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Assuming self_made_human is as competent as the median American doctor, it is obviously not "unfair to Americans" for them to get a new Doctor willing to charge less. Unless their hatred for Indians outweighs their desire for access to cheaper medical care. It is of course "unfavorable" (unfair is a loaded word) for the 0.3% of Americans who are already doctors if a doctor for any country, including America, enters the market, which is why labor unions take great steps to increase the barrier of entry for their industry.
That is very kind of you to assume, though I can't agree or disagree beyond saying that all the American doctors I personally know are scary good. Look at @Throwaway05, who I highly respect, though I think he's well above median. And I hope for the sake of my self-esteem that he is significantly older and more experienced than me, because god knows I have stiff competition as is.
(I don't know many American doctors, but they have very high quality training, even by First World standards)
I do expect to be a better doctor by the time I'm (eligible) for the USMLE, and a rather good one if I can overcome the strong competition for the positions that are bookmarked for international doctors (around 4.5k the last time I checked, and you better believe the competition is an order of magnitude larger).
I'm early in training! I've only been a psychiatry resident for 6 months and change, so God knows that you wouldn't want to leave me entirely on my own to handle truly difficult cases. I'd probably not bungle it, because I can always look up treatment guidelines, but the mark of a competent doctor these days is the ability to make good decisions when operating outside the cut and dry, where guidelines and standard practice no longer apply.
An important addendum is that you don't have to be a median or better doctor to be a net value add! This is important, and the joke about half of all doctors being below average in their class is (mostly) a joke. A 10th percentile doctor is probably the point where I'd start having strong second thoughts, and that number depends on how strong the filtering is for both med students and fully qualified doctors with MDs. This is fair, because 90% of doctors will do an adequate job of treating you.
I have no firm numbers on hand for the relative difficulty of getting into medicine in either the States, the US or the UK (I'm tipsy at a pub), but I can definitely admit without shame that the average American doctor has better training than the rest.
I would very much like to charge as much money as people would pay me, especially in the States, but on a macro level letting more foreign doctors in will both suppress local wages and also increase access to healthcare for the average American. The former is likely going to be barely perceptible, unless the AMC does something drastic like allowing all Western doctors from near-peer nations to practise in the States automatically (and they never will). The latter also depends strongly on multiple factors, but the average IMG who does get into the States will probably be forced to take a role that pays less than the median (because it's easier for us to get into the unpopular things like Family Medicine), which will make IMG doctors cheaper on average for the average Joe.
If you want to peg my capabilities, I was around 75th percentile for all doctors, both British-trained and foreign (who met the eligibility criteria to sit it) in the clinical section of the exam I gave to enter higher training. When you include both the clinical knowledge and the ethical section of the exam, I was around 65th percentile. I will say that the ethics section of the MSRA, called the SJT, is universally panned as absolute bullshit and barely better than random noise on a good day.
I meant "my analysis holds if you're as competent as the median American doctor" not that I already assume that.
This seems plausible but I'm unsure. I did realize my analysis depends on the belief that the median doctor is a net value add, which some people dispute.
You do agree or at least consider it plausible, so I guess I can only express frank confusion about those who don't. I can only hope they're a small minority (haha).
I don't know if my opinion about doctors is invalid because I'm one, but I've never felt myself having to exercise particular caution when looking for a doctor, and I'm usually happy with the treatment I receive. This is, of course, confounded by the fact I've been a doctor for a while, and a med student for about as long, and the scion of doctors for as long as I've been alive. Other doctors will treat you differently for any of the above, but I expect not to the point they wouldn't do a good job for the average person. They'll treat you regardless.
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A nation is a group of people with shared heritage and language. It is not an economic zone, and it is not a above-median-skilled person. GDP is not a nation. Ideals are not a nation.
I will not give away my inheritance, and the inheritance of my children, for cheaper healthcare. I will not do it for cheap fruit or cheap cotton. My ancestors lived and died on the frontier without healthcare, and I'd rather my descendants do the same than live in a country where they are a hated minority. We already are hated, by blacks and asians and yes, indians, and as soon as we're a minority we will see the landscape shift rapidly against us.
Additionally, he's a shrink. Not even a PCP or surgeon or ER doc. He's not curing diseases, or treating the sick, he's treating depression and anxiety and ADHD. I don't think we need to be importing people for that purpose at all, and to conflate this with that is part of the shell game.
This sounds like you mostly agree with my analysis, it's not exactly "I hate Indians" (though it might be) but "I think the presence of even competent Indians that benefit the economy is bad for my descendants" and you basically do think he's less competent than the median American doctor because you don't think psychiatry is all that useful (or that it's just saturated).
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