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Siddhartha Yadav: I am an international medical graduate (IMG)

25 Aug, 10 | by BMJ

The term international medical graduate or IMG, here in the United States (US), applies to those who are applying for a higher medical training in the US but did not graduate from a US medical school. I am an IMG. After completing my medical school from Nepal, I am now in the US with the determination of pursuing my further training in internal medicine here.

A large portion of IMGs is made of graduates from poor countries. There has always been a debate on how justifiable it is for rich countries to accept graduates from poor countries into their health system, especially when there is a dearth of doctors in poorer countries. Poor countries invest huge amounts of money, by their standards, to create doctors. For these governments, it is a futile investment if these investments end up leaving the country.

A few weeks ago, I came across an interesting poll on doc2doc, “Should rich countries pay ‘transfer fees’ if they poach health professionals from poorer countries?” Although I answered yes, I do not think that is the solution. Paying the poor countries will not give them back the doctor they just lost and it will only justify this transfer. I guess the issue is more about fulfilling the need for doctors in the health care system of poor countries than about financial loss or gain.

On this note, I wonder how we should view the clustering of doctors in and around major cities in a country like Nepal when people in the remote areas have to walk for days to reach the nearest doctor. Clearly, their presence in the cities is superfluous in terms of providing health care. And then, there is another group of doctors whose fees can only be afforded by the financial elites of the society. Many of these doctors in the cities, and also those with expensive fees, studied in government funding as well. Although they did not leave the country, can they still be considered as a futile investment?

The issues are more complex than they seem. One of the reasons for this is that people are more than just investments. We are individuals bundled with emotions, dreams, and interests. I am not trying to justify, in any way, doctors leaving their countries. Nothing can justify it. I understand the implications of leaving my country. I am laying down my perspectives in an honest attempt to understand why I, myself, made that decision.

For me the single most important reason to take the decision to leave my country for further education was my interest in clinical research. I had to struggle a lot to even get a brief taste of clinical research during my medical training. I do not wish to remain under privileged in that aspect during my further training now. I believe that post graduate training is the ultimate opportunity to indulge myself into clinical research. Unfortunately, this is not the case with post graduate medical education in Nepal. 

My mentor, Dr. Buddha Basnyat, often says that Nepal has a huge potential for clinical research (Read about Dr. Buddha Basnyat’s and my say on mentoring in a recent Student BMJ article ). I agree with him. I hope he will agree with me when I say there are, however, very few opportunities to learn how to do research during post graduate training in Nepal. I highlight the word learn in the sense that there are very few doctors in academic institutions in Nepal who have the experience, knowledge, or willingness to guide or encourage a trainee into clinical research.

Other aspects probably contributed as well. Corruption, poor work environment, inappropriate political influence, weak governance, to name a few. I could write pages on each of these and how they influence our decisions in the long run. But that’s beyond the point for now.

The journey as an IMG is not an easy one either. It is fraught with many obstacles at each step. I have already spent thousands of dollars to be in the US and take the US medical licensing exams. The cost of living in the US for months is beyond my financial capabilities. I have been lucky in this regard that I have found refuge in the home of two kind and caring seniors from my med school.

Not all of the IMGs get what they come here for. The programs are ruthless in their selection. They do not usually prefer to have IMGs because of the visa issues and the relative newness of IMGs to the US health care system. An IMG has to be extraordinarily better to be picked over an American graduate. Each year, only around half of the IMG applicants get into a residency program. The other half will have to return back to their countries or apply another year. 

So, here I am, starting on a totally new journey as an IMG. The days ahead seem to be tough and unclear. I will blog on how things go for me and my fellow IMGs. I’d be interested in your thoughts on doctors leaving their countries and about IMGs.

Siddhartha Yadav is a former BMJ Clegg Scholar

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  • Elixir321

    dear sidharth
    I read your blog. I came to understand that you came to USA because you are interested in clinical research. I contradict that. I think research can be done even in the poorest and underdeveloped countries. You dont have to move to US or take training from any country of equivalence to US to get your dreams. Your writing tries to project yourself as a true Nepali who cares about the shortcomings of the health system in your country. But I think most of the IMGs have a hidden agenda. they are fleeing their home country not able to face the music.You complain of doctors not working in the periphery and clustering in the so called city. I would be delighted to hear your contributions to the periphery. Also, it would be really nice if you could blog high talks on how that problem can be solved.Some people run from periphery to the city and some run from the city to the USA. Everyone has the same reason. Everyone is fearing to face the music

  • Siddhartha Yadav

    Dear Elixir321,

    Thank you for your comment. I thoroughly enjoyed reading it and I truly appreciate your view on this matter. However, I would like to point out few inaccuracies in your comment and clarify them:

    1.Yes, you are right in saying that clinical research can be done even in the poorest and the most underdeveloped of countries. In fact, I have quoted my mentor as saying that a lot can be done in clinical research in Nepal and I agree with him. If you read my blog carefully, you will see that I am not talking about conducting research but learning how to do research.

    “My mentor, Dr. Buddha Basnyat, often says that Nepal has a huge potential for clinical research. I hope he will agree with me when I say there are, however, very few opportunities to learn how to do research during post graduate training in Nepal. I highlight the word learn in the sense that there are very few doctors in academic institutions in Nepal who have the experience, knowledge, or willingness to guide or encourage a trainee into clinical research”

    This is a huge statement but I stand by it and I am sure you cannot deny this fact if you understand the Nepalese medical education system.

    2.This blog is not about a lot of things that you attribute to. There is no such thing as a ‘true Nepalese’ of ‘false Nepalese’. You are either a Nepalese or you are not!

    3. Again, nowhere in the blog have I said that my contributions towards the health of people in rural areas (periphery, according to you) are significant. I honestly admit that my contributions to the health sector of Nepal are negligible. But my question remains and I believe that it is a genuine question to ask at this point:

    “I wonder how we should view the clustering of doctors in and around major cities in a country like Nepal when people in the remote areas have to walk for days to reach the nearest doctor. Clearly, their presence in the cities is superfluous in terms of providing health care. And then, there is another group of doctors whose fees can only be afforded by the financial elites of the society. Many of these doctors in the cities, and also those with expensive fees, studied in government funding as well. Although they did not leave the country, can they still be considered as a futile investment?”

    4.What kind of hidden agendas are you talking about? Could you please be a bit more elaborate? I have laid down my facts honestly for you and I cannot fathom any hidden agendas. What kind of music are you talking about? Could you please clearly state your facts with reasons and not talk abstractly?

    5.I am surprised by your lack of ability to appreciate the diversity within the human race. Not everyone is the same. Not everyone thinks the same. Not everyone went to the med school for the same reason. Similarly, not everyone is an IMG because of the same reason. I hope you can understand this fact. If you talk with IMGs, you will come up with hundred different reasons on why they are here.

    I hope I have been able to answer the questions that you have put forth for me. If not, please let me know and I am willing to further elaborate on them. It was a pleasure reading your comment and I thank you for your interest in my blog and raising some critical issues.

    Best wishes,
    Siddhartha

  • http://twitter.com/medicine365 Medicine Hacker

    Are you sure you are being completely honest here and not just trying to assuage your guilt over leaving Nepal? I can't say I am convinced by your argument. I do understand why you would want to move to the US, since I myself am a recent medical graduate who is scoping out the US scenario as well. But honestly speaking, I think doing JUST clinical research is a poor excuse.

    And well, if people of your calibre and stature decide to leave for the US, the least you can do is not talk about there being “very few doctors in academic institutions in Nepal who have the experience, knowledge, or willingness to guide or encourage a trainee into clinical research.” There are very few doctors because all of the capable ones, like you, left for greener pastures!

    I am not saying that you shouldn't go or whatever, but what I am trying to say is that if there is something wrong, why not try to correct it first before giving up.

    All the best in the journey ahead. As always, loved your writing!

  • Priya Khanna

    Dear Siddhartha,

    I can absolutley understand your sentiments. Though I am not a doctor ( but I have a doctorate in Education), I work in a specialist medical College in Australia and so am well aware of various problems faced by IMGs. An immigrant myself (originally from India), I feel that while we leave our country for a better future, we do pay a heavy price for it by leaving behind our near and dear ones. It is, however, important that the country which invites IMGs/ immigrants should take the owenership of helping immigrants in settling down because the country in question does get substatial economic and other workforce related benefits from immigrants.

  • isibobo

    I have read all the comments and would like to add my 2cents. I am an IMG, with British Citizenship. I understand both sides of this discussion and will try to explain based on my personal experience.
    I trained in a West African country and there are MANY difficulties, ones which most doctors in the Developed world do not even know exist because they seem unfathomable. The reason why so many IMG's leave their countries of Origin is not only because they want to RUN away as appears to be a recurring thought, but like ALL medical professionals they want to be trained in the BEST facilities, by the BEST teachers so that they can be the BEST. It's as simple as that. Not everyone has the personality to work in rural settings, especially when there are no facilities. It takes a special mindset. To be forced to do that would be misery. Would all the doctors in the developed world want to be pushed into 1 specialty? I guess not. On the other side, the Developed countries see the need to protect their 'home-trained' doctors. It is an understood and respected FACT. IMG's are Visitors and thus have no 'rights', they can only take what is offered. But to assume that IMG's are on the RUN from home because of the financial and social issues is rather myopic. There is no Universal rule on the reasons for migration. If the expertise could be received back home a lot of hospitals in the developed world would have LESS IMG'S

  • Elixir321

    Dear Sidhharth,

    I have a feeling that my comment has offended you in a way, though the intentions weren't so.
    I appreciate that you are good with words, and you have tried to validate your point taking help of those words. We can go on discussing on things mentioned above. Let me try to be less abstract and clarify a few things

    1.I am astonished by the fact that a blogger like you, who has written so much can't appreciate the meaning of being a true Nationalist. It might not be for you but for many of us; either one is a “True citizen” of a country or ” no citizen” at all.
    2. About the learning and conducting research part, we are playing with words again. Whatever name you give to your action, Sir, the main point is ,You are spending more than a 10,000 dollars on just applying for an exam to get into a US residency ( which according to you is to LEARN how to do research).I am sorry for being so ABSTRACT the last time. You want me to believe that someone who comes from a developing country, spending a fortune just to learn how to do research will go back to his home country. It sounds good when you write big things..but i think you are a public figure now..and years from now..the eyes who read your articles will certainly follow your whereabouts.Time will testify. I think there were cheaper routes to follow for someone inclined in clinical research than wasting so much for a residency in the US.
    3.No where in the blog u mentioned ur contributions.. that is what i wanted to know. you are a medical graduate from an underdeveloped country which has bad rulers and governance and this that blah blah. But what have u done to change that..I just request you to mention your efforts.Every article of yours i read has some complaints about your government, health system, politics. But what have u done to make a difference. You belong to the most literate bunch and you leave your country looking for a better future in USA. Give it any name sir, the fact is …you couldn;t face the turmoil, you couldn't fight the system, you couldn;t change the system. You would learn a lot on clinical research from USA. But your home country would not have changed. The government, the system wouldn't change.

    My humble request to you is ..please kindly don't use the sentiments of the poverty, ill governance and the discrimination for your own good. You are an IMG. USA is doin you a favour on letting you practice medicine in their land. So you will have to go with their rules.
    You fled your home becos you couldn't change the rules there..now don't grumble about the rules the americans have set for you.
    5. I am in touch with a lot of IMGs. I well appreciate the diversity the nature has blessed the earth with. None of us are the same. I am sorry i have to talk abstract here because i haven't neither done any research on this matter.But my personal experience with the IMGs tells me that majority leaves home looking for a better shelter and a prosperous future. People hide themselves behind a veil of clinical research, better opportunities, and this that…

    I am so glad to know that you are not among the majority. I am equally thrilled that you have a vision to do something for your country (i suppose).
    To end it for now..what i want to say is…
    It is easier to write and complain,but very difficult to come up with a solution.

    I hope i have clarified a lot. I might have still missed a few explanations. please do let me know if you still want to play with words, twist them around.

    Best regards
    Keep writing

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • Rajni Srivastava

    To Elixir:

    I have spent most of my life working in the health sector of nepal.

    you say that doctors leave for money/prosperity. I think you are wrong. If you really understand you will see that many doctors in india and nepal earn money comparable to doctors in usa. and the expense here is less. how they earn it, we all know. their salary on the government record may be 30,000 rupees per month but we all know majority of them (yes, majority) are corrupt in government service. yes, even those who are working in rural areas. we also know that doctors working in nursing homes and private clinics in nepal earn huge commission by prescribing unnecessary investigations, doing unnecessary procedures and prescribing lots of medicines.

    so my question is if money is the main issue, why not become such a doctor in nepal and earn a lot, be respected and have to spend less than leave country for money. all medical persons know this. see, doctors probably earn the most in nepal apart from businessmen and politicians. if u check, the have the biggest houses, expensive cars and are very much respected. so if this is the case why would a doctor leave for money??

    so maybe you should think. if somebody is leaving is whole family and friends to go to a new place with new language and culture, there must be something really strong reason. Money is one of the reasons, but it alone cannot be sufficient. especially for doctors because they have very very good life in nepal.

    Just a suggestion: I think discussions are more genuine if you use real name. you talk about hidden agenda and veil for others but yourself hide your name.

  • Elena Stanton

    Seems like lots going on with this blog. I am an IMG as well. I moved to the US because I fell in love with a doc from US. I agree, not everyone has the same reason. I would be pissed if sb told me that I had a hidden agenda to fall in love :p

  • Uahmed_pak

    dear frens,
    thanks siddharth for writing this. he has shown the courage to write such controversial issue.
    for people criticizing him, at least give him the credit for bringing this issue. I have seen many politicians like people who give big talk on nationalism and working for the country but most of them are corrupt people who cannot see the progress of other people. so i dont like such people. they are the ones who spoil the country and blame others. they silently eat up the country from inside but ask others what you done for your country.
    Insallah, tum apney kaam me lagey raho siddharht. follow your dreams and don't listen to what people will say. people always talk. think what would happen if einstein did not leave his country. scientific progress would suffer.

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
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  • Priya Khanna

    Dear Medicine Hacker and Elixir 321,
    With reference to your views that if something is wrong , one must stay back ( in one's country of origin)and correct it rather than running away,…it is very easy for you to say this because you never had to 'face the music'… !! I suggest, with all due respect that please come out of your comfort zone and have a look at the other side of the world …yes there is a big world beyond The USA/UK…

  • Priya Khanna

    Hi Elena,

    If you had fallen in love with an Indian/Nepalese, would you have moved with him to India??

  • Est

    So true. everybody wants to be trained at the best place with best teachers to be the best. Noone want to run from their country of origin after spending their whole life there. Nice comment.

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
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  • Abdul Jaleel

    You are a very fortunate person to have been blessed with high intellect,great opportunities and writing skills.

    However, I must warn you against emphasising diversity among the humankind. The apparent differences are ,in Descartes' words, often illusory. Underneath ,we are all the same. I wouldn't have made this bold staement 50 years ago when I was a young intern but now,in the twilight years of my life, I have good resason baseed on experience to declaim this fact.
    And this is why Cicero announced that ,”I am a citizen of the world “. So are we all.

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

  • Siddhartha Yadav

    Dear Elixir,

    Thank you, once again, for your comment. I apologise if I gave you the notion that I was offended due to your earlier comment.I am not in any way. In fact, I truly appreciate your views and I feel that discussions are one of the ways of broadening our perspectives and educating ourselves. That is the whole point of writing this blog.

    Now that you have elaborated on a lot of issues, I must admit that I agree to some of them. I have no intention of playing with words. I am clear about my intentions. At this point, I agree with you that we should let time be the judge. Meanwhile, I assure you that I will make an honest attempt to understand things from your perspective.

    I am glad that we had this conversation. It has reaffirmed my reasons to be here. I hope we will continue interacting in the future as well.

    Good luck with everything ahead!!

    Best wishes,
    Siddhartha

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

  • Siddhartha Yadav

    Dear Abdul,

    I always like reading your comments on my blogs. They are always full of wisdom. Thank you for this one as well. Like you said, may be it is my inexperience that is speaking at this moment. Certainly, It would be interesting to get back to this blog at a later point in time and compare my thoughts.

    I think I too believe that underneath we are all the same. But I also believe that there is something beyond the underneath that makes each individual unique. May be in the way our underneath learns to react to a given environment. Illusion (or the concept of 'Maya' in Hinduism), it may be, but I would like to think of it as the beauty of life. Or else how different we could be from the machines? This is a random thought that came to my mind while reading your comment. So, I could be totally wrong.

    Thank you for your interesting thought ( I am still thinking ) and words of wisdom. I hope to hear from you in the future as well.

    Best wishes,
    Siddhartha

  • Siddhartha Yadav

    Dear all,

    I thank you all for participating in this discussion. This has been a thought provoking discussion for me, and I hope the same is true for you as well. I hope we will continue such interactions in the future as well.

    Best wishes,
    Siddhartha

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • Remmelkemp

    Problems of poor countries are not “enough research” but implementing the existing knowledge in an economical way.
    Most(more than 80%) of the mortality benefits which we see today in developed world is because of better environmental improvement and food and water security. Newer medical therapies probably do more harm than good. (1.http://www.nytimes.com/2010/08/19/health/19care.html?_r=1
    2.http://www.bmj.com/content/320/7249/1561.1.extract/reply#bmj_el_11879 ).
    Majority of the doctors come to western countries for better life and money. If they came here for something else, they would return(most of them dont).
    So telling on public forum that you are here for research is underestimating the common sense of common people.

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • Elena Stanton

    ofcourse i would.. why not? i did not fall in love to go to the states.. :(

  • Elena Stanton

    oh yeah?? modern medicine is based on research. Next time try not giving your children vaccines, or when you get a heart attack or HIV, don't demand for best treatment, because they all come from research. This is not the common sense of common people. People who are after money think the whole world is after money. what happened to all the words about having passion for something, following your dreams and love? they mean a lot more to many than money. :p

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • Kim

    I can't agree more, this guy was in UK seen the shop floor; decided to try in US. I have no problem with that but dont give stupid reasons. I remember him coming up with the term Global health service??? I am sure he will try and re-name IMG.

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

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  • Arshavin

    Its hard to change a system,more often the system changes you.
    We all have our reasons for being an IMG or staying back at home as a nationalist but in the long run if we go back home and be good teachers to the the young blood there ,our job there would be done.In fact all the teachers in my med school who inspired me have been abroad at some point of time,they had their reason ,we have ours.I think if few years of training abroad improves you as a person, as a medical doctor then why not ,now how many of us will go back home that is entirely personal choice ,one i believe that is due to many factors .If we improve as a person ,we improve as a society,if our views are broad ,we are more open to change ,we improve in the long run ,that`s the common theme in the society,And last but not least if i knew spanish or french i might be doing my residency somewhere else …

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
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  • Magbadelo, MBBS;MPH

    I am often amused by the intellectual snobbery and the moral posturing that accompanies debates about what serves the greater good when it comes to health care and health in general. The truth of the matter is that at every level, the decisions made by any given individual is influenced by a multitude of factors, and these factors impact on each other as well as on the situation at hand.
    Whichever way one chooses to look at it, the decision to migrate from ones country of birth is one that is never made lightly. An IMG faces a lot of obstacles , not least among them the socio economic implications of such a move, the attendant identity crisis during the transitional stages and subsequent depression / personality changes that may follow. These highly skilled , very intelligent individuals have morgaged their present in the hope of securing their future and while their home countries may require their services, they owe it to themselves to make the best out of their lives , issues of patrotism and nationalism aside.
    While many of our UK/US counterparts may blithely suggest a return to base, most IMGs are not “independently wealthy” neither is there a well set up social security safety net for them to rely on when they return to their country of origin. The high incidence of industrial action/strikes by health care professionals, particularly in Sub-Saharan Africa only serves to butress my point.
    I have worked as a medical officer in a secondary health facility in Northern Nigeria. Though things are slowly getting better, the situation is far from perfect. While you might get a warm tingly feeling for “doing good”and helping your people, giving back so to speak, feeling good will never fill your stomach, pay your rent or provide you with a pension, so excuse me while I do my best to look for the best option for me.

  • Priya Khanna

    Glad to hear this, Elena..:)

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

  • Matiram Pun

    Sid,

    Thanks for this nice blog with your vision and commitment. I am really glad that you have figured out this area to focus on.

    Yes, most of IMGs have been consumed with primary care delivery and as a workforce despite their talents and hard work. That's not bad.

    As you mentioned, the research for and in the developing world need to be capitalized as there is so much to do. Hence, if some IMGs get trained and oriented with research perspective; that will be fantastic. I think you are on right track on this matter.

    Sid, good luck and I hope to work with you in the future!

    Best wishes,
    mati

  • RPAgarwal

    I am an IMG myself (from India) and at present settled in U.K.
    I am probably going to digress the discussion some what.
    I recently came across few websites, who seem to offer postgraduate degree in medicine to IMGs. It appears to me while reading on the websites that the course itself is not recognised or regulated by GMC. I just feel that it is the attraction of a “degree from western world” that pushes these candidates to apply and perhaps only after landing in the country they come across the reality. Just wonder if any body has any views?

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