Why your waiter has an M.D.
March 16th, 2012
07:29 AM ET

Why your waiter has an M.D.

Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir about his Match Day and becoming a doctor.

I met Sam* in the OR a few years ago. A polite surgical technician in his early 30s, we’d often chat after work.

Sam obtained his medical degree from a school in Eastern Europe prior to immigrating to the United States. Now he spends his days cleaning surgical instruments and his nights working in a restaurant.

“Someday I’ll be a surgeon, just like you,” he says to me.

How did this happen? Sam had a bad Match Day.

Medical training in the U.S. involves four years of medical school followed by 3 to 6 years of residency training. International graduates must also attend residency in the U.S. if they wish to practice here.

On Match Day, graduating medical students learn which residency program they’ll be joining. Residency determines a physician’s field of medicine. For a young doctor to become a pediatrician, for example, he or she must complete a pediatric residency.

This year Match Day occurs today, March 16.

The National Resident Matching Program (NRMP) couples prospective applicants with residency programs, sort of like a medical version of eHarmony. Each applicant makes a list ranking the residency programs in their order of desirability. The residency programs do the same with the applicants, and the NRMP matches them up.
Not all graduating medical students get matched.

According to the NRMP, last year 971 graduates of U.S. medical schools were shut out, accounting for 5.9% of U.S. grads. Graduates of international medical schools fared even worse - less than 50% of them obtained a residency.

That means more than 7,000 doctors were left with a diploma that said “M.D.” but no guarantee they would be able to use it.

Just like Sam.

So what are all of these doctors doing?

The majority of unmatched grads obtain a temporary one-year residency spot with no guarantee of future training. They then reapply the following year with hopes of landing a permanent, multi-year residency position.

Others wind up performing research in labs prior to re-entering the Match. Still others abandon their dreams of becoming a practicing physician and exit the medical field altogether.

This situation is only going to worsen. Due to the pending doctor shortage, the Association of American Medical Colleges (AAMC) has called for a 30% increase in medical school enrollment, or 5,000 more doctors each year. College universities have responded to this demand, with 18 new medical schools currently in the process of opening.

The increase in the number of medical students would lead to an increase in residency positions as well, right?


Since 2001, the number of first year residency positions has increased by 3,000, compared to a whopping increase of 6,500 applicants. The slow growth in residency positions is likely due to a 15 year freeze in Medicare support. The current federal budget problems make lifting the freeze unlikely in the near future.

So what does this mean?

For an unmatched M.D. like Sam, it doesn’t bode well. After going unmatched his first year, he tried to match again the following year, but failed.
As the years pass, it’s becoming more and more likely that Sam will never be able to use the degree he earned.

I watch Sam meticulously clean and rinse the surgical instruments, his hands moving steadily and purposefully. There is not an ounce of unused motion. The fluidity and grace in his hands remind me of my surgical mentors.

Then the sad realization hits me. It doesn’t matter how much Sam wants it.

He will never be a surgeon.

*Sam’s name and identifying details have been changed to protect his privacy.

Update: The National Resident Matching Program has matched 95% of U.S. medical school seniors this year - the highest rate in 30 years, according to a press release sent out on Friday. The largest residency increases were seen in internal medicine, anesthesiology and emergency medicine. Also, 510 more international students were matched than were matched in 2011.

soundoff (915 Responses)
  1. DC

    I'm a waiter Jim, not a doctor!

    March 16, 2012 at 07:53 | Report abuse | Reply
    • Dee


      March 16, 2012 at 07:59 | Report abuse |
    • Skot


      March 16, 2012 at 08:01 | Report abuse |
    • mfb

      now that's funny!

      March 16, 2012 at 08:01 | Report abuse |
    • Ace

      Love it.

      March 16, 2012 at 08:32 | Report abuse |
    • FauxNews

      too funny 🙂 As Spock would say, "Colloquially expressed, but essentially correct."

      March 16, 2012 at 08:43 | Report abuse |
    • DB5


      March 16, 2012 at 08:48 | Report abuse |
    • Allan

      Perhaps the Government should create a nationwide residency program in public health which would allow these unplaced grads to enter into programs at the VA hospitals where their talents could be put to good use. The only catch is that these new doctors would have to work for a few years in the public health system.

      March 16, 2012 at 08:57 | Report abuse |
    • Soulcatcher

      Should have been, I'm a doctor Jim, not a fri gging waiter. Why do we have so many Rigelian doctors?

      If there is a shortage of doctors, they definately need to add more residency positions. I think the problem is too many foreign doctors and Congress is trying to put the breaks on that.

      March 16, 2012 at 09:28 | Report abuse |
    • Lolgan

      Well Said!

      March 16, 2012 at 09:35 | Report abuse |
    • terry

      The bottom line of all this is that the American medcial profession holds down the number of doctors in this country intenionally in order to keep those outrageous salaries high.

      March 16, 2012 at 09:39 | Report abuse |
    • Scott

      @Dee; so you are easily amused? And you're amused at others failing obviously.

      March 16, 2012 at 10:23 | Report abuse |
    • momof3

      I completely understand what he is going through. First you go through 4 years of undergraduate studies to get your B.S. or B.A. before you can even apply for medical school and your grades have to be top notch as well as your personality. Then you have another 3 to 4 years of Medical school, just to wait and see if a residency group will pick you up to join them. Its a very long, hard and expensive gamble you take, but for those who have the passion its worth every bit of it. I think if he keeps pushing every year he will get excepted!

      March 16, 2012 at 10:47 | Report abuse |
    • Just Matched MD


      March 16, 2012 at 11:28 | Report abuse |
  2. Abe

    Seeing how easily a lot of places are handing out medical degrees right now THIS IS A GOOD THING, You really want a bottom 5% candidate opening you up for his first surgery?

    I think not.

    March 16, 2012 at 07:58 | Report abuse | Reply
    • Joe08

      Since 2001, the number of first year residency positions has increased by 3,000, compared to a whopping increase of 6,500 applicants.

      It seems to be more than 50% This is not good.

      March 16, 2012 at 08:07 | Report abuse |
    • Koojo

      "Handing out?" You obviously have NO idea that training that occurs to get those two letters after your name.

      March 16, 2012 at 08:08 | Report abuse |
    • MD

      This is a comment ignorant to the mechanism of 'grading' in medical eduction and what rank in class actually represents for medical trainees. A bad day writing the USMLE Step 1 can mean no match. Does a bad test day mean one is incapable of being a talented physician and/or surgeon? I'm sure you think you're pretty good at your job Abe, but I bet there have been days that you just couldn't perform your best. The lay public should know, that the only true correlation between medical school testing and ranking within class is a direct relationship with increased lapses in professionalism, meaning the higher you score, the more likely you are to make serious ethical/moral mistakes.

      March 16, 2012 at 08:13 | Report abuse |
    • Paul

      The bottom 5% of medical graduates are still smarter than 75% of the normal population (and probably smarter than you). Don't take a serious problem of Medicare not living up to its mandate and slam someone for trying.

      March 16, 2012 at 08:36 | Report abuse |
    • Nonimus

      "The lay public should know, that the only true correlation between medical school testing and ranking within class is a direct relationship with increased lapses in professionalism, meaning the higher you score, the more likely you are to make serious ethical/moral mistakes."

      I'm not sure I understand this, can someone expound on it? I understand the correlation, but what causes such a seemingly counter-intuitive and negative aspect of such a system?

      March 16, 2012 at 09:36 | Report abuse |
    • llotz

      You know not of what you speak, but, that's typical.

      March 16, 2012 at 09:44 | Report abuse |
    • mjpsych

      Not being matched does not mean that he's a bad physician.there are many factors leading to foreign graduate not being chosen ifor a residency. And please also understandthe recent studies have found that 20% of practicing American doctors should not be practicing because they are not competent enough. But they end up seeing patients anyway.

      March 16, 2012 at 10:06 | Report abuse |
    • Bageldog

      @Nominus, it's because MD was in the bottom 5% of his class and needs to rationalize it. I'm sorry, but I'll take that as rank nonsense unless they care to prove it.

      March 16, 2012 at 10:06 | Report abuse |
    • DeeNYC

      did you ever even go to college? Most people wouldn't even survive pre-med course in undergrad let alone medical school.

      March 16, 2012 at 10:06 | Report abuse |
    • danny

      "Handing out"....LMAO, you obviously have no idea about what it takes to graduate from any medical school.

      March 16, 2012 at 10:22 | Report abuse |
    • Nonimus


      March 16, 2012 at 11:29 | Report abuse |
    • Just Matched MD

      "Seeing how easily a lot of places are handing out medical degrees right now THIS IS A GOOD THING, You really want a bottom 5% candidate opening you up for his first surgery?"

      Abe, you have no clue what you're talking about. Just because an American medical graduate is in the 5.9% of AMGs who didn't matches doesn't mean they're in the bottom 5.9% of residency candidates. There are many reasons that a residency position could be claimed by a foreign medical graduate instead of an American, such as "pre-matching," which is an options only available to non-allopathic (MD) seniors. An unappealing residency program might fill a majority of it's positions by pre-matching less qualified, but good-enough FMGs, instead of taking a chance of not filling all its positions through the match. As far as I'm concerned, the only thing pre-matching does is rob MD seniors of residency positions and give an unfair advantage to FMGs, independent candidates, and DOs. Thankfully, any program that wishes to use the NRMP Match will be forced to stop offering pre-matches next year.

      March 16, 2012 at 11:39 | Report abuse |
    • Emma

      We're not talking about the bottom 5% from high school. Do you know what the bottom 5% in med school looks like? You're talking about people who graduated college with an average GPA of 3.8 in such courses as organic chemistry, molecular biology, neuroscience, biochemistry, and physical chemistry, then took the MCAT exam which is a beast all on its own, then were part of the top tier of students to actually be accepted into medical school (many people don't get in), then went through two years of rigorous pre-clinical study reading more in one night than other graduate students read in two weeks, then sat for an eight-hour exam before starting two years of clinical rotations, then sat for another eight-hour exam, followed by a full day of a practical exam where they see patients, then finally graduated med school. The bottom 5% you're talking about are still perhaps the top 5% when compared to the general population.

      Also, your assumption that the 5% who don't match are the bottom 5% of med school graduates is wrong. Some top students fail to match as well for various reasons.

      Think about the bottom 5% from Harvard.

      March 17, 2012 at 00:39 | Report abuse |
  3. Ann

    Sorry, but if they weren't good enough to get into a residency program, I don't want them performin surgeries on me. Or anything else, for that matter.

    March 16, 2012 at 08:00 | Report abuse | Reply
    • mpouxesas

      Ann, you clearly got it wrong. It is not that he was not good enough...Matching is not exactly about how good (or bad) you are. There is a reason they call it match. And it does not have (only) to do with your credentials/qualifications.

      March 16, 2012 at 08:10 | Report abuse |
    • sara

      spoken out of true ignorance of the process.

      March 16, 2012 at 08:13 | Report abuse |
    • muddiepitt99

      Amy, Matching has very little to do with qualifications and is more of a numbers game. Each applicant is qualified, however their are so many spots to fill. This is why so many applicants end up in the Scramble trying to work as an intern for a year and then reapply to another residency program.

      March 16, 2012 at 08:20 | Report abuse |
    • Brent

      Ann never go full retard before leaving a comment.

      March 16, 2012 at 08:39 | Report abuse |

      I believe not many on this comments board knows about the matching of foreign graduates. They apply to nearly 200/ 300 places and with USMLE pass. Graduates from US apply exactly to the few places they want to be matched. Many voulenteer to do research because they may never find the oppertunity any time in the near future. The USMLE and other test system – that provides a continious source of income for some group. Any gaurantee the performance in the exams are performance on the job.......

      March 16, 2012 at 08:42 | Report abuse |
    • Andrew

      When someone's life is on the line, you aren't allowed to have bad days. Better to have a bad day now and not get matched then a bad day later and kill grandpa. But then again, it is a medical practice, and practice makes perfect. So if the doctor does kill grandpa, I'll feel good knowing at least the doctor got some good practice and will do better next time.

      March 16, 2012 at 09:20 | Report abuse |
    • llotz

      Ann, you're kind of a dope, no?

      March 16, 2012 at 09:45 | Report abuse |
    • FatAnn@TheBuffet

      Odds are Ann is a fat american wearing sweat pants right now.

      Maybe when she visits the buffet later a doctor will be working there to monitor her calorie intake.

      March 16, 2012 at 09:59 | Report abuse |
    • cutedog2

      Did you read the article?

      March 16, 2012 at 10:05 | Report abuse |
    • mjpsych

      you have no idea how the selection process works

      March 16, 2012 at 10:07 | Report abuse |
    • danny

      Ann you don't know what you are talking about. The reason he didn't match into surgery is because he graduated from a medical school in a foreign country. The match system is extremely prejudiced against grads from schools in other countries, no matter how good they may be. In other words, he was most likely rejected over candidates that very likely had lower scores/grades and even experience than him. I am not saying this is right or wrong, it is just the way it is. In other words, it is not nearly as simple as you make it out to be.

      March 16, 2012 at 10:28 | Report abuse |
    • Just Matched MD

      I don't think you understand medical school or residency training, Ann. No one graduates medical school knowing how to, say, perform a Whipple procedure or manage an ECMO patient. That's what residency is for!

      In fact, different medical schools don't even necessarily leave their graduates at the same level, only that they have attained a certain baseline level of performance. The job of residency is to take that qualified medical school grad, who meets that baseline level of performance, and train them to practice independently. How far beyond that baseline a student goes depends on the student and the quality of education available, but I can safely say that an American medical graduate is qualified for a residency position. In fact, before the NRMP Match, medical students were signing contracts in their second or third year of medical school, before having met any benchmarks of performance.

      March 16, 2012 at 11:50 | Report abuse |
    • Emma

      Ann, let me try to explain it to you this way. Forget the applicants. There are also residency programs that don't always fill. Last year or the year before, a program at Yale didn't fill. YALE. Do you think it was because people genuinely wanted to take the residency program over at the community hospital instead? No, of course not. It's a MATCH. That means that a computer matches everyone up and sometimes, things go wrong. It isn't that these people didn't have the credentials. Sometimes, the unmatched candidates have higher numbers and board scores than the ones who did match.

      For example, say someone graduates from a top 10 med school and is at the top of the class. This person might want to apply to top-tier programs. So this person has a 3.9 GPA (let's just use a traditional GPA system out of 4.0) and board scores in the 99th percentile and applies to Dartmouth, Harvard, Columbia, and Stanford. Another student who graduated from a middle-tier med school toward the bottom of his class with average board scores applies to lower-tier programs. Student B will probably match while Student A may not match. Is it because Student A was less deserving? Of course not. A lot of this is about strategy and where you fit in, not about intelligence or competence.

      March 17, 2012 at 00:49 | Report abuse |
  4. kevin

    If there is a MD shortage why can't Sam get the training he disires? I wish Sam the best.

    March 16, 2012 at 08:00 | Report abuse | Reply
    • muddiepitt99

      Not enough residency programs. That's why he can't get enough training.

      March 16, 2012 at 08:21 | Report abuse |
    • Jessica

      If he can't get a residency position, it's likely because he wants a specific specialty. There are unfilled family medicine (day-to-day Dr) every year.

      March 16, 2012 at 08:47 | Report abuse |
    • mpouxesas

      It is the irrational way the system works. I know of a few highly qualified foreigners (here in the boston area) who had practiced for years medicine back in their home country but here they can't even match...It's sad. Another fact is...we don't have enough americans pursuing careers in medicine yet qualified foreigners are not making the cut because of the craziness of the system.

      March 16, 2012 at 08:49 | Report abuse |
    • Johndoe

      If he got his degree and was practicing in his home country he had achieved his dream of practicing medicine.

      Couldn't he have been smart enough not to leave his country until he had a sealed residency in the US or is that common sense "not practical."

      March 16, 2012 at 09:02 | Report abuse |
    • bostonBC

      mpouxesas – "we don't have enough americans pursuing careers in medicine"

      Your lack of logic is amazing. Almost 1000 citizens can't match each year, before that a small percentage of those who apply actually get into medical school. There are more than enough citizens pursuing the career if you pull your head out you might see that.

      March 16, 2012 at 09:05 | Report abuse |
    • Bob

      hey Doofus – did you try reading the article???

      March 16, 2012 at 09:12 | Report abuse |
    • Just Matched MD

      In the US, there is a physician shortage.

      Sam IS able to get the training he desires! In fact, he was trained as a surgeon in his home country. His problem is that he can't get this training in the US. Does he want US surgical training in order to provide better patient care back home, or does he feel that the facilities back home did not provide adequate opportunities to obtain a quality education? (Both of which are common reasons given for wanting to obtain a US residency position.) I don't know, but I'm not sold on either of these arguments in Sam's case. For one thing, MSF surgeons have performed surgery on dusty patios in Afghanistan, so physical plant is not an issue. Secondly, if he wanted to provide excellent medical care back home, he wouldn't be depriving his countrymen of a skilled surgeon by biding his time waiting tables; he be back home doing surgery until the next Match season. I think the underlying reason Sam is trying to get into residency is to increase earning potential by completing a US residency and then practicing the in US.

      March 16, 2012 at 12:11 | Report abuse |
  5. AdolfoSJones

    Healthcare is not subject to normal market forces! Anything that you have to buy at any random moment in order not to die is not something to which a rational supply/demand calculus can apply. Check out "Penny Health" articles on how to reduce the cost of insurance.

    March 16, 2012 at 08:02 | Report abuse | Reply
  6. bostonBC

    Sorry – the hard luck immigrant piece doesn't move me. When there isn't room for almost a thousand US citizens we shouldn't have imported 'Sam'. Let him go back to Eastern Europe and practice medicine there.

    March 16, 2012 at 08:05 | Report abuse | Reply
    • mpouxesas

      Hello fellow bostonian...If you are really from the area, you may have noticed the wealth of 'd@mn foreigners' who are filling up all those offices at the local hospitals...and guess what. they are the same doctors treating you...I guess they are not good enough (or maybe their accent is no ...match with our bostonian accent, right? iiight!)

      March 16, 2012 at 08:16 | Report abuse |
    • MedStud

      Agreed, if Sam* really loved medicine and surgery then he could have easily stayed in Eastern Europe and practiced happily there. Instead, I guarantee Sam loves MONEY and thought once again the land of opportunity could help him out. Wrong.

      March 16, 2012 at 08:23 | Report abuse |
    • rob

      MEDSTED... you are correct, America is no longer the land of opportunity, thats where Sam made his mistake. also same reason your ancestors left from whereever they came from, for MONEY

      March 16, 2012 at 08:47 | Report abuse |
    • bostonBC

      mpouxesas – Sorry troll, even in the inner city foreigners aren't taking over yet (Roxbury/Dorchester if YOU are from the ares). But they are part of the overall immigration debate that needs to be discussed as it relates to wage depression and the desire by the corporations that run the world to keep everyone down.

      March 16, 2012 at 08:58 | Report abuse |
    • cutedog2

      I didn't read it as a hard luck article, but simply an aricle that informs us the juxtaposition US healthcare is headed. Once an MD was a sought after degree. Now many US students are considering alternate careers. I work in the healthcare field and know several MD that have gotten out of primary care all together by choice.

      March 16, 2012 at 10:13 | Report abuse |
    • Just Matched MD

      Agreed. Less-qualified foreigners with poor patient communication skills have a better shot of getting into our medical training programs than the best American medical graduate has of getting into a foreign residency program. If I went to a hospital in India and said I wanted to join their OB program, they would laugh me down. I think we should be investing in our own 971 American graduates. It is, after all, taxpayer money that goes to their CMS funding.

      March 16, 2012 at 12:18 | Report abuse |
  7. bostonBC

    The 'shortage shouters' have been doing this in various industries for years to imcrease the number of legal immigrants in a field and drive down wages. Despite a glut of labor in this country and tens of millions of people out of work – we continue to allow the highest legal immigration levels in the history of the country – over 1 MILLION a year not counting all the specialty visas. That has severely depressed middle class wages and now I see they are starting to push for increased numbers for foreign doctors because of all the shortages. BS. We need to halt ALL immigration and allow the middle class to recover from the 47 years of Kennedy's immigration nightmare (1965 immigration act that caused the massive increase in immigration that we are paying for now).

    March 16, 2012 at 08:10 | Report abuse | Reply
    • Gogogi

      Immigration does not just "happen" because someone comes to the US. The process for a foreigner to obtain work validation requires companies (n this case hospitals) to do a thorough public search for all possible qualified individuals. Then they do their selection. When you see a "foreigner" has been selected for a given position it is because there was no US national who was as qualified for the position. Therefore the doctor that you see in any given hospital should be highly trained and qualified to treat you – regardless of their nationality. It should not be about keeping foreigners out but be about providing the highest quality of services to the American people.

      March 16, 2012 at 08:32 | Report abuse |
    • RealityCheck

      You don't see a real shortage of doctors? So you're a healthcare analyst, practicing and educated medical professional, or someone else with the training and resources to know what you're talking about?

      And 'halt ALL immigration'? Is bostonBC the name that your tribe gave you when you completed the rigorous training program that provided you with such educated insights into our medical system? Or are you forgetting that unless you do have a name given by your tribe, you are at least the descendant of immigrants?

      I suppose that the jobs which wouldn't be created if immigration were stopped (or are US citizens the only ones who create jobs?) would somehow 'depress wages' as well?

      March 16, 2012 at 08:33 | Report abuse |
    • Alien

      You're hilarious!!! You obviously don't have a clue what immigrating LEGALLY to the US implies. You and many others support the current system that is designed to encourage illegal immigration and to discourage highly skilled people to migrate to the US to help building a better country. I won't lose another minute trying to explain this to you, I just wanted to let you know that you made me laugh really hard. Have a great day and enjoy! Ignorance is a blessing for some 🙂

      March 16, 2012 at 08:37 | Report abuse |
    • bostonBC

      Reality – as a matter of fact I am a grad of Harvard med and have apparently seen things in the industry that you are blind to.

      With regards to the illogic of your rant – I am for protecting the middle class and for almost the last 50 years there has been uncontrolled immigration in this country and severe overpopulation. Water supplies are being drained and we face true shortages of that and fuel in the very near future.

      But I guess it is okay to you if we keep allowing in millions of people each year to an economy that can't keep up with the natural population growth (caused in large part by the huge numbers of immigrants over the last 50 years).

      All that does is continue to depress wages and with even lower wages people won't be able to afford much in the way of health care or anything else.

      Continued insanely high numbers of immigrants is going to cause further wage depressions. If you don't understand cause and effect look it up.

      Gogog – your note made me laugh. Aren't you aware that most residency programs want several foreign doctors on staff because it pushes wages down and keeps a lid on the US residents from complaining about the slave labor conditions and low salaries? When you grow up and open your eyes to what happens in the real world you will find there are lots of other reasons people get matched aside from their educational qualifications.

      March 16, 2012 at 08:47 | Report abuse |
    • Brigit

      Amen! The current trends in immigration - illegal and otherwise - are unsustainable. This is not a liberal or conservative argument; it's about numbers. The Depression we are living through has become the new normal. Adding millions of immigrants to the mix will continue to sink wages and living standards. If you are pursuing a medical degree or law degree right now, you do so at your peril.

      March 16, 2012 at 09:06 | Report abuse |
    • NotHappy

      Right on bostonBC. I'm one of those industries, IT. I've watched my wages go down for over a decade, US unemployment in my profession go up OVER the average for other professions, largely due to H1B visas. The industry leaders cried to Congress "oh we don't have enough IT people" and congress blindly raised the immigration limit. Now we truly don't have enough US IT people – what student wants to get into a profession where they have to compete with foreigners willing to work for 20-30% less than what was the going rate? And I can tell you from personal experience – they are not smarter than we are. I've been telling my wife who is a nurse the medical profession is next – there was already a bill in congress to add 20,000 H1B visas for medical professionals which somehow they had the good sense not to pass.

      March 16, 2012 at 09:22 | Report abuse |
    • danny

      @Reality check. There is actually no shortage of doctors, that is a myth. What they really mean (and conveniently don't tell you) is that there is a mal-distribution of doctors. In Manhattan, for example, there are actually too many doctors and you can see that in the poor salaries offered in many fields. Places in rural parts of the country where most doctors don't want to live have the "shortage". But guess what, the doctors that come over here on visas don't have any desire to go to those places either, and they end up in the big cities as well, just not always on Park Avenue. As other people have mentioned before, each year (and increasingly so) there are many US citizens that fail to match. There is really no reason at this point to bring in foreign doctors.

      March 16, 2012 at 10:39 | Report abuse |
    • Gogogi

      your note really helped me wake up/grow up!!! thank you for your insight....you should try accepting a balanced view when commenting on articles like this. while your theory may be evident in certain fields, i can speak to the "match" process that those in the medical and psychology fields go through. wages at the residency levels are not driven down by the use of immigrants, wages are offered based on budgets for a given program. the program makes the decision on who fills the positions. you can't tell me that these programs are intentionally choosing foreign candidates over American candidates while disregarding their respective qualifications for the sole purpose of driving down the wages of these early professionals. i welcome you to the other side of this discussion...it's beautiful when you can see both sides.

      March 16, 2012 at 11:42 | Report abuse |
  8. Buddy

    A friend of mine's wife couldn't, for one reason or another, get accepting into medical schools in the U.S.. She was accepted, though, overseas and is currently studying there. Take that as you will.

    March 16, 2012 at 08:15 | Report abuse | Reply
  9. IndyNC

    Alot if it is marketing and hype... IF colleges think they can market your future earnings, they will... 20 year ago it was computers, now it's medical. They ignore the fact that there are only so many positions, or only so many will actually make it through the program and push anyone and everyone into joining. So far the loudest voice I hear saying "there's a shortage of medical" are people trying to sell you on a medical career.

    I know many medical techs, trainers, therapists etc who have LEFT the industry and no extrordinary effort was really made to retain them.

    All in all, if there's a REAL shortage of doctors, then I would think there would be more lobbying to correct this problem, but I don't see a real shortage of Doctors locally. If anything many of the doctors are losing business because insurance covers less and less and people are afraid to go because they cannot afford their deductible. What there is a shortage of is Patients who can afford quality medical care and Insurance companies who actually care about their customers rather than seeing them as dollar signs who occasionally whine and cost them money sometimes.

    March 16, 2012 at 08:17 | Report abuse | Reply
    • muddiepitt99

      Indy, these positions are NOT doctors: "medical techs, trainers, therapists ", it does not take the same amount of training to become any one of these professions. There is a doctor shortage because medical school is expensive and funding for residency programs is not enough to meet demand for doctors, especially with an aging popualtion.

      March 16, 2012 at 08:28 | Report abuse |
    • letsgomets2012

      Any med tech will tell you the money stinks.

      When I began working as a tech over 30 years ago, the starting pay was less than six bucks. If you got a job in one of the better hospitals, you'd maybe make a dollar or so more. And if it was evenings, and additional 50 cents/hr or so, because of the "bonus" for the evening hours.

      There also is no career ladder - you can be a section head of your department but all that is is administrative paperwork and scheduling employees weekly.

      It is also a very high presure job. Try working a night shift in a hospital lab by yourself and attending to floor patients, a bleeder in the OR, a patient going bad in ICU and bucking a very busy ER that night, also, with nothng but stat bloodwork.

      March 16, 2012 at 08:58 | Report abuse |
    • Percysmama

      You know nothing about Doctors. Those tech and helpers have no where near as much responsibility and liability and long hours a Doctor has. Doctors work long after that staff person goes home. If that tech makes a mistake it is the Doctor who is responsible for it.

      March 16, 2012 at 10:09 | Report abuse |
    • Just Matched MD

      There is a shortage, no joke. In rural America, especially. Where I went to school, pediatric neurology patients have to travel 6 hours to see a pediatric neurologist. There are only a few hundred neurosurgeons in the entire nation. Our pulmonologist splits his time between two cities. So yeah, there's a physician shortage.

      March 16, 2012 at 12:23 | Report abuse |
    • Emma

      You might want to open the paper sometime if you don't believe there's a doctor shortage. Perhaps your area isn't affected, but most areas are.

      March 17, 2012 at 00:56 | Report abuse |
  10. Ernie

    There are 2 issues this story is trying to convey. One the shortage of doctors which is a real issue. The other is issue regards the foreign medical graduates and their difficulties obtaining necessary training to practice medicine in the United States. It might sound pompous but I'm glad that Sam and his inferior Eastern European medical training did not get a residency spot. We may need doctors but we don't need ones that have poor quality educations.

    March 16, 2012 at 08:22 | Report abuse | Reply
    • muddiepitt99

      i would not say that their training is inferior, much of this happens to because the foreigin grads are over represented groups.

      March 16, 2012 at 08:37 | Report abuse |
    • matching

      yeah that is pretty pompous actually

      March 16, 2012 at 08:44 | Report abuse |
    • Sighing

      It doesnt sound pompus dearest...you just sound like a downright biggot/idiot.
      Eastern European training is not inferior in the least . If anything it maybe the opposite. The amount of work which has to go into getting such a diploma would make most US young people bawl for mercy.

      March 16, 2012 at 08:57 | Report abuse |
    • danny

      The issue isn't his medical education. Medical school curriculum is generally pretty uniform. Most of them all use the same textbooks. And really, most of a doc's real training is acquired during residency. The issue is whether you want foreigner's competing for the same spots that Americans are competing for.

      March 16, 2012 at 10:50 | Report abuse |
    • Emma

      Actually Ernie, you missed the REAL point of the article, which was neither of the things you cited. The real point of the article was about Match Day. Sam was used to tell the story and unfortunately, he happened to be foreign. I wish the writer would have chosen an American grad for this story to take out the immigration issue. The truth is, that 5% of U.S. graduates also didn't match. That's what the story should have focused on, in my opinion.

      March 17, 2012 at 00:58 | Report abuse |
  11. muddiepitt99

    What I find interesting is that they are speaking to surgeon, I wonder what the statistics are for Family and Internal medicine matching. The reason why I ask, is that my wife applied and was placed into two programs, one of the programs did not fill. So, it there a shortage of specialty programs versus internal medicine/family medicine programs?

    March 16, 2012 at 08:24 | Report abuse | Reply
    • Emma

      I was told IM filled this year. But really, it doesn't matter. If someone wants to be a surgeon, asking them to go into IM or FM is like asking someone who wants to be a cop to consider teaching instead. It's an entirely different job. That's what I think the public doesn't understand. They think a doctor is a doctor is a doctor when nothing could be further from the truth when comparing a something like a surgeon to someone in FM.

      March 17, 2012 at 01:00 | Report abuse |
  12. Jessy

    I am rather confused. Exactly what is the process of getting matched? I mean, is it like trying to see if there is an available position for someone who has earned an M.D.?

    March 16, 2012 at 08:25 | Report abuse | Reply
    • muddiepitt99

      No Jessy, it is not the same as applying for job after you finished medical school. You finish medical school and apply to programs which you and the program rank you. depending on how high you and program rank each other your match. The issue here is that there aren't but some many spots that each program has. So say you have 14 candidates and 10 positions, each applicant gets ranked by the program and depending on how each program and each applicant rank the positions are offered and fillled. Each applicant ranks each residency accordingly, however, there is a possibilty that you aren't ranked highly enough to match into a position at said residency program. Then what usually happens is that you apply to be part of the internship program, which residents call "Scramble" that means you work at the hospital or program but will still need to go through the whole process again with no assurance that you would be matched during the next cycle.

      March 16, 2012 at 08:34 | Report abuse |
    • jm

      Basically the MD applies for and interviews at a variety of programs much like job or college interviews. Then every applicant and every program lists who or where they'd like to match. Then a computer runs an algorithm to maximize pairs. Thats the key...maximize pairs. Even first choice program-candidate pairs aren't guaranteed if placing a candidate at his 2nd choice, 12th choice or NOT AT ALL makes more national pairs. The computer 'cares' about making the most pairs not the best which means someone can go without a program pair based on the algorithm not their own performance!

      March 16, 2012 at 08:48 | Report abuse |
    • PedsDoc

      Well, the above posters are mostly right, but the process is actually designed to favor the student, NOT the program. THe issue here is that there are only a fixed number of residency positions available at each program. But since it favors the student, this is why there are spots that go unfilled while some students get shut out and then have to "scramble".
      In other words, say a student appplies to 20 programs in pediatrics. Those 20 programs then will decide whether or not to offer an interview to that student. Say the student gets 10 interviews. Automatically they cannot rank the other 10 on their list so those are out. The student goes on all ten interviews. The student really doesn't want to risk ending up at #10 on their list, so they only rank 9. They rank them in order of preference. Those programs are also ranking the students they interviewed in their preferential order (say from 1-200). There might be some students they don't rank either for a variety of reasons (worries about professionalism, academic standards that came out on interview day, poor interview, etc).
      Back to our student. Program 1 on his list likes him and he is number 20. So he goes into their slot in the computer's algorithm. Now onto another student who also likes that program and ranks them number 1 on their list but the program has that student at number 10 on their student list. This bumps student 1 down to #2 on the list, and so on. If there are 10 students who the program ranked higher than the other student, and they are all number one on their list, the student falls off his number 1 choice's list and the computer starts over again with his #2 program. So the program tries to favor the student AND make the most matches possible. Even if the program he didn't rank on his list is open, he can't match there since he didn't put them on his list.
      If all the student's choices are exhausted, they will not match and will have to "scramble" where they can either choose to see the other programs (if there are any) that are still open. OR, they postpone a year. In some fields there are "preliminary years" or "transitional" years where students can work somewhere and then try to reapply for their field of study.
      Hope that helps!

      March 16, 2012 at 10:20 | Report abuse |
    • Emma

      muddiepitt99, that's not what the scramble is. The scramble (this year called the SOAP), is when applicants are told on Monday of Match Week that they didn't match and they then re-submit their applications to the residency programs that didn't fill. Sometimes, this means they have to change specialties. Then the residency programs make offers. Some still fail to secure a program and those people are unemployed for the next year and have to re-enter the Match.

      March 17, 2012 at 01:03 | Report abuse |
  13. David

    As an MD and foreing medical graduate , I understand your pain Sam. The process of getting into residency in the US is quite difficult and becoming more difficult. Passing the United State Licensure Examination is not a guaranty. The numbers of doctors certified by the USMLE that are doing odd jobs around the country is huge. The problem is there isn`t enough residency program in the US, in the other hand the shortage of doctors is getting worse and worse as the us population is growing and the baby boomers are adding up .It is a lost of resources. The governement has to step in and look at this problem seriously. This is not going to resolve by its own. I wish you luck Sam for next year match, hopefully you will get a spot somewhere and put your surgical skills at work and save some lives. Persistency is the key word, be persistent Sam , don`t give up Medicine.

    March 16, 2012 at 08:39 | Report abuse | Reply
  14. Eric

    Sounds like the legal field...too many unqualified persons attending 3rd tier law schools that are simply diploma mills, and expecting jobs when they get out, only to find a job a starbucks and $100k in debt. Moral of the story: if you don't get into a good medical school, maybe you shouldn't shoulder the debt of medical school.

    March 16, 2012 at 08:40 | Report abuse | Reply
    • E

      Tell me what a "good" vs. "bad" medical school is, and the rest of us can better understand why we find your argument flawed.

      I thank you not to compare medicine to law.

      March 16, 2012 at 09:54 | Report abuse |
    • Percysmama

      Lawyers are the biggest problem with medicine. Both for the Doctor and the rising medical costs.

      March 16, 2012 at 10:14 | Report abuse |
    • Just Matched MD

      Med school isn't like law school. There aren't any bad medical school in the US. Law schools on the other hand, can be found on just about every city block, so of course there are going to be bad ones.

      March 16, 2012 at 12:31 | Report abuse |
    • Emma

      Eric, it's NOTHING like law school. There are no bad med schools in the U.S. and school name has very little to do with residency. It's all about board scores and third-year grades. Med schools are standardized by the national boards.

      March 17, 2012 at 01:07 | Report abuse |
  15. The Crazy Gyre

    I'm glad I read this. Some days, the world seems off kilter in fairness. This reminds me the majority of endeavors are
    gambles. In this case one spends all his/her money and 4 years to get into the casino and anything can happen.

    March 16, 2012 at 08:40 | Report abuse | Reply
  16. Owl Capone

    Utterly untrue. The US medical establishment believes it should be the educator of the world. There are enough residencies for US graduates, but residencies can admit newly minted doctors who graduated from any school in the world.

    There are more residencies than in the US than US medical school grads. There is not enough residencies in the US to accept every foreign applicant.

    March 16, 2012 at 08:43 | Report abuse | Reply
  17. TexDoc

    This is partly the fault of the current medical training system. The state allocates money for the medical school to graduate 100 doctors. But if the medical school finds that Bob shouldn't be a doctor; they are very unlikely to let him go. The state should require that they admit 110 students and let the worst 5 go a the end of the first year and the next worst 5 go at the end of the second year.

    March 16, 2012 at 08:45 | Report abuse | Reply
    • E

      Medical students ARE let go if they don't meet standards (i.e., failing).

      And how does this solve a shortage in residency positions AND the pool of physicians serving the country?

      Seen your posts before. Are you TRYING to be a troll?

      March 16, 2012 at 10:00 | Report abuse |
    • Emma

      In case you haven't heard, people do fail out of med school. It's not many, but most med schools lose a few people from each class. Don't forget that med school isn't like college where just about anyone can attend. When you admit people at the top of their undergrad classes who are used to getting straight A's and taking long exams, the chances are that they're smart enough to do the work.

      March 17, 2012 at 01:09 | Report abuse |
  18. jm

    Basically the MD applies for and interviews at a variety of programs much like job or college interviews. Then every applicant and every program lists who or where they'd like to match. Then a computer runs an algorithm to maximize pairs. Thats the key...maximize pairs. Even first choice program-candidate pairs aren't guaranteed if placing a candidate at his 2nd choice, 12th choice or NOT AT ALL makes more national pairs. The computer 'cares' about making the most pairs not the best which means someone can go without a program pair based on the algorithm not their own performance!

    March 16, 2012 at 08:47 | Report abuse | Reply
  19. letsgomets2011

    Here we go again.

    A resdency should be a given, not a chance.

    And as they can see, just like any other interview like the ones us poor slobs attend, an interview for a residency is nothing but a game and a hoop to jump through.

    Our local paper always runs this wonderful feature article on Match Day. They describe all the whoops of joy, the happy smiles and so forth.... but no mention of the students who get no residency at all.

    March 16, 2012 at 08:49 | Report abuse | Reply
  20. rhubarb

    Not enough residency programs to match applicants with a shortage of doctors?
    Why am I triaged to a practical nurse if I call for a doctors appointment?
    With senior residents and practical nurses filling in for staff it has got to be the bottom line in some cases.

    March 16, 2012 at 08:54 | Report abuse | Reply
  21. archived

    Too many doctors!! Too many lawyers!!

    March 16, 2012 at 08:54 | Report abuse | Reply
    • E

      Disagree with the former.

      Agree with the latter.

      March 16, 2012 at 10:01 | Report abuse |
  22. Sam's Advisor

    The one problem with this article is that many residency spots go unfilled each year. Sam can't be a surgeon, but he could be a family practice doctor. And that's where the shortage is, rural areas, poor socio-economic areas, where people need a primary care physician, not a surgeon. If Sam really wanted to practice medicine in this country, he could go where he is needed... but he doesn't want to. You can't blame the system entirely for that one.

    March 16, 2012 at 08:56 | Report abuse | Reply
    • McBain04

      The reason there are shortages there are that doctors practicing there don't make much money... not nearly enough to pay off student loans. They make more as surg techs and waiters. Specifically, because Medicare has a freeze on it. Can't make any money in those low income neighborhoods or rural areas if those folks have no money and no insurance.

      March 16, 2012 at 10:31 | Report abuse |
    • Sam's Advisor

      Ah, but Sam probably doesn't have medical education debt. He was trained abroad, likely in a place where he medical education was paid for by the country's government. So making money to pay back his debt should not be a valid argument as to why he can't practice family medicine.

      March 16, 2012 at 10:47 | Report abuse |
    • danny

      Actually the MD salaries is the rural areas are better than they are in the cities. Taken together with the low cost of living, doctors can do well in those places, its just that they don't want to live there. The other thing you don't realize is that foregin students generally do not have anywhere near the level of debt that Americans do. Sam probably got his education for free.

      March 16, 2012 at 11:03 | Report abuse |
    • Emma

      Sam's advisor, I think you need a new job. A person who wants to be a surgeon will most likely not be happy as a FM doctor. They are two entirely different fields.

      March 17, 2012 at 01:12 | Report abuse |
  23. PK

    This is puzzling. So the AMA wants doctors to make good money and does that by controlling the number of people admitted into residency programs, right? The demand for healthcare is taking a hit because of the Medicare cuts, hence limiting the supply of doctors is the only way to keep their wages up. Why would they expand med school programs then? Is it because universities want to make more money by minting new MDs? The natural response would seem to be to cut the number of people who are admitted to med schools, so that they don't have to waste their time pursuing careers that they won't be able to have...

    March 16, 2012 at 09:01 | Report abuse | Reply
    • E

      Take a step back and ask:

      Are we talking MD's from other countries (foreign medical graduates)?

      Or MD's from our own (american medical graduates)?

      The challenge for each is different with respect to obtaining residency positions.

      March 16, 2012 at 10:03 | Report abuse |
    • Emma

      Your problem is that you're perpetuating the myth that the AMA is trying to keep residency programs low. They are not. In fact, they're lobbying the government for MORE residency programs. You guys think that everyone wants their to be few doctors so that they can make money when nothing could be further from the truth. Many, if not most, primary care doctors are overworked as it is. They WANT more doctors. The problem is Medicare funding and the politics that goes with that. That's what funds residency programs.

      March 17, 2012 at 01:15 | Report abuse |
  24. Jt_flyer

    Is this an issue of supply and demand?

    March 16, 2012 at 09:03 | Report abuse | Reply
  25. Joel

    This shortage of residency programs also leads to discrimination, both racial and disability discrimination. The match process is competative. Why pick that person using a cane for family practice when you can get someone healthy. The sad part is that person using the cane may have life experiences they can share with their patients that the type-A young doctor could care less about.

    March 16, 2012 at 09:04 | Report abuse | Reply
    • Jt_flyer

      I'd you think the medical perfession discriminates against the disabled imaging what less sensitive and nonmedically inclined industries do.

      March 16, 2012 at 09:07 | Report abuse |
    • E

      When it comes to procedures and performing lifesaving CPR, the sad reality is a physically disabled person will be less likely to perform them. Patients should not be sacrificed just to allow disabled physicians.

      Not to say that they shouldn't be doctors. Many specialties are flexible with accommodating them.

      However, certain specialties require its doctors to be capable of critical skills.

      And they cannot and should not be compromised at a cost to the disabled patient.

      March 16, 2012 at 10:28 | Report abuse |
  26. Medical Student

    This is a terrible article, and I'm surprised that it was written by a plastic surgeon. "Sam" was educated in another country, and many times, other countries do not have the same quality of education that US medical schools have. The US has many of the BEST medical schools in the world (our healthcare system, however, needs to improve to such standards, but we are trying). Anyway, just because someone has an MD does not mean they will be qualified to practice medicine in the USA. Physicians from other countries must take the SAME board exams as US physicians to qualify for a residency position. If their scores are not good, they probably wont get a residency.

    The vast majority of all US medical school graduates will obtain a residency. This has been shown to be correct year after year. This author uses scare tactics to say that doctors arent getting jobs. QUALIFIED doctors are getting jobs. Would you want someone not qualified to practice medicine? no.

    Basically the US needs more doctors, and we are slowly in the process of creating more medical schools to have more US educated physicians. There are currently MORE residency spots in the US than US medical school graduates, which means that MANY of these residency spots will go to foreign educated doctors who qualify. This is fine, this is good. We do need more residency spots to train the increased need for physicians, but we cannot just give away residency spots to anyone with an MD from random foreign medical school. If we did that, then medical schools would run as a business abroad "educating" people to get MDs, instead of the true mission of medicine, which is to be a physician (there is a difference between just someone with an MD and someone who is a true physician).

    This is kind of a rant, but the author is misleading. Sam probably is not qualified to practice as a doctor in the US.

    March 16, 2012 at 09:05 | Report abuse | Reply
    • in error - Medical Student

      I think you mean that International Medical Graduates (IMGs) have to take the USMLE Parts I, IIA an IIB (and sometimes III), not "boards". Board certification is for specialties AFTER one has a Residency finished. My wife completed a British-system SIX year Residency in Emergency Medicine in Singapore, and has now practiced as an Emergency Medicine Specialist for NINE years, is considered a "senior" (she is a consultant in the busiest ER in Singapore), yet she is having a hard time trying to get a Residency here in Colorado. America does not have enough doctors, BUT the protectionistic system prevents qualified, experienced IMGs from even applying to Residency Programs (some won't take you if you are more than 5 years out of medical school). So the MOST experienced IMGs are prevented from coming here to practice medicine. That is not to the benefit of Americans needing quality medical care. It IS to the benefit of the American Med School grads who are preventing qualified foreigners from practicing here, by creating insurmountable barriers to entry. My parents (both MDs) came here in the 50s from England. The British medical system is on par with and some argue better than the American system, as it is not profit-based, but solely focuses on healing. My parents had to go through US residency programs, and hop from state to state. How silly IS that? After all, Medicine is a science, and does not change state to state, or country to country. I DO agree that every IMG should present his/her qualifications, and take the USMLE, but as one comment pointed out, if Part I of the USMLE was taken on a bad day, the doctor is screwed. Part I is the basic stuff that one hardly ever uses in practicing medicine - and after being out of medical school and practicing for years, one forgets the basics and focuses on one's specialty. So if USMLE Part I was "on a bad day" ... you get waiters who have MDs, or you have highly qualified IMGs staying home as my wife may have to do (where she makes about 5x what a Residency program offers in wages). So preventing IMGs from entering and practicing is to the detriment of the American patient pool, and only benefits those "already here" and practicing by increasing their job security.

      March 16, 2012 at 09:25 | Report abuse |
    • Emma

      This can't be a real medical student. I have yet to meet one who thinks that the only people who don't matched were those "unqualified." You must be a pre-med who just now got into med school.

      March 17, 2012 at 01:17 | Report abuse |
  27. Jason

    You're just describing a manipulated supply and demand of talent by government. Perhaps Sam could stick it to the system since he isn't politically "in" by starting his own medical type of business/sales (especially with his MD credentials) and reap millions from the very same people that are screwing him and remain in the field (but on HIS terms!) with his colleagues.

    March 16, 2012 at 09:05 | Report abuse | Reply
  28. Caregiver # 7

    Gee, Life is sure hard for Sam and even harder for caregivers in nursing homes that put
    old senile patients in diapers,clean and feed them ,who work for 7 dollars an hour in this country
    with little thanks.

    March 16, 2012 at 09:07 | Report abuse | Reply
    • Nick

      You didn't go through 8 years of post secondary education did you to be a caregiver did you?

      You didn't pass any nationalized med school exams did you?

      Did you even get through high school?

      No wonder you have to change diapers! But I appreciate you're efforts.

      March 17, 2012 at 14:09 | Report abuse |
  29. iceload9

    I don't see why they are accepting any foreign applicants while turning away US graduates. Especially when we are supporting this program through tax dollars. Another upside down program that's not benefiting the US.

    March 16, 2012 at 09:10 | Report abuse | Reply
    • in error - Medical Student

      supporting a program with tax dollars? Huh? So do you realize that Residency Programs are profit making enterprises whereby qualified doctors are made to work insane hours for wages that would make a plumber laugh? So no, bucko, you are NOT paying for medical residency programs with your precious tax dollars. You are paying for a bloated military budget, a ridiculous pork-filled system of political cronyism that still gets NASA billions, and the Congress's free healthcare-for-life system. You most certainly do NOT pay for the private residency programs that hospitals create. Wow, what ignorance!

      March 16, 2012 at 09:31 | Report abuse |
    • mjpsych

      because of the simple fact that all American graduates qualified to be accepted into residency programs. Just as poor law school graduates do not qualify to be called a good lawyer. All of you know that there are enough lousy doctors who graduated from American medical schools and there are many great foreign graduateswho saved thousands of American lives.

      March 16, 2012 at 10:14 | Report abuse |
    • Lee

      Most residency positions are government funded, usually through Medicare. There is very little private funding for residency. So yes tax dollars do go toward residency for MDs. This is nothing new. It's been that way for a long time. The ignorance is thinking that isn't the case. And that bloated military budget is also part of how most of the technology you people use even came to exist. People don't realize the military budget is not just to fund wars but also to develop new technologies. Satellites, GPS, cell phones were all military funded technologies that all of you use everyday without thinking about it. More technology has been developed through DOD spending to the military and NASA, which includes medical diagnostic equipment and surgical equipment, to help MDs in their fields.

      March 16, 2012 at 10:21 | Report abuse |
  30. bostonBC

    Brigit – thanks for that sound note. A few people get it that we aren't on a sustainable path right now. No matter how high unemployement numbers get the shortage shouters will claim that there aren't qualified citizens while they laugh all the way to the bank with increased profits due to wage depression.

    Unfortunately too few people see this and don't understand that without severe immigration cuts we are going to have even worse problems in the coming years.

    March 16, 2012 at 09:14 | Report abuse | Reply
  31. MatchDay2012

    Good luck today everyone!

    March 16, 2012 at 09:15 | Report abuse | Reply
  32. Absurd

    A guy whose body is so broken down at thirty from doing construction work that he can only manage to mop floors in a hospital for minimum wage, him I might feel sorry for. A petulant MD who doesn't get exactly the future he envisioned, not so much. Grow up and change your goals to fit reality like the rest of us.

    March 16, 2012 at 09:20 | Report abuse | Reply
  33. Myto Senseworth

    From what I've observed, they must be getting the wrong people to practice.

    March 16, 2012 at 09:23 | Report abuse | Reply
  34. Myto Senseworth

    The waiter is probably more qualified.....

    March 16, 2012 at 09:24 | Report abuse | Reply
  35. terry

    Then the guy needs to go back home to his country. Ths obvious reason for his being here is to get big bucks.

    March 16, 2012 at 09:40 | Report abuse | Reply
  36. Psych

    This is a problem for medical students.
    It is an even bigger problem for Psychologists. Thanks to several "professional" schools admitting hundreds of students each year, more than 1/3 of psychology students don't match each year. The APA refuses to admit that their endorsement of these Psychologist factories is degrading the field and making it more difficult to students at legitimate PsyD and PhD schools to obtain proper internships. we undergo a similar match system. It's sad to know that the unmatched students are rarely the underqualified ones; they're simply the ones with bad luck. I was lucky enough to match (albeit not to an accredited program – most refuse to consider any PsyD students because the professional schools produce such poorly qualified candidates), but because I have PsyD after my name instead of PhD, prospective post-doc employers refuse to look at the facts – my school has a strong research program, top notch training, and produces much better Psychologists than professional schools, so it took me 2 years to find a program that would allow me to be licensed.
    Another fun fact: Most of the professional schools encourage their student to take out hundreds of thousands of dollars of student loans, using overall Psychologist data to show that students will be able to pay it back. Fact of the matter is, most of these students will be stuck in low paying jobs, and eventually the government will have to forgive their loans. We're all subsidizing the greed.

    March 16, 2012 at 09:43 | Report abuse | Reply
  37. DMcG

    I'm matching today, most exciting day in medical school !!!

    March 16, 2012 at 09:43 | Report abuse | Reply
    • Apryll

      Congrats on your hard work. Let us know how it goes!

      March 16, 2012 at 11:05 | Report abuse |
  38. Brian

    So why don't these well trained people work as badly needed and well paid Physician Assistants (PAs) ? Huge demand, great pay. At least when compared to a waiter.

    March 16, 2012 at 09:44 | Report abuse | Reply
    • gf

      Because then they'd have to go to PA school here in the states, equally as difficult (perhaps even more so) to get into as a medical school. They can't "just be a physician's assistant" ... they have to go to school for it and be certified.

      March 16, 2012 at 10:45 | Report abuse |
    • Emma

      Because they'd have to go back to school and PA schools are reluctant to take someone who truly wanted to be a doctor because it seems like they're "settling" for being a PA. Personally, I think that since med students get more training than PA students, any unmatched MD should be allowed to work as a PA without more schooling. It makes no sense to me why that isn't allowed.

      March 17, 2012 at 01:22 | Report abuse |
  39. Jacob

    As a medical student from the United States, reading this article sparked a few interesting thoughts. It is a known fact that there is a need for qualified doctors, as well as the need to expand residency appointments for future doctors. The number of United States MD and DO medical students in US schools has begun to rise. Unfortunately, residency programs are funded by the government and therefore takes significant time for expansion. It should also be noted that the pool of those entering residency consist of MD students, DO students, and then foreign graduates like Sam. As more qualified US MD and DO students graduate, the number of spots for foreign students declines. Thus, we will be seeing more people like Sam out of a spot. However, I honestly believe that this is not a bad thing. I know that I would rather be treated by an MD or DO from a qualified US program simply because all US medical schools must meet specific standards in the education they provide, while in other countries this may not be the case. Thus, I implore everyone to worry about expanding residency programs for US students so that these people have a place to train thereby addressing the physician shortage.

    March 16, 2012 at 09:49 | Report abuse | Reply
  40. EliteMD

    The world needs Podiatrists, too!

    March 16, 2012 at 09:50 | Report abuse | Reply
    • ElitePhD-PAC


      Can you clarify? Why does the world need “podiatrists too?"

      March 16, 2012 at 11:22 | Report abuse |
  41. Jeff

    What did I take from this article? Apparently it better to wash medical instruments and be a waiter in America than a surgeon in Eastern Europe.

    I would imagine Eastern Europe would appreciate him staying in his home country and helping there, rather than educate him (probably a large part paid for by the state) and simply to have him leave for America. I would imagine his great surgical abilities are much more needed there, than here.

    March 16, 2012 at 09:58 | Report abuse | Reply
    • gf

      Yeah, but nowhere else in the world can a doctor charge such outrageously high prices for their "service" and thereby increase their own income. It's just too hard to pass up. Either they can make 2-3 times the average income in their own country and help out their own people, or they can make 4-5 times the average income in a wealthy country and live among the American elite. Who wouldn't choose the latter?

      March 16, 2012 at 10:42 | Report abuse |
  42. woops

    glad im a nurse =P

    March 16, 2012 at 10:07 | Report abuse | Reply
  43. Lee

    Sam should look back in his home country, or somewhere else in Europe or even possibly in Asia for possible matches. He came here because of false promises and the prospect of far more money being a doctor here versus other countries, but if he is really passionate about being a doctor then look everywhere, not just here. He already made the leap to leave is home, so why not continue that leap and look outside of the US as well. Doctors are needed all over the world, so I'm sure he could find residency somewhere. People come to this country and think everything is just going to be easier for them, but we have enough problems getting our own people jobs as it is, so they might want to take that into consideration before coming here.

    March 16, 2012 at 10:11 | Report abuse | Reply
  44. anotherMD

    If Sam would take a family practice or internal medicine residency in an underserved area we would not be having this conversation. There are always some of those that go unfilled even after the scramble. The reason he is not working as an MD is that he is holding out for a surgical spot, probably in certain popular metropolitan areas of the country. If he really wants surgery THAT bad he should reapply for residencies after he's been out doing primary care for a while. That would certainly look much better on his CV than waiting tables. But in the meantime, he does have options, so I don't really feel that sorry for him. He needs be willing to go where they do need and want him. And there are LOTS of places that need him and want him as long as he'll do primary care. But if he chooses to wait tables instead, well... that's really sad for him and for all the people he could be serving. I do agree, though, that there needs to be more residency spots opening up, but they need to be where there is the greatest need in the communities, not in necessarily in the areas that are fun and cool for 26-30-year-olds to live in.

    March 16, 2012 at 10:14 | Report abuse | Reply
    • Sam's Advisor

      Yep, this is exactly what I said before. If he doesn't want to be a family practice, internal medicine, pediatric doctor, where there are spots available, but he wants to be a surgeon, where there is less demand, then that is his problem, not the systems. If everyone went into surgery, there would be no one to take care of the 95% who don't need that kind of medicine.

      March 16, 2012 at 10:51 | Report abuse |
  45. Realistic expectations

    By the way, 'dreams' are always attainable, but never when pursued blindly.

    I suspect that the Eastern European country this MD comes from is looking for driven, motivated, intelligent physicians too. Rather then waste years and risk losing his chance to practice, he should look at what he could offer to his own country?

    Again, this is an interesting topic for conversation, but those who've been through the match process can see this isn't a Match problem, this is this particular individual's problem. And not a terribly sympathetic one.

    And by the way, residency programs run on federal $$$, as it's money from the government that pays residents's salaries. So in many ways, the hospitals receive employees who are 'free' to them. The problems with the system shouldn't focus on foreign students,

    March 16, 2012 at 10:23 | Report abuse | Reply
  46. Medical Researcher

    I worked in a university medical research lab a few years ago and the department that I was in had ~75% of its workers from China, and that number was increasing. I can assure you this was not due to the lack of qualified american applicants available. Keep in mind that most of these labs are funded with american taxpayer dollars. The postings for any open positions were a joke – a 2 week listing – they barely offered a living salary for the position, and when no american was willing to work for that salary (I assure you it was not much above minimum wage for a highly skilled position), the department would then import a new worker from China. Subsequently, the salaries for all the researchers in the department wetre severely depressed. Would you earn a bachelors and even a graduate degree and then go work for 20K a year? This is a huge problem developing in a related industry. I will not even go into the dangerous work environment for someone working with radioactive trace elements or hazardous chemicals who could barely speak english, much less understand the hazard labels on the chemicals they were working with.

    March 16, 2012 at 10:30 | Report abuse | Reply
    • bostonBC

      I have a number of friends with PhD's who have seen their salaries decline for the past 20 years. We now import cheaper Eastern European and Asian's to do research and American's in the field have seem what was once a good career turn into another lower middle class slave job.

      March 16, 2012 at 10:55 | Report abuse |
  47. Don't Care

    I don't care about this poor Doc from another country. The fact is that we need to make sure American Docs have jobs first. But even so – we want qualified American Docs. Not just some slouch that skimmed by in Med. School. We have enough problems with good Docs making mistakes....lets keep the bad ones out.

    March 16, 2012 at 10:34 | Report abuse | Reply
  48. gf

    Ok, informative, but no way will I feel sorry for these guys. It's still a small percentage, and probably more likely than not they'll end up with a residency, out in the work force earning 4-5 times the national average, with some of the lowest rates of unemployment, if unemployment even exists other than "I'm burned out so I'm going to take my stock pile of money and not work for a while". So again, I'll take this personal interest story as just informative, but by no means something I'm willing to give my pity for.

    March 16, 2012 at 10:39 | Report abuse | Reply
  49. Naser

    Well, let him try Canada; I am sure he will do just fine like many like him. I would trust a nurse over (most) of the doctors in Canada.

    March 16, 2012 at 10:39 | Report abuse | Reply
    • Just Matched MD

      To match in Canada, you HAVE TO BE Canadian.

      March 16, 2012 at 12:49 | Report abuse |
  50. aginghippy

    Here's the bottom line: This is just another symptom of a health care system in crisis. We have allowed mega insurance companies to take our medical profession hostage. The USA is the only Western nation that has failed to implement a national health care system. Hospitals AND doctors struggle to be reimbursed for their hard work and financial overhead. If hospitals are watching every dollar spent, there will not be enough residency positions.
    You REALLY don't want to be a patient in any hospital in America, these days. They are short staffed and are cutting corners.
    Medicare is going broke. As unpleasant as it is to acknowledge, a huge reason for Medicare's financial crisis is our unwillingness to admit we cannot defeat old age and devastating illness. There are millions of patients with absolutely no hope for recovery or a return to a quality life. Yet, we spend billions of dollars maintaining them on life support, in a horrible hell on earth of a vegetative state.
    President Obama wanted to address some of these issues. He wanted to require health insurance companies to live up to their part of the bargain. He wanted to provide a public option form of health insurance, which would be a good first step toward joining the rest of the civilized world in a national health care system. Of equal importance was his desire to persuade patients, their families and physicians to engage in an honest dialog about advanced directives. He wanted doctors to actually HONOR a patient's wishes not to be kept alive by chemicals and machines.
    The republicans called his efforts at health care reform the evil "socialism". They called his realistic approach to correcting the end of life issues "death panels".
    Until the day comes when we stop allowing corporate interests to control our health care, things cannot possibly get any better. If Republicans have their way, nothing will change, including the ton of money they take from HMOs and pharmaceutical companies.

    March 16, 2012 at 10:41 | Report abuse | Reply
    • E

      DrK. Do a search on cardiology and shortage. You will find that a shortage of that sub-specialty exists, too. CT surgeons on the other hand ... but that field is dwindling.

      March 16, 2012 at 12:56 | Report abuse |
    • ProudVietVet

      What aginghippy said.


      March 16, 2012 at 13:02 | Report abuse |
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