The ACGME, via CEO
Thomas Nasca MD, does not support
the legislation enacted in Missouri.It deals with using unmatched doctors in
underserved rural areas, supervised by a licensed physician within a 50 mile
radius.The doctors could work and
reapply for a residency, while performing meaningful and necessary work until
the number of residencies catches up with the deficit.Dr. Nasca bases this belief on patient safety
and quality concerns.(1)He further
states that once an unmatched doctor has gone through 2 application cycles,
he/she will probably never get trained.They will remain untrained for the duration of their career.Dr. Nasca also infers that unmatched
international medical graduates are not as smart as US grads, or they would
have been accepted into a US
medical school.It sounds like Dr. Nasca
is not too worried about unmatched IMGs (International Medical Graduates)!
I can certainly see the points Dr. Nasca makes about patient safety and
quality.Yet, residency also deals with
training “new doctors” under a supervisory set of physicians, albeit closer in
proximity.
However, I have a different opinion about the qualifications of the
IMGs.Two of my own children have
graduated from medical schools, one a US
grad and one an IMG.As an educator and mother, I would categorize
the child who went to a US
medical school as “system smart”, and the one who went to an IMG
as “intellectually smart”.
The US
grad decided to go to medical school 2
years after graduating from college in “Broadcast Journalism”, with an “A”
average.The IMG
attended the same, very competitive university (97% of incoming freshman have
an academic scholarship), intending to go to medical school from the beginning, and majored in
“Cell Science/Microbiology”, obtaining a “B” average.The US
grad attended a local less competitive
university forpre-med classes
and got an “A” average.The IMG
grad took pre-med classes, along with a competitive pre-med science major,
while at the highly competitive university, getting a “B” average.
The US
grad was accepted “Early Decision” into a medical school with 1 application.The IMG
med student was only accepted into an international med school.Two graduates, fairly comparable
intellectually, one worked “smarter” in applying for medical school, while the
other majored in a subject intended to “help” in Medicine.It pays to know the system before you begin!
Yes, this story deals with only 2
medical students. There is a whole “continuum” of ability and IQ in MDs, some
are “book smart” and some are “system smart”.Probably all applicants wished to have gone to a US
medical school.They would not have had
to deal with this residency deficit, waited heavily against IMGs.In spite of all these points, all doctors
applying through NRMP have PASSED ALL THE REQUIREMENTS!Why shouldn’t they be allowed to complete
the last step of their training!
As CEO and spokesperson for the ACGME, I believe Dr. Nasca has a
responsibility to suggest a workable solution to this residency dilemma.Not only is a solution warranted, but
leadership in this role of CEO for such a vital organization in medical
education is warranted!If such
leadership had taken charge of this travesty, we would not be talking about
each state enacting its own legislation.We would not be dealing with the utter waste of human time, talent, and
money.The AMA has “adopted” a similar
stance, based on Dr. Nasca’s recommendation.So 2 of the most powerful agencies dealing with healthcare in the US
are leaving it up to others to fix this bureaucratic nightmare!
