I once wrote about Medical Residency in the US – how tough is it? Now that my attempt to take USMLE Step 1 during summer holidays 2008 failed miserably due to failure of either ECFMG (Educational Comission of Foreign Medical Graduates) or NNSMA Deanery to verify my medical students status, perhaps it’s time to weigh and rethink residency in the US all over again. As of now, 13th January 2009, I am prone to think that residency in the US is a bad idea. While I might change my opinion as time goes by, let me tell you what I think now:
- The Programs – while the US has best teaching hospitals in the world with the best programs of medicine, it is tough to get in as well. While US-trained medical students can get into these programs with mediocre scores, the international @ foreign medical graduates (IMGs @ FMGs) need to score much higher and work twice harder (researches, publications, externships etc) to get into excellent programs. Usually entrance to residency programs like surgery, radiology, anesthesia, orthopedics, ophthalmology, obstetrics, dermatology and emergency medicine is real tough for IMGs. IMGs usually resort to Family Medicine, Psychiatry and Internal Medicine (in which cardiology, gastroenterology and nephrology specialties and fellowships are tough to get in due to its competitiveness and high market value)
- The Timing – usually IMGs applying for residency in the US had to gain 3-5 years of experience of medical practice from home country. It sucks real bad for Malaysian Medical Officer at his/her 5th year of practice needing to start the residency again from scratch (internship). Although the residency programs in the US are short (5-7 years for surgical and 3 years for other specialties), the process of restarting the whole thing again is frustrating.
- The Work – the work of residents demands perfection out of their sucky systems. Although that is good for the training of a physician, the demand is far too overwhelming for IMGs. To get into excellent programs of post-residency fellowships, an IMG has to work twice harder than their American counterparts. Stress level is always to the roof. Thus, it is always reported that physicians in the US has low job satisfaction.
- The Money – although at this time of economic recession, physicians in the US have job security. With starting salary 40K (above median and average national income per capita), the tax rate is 25%. That doesn’t include other taxes, apartment rents, bills and credits, foods and clothing etc. Well, it is hard to argue with this point as US residents make better money than any other countries in the world. But with the introduction of UD41 (RM3,768.39) at first year of housemanship and UD44 (RM6000+) at third year of practice, I ‘d say I’m more satisfied with the current Malaysian government pay scheme for doctors. Haha, doctors don’t make money! Wanna make more money, quit medicine!
- The Others – social factors, far away from home, culture shocks, economic collapse of the US, high crime rate, despicable foreign policy, their support of killing innocent people and all that stuffs.
That’s all. Resuming studies now 🙂 Thank you all for the birthday wishes.