, I worked with Floating Doctors, an international nonprofit organization in Central America. In 2014, I published research from the Research Institute on Addictions. After 2014, I received grants to work as an extern under supervising psychiatrists at St. Elizabeth’s Hospital, the first federally operated mental health hospital, and the Veteran’s Administration Mental Health Clinic in Washington, D.C. I’ve worked jobs in electronic medical records and as an intake clinician admitting patients at a mental health hospital. I’ve had nine supervisors give me high marks and provide letters of recommendation.
To obtain my medical degree, I incurred debt of $50,000+ per year in federal student loans to pay tuition at Georgetown. With an interest rate of 6.7 percent, my student loans accrue interest of more than $25,000 annually and have ballooned to more than $460,000. Even with my job as an intake clinician earning $30 an hour, and paying my student loans via an Income Driven Repayment (IDR) plan, I’m not even able to afford to pay the accruing monthly interest on my student loans.
Last month, more than 1,200 U.S. medical seniors did not match into residency through the NRMP. In addition, an untold number of prior medical graduates didn’t match. In fact, each year, upwards of 2,000 current-year grads and prior-year graduates don’t match.
Yet just this year, through the NRMP, 4,222 non-U.S. citizen international medical graduates (non-U.S. IMGs) from medical schools outside the U.S. were provided medical residencies, which are largely funded by U.S. taxpayers (via Medicare funding). In fact, each year since 2011, the year I graduated, the number of non-U.S. IMGs receiving U.S. residencies has increased – from 2,721 in 2011 to more than 4,200 in 2020, a total of more than 36,000 foreign doctors in a ten-year period.
To ensure fairness to American citizens, a simple solution is to prioritize U.S. graduates. This may mean a lower number of foreign doctors receiving residency positions, but in this current pandemic, doctors are needed in their home countries. For instance, currently, India has a shortage of 600,000 doctors.
Institutions that should do more to help American doctors achieve their goals work against them. That includes the powerful, influential American Medical Association, which has been lobbying to issue more employment-based visas like the H-1B and the J-1.
U.S. medical students go through a highly rigorous process to get one of the coveted first-year slots. We have a reasonable expectation that when we graduate medical school, we’ll practice our chosen profession. To be shut out while foreign nationals are hired violates America’s social contract with its citizens.
There are reasonable solutions to address this serious problem that is ruining thousands of American lives per year. The governing medical organizations, universities and our elected officials must right this wrong.
Dr. Doug Medina is a graduate of Georgetown University School of Medicine and advocate for ensuring U.S. doctors in good standing receive residency status in order to practice medicine. Contact Medina at info@doctorswithoutjobs.org.
Argue all you want about the fastest animal whether it be the cheetah or the peregrine falcon (OK, it’s the falcon), but what about the slowest animal? TheMysteriousWorld.com gives the title to the three-toed sloth which at .003 mph is even slower than a starfish or garden snail. Aw, but what about the giant clam? As an adult it is sessile, which means it lacks any form of self-locomotion? The clam has our vote.
Cat litter is a $2 billion industry in the United States.
Ever hear of William Dawes? Samuel Prescott? They rode with Paul Revere shouting “The Redcoats are coming” to warn the colonists of the British advance on Concord on April 18, 1775. Prescott was the one who actually completed the ride to Concord.
Sidney Powell Weiner Laptop — Best-selling author and attorney Sidney Powell, who has served as Assistant United States Attorney and Appellate Section Chief in the Western and Northern Districts of Texas, and is a past president of the American Academy of Appellate Lawyers, brought up Clinton-connected ex-Congressman Anthony Weiner’s laptop during a recent speech at Hillsdale College.
“There’s a lot that can be prosecuted, I have no doubt on that laptop,” she said. “In fact, I heard that the New York police officers who saw some of it even though they are hardened investigators literally had to throw up. It’s bad. ”
You’ll never see the clip in the establishment news but you can see it below.
By the way, Out Of Shadows has 8.2 million views as of this posting. Have you seen any mention of it, in the establishment news?
The Allies bombed neutral Switzerland 70 time during World War II including the major cities of Zurich and Basel on March 4, 1945. The official explanation is navigation errors on the way to bomb German cities. Some, however, think it was an attempt to pressure the Swiss into ending its economic cooperation with the Nazis. The Swiss, in their turn, shot down or forced to land numerous allied bombers ultimately interning 1,700 American airmen.
US Doctors Bypassed For Foreign Ones?
By Joe Guzzardi
Congress, immigration advocacy groups and immigration lawyers are urging the Trump administration to increase the number of foreign-born doctors to alleviate the alleged medical responders’ shortage during the coronavirus pandemic. Minnesota Democratic Senators Amy Klobuchar and Tina Smith, along with colleagues in the House and Senate, wrote to U.S. Citizenship and Immigration Services requesting that the agency resume premium processing for international medical school graduates (non-U.S. citizen international medical graduates) who are seeking employment-based H-1B and J-1 visas. On March 20, USCIS announced that because of COVID-19, it would suspend premium processing.
According to the letter, more foreign-born doctors would increase health care availability, especially in rural areas, through the Conrad 30 Waiver Program, which allows U.S.-trained foreign medical school graduates to stay in the country as long as they practice in underserved areas. The “30” refers to the number of doctors per state that can participate in the program.
Traditionally, foreign national doctors who trained in the U.S. must return home for two years after their provisional period has ended before they can reapply for a new visa or permanent residency. Last year, Senators Klobuchar, Susan Collins (R-Maine) and Jacky Rosen (D-Nev.) introduced legislation to extend the Conrad 30 program through 2021. The Conrad State 30 and Physician Access Reauthorization Act, S. 948, has 15 cosponsors, eight Republicans, six Democrats and one Independent.
Americans are united in their desire to do all possible to end the spread of coronavirus. But a reality dose is in order. There are U.S. doctors ready to work who Klobuchar, Collins, Rosen et al appear to be ignoring. National Resident Matching Program (NRMP) data shows that each year since 2011 up to 2,000 current year medical school graduates and prior year graduates did not place into a medical residency at a teaching hospital. Without that residency, they cannot practice medicine.
But in that same ten-year period, more than 36,000 non-U.S. citizen international medical graduates (IMGs) received residency positions – spots that are largely funded by U.S. taxpayers through Medicare dollars. In fact, the number of non-U.S. citizen IMGs has increased each of the years since 2011, from 2,721 to more than 4,222 in 2020.
A sensible solution to the imbalance between overseas and U.S. doctors would be to reduce the number of residencies available to non-U.S. doctors which should increase residency slots for U.S. doctors.
American medical school graduates have worked hard, often taking on tremendous debt loads to earn their undergraduate and M.D. degrees. An unmatched Georgetown University School of Medicine graduate who I’ll call Dr. X, and who I interviewed for this column, told me that to obtain his medical degree he took on $50,000+/year in federal student loans to pay for his education. The cost of a medical degree at GUSOM is even higher today.
With an interest rate of 6.7 percent, Dr. X’s student loans accrue interest at more than $25,000/year and have ballooned to an aggregate that exceeds $460,000, a sum he’s unlikely to retire if he’s unable to work as a physician. Dr. X passed his U.S. medical licensing exams and has extensive medical volunteer experience, as well as other health services experience. Still, without residency, Dr. X can’t practice.
Yet, just since 2011, 36,000 foreign-born doctors are practicing throughout the U.S. even though the federal government has no regulatory authority to oversee the quality of medical education in India, Pakistan, China and Iran, the home countries of the majority of these incoming doctors.
Not only is the existing system and the proposed congressional effort to increase the total number of foreign medical practitioners unfair to American doctors, it’s unjust to the sending countries. In this current pandemic, doctors are needed in their home countries. For instance, India reported a shortage of 600,000 doctors which means that there is one government doctor for every 10,189 persons versus the World Health Organization’s recommended ratio of 1:1,000.
American doctors have the reasonable expectation that upon earning their medical school degrees, and passing their licensing exams, they’ll be able to practice their chosen profession. To shut U.S. doctors out while hiring foreign nationals violates America’s social contract with its citizens, and is a gross injustice.
Joe Guzzardi is a Progressives for Immigration Reform analyst who has written about immigration for more than 30 years. Contact him at jguzzardi@pfirdc.org.
3D Chess Wuhan Style — How do you play 3D Chess Wuhan style? Start by being President of the United States. Declare that you have the power to end state quarantines. Watch your adversaries say “No you don’t!!! We’ll show you!! We’ll keep our people locked up for two extra weeks no matter how much it ticks them off!!!”
COVID-19 is a real threat and far more dangerous than the common flu. The vast majority of citizens are more than willing to take directions to beat it. About the only thing that could make them change their minds are petty pointless dictates from the wannabe kings and queens who disproportionately fill our political offices and government bureaucracies.
Tip to police: If you see a dad playing with his daughter in a park, walk the other way.