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Notes -
I've never met a foreign trained doctor who came to the U.S. with Medical School and Residency training in Western Europe. We might actually have reciprocity agreements for those countries, I don't know, I've never encountered one. Scott did his Medical School in Ireland IIRC, which is note quite the same. The vast majority of foreign doctors I've met are from Asia (mostly India) and do absolutely need retraining and will generally admit as such, however frustrating it is.
Every time this comes up I have to drag out a few facts.
-There is actually a surplus of residency spots. Yes you heard me.
-We do have something of a shortage of some specialties, but this can't adequately be solved by increasing spots without decreasing training quality.
-Nobody wants to go into primary care because it pays significantly less, is one of the harder jobs, and has been made less attractive by regulatory burden and other factors.
-Most jobs are in primary care anyway, aka most doctors work in primary care.
-Even within primary care we have more of an allocation problem than a shortage. Doctors train very hard and start their adult life late. They want to be in desirable locations so Iowa has a shortage but NYC does not.
-NPs and PAs were meant to fix this but make it worse - they still want to go into specialties (and can since they have no specialty training, they can just do what they want) and they still hang around the same urban areas.
-You could hypothetically fix this by importing a ton of foreign doctors but you'd have to enslave them and force them to work in the undesirable locations long term or they would just leave immediately when given the option.
-You can fix this using the resources we have by raising salaries to what incentivizes the behavior you want. Nobody wants to do this, they just want to continue giving doctors the pay cuts they've been getting for the last 20-30 years, even though doctors are not a high percentage of healthcare costs.
Thanks for taking the time to share your experience with me.
Here's a citation re: open residency spots
https://www.nrmp.org/match-data/2024/06/results-and-data-2024-main-residency-match/
Table 1A - pretty normal for about 5-10% of offered spots to be unfilled.
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