This Is a Shout Out! / #Save GME

https://www.youtube.com/watch?v=zCy3czECcgA 

I want to hear your stories…I want the Nation to really know and feel “your pain”. That is how we relate.  We imagine ourselves in someone else’s shoes, and then the problem seems real.

If you are willing to share your story, I will gladly protect your identity.  I realize how devastating this travesty has been.  I know how you must cringe every time a friend or relative asks you where you are in your training.  The answer for an unmatched doctor is “no where”.  That answer is a real conversation stopper in any social setting.  Do you quickly answer, “I did not match into a residency because there are currently too many med school grads for the number of available residencies”?  And those around you are thinking, “Yeh, right.  You must not have been a very good student.”  This situation has nothing to do with how good a student you were.  It has everything to do with a bureaucratic “slip up”.  The slip up occurred when the Federal Government decided to save money by reducing the number of residency slots, but forgot it still needed enough residency slots to accommodate the number of graduating med students.  This situation has NOTHING to do with how “smart” the unmatched doctors are.

Please tell us about your path to becoming a doctor, its challenges, sacrifices, and “costs”.  I will edit your story to fit into a blog (I have been told that blogs have to be short to keep the reader’s attention).  I will not reveal your identity, since I know how mortifying this tragedy has been.  My email is:  leslapol727@gmail.com
http://nomatchmds.blogspot.com/

Know Better, Do Better / The Match

https://www.youtube.com/watch?v=A6GdfQOMyKY

I am going to begin this blog by starting with the “bottom line”.  DO NOT match non-US citizens into residency slots until all US doctor graduates have matched into a residency.  It is as simple as that.  Get your own “house” in order first, then be generous with your excess.

 We DO have a responsibility as members of the human race to care for the well-being of others, namely, world-wide healthcare.  However, the licensing rules for the practice of Medicine in the US require the completion of a US RESIDENCY.  So first we owe the right to complete their training to our OWN graduated US DOCTORS, before offering residency slots to non-US citizens.  That is the way the “World” works.  Hurdles abound to protect the rights of the citizens of each country.  Their citizens’ right to work is met before hiring foreigners. 

Our country once welcomed non-citizen doctors to fill the gaps in our doctor shortages.  Since the Balanced Budget Act of 1997 ironically created an “imbalance” between the number of medical school graduates and residency slots, that situation has changed.  I would suggest an immediate freeze on matching non-citizens into our inadequate supply of residency slots, until this shortfall has been corrected.

Reporter Tony Dokoupil of CBS News presented a story about  foreign doctor graduates from President Trump’s 7 travel ban countries.  They were applying for residency slots in the US (1).  It turns out more than 1,000 doctors from these 7 countries ALONE were applying through the NRMP for the residency match on March 17, 2017 (does not include applicants from other foreign countries).  There are currently 15,000 doctor graduates from these SAME 7 countries ALREADY WORKING in US residencies today! 

Mr. Dokoupil interviewed the Dean of Southern Illinois University School of Medicine, Dr. Jerry Kruse, about these foreign applicants.  Dr. Kruse was anxious to help these doctors match, in spite of the travel ban, in hopes they would someday practice in the rural underserved areas of Southern Illinois.  Dr. Michael Gannon, president of the AMA, weighed in on this situation as well.  This is the misinformation that galls me!!!!  I “know” of 8,640 doctor graduates, 42% of which are US citizens, who would have loved to work in Southern Illinois.  They were the UNLUCKY doctor graduates who did NOT match into a residency on Match Day, March 18, 2016!!!  They cannot get a license without a US residency.

I am NOT saying “DO NOT MATCH FOREIGN MEDICAL GRADUATES”.  I am saying, “Match US citizen graduates from both US and Foreign Medical schools FIRST, and then match non-citizens second.  So now we KNOW BETTER, let’s do better…

(1) http://www.cbsnews.com/news/trump-travel-ban-impact-on-international-doctors-american-health-system

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Why Are We Not Upset? / DOC SHORTAGE

https://www.youtube.com/watch?v=LoiM4aHIr1o

Initially upon learning about the “why’s” of the residency shortage, I thought the lack of action to correct this travesty was due to the lack of knowledge about its existence.  The doctors I contacted had heard a little about the residency shortage but just assumed the unmatched doctor grads were “weaker candidates” and would just have to reapply again next year.  As discussed in prior blogs, the residency shortage has NOTHING to do with applicant qualifications (since all have met the requirements for applying in the NRMP), and everything to do with the shortage and the compounding effects of re-applications.  Now we know the story.  Why are we not enraged??!!

Perhaps a feeling of powerlessness causes most of us to shrug our shoulders and feel grateful it does not affect us personally.  But what if this circumstance involved one of your children or a relative?  Knowing all the years of study, sacrifice, and money they had endured, only to be denied the right to complete the last requirement for practicing Medicine, might get your interest and action!

Just think of all the rural and underserved areas of our country which would be overjoyed to have one of these fully educated doctors work in their areas.  The healthcare professionals who serve for a week in a third world country know first hand the “preciousness” of a doctor.  Some friends of mine travel annually to Guatemala to perform orthopedic and gynecologic surgeries for the masses.  One team makes an initial visit prior to the team trip just to triage the patients on which they will operate.  That way, there will be no time wasted when they return during the actual team visit, and as many surgeries as possible will be performed.  How can we just “discard” our unmatched doctors with no regard for the “human condition”?  What would Guatemala not do for one of our “cast offs”??!!

Some might say, “Look at all of the lawyers who do not get jobs”.  Although this comparison is quite a “stretch”, at least the lawyers were allowed to complete all their requirements to practice Law.  They probably were aware before Law School that getting a job might be difficult.  I do not think most students beginning Medical School worry about not being able to “complete” the requirements to practice Medicine.  Usually, the hard part is getting “into” medical school.  If there was a “glut” of doctors in the US today, prospective students would enter medical school at their “own risk”, and not be “blindsided” in the end.

I believe the Medical community and all Healthcare Professional should actively promote a solution to this residency shortage.  The “Public” is clueless as to the traditions and requirements of Medicine.  Only those who have taken this path can fully appreciate the devastation that is occurring with the discard of thousands of fully educated doctors.  Yes, I know, you are all “very busy”, and do not have time to take on this cause.  But, you DO have your voices, your email contacts, your “followers”, your legislators, your colleagues, your Medical Societies, and ”theoretically” the AMA, to help promote this agenda FOR YOU.  So talk to them about it and demand a solution!

http://nomatchmds.blogspot.com/

Blog Plan / Residency Shortage

https://www.youtube.com/watch?v=NRiGZnNS9Oo

The goal of this blog is to create a “tsunami of outrage” over the betrayal and waste of fully qualified doctor graduates who cannot complete the last step of their medical training.  Due to the bureaucratic mismanagement by the Federal Government, this outrage should lead to ACTION to correct this travesty before the loss of thousands of fully educated doctors.

The actual “loss” of these doctors to the practice of Medicine has been caused by the pyramid effect of too few residency slots available compared to the increased number of graduating medical students.  This “pyramid” should have occurred prior to acceptance into medical school, and not after, as has been caused by the Balanced Budget Act of 1997.

 My plan has been to write a series of blogs to fully explain how the residency shortage began, what has resulted as a consequence of the shortage, the misconceptions about the unmatched doctors’ qualifications, the multi-state approaches to correcting the shortage, and the lack of National leadership in correcting this travesty.

I decided to post blogs 3 to 4 times per week to get the whole story out before readers lost interest.  That has been accomplished.  If you have missed any prior blogs, I would encourage you to go back to the beginning and read/listen to all of the blogs (I can read all of them in less than 1 hour, and the videos are 3-4 minutes each and would take an hour+).  My plan going forward is to post a blog one time per week on Tuesdays.  However, I would also post again on Thursdays if any important developments occur or if I received any personal stories to share.  I would encourage anyone with a personal story to share to write to me.  I will keep your identifying information private.  If you subscribe to the blog, you will receive email notification of any new posts.

 The success of a blog depends upon its readership.  So my next area of focus is going to be blog promotion.  I am still writing letters/emails, sending out press releases to the media, connecting on Twitter, and “Like/Share” on Facebook.  Please help me by sharing this blog with your colleagues and contacts.  I am very receptive to suggestions you may have for me which you can communicate by email (Leslapol727@gmail.com)

 Although I do not relish being called Saturday Night Live’s version of “Debbie Downer”, history will probably repeat itself this week on Friday March 17^th, Match Day 2017.  I wish I could say that all of the doctor applicants will match, but they will not.  Since there have been more than 8,000 unmatched doctors for each year over the last 5 years, I  imagine that this year will be the same….Add another 8,000+ unmatched doctors to this story!!!
http://nomatchmds.blogspot.com/

Second-Half Summary/ Residency Shortage

Second- half Summary/Residency Shortage

https://www.youtube.com/watch?v=LT2xcjL-eNo

Here is the second half of the “story”:

• What is the AMA doing?
• The Nation has broken the “Social Contract”
• 25% international medical graduates do not match, yet ECFMG has been monitoring and making recommendations to them for 60 years!
• We want to think US Medical Schools are “better”, yet individual learning and passing of the “Criterion Task” have leveled the field.  Only fully qualified applicants are eligible to participate in the NRMP in the first place!
• ACGME is not in favor of Missouri’s plan for Assistant Physician License, yet has not taken the lead in finding a solution
• AMA and ACGME, two of the most influential agencies in Medical Education, are not leading in timely fashion to prevent an utter waste of human talent
• The impending doctor shortage will be more than 90,000 doctors short in the next decade
• Some question the legitimacy of the “Doc Shortage”.  Either the demographics are correct, or they are not!  Baby Boomers are ageing and will require even more medical care.  Is this really politics trying to use lesser trained medical professionals to provide patient care at lower costs, using physician assistants and nurse practitioners?
• Are P.A.s and N.P.s as qualified as MDs?
• A number of states are approaching this problem but tend to favor their own residents
• Need a “tsunami” of outrage to solve this
• Need action by each person concerned about this solution

http://nomatchmds.blogspot.com/

Uncle Sam Wants You! / Residency Shortage

Uncle Sam Wants You! / Residency Shortage

https://www.youtube.com/watch?v=x81Rl9TzL_8

The only way the residency shortage will resolve in a timely fashion depends on YOU!  I mean this literally.  There is a no “One” person who can effect this change before countless fully qualified doctors are “lost”.  It will take a groundswell of voices to bring this travesty to the forefront of our Nation.  We need YOUR VOICE.

The solution to the residency shortage will not be linear.  As you have read, some states are creating legislation to “preserve” their unmatched doctors until the number of residency slots catch up.  Some states are increasing their budgets to teaching hospitals to underwrite the addition of residency slots and the beginning of new residency programs.  Some states are allowing other health care professionals to perform services once performed only by doctors.  Some states are still “wallowing” in bureaucratic doldrums.  The solutions are a “little bit of this and a little bit of that”.

 In the meantime, thousands of unmatched doctors are dealing individually with an unimaginable “betrayal” and all that it encompasses (school loans, no career path, and despondency).  They “did” what we told them to do, and we “broke the contract”.  Ultimately, “we” will pay the price for this travesty.  Right when the baby boomers tap into healthcare the most, there will be a doctor shortage.  Forget about “preventative care”.  We will be lucky to get “reactive care” for our healthcare challenges.

 When the Balanced Budget Act of 1997 reduced the reimbursement for residencies, yet increased the number of medical schools, the resulting impact has been devastating.  “We” knew this Act was not perfect at the outset, and changes would have to be made.  Little did we know the “individual” repercussions that would ensue. 

 These unmatched doctors have worked so hard, for so many years, and at such great expense, not to be able to complete the final step in their training.  The “right hand” of Congress definitely did not know what the “left hand” was doing.  We have got to make this RIGHT! 

 Only your voices and those of your contacts can effect the “tsunami” needed to bring this solution to the forefront.  Please write, tweet, share, and “demand” a solution now!

http://nomatchmds.blogspot.com/

A Tsunami of Outrage/ Residency Shortage

A Tsunami of Outrage/ Residency Shortage
https://www.youtube.com/watch?v=wvXBq9P_hjw

 

   Do you remember the outrage that ensued after the 2-3 hour wait times and missed flights that occurred at O’Hare Airport the weekend of May 14, 2016?  Frustrated passengers began tweeting #IHateThe Wait.  US Senator Mark Kirk, IL, called for TSA Administrator, Peter Neffenger, to fix this problem by Memorial Day or step down.  Even the White House weighed in on this travesty. (1)  By May 25^th Mr. Neffenger told members of House Homeland Security Committee that the agency was taking measures to resolve this issue.  By May 24^th an airline official said that O’Hare’s waits were down to 15 minutes.  That took 10 days to “fix”!

 This outrage is what has to happen to solve the current travesty of the residency shortage.  There are no “normal channels” to solve this crisis.  The Federal government is moving in typical fashion, slowly.  The first legislation introduced was “Resident Physician Shortage Reduction Act of 2011.  It was proposed again in 2013, and again by Senator Bill Nelson, FL, in 2015 (S1148) and by Representative Joseph Crowley (HR 2124) in the House.  Nothing has been passed or implemented at this point.

 This bill would increase the number of residency slots by 15,000 over a 5 year period.  We already have more that 40,000 unmatched graduates right now over the last 5 years alone!  The AMA and the ACGME have not proposed any solutions.  Only a few states have created legislation (generally applicable only to their own citizens). 

 The only glimmer of hope has been the budgetary allocations some states have made.  They have offered financial incentives to hospitals to increase residency slots or add new residencies.  This has had some success.

 Why are we not as outraged as the passengers at O”Hare Airport?  These unmatched doctors have spent more that 4 years of their lives and countless dollars trying to complete their medical training.  But they are deadlocked.  If I were they, I would gladly accept a 3 HOUR security delay in view of their own situations.

 We have to get the “word out”.  We have to tweet, blog, share on facebook, contact healthcare professionals and societies, contact legislators, and yes, even the White House!

(1)http://www.zerohedge.com/news/2016-05-18

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