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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]They should have 3 years of heavily focused undergrad followed by a year of a related medical experience (paid internship) and then med school.

And they need to let more kids into med school. We need more American-educated doctors. [/quote]

Sigh. This was addressed above. It's not as simple as simply admitting more students. Could you pack more into the lecture halls? Sure (especially now that lots of students don't go to lecture, it's recorded and many watch it ... or plan to anyway ... later). But there simply are not enough rotation sites or residency sites. [/quote] This is not true. There are 6000 more residency spots than US MD/DO grads per year.[/quote]

And American grads do not want those spots. You realize that not all programs/residencies are the same, right? That not all are created equal? And that rotation sites are not residency spots? I had an M4 complaining bitterly to me just last week about lack of rotation spots. [/quote]

So to me there seems to be a gap here that I’m not understanding.  We have a fairly low medical school acceptance rate, but we are importing doctors to do jobs Americans supposedly don’t want.  Further, those foreign doctors are graduating from medical school with fewer years of training and less expensive training (undergrad and medical school is free in many countries), no shadowing, etc. This doesn’t make a ton of sense.  [b]Why don’t we admit more Americans on the basis that they will take those primary care jobs?[/b]  Why don’t we make medical school more affordable so people can better understand the community they serve?[/quote]

[b]Because they won't. [/b]

They will not take primary care jobs in BF Nowhere Town, Flyover State that do not pay enough to pay back their loans.

So yes -- you are not understanding. [/quote]

[b]How do you know?[/b]  Don’t quite a few doctors go into the army on the basis of having their medical school paid for?  If medical school were cheaper on the basis of doing your residency in nowhere town a lot of regular, middle class people who might not afford medical school otherwise may take it.  We’ve created this hyper-elitist system with a certain set of incentives and then we’re not willing to adjust the incentives, we’ll just get foreign labor.[/quote]

Decades of these programs not being able to fill without IMGs!
These programs are not the best training! For example, When you start Internal Med residency, a 3 year program, you have the option to do a fellowship and subspecialize later, same with Peds. Most IM and Peds residents start residency undecided. Those who chose to go into general peds or general IM often do not decide that until the last year of residency. If you match into a rural/non-academic med center you have essentially eliminated all possibility of choosing a subspecialty as well as all possibility of being on the general peds or IM wards running rounds in a known teaching hospital.  Even for family med, it matters! For instance my T7 med school had less than a third of grads pick family med. All of them picked top residencies because they wanted to be head of Famliy Med at the Brigham one day, or live with a spouse who already had a job in a top city, or run one of the highly competitive foreign medical relief camps. None of that happens from those lesser residency programs--the teaching cases are not nearly as many nor as complicated as one needs to get the experience, and every doc and hospital involved in hiring knows it. 
Fast forward 20 years: when you are in private practice General Internal Med in a known top practice in popular East coast/DMV city and you are hiring for your group, you look at the med school and residency they trained in to make sure they have the case exposure to be able to not miss the zebras. Typically you get 3-4 good applicants who meet these criteria for one spot. The rural-residency doc has does not make the final 3-4.  
Residency matters. Med school matters. Even Undergrad matters, though more for the curated and likely to be paid opportunities for premeds discussed on this thread. [/quote]

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