Residency Policy Punishes Good US Doctors — And The Rest Of Us

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.

Residency Policy Punishes Good US Doctors -- And The Rest Of Us

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

Residency Policy Punishes Good US Doctors — And The Rest Of Us

Black Plague Looms For Los Angeles

Black Plague Looms For Los Angeles — Dr. Drew Pinsky on last night’s (May 30) Ingraham Angle reported that Los Angeles is experiencing medieval diseases such as typhus, typhoid fever, and, notably, the bubonic plague, which killed half of Europe in the 14th century.

Black Plague Looms

“We have a complete breakdown of the basic needs of civilization in Los Angeles,” Pinsky said.

He said airborne disease like tuberculous is exploding.

He said that rat-borne disease is unchecked as L.A. is one of the country’s few major cities that doesn’t have a rodent control program.

There will be a typhus outbreak this summer, he said, and worse.

“I’m hearing from experts that bubonic plague is likely. It’s already here,” he said.

And of course, there is the disease spread by fecal filth in the street like typhoid fever.

“This is not Third World,” he said. “This is medieval. Third World countries would be insulted if they were accused of being like this,

Welcome to the Golden State. Guess that’s what happens in “sanctuary states” that consider unrestricted abortion to be the primary health objective.

Pinsky noted that L.A. is sub-optimally immunized.

“God forbid if measles gets in,” he said.

Questions for all the progressives sneering at the anti-vaxxers: Do unvaccinated illegal immigrants — who exponentially outnumber anti-vaxxers — cause any concern for you?

For laughs, the Los Angeles Times is blaming “climate change” for the looming plague outbreak. Do people really still believe the garbage the establishment media is feeding them?

Black Plague Looms For Los Angeles

Transgender Surgery Big Moneymaker

Transgender Surgery Big Moneymaker –The Wall Street Journal, May 3, had a great article by Abigail Shrier concerning Paul McHugh, the brilliant doctor who shut down Johns Hopkins Hospital’s Gender Identity Clinic while the hospital’s psychiatrist in chief in 1979.

“(The hospital) wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it,”  he said.

The clinic was reopened as the Center for Transgender Health in 2017, performing what it now calls “gender-affirming surgeries.”

“Demand is massive,” Ms. Shrier reports.

The complicated operations are “big moneymakers,” she was told.

We guess that’s the rest of the story.

“Either the plastic surgeons and the transgender psychiatrists are right and I’m wrong—and if that’s the case, they will have done a lot of good by opposing me, and I will have been a drag on the system,” said McHugh, who has just turned 88. “Or the opposite. Suppose they’re wrong and I’m right? They will have mutilated thousands of children, and I will look good. Who do you think is sleeping better at night?”

Transgender Surgery Big Moneymaker
ransgender Surgery Big Moneymaker --The Wall Street Journal, May 3, had a great article by Abigail Shrier concerning Paul McHugh, the brilliant doctor

Prevailing Wage Ban All Gain No Pain

Prevailing Wage Ban All Gain No Pain — President Trump minutes ago signed significant reforms that he points out will significantly improve our health care system while costing the taxpayer nothing.

Sort of like what would happen if Pennsylvania repealed its prevailing wage law.

The 1961 law  requires labor cost to be be paid at a rate set by the state for most public construction projects.

It is estimated  to increase the cost of these projects by 20 percent.

In other words, a new high school costing $150 million under the prevailing wage law would cost $120 million without it. In other words all gain and no pain just by crossing out some words on a piece of paper.

Are you listening Springfield residents? Alex Charlton? Tom McGarrigle?

Prevailing Wage Ban  All Gain No Pain

Prevailing Wage Ban All Gain No Pain


Fluoride Drops IQ Says NIEHS Journal

Fluoride Drops IQ Says NIEHS Journal
Mandrake! I told you so!

Fluoride Drops IQ Says NIEHS Journal — You should fear for your precious bodily fluids, according to a study published by the National Institute of Environmental Health Sciences (NIEHS).

The study, which appears in the September 2017 edition of the NIHS journal Environmental Health Perspectives, found that higher levels of fluoride in pregnant women resulted in children who scored significantly lower in IQ tests.

“. . .our findings, combined with evidence from existing animal and human studies, reinforce the need for additional research on potential adverse effects of fluoride, particularly in pregnant women and children, and to ensure that the benefits of population-level fluoride supplementation outweigh any potential risks,” the study concluded.

You were right Jack D. Ripper.

Hat tip

Fluoride Drops IQ Says NIEHS Journal


Easy Obamacare Replacement, A No Brainer

Easy Obamacare Replacement, A No Brainer — It appears the Obamacare disaster will remain with us for the time being, so we would again like to point out the solution is not complicated albeit it requires humility and honesty and the strength to fight those who lust for wealth and power whether they be in government or the private sphere.

First step is recognizing that there are two types of persons regarding insurance — those who carriers want as customers and those who they don’t. The latter consists of the elderly and those already with conditions. Their insurance will be funded entirely by taxes via Medicare, which is not much different than the status quo.

Second step is to abolish Medicaid. Most on Medicaid are desirable customers for  a private insurer — if they can pay the bill.

Third step will be to treat company health care plans as fully taxable income. This is the trickest. To make it palatable, business will have to fully convert the coverage to cash then add a premium so the employee’s disposable income actually increases. The incentive for business is the end of a major paper-work headache along with the uncertainty of unexpected rate hikes. The incentive for the employee is greater disposable income. The incentive for the rest of us is more market pressure on the cost of insurance policies resulting in less expensive ones.

Fourth step will be to maintain an individual mandate to carry catastrophic and emergency coverage. There will be no abortion or birth control or sex change coverage requirements. Those unable to afford a decent policy will be subsidized though taxes. Unlike Medicaid, however, the individual rather than the state will pick the policy. You think that’s unconservative? See step 2. Medicaid is abolished. An entire bureaucracy has been sent to the great oblivion to be replaced with something that is philosophically no different that school choice. The policies individuals choose will be in the private sector. Yes, we can have a work requirement for subsidies.

We believe this will solve all problems although expect tenacious opposition from insurance company croynists, social engineers and Randian objectivists.

Easy Obamacare Replacement, A No Brainer

Easy Obamacare Replacement, A No Brainer

Easy Obamacare Replacement, A No Brainer

Libertarian Opposes GOP Health Reform Bill

Libertarian Opposes GOP Health Reform Bill — The Dale Kerns Campaign issued this statement concerning the GOP replacement of the Affordable Care Act with the American Health Care Act.

Libertarian Opposes GOP Health Reform Bill
Dale Kerns

Today the House passed the American Health Care Act as a replacement plan for the Affordable Care Act. If I had the pleasure of being Pennsylvania’s representative in the Senate, I would vote no to this bill. The AHCA bill is just an Obamacare Lite that does not fix the overall problems that the Affordable Care Act is causing Americans. Without a mandate, the government monopoly on healthcare cannot work, and with the mandate the system is corrupt. The GOP bill will cause premiums to skyrocket. We need to bring the purchasing power of insurance back to the consumer by offering free market solutions. Instead the AHCA gives the insurance companies an open check book to make insane profits while driving the level of care further into the ground. We must repeal, but not replace. When you put out a fire do you look for another catastrophe to replace it with?”

Dale Kerns of Ridley is a Libertarian seeking to replace Bob Casey as U.S. Senator.

Libertarian Opposes GOP Health Reform Bill


Pennsylvania Obamacare Repeal Nays

Pennsylvania Obamacare Repeal Nays — A quarter of the House Republicans voting to save Obamacare come from Southeastern Pennsylvania.

You can guess the names of these profiles in hackery but we will list them anyway:  Ryan Costello of the Chesco-centered 6th District; Pat Meehan of the Delco-centered 7th District, Brian Fitzpatrick of the Bucks-centered 8th District and Charlie Dent of the Lehigh County-centered 15th District.

Note that all the districts but the 8th are horribly gerrymandered and cross more than one county line.

All these men run as pro-lifers but voted, May 4, to save Obamacare’s mandate that businesses pay for abortions. All these men claim to be “fiscal conservatives” but voted to keep 12 job-killing taxes including taxes on prescription medicine and medical devices.

What could these men have been thinking? Why of coasting on the easy road, of course. They listened to pressure groups paying for push polls. They bowed before political consultants — you know, the kind that President Trump notably ignores.  They figured they’d follow that broad path to the wide gate of wealth and power rather than fight for what’s right.

They lacked the will — or perhaps, more charitably, the imagination — to articulate to those whom they represent why getting rid of these taxes and mandates will make their lives a lot, lot, lot  better. They refused to go out and sell this repeal plan to their constituents just as they refused to sell President Trump’s candidacy last November. This is especially ironic as the passage of Obamacare was responsible for sending three of the four to Washington.

Pennsylvania Obamacare Repeal Nays

Pennsylvania Obamacare Repeal Nays


Health Care Basics Must Be Recognized By GOP

Health Care Basics Must Be Recognized By GOP — With the Republican health care reform in a mess, we’d like to suggest getting back to the basics with regard to principles and purpose.

Health insurance is not health care. “Insurance” does not insure your health, something that should be blindingly obvious. What it does is to insure that the doctors and other medical professionals get paid.

The purpose of public health is to minimize the need for care yet provide it when needed for those who cannot pay what medical professionals ask as going rates.

Minimizing the need includes things like sanitary sewer systems, draining swamps and discouraging pointless risky behavior such as that which spreads HIV. One of the first steps in getting back to basics is to stop being afraid to point this out.

When care is needed, an insurance policy is not the only means to do so. Bill Gates and Warren Buffet would be silly to have an insurance policy. They can easily cover anything that might happen to them out of pocket.

For those who aren’t billionaires, places like Philadelphia General Hospital existed in the last century to provide free care to the desperate. Of course there was no incentive to maintain them and a huge incentive to use them as dumping grounds so their demise was practically ordained.

Free markets cannot be mocked.

Step two concerning back to the basics is to recognize that health care is provided by people not governments, corporations or bureaucracies. Maximizing health care means maximizing the number of competent people who can provide it and giving them an incentive to do so to all comers.

Money is obviously going to be a factor even for the most saintly, but except for the most vile — and they are rare — it is not going to be the only factor. Social rewards are almost as important. Most successful people will discount services to those who can’t afford what they normally charge. Most will even do charity work — unless, of course, regulation and time available prevent them. You doubt this happens ponder that retired doctors can’t work part-time without still carrying malpractice insurance.

An OB/GYN pays about $20,000 per year for it.  Insurance companies will discount about 50 percent for part-timers. A $10,000 per year nut to cover would certainly put a damper on a doctor wanting to occasionally help out at a charity hospital for $50 per hour.

And no amount of money is going to keep someone from bailing out when the job stops being fun and they no longer need it. One of the biggest complaints doctors have is mandated paper work either by government or an insurance carrier.

And this gets us to insurance companies. An insurance company is a business that seeks to spread risk while making a profit. The top executives at these places easily surpass six figures. Do they earn it? Probably not but that’s not their fault. With government mandates for  features not necessarily wanted by all customers (substance abuse counseling, birth control) and restrictions on competition, they can do a lot of coasting. Call it the joys of cronyism.

Insurance companies have a use and they are not inherently bad. The Trump plan to open competition across state lines is excellent. We don’t have an objection either to a mandate for individuals to carry it. Public health has a cost and its better for people to be allowed to choose their coverage rather than leave the decision to government agents who will inevitably pocket as much of it as they can if funded via a traditional tax.

Regardless, it must be remembered that it is people who provide health care and not bureaucracies. Forgetting this while ignoring that bureaucracies inevitably become corrupt are the biggest failings of doomed Obamacare.

Health Care Basics Must Be Recognized By GOP

Health Care Basics Must Be Recognized By GOP Health Care Basics

Obamacare Fix Should Be Simple

Obamacare Fix Should Be Simple — Debate rages about how to fix the Obamacare disaster.

Some Republicans understandably want to keep the program’s massive Medicaid expansion. Medicaid is the “government insurance program for those whose resources are insufficient to pay for health care“. Many now have health insurance who didn’t before. Taking it away is something that would likely come back to bite.

Of course, Medicaid is a disaster in itself so hold that thought.

Then there is the employer mandate. Employer-provided health insurance had a value of $17,545 for a family in 2015. It would be a serious blow to working people if it were to disappear. Of course, company health insurance plans were widespread before the mandate. Ironically, they may become less widespread as businesses increase the use of part-timers and independent contractors and automation to avoid the mandate so hold that thought.

And then there are the mandates to guarantee insurance for those with pre-existing conditions, and for adult sons and daughters, which President Trump has promised to keep.

The knot appears impossible to unravel and it is. That, though, makes the solution simple. Cut it off entirely and re-splice the loose ends.

Switzerland has an indisputably successful health care system. It has an individual mandate as per Obamacare but limits it to accidents, illness and pregnancy. If one wants things extra, one can pay find policies beyond the mandate and pay extra.

There are subsidies for those who can’t cover the minimum.

If the U.S. were to adopt such a system, Obamacare, Medicaid and Medicare could be abolished and the swamp-filling bureaucracies that run them could be drained. As the policies would be purchased by individuals, the government wouldn’t have the chance to play with the money.

Regarding business, don’t just end the employer mandate but treat health benefits as taxable income. Cold? Does your employer pay for your home, clothes and groceries? Once people get used to buying their own health insurance just as they do their home, clothes, groceries and other insurance, the cost will drastically drop as they shop. Employment will boom as will living standards.

Obviously, insurance should be allowed to be sold across state lines.

Obamacare Fix Should Be Simple

Obamacare Fix Should Be Simple


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