I went to undergrad at Fresno state. I have a BS in Environmental Health science and a Masters in Public Administration. I went to medical school in the Caribbean. I finished in 2015. I have applied to residency since 2015. I have spent $5,000 to $7,000 every year for applications. I have over 200k in student loan debt. I apply to at least 300 programs each year and I will usually get 2 to 4 interviews. I put off having a family for many years in hope of having a career. I am now 36 years old with a 19month old and a 5 month old. I am volunteering as an assistant physician in Missouri at a free clinic. The assistant physician program was created to help the many unmatched/unemployed doctors use their education working as a mid-level, however, many hospitals and clinics are unable to hire us because insurance companies do not recognize assistant physicians. We are also being exploited as free labor. I have been an advocate for the unmatched doctors for many years and I haven written a few articles on his issue. I was also the Vice president of the assistant physician organization for a few years.
Unmatched American Citizen (IMG)
Medical residency is a combination of training and work. The resident doctor is an employee, gets paychecks & signs a contract with the hospital. So simply it is a job and it is the only route that medical school graduates should take to be able to practice medicine in the United States.
We agree that at some point foreign International medical graduates were an important part of the healthcare system in the United States. J-1 and H1-B visas were created to make it possible for those foreign international medical graduates to come to the United States and start their residency training. But this should not negatively affect the American labor markets and leaves thousands of American medical graduates and American international medical graduates without residency training and thus with no jobs.
Also, residency training is so expensive that costs the health care system billions of dollars to train those foreign medical graduates; the thing that makes this whole process not only unacceptable but also questionable; why would we spend billions of dollars to train foreign medical doctors and leave American citizens without jobs?
No country in the world gives the privilege to foreigners and leaves its citizens lives in poverty. America is our country and by the law, we have the priority for any job opening over the others. The health care system needs should not be used as a Trojan horse to manipulate this process of the medical residency application.
3. Unmatched US-MD
I am a US citizen, graduated from Jordan in 2016. I am working as a research
assistant at Wayne State University beside my job as a medical scribe in a primary
care clinic. I have a US hands-on clinical experience of 2+ years. I have been
involved in multiple volunteer experiences since medical school serving the
community, refugee camps and teaching younger colleagues. I was interviewed on
a national TV talking about medical awareness and the contribution of voluntary
work to the society. I was an active member of the International Federation of
Medical Association and Medical club in the university.
Despite all the effort I put into medical school and clinical experience in the US
unfortunately I did not match in 2020 match cycle. I passed my USMLE exams
first attempt and became ECFMG certified. I am still working hard to reach my
goal and match into a residency in primary care but as a US citizen it is really
unfortunate to experience rejections and being unmatched where many non-
citizens are getting residency spots in my country discarding the fact that
thousands of unmatched candidates have many potentials to serve the community,
willing to be involved in fixing the physician shortage and supporting the health
There is no doubt that there are many qualified international graduates who worked
hard in their medical journey but as a citizen who finished all the pre-requisite for
residency it should be a priority to offer training in my country rather than leaving
thousands of qualified candidates unmatched and helpless. This country has to
secure its own citizens first and then supplement empty residency spots with non-
4. I was a professor of OBGYN in Faculty of Medicine Cairo University, the First and largest Medical School and teaching hospital in the Middle East .
I finished residency , Masters and PhD of OBGYN in Cairo University/Egypt also a Fellowship of Reproductive Endocrinology in Cochin Hospital , Paris /France.
I got married to an American Citizen and was planning to move to live with him in the US, but faced with the fact that I cannot practice medicine before passing the USMLE exams.
I stayed in my home country and studied for the USMLE while working a full time Job Physician and caring for my kid and my ill father.
I passed all the steps 1,2,and even step 3 USMLE and then I decided to move to the US after 9 years marriage .
I applied for the match 3 successive years paying more the $3000 each year without a single interview ,why? Because the programs filter my application according to the year of graduation .
I tried to search for a healthcare job , I emailed hospitals and universities more than 100 emails per day and either no reply or you are not licensed to work for this position even as a medical assistant what a shame !
Now my marital life is on the verge of breakdown, I am thinking to go back home to practice as an ObGyn, leaving everything in the US .
At the age of 13, my family and I, left my birth country, Iraq, fleeing persecution from Saddam’s regime and the poverty resulted from the Embargo. We moved to Jordan, Egypt, then Libya where we claimed asylum and became refugees. After finishing my medical school in Tripoli Libya the civil unrest took place. Again, we were displaced, my next station was a refugee camp in Tunisia. There we lived in limbo waiting for salvation. Not knowing where we would end up. After 3 years of waiting, I was granted resettlement to the US.
The United States of America was the only country in the world that offered me the right to be acknowledged as a citizen, and land to claim as a country. I fell in love instantly with this amazing country, I was restless to be part of this American dream. I want to give back to my community, state, and country. So I started the next 5 years’ journey, between working different jobs and studying for my medical boards to be able to apply for a residency. To be a fully licensed doctor you have to go through a federal program, tax-funded, called residency. It is a training/education/and a job. But, I was oblivious to the fact, there is a gargantuan number of foreign medical applicants hunting the medical market from overseas, from every corner of the globe. For a very modicum of positions. They tirelessly exploiting a loophole in the immigration system to get quickly in. Achieving it through confabulating resumes. In this day and age, it is very possible within few clicks. You can claim you wrote books and have multiple certificates as long as you have the financial means to do so.
To apply for a single medical program you have to pay a $26 cap fee. So a hundred programs applied to cost $2600. But to fight against this foreign army of medical graduates coming from every corner of the world, you have to increase your expenditure cap or someone else will do it! And they are capable of doing so! According to the NRMP data release of 2020 the number of applications sent per one applicant exceeded 500. This is about 13-15 thousand $ per applicant. Where are they coming from? Supposedly impoverished 3rd world countries. But they don’t seem to fall under these categories.
The American citizens who finished medical schools domestically and internationally burdened with debts, have to fight against debt-free applicants. These foreign applicants start their resume preparation as early as after finishing high school and finish medical school at a very young age while holding other unrealistic skills. Because they knew prior, that the hiring process relies on an algorithm built around in favor of the younger applicants and the ones with a higher GPA in their basic science (USMLE step1, per ECFMG data release). However, Age decay and lack of these purchasable skills work against most Americans.
I am one of the thousands of American doctors who ended up unemployed, due to the endless numbers, of foreign applicants and applications. Who has been targeting the job industry in the medical sector, through the hiring process called Matching.
As a first-generation immigrant who survived through the Gulf War in 1991, lived throughout the prosecution of Saddam’s regime and escaped the second war in 1998. My family and I kept immigrating from one country to another. Where we constantly experienced racism and xenophobia. Eventually, we ended up living in a refugee camp in North Africa, waiting for salvation. Not knowing where we would end next. After 3 years of waiting and following every legal channel. We were finally granted resettlement to the US.
The United States of America was the only country in the world that offered me the right to be acknowledged as a sovereign individual and citizen. I was finally given land to claim as a country. Instantly I fell in love with this amazing country. Hearing about all of the success stories by many other immigrants. I was restless to be part of this American dream. I want to give back my community, state, and country. I was more than eager to start my upcoming journey. I started my 5 years’ journey, between working different jobs, spending hundreds of hours in the libraries, sleeping in my car, building up my resume, to finish my medical boards. To be able to apply for residency training. But the reality couldn’t be further from the truth. I wasn’t able to get a job as a medical doctor in my country.
To be fully licensed as a doctor you have to go through a federal program (tax-funded) called residency. It is a training/education/and a job. I was oblivious to the fact this beautiful land was a target by many exploiters, who dedicated their time and power to sneak through loopholes. Avoiding all the legal channels. After I couldn’t even land a single residency interview. I was confused and questioning, what did I do wrong? I wasn’t able to land a single interview invitation, which I will pay for its expense. So I blamed myself. Until I started my own research. I went through the National Residency Matching Program NRMP statistics, to my astonishment, I discovered I wasn’t alone. There are thousands of other American doctors suffering from the same fate.
There is a gargantuan number of foreign medical applicants hunting this medical market from every corner in the world. For extremely modicum numbers of positions. They are equipped with financial means and confabulating resumes. In this day and age, it is very possible within a few clicks. You can claim you wrote books, having multiple cited clinical research and certificates to overcome the algorithms.
To apply for a single residency medical program you have to pay $ 26 cap fee. To apply for 100 programs it cost about $2600. These fees are designed to halt excessive applying. But failure was the destiny for such a mechanism. These debt-free applicants were able to hoard a large number of interview opportunities. According to the NRMP data release of 2020, the number of applications sent per one applicant exceeded 500 (in comparison to previous years, per interquartile range). This is about 13-15 thousand dollars per applicant.
The American citizens who finished medical schools domestically or internationally burdened with debts, have to fight against debt-free applicants. While, we must support our families, and pay bills. One of the only solution to overcome this attack we have to increase your expenditure cap or someone else will do it! And they are capable of doing so! That’s a reality of the new globalist waves we as first-generation American immigrants are facing.
Since these hiring agencies (hospitals) are incapable of mitigating this flood of applicants. They started to come with unrealistic criteria in their search for applicants, relying on the algorithms. For example, they are judging us by the year of graduation and age. While we are only allowed once to apply per year, this rule by itself would eminently put an applicant who didn’t match in a disadvantageous position of age decay. These algorithms are built to avoid favoritism yet it was solely used to judge its applicant by a few criteria rather than individuals with merits. Per ECFMG data, the number one factor was the target by the program directors was the USMLE step 1 score. It is a GPA-like, which forced the ECFMG to cancel it completely.
The foreign applicants start their preparation as early as they finish high school. While holding other unrealistic skills at a fairly young age. But this is how the system works, the more you pay to be cited in academic literature, the more your resume will look appealing, they know how to penetrate the algorithms.
Growing up encountering prosecution and living among the refugee camps taught me to be grateful for the minimum of what I have. To work hard and not to be afraid of censorship. But the policies and the scary numbers of the applicants versus the residency slots pushed me to advocate about the other less fortunate Americans. This conundrum requires immediate surgical intervention.
The quagmire we are living is created by the top CEO’s, who marionette us down at the bottom. They manipulate the system by calling these residency programs Graduate Medical Education GME. The matter of fact, they are federally funded jobs. Per ECFMG (Educational Commission for Foreign Medical Graduates) in 2018 J-1 visas were offered to 11,385 people. While the numbers of American graduates (from domestic or international schools, who were accepted accepted are 662 and 2,900 subsequently).
As you can see globalism started to devour American jobs in the healthcare sector. We are coming from different creed, color, ethnicity, and immigrants are part of the American dream. But this is a non-immigrant approach that got us badly affected. No other sectors like us suffer from such a phenomenon.
Years are passing by and age decay is a factor for this career. A lot of American citizens in my positions considering immigrating to different countries where their medical skills and expertise will be appreciated. The only privilege we have now as Americans are in the name only, without the dream.