Nis 222012
 
  • Original text is written in Turkish by Dr. Ulaş Mehmet Çamsarı, it was kindly translated into English by USMER member Gülsüm Ramazanoğlu 
  • Metnin orjinalini büyük bir emek vererek İngilizce’ye çeviren Gülsüm Ramazanoğlu‘na çok teşekkür ederiz.

 

How far is it possible for an FMG (Foreign Medical Graduate) to have medical residency in the best hospitals and universities?

This point will be analized under three headings…

    • The concepts to be clarified
    • The ways to get in those top-notch schools
    • The US top-notch schools known in Turkey and their de facto status in US

Clarification of the concepts :

To answer this question, first, there is a need for clarification of some concepts. Let’s begin with trying to open the concept, “the best schools”. Even though “the perceived best schools” for the M.D.’s coming to US from abroad and “the real best schools” intercept at some points and for some schools, they are not the same at large. So-called best schools, from the point of view of an outsider, means in general the names of a few worldwide known schools. These American and English school trademarks, with names reverberating through the skies of the world, deserve their reputations to a degree of course. It should be known, however, that there are too many schools in US which are not globally known much, or “that much”, but can take place well in the list of “the bests”. With a sector-conscious viewpoint from Turkey, it can be seen that there are a lot many US health institutes which are not that known, but high quality by real criteria. In our country, Turkey, the aspiration of having education in US shapes up most often by the motives of “images” and “icons”. In my opinion, it is a wrong starting point. Names and brands, of course, are important. There can be nothing to raise objection in it. Just, to define “the quality education”, a vitally important goal, “only” with brands, and to make a startup this way is wrong. With such a beginning, in Turkey –and I am sure in many other geographies of the world as well- “the education abroad” paradigm will be limited only with running after the brands which are known “even” by everyman and gaining only those brands, disregarding their quality and quantity in educational merits. Yet, with regard to the M.D.s in our country, if there is a consideration of a goal of education abroad and specifically in US, it should be, first, an education which cannot be surpassed by its counterparts in Turkey, or the standards of the education to be taken abroad should be “at least” higher than that of Turkey, so that this substantial route should serve for a substantial reason, and be worth of that much investment and leaving your country. Therefore my recommendation for my friends getting in this issue in Turkey by looking for “the best schools” in US is that, they must weigh well what exactly they are motivated “for”. The goal of “only” having a brand, as I will come to a little later, is strategically wrong, and it flaws the due virtues one should have in this field. What’s more, it’s most inevitable to make wrong decisions over this way, since, as I have mentioned earlier as well, the concept “the best school” with a viewpoint from Turkey and the one in US are not the same.

Haw far is it possible to get in those “best schools” for the FMGs coming from abroad?

Before building up a “principle” guideline as elucidated above, the rush of the FMGs only to the American brands which have overseas reputations, (Harvard, the most known example), created a competition venue in those high quality schools, “more than they deserve”. And those institutes exploit it as much as they can. They invite the foreign MDs to their research labs, and even grudging peanuts. The research machinery of those institutes is  based on the manpower of the third world nations’ MDs, who are working  for years with the hope of being an assistant someday, by their own financial means which they got from their countries, from their universities, but mostly from their own pockets, and with miscalculations came to agree to work under any circumstances, totally out of their scopes. Since those schools know that they cannot offer these conditions to the Americans, and because they run this machinery based on foreigner manpower for peanuts, they spare the official means of education (accredited by ACGME) to the Americans, and very rarely to the foreigners. This unfair machinery is mostly  invisible for our MDs when they set foot in it first. To get in the accredited programs as FMGs over aforementioned way in those institutes(which intake mostly over “match”) and to move up, is much harder than any other institute. After getting in the system (that’s, after being admitted in any ACGME program), however, it’s much more possible to come to those positions. Even though it looks good at the beginning with the considerations of “better than nothing” or “looks good in the CV”, actually to accept the research positions offered under such bad conditions as mentioned above,  may cause an awful time loss and disappointment for the MDs, considering to apply for residency positions, but not taking the right strategical decisions on the right times; by that regard, on the verge of accepting these positions and making a sacrifice on many things, one should consider to specify the goals and timing ciriteria, and not to let to be exploited by the fame of the institutional brand.

What is the assessment of the list of, as known abroad, “the bests”, regarding the American realities?

The academical ranks of the aforementioned institutes, of course, are high in US as well. But they are not that different than others, as they look. They may not, as well, have any difference other than the field they become prominent. In US there are various institutions which are prominent in various fields.  Not everyone is the best in everything, various institutions are good in various fields. And those “brands” are no exception. Depending on my personal experiences and observations, the US graduates are not that fond of those “brands” as much as the FMGs are. The reason of that is, the “brand” concept is not that important in US, as in Turkey, and I’m sure, in the likes as well. To maintain the success in time assidously is a fundamental virtue that American system supports; rather than the school you graduate, it’s more effective on your carrier, what you produce after graduation. Best part of the permanent MDs/academicians –I cannot give a specific number- in the instituitons which take place in those so-called best list, made up by the Turkey realities, are not the graduates of those schools we know as “the bests”. There is a significant variation in US, and the institute, so-called ACGME, has a great effect and effort to get the schools up to par, and that caused the result of losing the significance of the school of graduation for everybody, other than FMGs that are fond of brands. Those all are my personal opinions.

Conclusion:

To summarize the detailed answer above, yes, it is possible to get in the American schools which are known in Turkey, as “the bests”, as FMGs, but  it’s too tough at the first entry phase to the system, as mentioned above, ( “entry to the system” implies an ACGME accredited program.) But as explained above, how far it will be effective on the career to get in those schools, is another point to examine, and in my opinion, it is absolutely not that important in US as it is in Turkey. If one will “mess up” with one of those brands which are known in Turkey, “the bests”, in any case and for some personal reasons, then instead of straining for a direct entry at the beginning, it may be more feasible to check the exits for those schools after getting under the ACGME umbrella.

Ulas Mehmet Camsari, M.D.
 USMLE Strategy Center

 

Translated into English by Gülsüm Ramazanoğlu 

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