# Will the stigma of being a IMG always follow me around?



## bigboi_baller (Mar 19, 2007)

Assume I got to Pakistan, go to a good school like Shifa or KE. I get good grades and do well on the USMLE. I manage to get a decent residency.

After residency, will the stigma of being an IMG always be a weakness on my resume? Will I always be looked down upon, especially with the future of Pakistani-American relations looking bleak?

Thats what I'm really afraid of at this time. What happens after I am done with medical school & residency and try to pursue a career?

Obviously, you guys have some motivation/some light at the end of the tunnel because a lot of you are in Pakistan attending med school. But I've finally come to the point where that fear is what I'm going to base my decision on. I'm willing to live in Pakistan. I'm willing to study hard. But I'm unwilling to basically waste all the effort I've put into doing well in well respected schools and become a 2nd class Professional for the rest of my life.

Any advice/insight would VERY appreciated.


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## DrPlasma (Jan 11, 2008)

bigboi_baller said:


> Assume I got to Pakistan, go to a good school like Shifa or KE. I get good grades and do well on the USMLE. I manage to get a decent residency.
> 
> After residency, will the stigma of being an IMG always be a weakness on my resume? Will I always be looked down upon, especially with the future of Pakistani-American relations looking bleak?
> 
> ...


Well, if you can get into medical school in America then great go ahead and do that. If you think that chances are that you will not get in then Pak or other foreign medical school are good options. 


As far as a Pakistani, Indian, UK, German or other FMG'S are second class doctor thats a bunch of b?. If some one has xenophobia then you make sure to tell them don't go to the hospital for any treatment, because sooner or later a you will see a foreign trained doctor. They are in every specialty now, they have to do take the same USMLE exams, same US residency training and then finally same US boards to get the license so what's the difference. 

A lot of American doctors have said excellent things about Pakistani/Indian doctors, and yes some are always putting foreign medical graduate down. NOTE; Being an fmg it will be harder to get into some competitive specialties, but again human being has limit less possibilities and you can do it. 


At the end of the day, it's the person behind the white coat who really makes the difference not the medical school you went to, as long as you go to a school which is accredited you should be just fine. Pakistan medical college grads are practicing in all the specialties of medicine and in virtually every American state. 

Good Luck to you. 

Thanks.


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## bigboi_baller (Mar 19, 2007)

Damn, I just typed out a huge response to this and the site logged me out and made me log in. That caused me to lose my reply....I'm kinda pissed actually lol

Condensed:

I can get into good US schools. I have over a 4.0, went to a priv college prep, got a 30 on the ACT, did sports/community service, and pretty good writer in terms of essays. I got into a couple of privates already including USC and Inshallah will get into some UC's...

I'm willing to go to pak even if its a little hard to get a great residency when I get back (just to clarify is it hard to get a _good_ residency or just _a _residency?) as long as I'm equal in terms of respected/paid by my peers/patients/employers after residency.

Talking to a woman who did med in India in the 70's, she gave me the impression that more and more IMG's are coming to the US lately and its getting harder for them to be accepted as equals because when they are asked where they went to med school, Internation med schools are looked down upon. She said many are treated as second class doctors which is something I don't want to be.

I've been very succesfull in terms of academics and whatnot and I could do just fine going to school in the US. I wanted to go to Pk for the culture, saving a year, and saving some money but I'm worried about throwing all I've accomplished down the drain by settling to become a "2nd class" doctor.

For those of you studying in Pk and wherever, I'm definately not trying to insult anyone but I'm just relaying what I heard. I guess the people who could best answer my question are those who've actually gone to PK and came back for residency and now practice actively.

After USMLE and residency, _will _I (not should I be treated, but will I) be treated as an equal to an American med school graduate? Thats basically what it boils down.

I'm sure there are examples of 1 or 2 really succesful foreign born graduates but are there lots more that never got treated as equals? I know its a battle to get a residency. But is it a battle to be equal to your peers professionaly after residency?

#laugh Guess I didn't stay as "condensed" as I was trying to. I just need to get some feedback. Feels like the biggest decision of my life.


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## DrPlasma (Jan 11, 2008)

Seems to me that you have a little ego problem, and you take very seriously what other people say. What if some one say that you are not a good person, are you be automatically be on the bad side, I certainly hope not. 

Lets put it this way, this is my last reply on this thread. 

If you can get into the US medical school as I stated previously then DO THAT!!! like many Pakistanis and Indians have done in past. 

US medical students are trained for US medical residencies and for the USMLES, and you will have more easy time matching into the residency as compared to FMG'S. This by no mean says that FMG'S are not equal to US medical grads, because I considered medical schools in Pakistan and India great. No doubt many of the residents from foreign countries and doctor I've met have virtually got a perfect score in USMLES, in addition to that they have passed all the boards in their home country and gotten into excellent programs. 

Now saving a year, some money and learning about your culture are all good things to do, but not good enough to justify that your going to Pakistan, if you have gotten into a US medical school. Now especially for a guy like you who is too worried of getting called a second class doctor lolz. 

Not all American doctors are great and the same goes for fmg's. 

Remember this respect is earned its not just given to anyone for free. 

I wish you the best of luck and hope that my replies can be a little help in making your decisions. 

Thanks. 



bigboi_baller said:


> Damn, I just typed out a huge response to this and the site logged me out and made me log in. That caused me to lose my reply....I'm kinda pissed actually lol
> 
> Condensed:
> 
> ...


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## bigboi_baller (Mar 19, 2007)

Maybe I'm not explaining myself right or maybe your not understanding me. I don't have a big ego or something. I guess what I mean isn't if I will be "looked" down upon but if I will be treated that way.

I don't want to be not getting a good job after completing my residency because I'm an FMG. I don't want an employer to see FMG and put me at the bottom of the stack.

From a few people who've done med in Pak and came back, I've gotten this story: "They all look down on me now and no one wants to hire me. I don't get paid as much as the other doc's. I don't get the same promotions/opportunities at my hospital. If I go private, its hard to get patients because many leave after they hear you were schooled overseas."

So... it boils down to: Is there is any kind of prejudice against FMG's in the American Medical landscape?

(BTW, thanks for your replies DrPlasma)


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## Rehan (Jan 26, 2006)

Bigboi, I understand what you're asking and I'll try my best to answer from my perspective. I'm a final year medical student and have had the opportunity of completing a few research and clinical electives in the United States, both on the east and west coasts, giving me a glimpse of how IMGs are treated in relation to US graduates.

I have found for the most part that a slight stigma does exist when comparing IMGs to US graduates however many times foreign graduates from developing countries like India, Pakistan, etc are also seen as superior in terms of their clinical skills as compared to their US counterparts. US students are not always taught in such exacting detail how to conduct a physical exam because they have the luxury of being able to order X-rays, MRIs and CT scans at the drop of a hat, whereas in the developing world most patients are unable to afford a simple chest x-ray and therefore the art of teaching medicine has adapted to stress the minute details of clinical skills in order to reach as much of a diagnosis as possible at the bedside.

In terms of residency positions, there is no doubt that IMGs will have a harder time competing for specialties which are highly sought after by US graduates (surgery, dermatology and radiology come to mind, just to name a few). Whereas the presence or absence of a stigma is debatable, this point is not. If you are an IMG, the doors of those residencies are not shut to you, they are just much harder to obtain. That being said I have seen many recent Pakistani graduates secure residency positions in surgery and other highly competitive fields but these people stood out from the rest of their graduating colleagues, whether it was due to publications they were a part of during medical school or extensive US clinical experience that they obtained during their summer breaks or taking a year or two after graduation to participate in research in the specialty of their choice. Simply getting super high board scores is not enough for those competitive specialties if you're an IMG -- instead, high board scores are only the beginning.

Also, there are some programs which will not even consider an IMG's application for residency however from what I have heard, the number of these programs is declining.

The thing to realize is that the USMLE Step1 and Step2 exams are designed to prove the caliber of training that you have received in comparison to US graduates. If you do really well on the board exams and show a well rounded resume with diversity and depth, securing a residency position will not be the hardest thing in the world.

As far as patients refusing to have you take care of them because you are an IMG, I have not heard of anything like this myself, but do not discount the fact that it does occur. I have noticed that many times patients are uncomfortable with a physician who has trouble speaking English with the same fluency that a US native would, and this may affect the patient-physician relationship, however I haven't heard of a patient refusing to see a doctor because he wasn't a US graduate.

And in terms of salary, IMGs and US graduates get paid the same in residency, depending on their program and which year of residency they are in at that time. Afterwards the pay that a physician receives will most likely be more dependent on where they did their residency training from and the evaluations they received in that training rather where they went to medical school. The medical school a person graduates from holds much less relevance than the residency program they completed their training at.

And ultimately, it really depends on you -- like Dr. Plasma said, it mostly comes down to the person behind the white coat. If you feel that coming to Pakistan is overall a worthwhile investment of your time so that you can learn about the culture, perhaps save some time, and definitely save some money, then I would recommend it.

Naturally though, you know what's best for yourself and I hope this has helped you better understand the degree of adversity (and the factors that contribute to it or reduce it) when an IMG attempts to secure a residency position.

Good luck!


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## bigboi_baller (Mar 19, 2007)

Wow. Awesome post. I had left for Pakistan before you posted this (thats why I didn't respond earlier).

While I was there I asked this question from every Dr/Med Student I came across. They all basically said what you said: 


You are at a disadvantage if you go back to the US as a IMG.
If you can pay/get in med school in the US, no questions asked that should be your first option.
The education is just as good as US but IMG's tend to have better clinical experience.
You don't save any time in the long run by coming to Pakistan. If anything, you spend more time afterwards with USMLE and stuff.
So when I explained that I had been accepted to US schools and that inshallah I'd probably be able to get admitted to a US med school after 4 years, they all said to not take the route the IMG route.


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