Medicine in USA

Tips and Tricks to got to USA for Medico's and also contains the possibilities to go to USA. 

It is established GMC tradition to go on for specialty training after MBBS, either abroad or at home; and among the destinations abroad, the United States has probably been the most popular over the decades. With each decade, the US has furnished a different reception to the International Medical Graduate (IMG), depending on the prevailing demand for physicians. In the nineties, medicine in the US is in a state of flux for both the American physician and the IMG, for several reasons - influx of HMOs, medical cost-cutting, down-sizing of residency programs and the introduction of additional exams. And the specter of oversupply of physicians in the early next century has not exactly made things easy for the US-bound IMG. 

A Jipmerite who is US-bound often passes through three stages. First, is the process of taking the USMLE exams, applying for and getting into a residency program and obtaining the necessary visa to come to the US. The second period is that of residency or fellowship training itself; an arduous three to six years. Finally, having completed training, and along the way often having started a family, gained a paunch and done other sundry things in life, the Jipmerite settles down in a career or practice - either back home in India or, often, in the US. 

These various stages come packaged with their own hurdles, and the purpose of this page is to provide a relevant guide for the US-bound Jipmerite. A few caveats. Check the currentness of the various web pages by looking for a date. Since a lot of the information is in the form of links to other sites on the internet, you should verify the facts and advice that you come across, from a second source. Official sites, of course, provide accurate information. 

Examinations - Since July 1998, to obtain the Standard ECFMG Certificate, you have to pass the USMLE Steps 1 and 2, the English language proficiency test and the newly introduced Clinical Skills Assessment, including an assessment of spoken English proficiency. The Student to Student Medical Web page and the Medical Study Guides page are two good sources for ideas on approaching the exam and the kind of topics you should review just before the exams. Also, have a look the costs of the USMLEs. The ECFMG home page has current application procedures and exam dates for the USMLEs. Note that the USMLEs will become computer based exams from the middle of 1999; check the ECFMG and the USMLE home pages for information on how these differ from the paper and pencil exams and where and when they are offered.

Application process - Completing applications for residency programs involves collecting copies of various certificates and letters. Look at the list of paperwork that you will usually need. The ECFMG has also introduced an Electronic Residency Application Service for IMGs.

Addresses - Many of the US Medical organizations that you will have to deal with have web sites of their own, which provide current information.

Visas - The issue of getting a visa for entering the US, is probably as important as scoring well on the USMLEs and getting into a good program. You should think about the visa issues at least a year in advance and contact Jipmerites in the US about their visa experiences. Browse through the details of the J1 and H1-B visas - the two non-immigrant visas available for IMGs. Also, have a look at the list of programs offering the H1-B visa, compiled by Amit Ghosh. If you are applying for a J1 visa, you will need a No Objection Certificate.

Miscellaneous - New sites dealing with issues relating to IMGs are cropping up frequently on the Internet. A good site to start is the Ghetto for International Medical Graduates. This site is part of a webring and you can go to other similar sites via the links at the bottom of the main page. 

Indian Consulates - You can renew expiring Indian passports either in person or by mail from the nearest Indian Consulate. The NOC issues are usually handled by the Consulate at Washington, D.C.

Canadian visa - You can obtain a tourist visa to Canada either in person or by mail from the nearest Canadian Consulate. Look at the list in Yahoo! for the nearest Consulate.

Travel - Many travel agencies serve the Indian subcontinent. Before buying airline tickets from a particular agent, browse through the Travel Agent Survey for information on experiences of previous shoppers. You are urged to email your own experiences to the survey after a trip to India. If you are flying within the US, you can buy tickets online; check out Ambalavanan's list of travel Net Archives. 

Returning to India - Shivshankar Sastry provides an excellent overview of how to settle down in India after being abroad for many years. 

Doctor Discontent - A 1998 editorial in the New England Journal of Medicine comments on the physician's quality of life in the US.

Graduate Medical Education, 1998-1999 - Some comments on residency training and the physician workforce, that appeared in JAMA in 1999. (PDF format)

Here are some statistics from a JAMA article that appeared in September 2000.

• Breakdown of residents according to visa status. Note the H1 and J1 numbers.
• Look at these three tables that show the percentage of IMGs in each of the specialities. They provide a good idea on which specialities are easier to get in. Table 1 | Table 2 | Table 3

Conversely, if you have some information, advice or tips to pass on, you may post publicly replies to queries at theGMC Message board or email privately to the author. 
 
 

Courtesy by http://www.jipmer.org/jipmernet