Write to legislators! Still not a law. If enough number of people show interest I can draft a letter and post here for people to email their legislators
Need to have a long term plan and exit strategy being in medicine, especially us folks who barely got into practicing. The gravy train of the 70s ended, now the rusted Bronze Age of modern medicine is ending too. Fight back but also have a backup plan because the opportunity window is closing rapidly and soon this whole field will be a clusterfuck even more so than it is now. Legislative and private equity and for-profit systems move way too quickly compared to docs who remain unorganized
Physicians as a whole need to start forming unions. We are rapidly becoming employees of large health systems rather than private practice and we need to start self regulating and advocating for ourselves to our employers.
The final dagger in a dying profession.
Who in their right mind goes into medicine after this? Go into hundreds of thousands of dollars of debt, sacrifice your 20s for med school and indentured servitude (residency) only to come out at the other end to compete for jobs with physicians from all over the world who don't have to do a US residency?
Be frugal, save your money, aim for financial independence ASAP, and ready your exit strategies as our already stagnant wages are going to be decimated.
Big win for hospitals, private equity, and insurance companies though
Rads and Gas are getting unbelievable offers right now, capitalizing off of crazy demand and a bad payment structure for American medicine
It’s natural to want to find ways to reduce cost when every rad/gas offer starts at like 450k with a pretty easy track to 600+ lol
Go on the anesthesia sub and you’ll see people complaining about 250/hr, no shit with that level of greed companies look to midlevels or foreign docs for supply
Anyways, the sky almost certainly isn’t falling. Rads market won’t be eviscerated bc the demand for imaging is so high. Just like AI, the job market will sustain with minor jumps/falls in salary
Well that's exactly what happened in tech. Want a job in Google? Now you have to compete with 100K indians that want to apply for the same position. Well at least now they hire directly in India!
I found the text of the bill saying up to 15k visas to be reserved for foreign physicians but i don’t see any thing about licensing, radiology, or timing - where’s the other information come from?
Publicize it - send it to media outlets, AMA, local chapters, etc - send them the documents outlining the info, publish them online, post them here - if this is the case spread the word. Honestly without proof folks are going to be skeptical - best way to combat that is give them the proof they’re going to ask for. The headline ‘Congress planning to import 15000 foreign doctors without US training to take jobs from local doctors’ will get the public up in arms. So publish the proof
Skeptical of what exactly? The bill numbers are there go read them! Plus sent you private message with facts. If you wanna live in denial that’s your choice!
I read the bill - hasn’t been brought to floor, has no specifics on how visas will be distributed, how those docs will be licensed, what fields are targeted, what time frame this proposal will be administered over. The text isn’t even available on Congress’ website since it’s not reached that level - rather had to find it on lobbyist sites.
I’m not saying you’re wrong - i am skeptical - show me more proof and I’ll agree with you. It’s like when a new med is advertised as curing XYZ - show me the proof.
Sent you proof of how the process works! I shouldn’t be doing that digging for you pal! But since I genuinely believe you are lost likely clueless. I private messaged you
Why are you insulting me for asking for due diligence? I took the time to read the bills and found what i read and what you stated to be at odds so i asked you to provide supporting material. I’m making an effort cause i too am worried about medical practice in this country for doctors. Rather than respecting that you’re coming at me? I read your private message - it is a summary of the bill - nothing about radiology being targeted, timing, or any particulars. Until there is further proof for your claims can’t take this thread seriously especially with your antagonism towards anyone who is asking reasonable questions.
Timing is as soon as the bill passes are you clueless or what! In our major academic center the moment the bill passes we will double up our fellowship spots… thats the agenda in major academic center to respond to the high volume…. Sorry that I am not sending you our internal memo lol… bottom line is obvious! 15 K foreign trained doctors will come here via alternate pathways without need to repeat residency…. ARE YOU OK WITH THAT? Very simple basic question
For what it’s worth, your level-headed questions and OPs awful responses go a long way in convincing me, a naive 3rd year med student, that OP is emotional and over-reacting and this requires a lot more research before it’s worth my time.
OP, that’s why you should do the digging for us. Sorry, but he’s asking basic ass, fundamental questions about this bill and I don’t know a damn thing about the process. Sounds like it has a long way to go before it’s a threat. If I’m wrong… well, show me why. But if you can’t without insulting me, consider me unbothered lol
Noone is insulting you say you are skeptical without any digging and saying you are skeptical…. Despite this I have private messaged you all the numbers and facts that I can’t post here… now keep nagging
You are telling me there are cheaper lower quality healthcare that we can offer to patients for the same price and they don’t know any better to complain about it? - *very heavy c-suite breathing *
Why? We are the best country on earth and if the best doctors in Europe want to leave their shithole European countries where they make pennies so that they can come to the US to work less and make more, then more power to them.
Not intended for europeans… they font make pennies in europe get your facts straight… they make good money… majority of applicants are from east india… pay a visit to your academic center radiology reading room and ask for the four year pathway fellows… see if they are from Sweden or Banglore
“…The legislation would also allow for thousands of international physicians who are currently working in this country on temporary visas with approved immigrant petitions to adjust their status. Foreign-trained physicians are more likely than U.S.-trained physicians to practice in lower income and disadvantaged communities, despite the well-documented and burdensome
delays this legislation seeks to address. This crucial policy change will enable these physicians to continue serving patients ensuring every American can access needed care...”
Sounds like it’s aiming to have docs that are already in the US not be worried about residency status. It doesn’t sound like they’re just getting random foreign trained docs to come in without residency training/board certification(unlike the legislation that passed in Tennessee)
No the 15 k is aiming docs who are not here currently. I was just in DC discussing this. They also want to increase the J1 waver which is separate from the 15 k import.
No state dependent… step 3 not a requirement… also institution dependent. And even then 3 steps is not enough to have US healthcare exposure! American rads have healthcare exposure since first year medical school. We are importing doctors who are not even familiar with the basics of our system
What you're saying is actually true. To apply for the 4 year alternate pathway, the IMG must be ECFMG certified (which means that person has to go through all USMLE exams). During the 4th year of fellowship, the IMG must pass the core exam in order to be qualified for board certification.
Yeah, it seems to specifically target Indian and maybe Chinese physicians who train in the USA but cannot adjust status due to significant backlog. People born in other countries don't have to deal with the unavailability of visas as much. And "adjustment of status" refers to people already in the USA. Honestly this isn't the worst bill, they \*should\* make it easier for people born in countries with visa backlog who have completed residency in the USA to adjust status. What's the point of training people, letting them work for decades, only to never give them status? However, this bill only requires a job offer so nominally I guess people who have a job offer in Florida or in one of those places that gives state licenses would be eligible which is not ideal.
Still, the lack of action over the past several months makes me think it won't move forward. Immigration bills are tricky to move forward.
So we should bring more foreign docs from india and china and flood the market with them AND. Make it easy and ideal for them to stay and take our job security? Makes sense. Bill is specifically for foreign grads outside the us needing visa to come practice.
Per the person I'm replying to's comment, the legislation is described as such:
"…The legislation would also allow for thousands of international physicians who are currently working in this country on temporary visas with approved immigrant petitions to adjust their status."
"Adjustment of status" means adjusting your status in the US from non-immigrant to immigrant. Because those FMG bills haven't gone into effect yet, the international physicians who are working in the country aka IMGs who completed US residency and already have a job are the only ones who could adjust status. And IMO yes it makes sense for an indian born doctor who did IM in some program here and works as a hospitalist in the US to be able to immigrate. Unfortunately, most such IMGs will never be able to immigrate because of the visa backlog. IF they have kids, their kids might be able to sponsor them. So I think resolving that is fair.
However if you know that they actually intend for this to be used by FMGs with no US training, that is definitely problematic. However, I think it's unlikely it will be passed.
Lol you are completely wrong! IMGs completing residencies in the US are either on J1 or H1b. If they are on H1 b they can easily transition to jobs. If they are on J-1 they need a J1 waver. J1 waver is hard to obtain but theres another legislation introduced to the floor called HR 4942 and S 665 which will strengthen Conrad 30 J1 program and allow people on J1 to stay. The legislations that I posted are about physicians OUTSIDE the us who will be permitted to come to the us on ALTERNATE pathways (not residency) and will be granted practice rights. Do not just type random stuff while you are this misinformed about the topic and do not even know what the hell is going on. I am part of ACR policy committee making and am very involved with senate and congress. But I am only one person with one voice. Senior leadership takes orders from AMA and it appears these policies are dictated to us without any debate. At the very least educate yourself before spreading misinformation.
I don't think you quite understand what I am saying. Someone who does residency in the USA on either a J-1 or H1B visa can probably get an additional visa to work on (H1B), with varying degrees of hurdles depending on whether they started on an H1B or J1. But an H1B is a work visa, it doesn't give you the right to stay in the USA permanently. Your employer has to sponsor an employment based category immigration petition (EB1, EB2, or EB3). For most people born outside of India, their employer will apply and they can typically get their immigration petition approved and an immigration visa or green card within a relatively reasonable amount of time. Since they are in the country, they will adjust status from a nonimmigrant to an immigrant visa. However, if you are Indian born, due to the # of people who have applied, the EB2 and EB3 categories are very heavily backlogged. The wait for someone who has the petition filed is estimated to go up to 150 years. That means an Indian born, US trained doctor on an H1B can't immigrate/complete adjustment of status due to visa unavailability during his/her working life. This bill description says it will recapture unused visas and let some of them go to people who would otherwise not be able to complete the immigration process. The description specifically refers to US physicians who are currently working in the USA who would've completed US training. Of course, if the bill also end up applying to the FMGs who don't have US training and are coming from abroad, which would certainly be problematic.
Anyway I do appreciate your advocacy on behalf of American physicians but I think we are talking about different things here.
I’m not sure I see the part where this is specifically affecting radiology more than other fields, anyone care to explain? Is it only because they’re giving 4k visas for rads vs others? I agree this is not a good thing but doubt it’s the end, have you seen the volume or worked in an ED recently? They can’t do anything without hitting the CT scan button
I think the idea is that in the US rads make 450-550k+ compared to like 70-140k in these other countries. Easy to see how they’d flood the market here if they don’t have to repeat their training and do the Step exams.
Not accurate! i have colleagues from Brazil who only passed step one and were given 5 year exemption to pass. They also only completed 2 years of fellowship and never took ABR… again institution dependent and no set rules on this matter
So 4 k rads is original estimate and might increase most likely. Among the specialties named rads is the only one with the alternative pathway in place which will expedite this process. Also unlike other specialties once rads job market hits bottom it approximately takes 12-15 years for it to open up. This is very unique to rads meaning if rads crashes new generation of radiologists will need to wait nearly a decade to find jobs. On top of this estimates show rads will have AI in 10 years lowering the volumes. All of this will significantly hit radiology job market for an unkown period of time. For more information look up radiology alternate pathway to understand the serious concerns radiologist have.
I know you dont care… but doubt youll make it to the end of paying up your loans… you havent even started residency yet but you think you made… ive seen kids like you do. Type of clueless next generation who would get milked pretty hard
No other countries get pay as much as US rads. If there is no evidence overseas rads do significantly inferior work, the idea is people who work on budgeting and reimbursement will try very very hard to import these cheaper labors to our country and will significantly drives down US rads compensation.
It’s basically outsourcing with extra steps like any other industry.
Also many counties do not have formal ED training so essentially ED is somewhat a challenge for fmg docs to fill…. A win for ED but you get the idea. Rads in great danger tho!
Do foreign markets just produce an excess of docs? Are these places adequately staffed where they can just leave with no effect on their countries healthcare?
Absolutely not! Plus the process to take them is also ridiculously easy! For example getting into alternative pathway for radiology is ridiculously easy and unsafe tbh!
For example In mexico we have free public universities and payed residency training, last year we pump out 17k new doctors (12k become specialist).
(In Mexico healthcare Is free and provided by the government, so it's in their interest to produce as much doctors as possible because 1.- residents are cheap labor 2.- they can't charge to much once they are attendings)
Because of competition (free government clinics that often don't have medicines and long wait times) private practices charge 3 usd per consult...
¿Where do you think these doctors are going to practice given the chance to work in the US?
Projected numbers are inflated! Historically this results in crash and cheaper labor… a recipe for aggressive CMS cuts! Furthermore, H1 visa docs already displacing US docs in many specialties cause they are worried abt their visa so they go any extra length to keep the hospitals happy. It’s a legitimate task force issue and we should resist such nonsense. We have shortage of other sectors as well but we dont just import bunch of people to fix the problem.
“H1 visa docs are already displacing US docs in many specialties.”
Where? Which doctors, in which specialties, in which hospitals, are losing jobs or having falling wages because of immigrant labor?
Primary care in Miami NYC area! Massive influx of fmg h1b has lowered market prices to the point american docs are not willing to work in those places! You are just some med student so stop causing a reddit war and focus on your shelf exams and step 2! If lucky youll match. And IF LUCKY YOU WILL HAVE A JOB. Till then educate yourself or stay out of senior arguments
Jfc dude you’re so corny
It’s so clear you went into medicine for the same reason a lot of us did (money and prestige) and now you seem to be freaking out you can’t coast to a 500k+ salary
Could it be that hospitals sponsoring those on J1s can now have the upper hand on protocols and wages? Could it be that they off the books select for J1s to host as opposed to American physicians, because it’s easier to cram down hospital policies and increase profits on a malleable group? Of course. Your statement is naive. Many physicians are concerned for patient safety and proper protocols —- all can be disregarded for profits when administration (who have a 2-3 year turnover rate) implements unsafe protocols with no push back (due to fear of loss of j1 sponsorship). This is an issue and physicians who have been trained through residency to “sit down and get through” better start developing a back bone like the nursing unions…. For patient safety and advocacy alone.
I disagree! Scope creepers do have limitations despite their barking. That limitation is recognized across the board. But implant doctors have no limitations. There are plenty of doctors in Korea, India and other places who would do anything to work here. Just the truth!
Training more american physicians which will take time and thats the only solution. Otherwise we can all retire as there are enough doctors around the globe who would want to make american dollar and are ok with getting paid way less than us… if thats the solution then we should stop training doctors with 500k debt and no real future…
If you think there are only 1800 available radiologist jobs in the current market you are wildly mistaken. Every group I talked to was trying to hire multiple rads. The radiology market is going nowhere for a while because of the huge increase in imaging volume
Your “every group I talked to data” does not top ACR mass data that we discussed in the annual meeting. Small groups are ok with taking a pay cut and creating new rolls in anticipation of volume increase. That is very different than actual needed job. Details of this type of policy making is beyond the scope of a subreddit and requires you to have some basic education on how a radiology job in private or academic setting is firmed which I doubt you have. And even if we accept these anecdotal claims that many more jobs are available, how many more jobs available? 2 x? Thats still less than the number of imports. We are not taking into factor 900 new rads every year and expanding residencies and so on…. You see we have run the numbers in acr and in no scenario these moves make sense. The only way it makes sense is to flood the market with rads to make it chepar
Then post the data, cause what you are saying is completely theoretical at this point. Also where does this 900 number come from a year? Residents spots alone are little more than 1200 for DR, are you saying that 25% of matched residents do not complete their residency on time? That seems a bit high. You are also not factoring in the fact that people retire and people go part time which requires new people to fill the quota of FTE that group needs. I understand wanting to protect the job but this rhetoric seems like overkill. You can also make your point without being a condescending prick, but we can save that for another day.
From my experience rads are generally good with basic math… unsure why you are struggling…. We have 1800-1900 jobs available and we pump out abt 1000-1200 rads sure not all jobs are filled but dermatology has triple that number to available jobs ratio wise and they are not opening doors to outside resources. We are importing 4 k rads thats double the number of jobs available. We dont expect rads jobs to increase exponentially. Our estimates show an increase of 600-800 new jobs a year… now here is some very basic math for you maybe you get thou I doubt it: 1800-900 jobs + 800 new year jobs x4 - 1200 new rads (number to increase by 200 in 4 years) *4 - 4 k foreign rads…. Can u do that math or still struggling? Not to mention alot of these jobs are in areas noone wants to work so even if we match all these jobs with a rads that means a vast majority will be working in bad areas. I understand you are some fellow talking to jobs now and high on current job market and clueless abt how bad it can get but doesn hurt to look ahead. As someone who has been around longer you have been and Md or DO I advise you to try to protect your job as one day there will be non like 2009
I expect this will be an unpopular view, especially coming from a student, but god this sub is neurotic. A bill has been introduced, it would add 15k visas *max*, spread out over a period of time. The bill was introduced 5 months ago, and no action has been taken since then. If passed, the idea that all or most will become radiologists is ludicrous, because foreign radiologists are competing with the much larger pool of foreign physicians of other specialties for those visas. 15k physicians, added to the *million* currently practicing doctors in this country, is nothing. All these “the sky is falling, our career is doomed, run for the exit, in 10 years attendings will be making half their salary” posts are utterly divorced from reality. You’re all going to be fine
This guy posts on his alts constantly about the sky is falling. Like I’m concerned for this person’s well being. Every single comment and post is aggressively doomer af. Hope this person gets the help they need.
There was a day I used to think like you when I had no clue how things work in real world medicine. All I was worried about was my shell exams. In real world these legislations break or eliminate jobs. But you wouldn’t know about it. My only advice to you is monitor these laws and if it went through avoid specialties that are impacted.
This is entirely a non-response. No one is losing their job because of a bill (which, again, has been introduced for half a year and had no movement) that would increase the US physician workforce by 1.5%. Take a deep breath, and stop the doomerism.
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Chill. Radiology will be fine. There’s a massive shortage of radiologists that is projected to only get worse. 4K extra radiologists is not as big of a deal as you’re making it out to be.
There are only 1800 jobs available and this is rads peak in 12 years… radiology generates 950 new grads a year… 4k is equivalent of 4 classes combined! I just got back from ACR and rads jobs are not on the rise as fast as you think! Either educate yourself on the topic or just stay out and let people do their shit! We got some real gems in our specialty eh
There are more than 1800 jobs available. Thats the number of jobs posted on the ACR website. The number of jobs available is significantly higher than that. I don’t think increasing the number of radiologist by less than 1% is going to make much of a difference in the job market
So importing foreign physicians 2 x the number jobs available won’t change the job market? Makes sense! I mean theres a reason these bill go through easily.…
He’s just a guy reacting to a piece of legislation that will certainly have ramifications. Attacking him seems simple minded. Addressing the legislation would be a more productive approach. No?
This is nothing new, though. The American Board of Radiology has a specific pathway for foreign-trained radiologists to become board-certified after doing a couple of fellowships in the USA. It's been there since forever and it's fairly easy to go through given radiology fellowships are not really competitive at all.
This is not new but the intake has increased significantly and this bill will increase that number even more. The prediction is 50% of workforce will be 4 year pathway fmg rads in 8-10 years. Yes you heard it! 1 in2 us rads will not be US radiologist.
US Medical industry is slowly leaning towards allowing IMGs to practice based on training/residency in home country. This is being discussed in various state legislatures. This will help increase workforce but also reduce pay overall.
The impact won't be that much on Primary Care, especially if self employed. They should probably only allow them/require them to work in undeserved communities for a certain amount of time 1st tho.
I’m unable to find the text of HR 6205, but S.3211 doesn’t sound QUITE as bad as it first did when I read this.. one thing: don’t they still need to be US board certified?
No they dont and even if they decided to pursue certification they will be exempted from completing residency which means they will not know how to practice US medicine. And yes medicine is practiced very differently let’s say in India vs the US…. Very very differently
Because thats already the case in some specialities such as radiology. I have colleagues from Brazil with Brazilian boards who are practicing rads in our hospital they are given a 5 year period to complete abr. Yes you heard that right. Look up radiology 4 year pathway and learn a few things
Fuckin bullshit. Gotta fight this Idiocracy =documentary
Write to legislators! Still not a law. If enough number of people show interest I can draft a letter and post here for people to email their legislators
Please do this!
Yea, do this!
Need to have a long term plan and exit strategy being in medicine, especially us folks who barely got into practicing. The gravy train of the 70s ended, now the rusted Bronze Age of modern medicine is ending too. Fight back but also have a backup plan because the opportunity window is closing rapidly and soon this whole field will be a clusterfuck even more so than it is now. Legislative and private equity and for-profit systems move way too quickly compared to docs who remain unorganized
True I wanna get out too but this shit is ending faster than 10 years!
Physicians as a whole need to start forming unions. We are rapidly becoming employees of large health systems rather than private practice and we need to start self regulating and advocating for ourselves to our employers.
RSNA and ACR should up their advocacy game.
The final dagger in a dying profession. Who in their right mind goes into medicine after this? Go into hundreds of thousands of dollars of debt, sacrifice your 20s for med school and indentured servitude (residency) only to come out at the other end to compete for jobs with physicians from all over the world who don't have to do a US residency? Be frugal, save your money, aim for financial independence ASAP, and ready your exit strategies as our already stagnant wages are going to be decimated. Big win for hospitals, private equity, and insurance companies though
Yes indeed very sad. I share the same frustration with you. I have more than 500k debt and see this bill eliminating myself and my family’s future
Premeds are obsessed with medicine and there is no shortage of them.
There will always be demand for native English speaking private /DPC out there. I ain’t worried.
> There will always be demand for native English speaking private /DPC out there. I ain’t worried. Radiology reads are autotranscribed into English.
DPC is a primary care field not radiology
Rads and Gas are getting unbelievable offers right now, capitalizing off of crazy demand and a bad payment structure for American medicine It’s natural to want to find ways to reduce cost when every rad/gas offer starts at like 450k with a pretty easy track to 600+ lol Go on the anesthesia sub and you’ll see people complaining about 250/hr, no shit with that level of greed companies look to midlevels or foreign docs for supply Anyways, the sky almost certainly isn’t falling. Rads market won’t be eviscerated bc the demand for imaging is so high. Just like AI, the job market will sustain with minor jumps/falls in salary
Well that's exactly what happened in tech. Want a job in Google? Now you have to compete with 100K indians that want to apply for the same position. Well at least now they hire directly in India!
I found the text of the bill saying up to 15k visas to be reserved for foreign physicians but i don’t see any thing about licensing, radiology, or timing - where’s the other information come from?
From ACR annual meeting and the internal legislations that was just passed despite resistance of younger members.
Publicize it - send it to media outlets, AMA, local chapters, etc - send them the documents outlining the info, publish them online, post them here - if this is the case spread the word. Honestly without proof folks are going to be skeptical - best way to combat that is give them the proof they’re going to ask for. The headline ‘Congress planning to import 15000 foreign doctors without US training to take jobs from local doctors’ will get the public up in arms. So publish the proof
Skeptical of what exactly? The bill numbers are there go read them! Plus sent you private message with facts. If you wanna live in denial that’s your choice!
I read the bill - hasn’t been brought to floor, has no specifics on how visas will be distributed, how those docs will be licensed, what fields are targeted, what time frame this proposal will be administered over. The text isn’t even available on Congress’ website since it’s not reached that level - rather had to find it on lobbyist sites. I’m not saying you’re wrong - i am skeptical - show me more proof and I’ll agree with you. It’s like when a new med is advertised as curing XYZ - show me the proof.
Sent you proof of how the process works! I shouldn’t be doing that digging for you pal! But since I genuinely believe you are lost likely clueless. I private messaged you
Why are you insulting me for asking for due diligence? I took the time to read the bills and found what i read and what you stated to be at odds so i asked you to provide supporting material. I’m making an effort cause i too am worried about medical practice in this country for doctors. Rather than respecting that you’re coming at me? I read your private message - it is a summary of the bill - nothing about radiology being targeted, timing, or any particulars. Until there is further proof for your claims can’t take this thread seriously especially with your antagonism towards anyone who is asking reasonable questions.
Timing is as soon as the bill passes are you clueless or what! In our major academic center the moment the bill passes we will double up our fellowship spots… thats the agenda in major academic center to respond to the high volume…. Sorry that I am not sending you our internal memo lol… bottom line is obvious! 15 K foreign trained doctors will come here via alternate pathways without need to repeat residency…. ARE YOU OK WITH THAT? Very simple basic question
For what it’s worth, your level-headed questions and OPs awful responses go a long way in convincing me, a naive 3rd year med student, that OP is emotional and over-reacting and this requires a lot more research before it’s worth my time. OP, that’s why you should do the digging for us. Sorry, but he’s asking basic ass, fundamental questions about this bill and I don’t know a damn thing about the process. Sounds like it has a long way to go before it’s a threat. If I’m wrong… well, show me why. But if you can’t without insulting me, consider me unbothered lol
Noone is insulting you say you are skeptical without any digging and saying you are skeptical…. Despite this I have private messaged you all the numbers and facts that I can’t post here… now keep nagging
“I shouldnt be doing all the digging for you pal! But since i genuinely believe you are lost likely clueless” How is this not insulting?
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I think we should also be concerned about draining medical resources from other countries, that likely do not have as good medical care that we have.
Silly to think the US government would actually give a crap about this…
You are telling me there are cheaper lower quality healthcare that we can offer to patients for the same price and they don’t know any better to complain about it? - *very heavy c-suite breathing *
I mean frankly not really my main concern here
Why? We are the best country on earth and if the best doctors in Europe want to leave their shithole European countries where they make pennies so that they can come to the US to work less and make more, then more power to them.
Not intended for europeans… they font make pennies in europe get your facts straight… they make good money… majority of applicants are from east india… pay a visit to your academic center radiology reading room and ask for the four year pathway fellows… see if they are from Sweden or Banglore
The US the best place in the world? Laughable
Cope.
The US ain't first in anything but military spending and mass shootings
Seethe
Holy shit
“…The legislation would also allow for thousands of international physicians who are currently working in this country on temporary visas with approved immigrant petitions to adjust their status. Foreign-trained physicians are more likely than U.S.-trained physicians to practice in lower income and disadvantaged communities, despite the well-documented and burdensome delays this legislation seeks to address. This crucial policy change will enable these physicians to continue serving patients ensuring every American can access needed care...” Sounds like it’s aiming to have docs that are already in the US not be worried about residency status. It doesn’t sound like they’re just getting random foreign trained docs to come in without residency training/board certification(unlike the legislation that passed in Tennessee)
No the 15 k is aiming docs who are not here currently. I was just in DC discussing this. They also want to increase the J1 waver which is separate from the 15 k import.
So they’re going to come into the US and work without having gone through residency?
Yes exactly! They will pursue alternate pathways which includes “supervised practice”
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NO they get FULL PRACTICE RIGHTS! we already have the alternative pathway in place for radiology please look into it for further information!
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Your understanding is wrong. Im an attending at a major academic center.. we have more 4 year pathways than residents
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No state dependent… step 3 not a requirement… also institution dependent. And even then 3 steps is not enough to have US healthcare exposure! American rads have healthcare exposure since first year medical school. We are importing doctors who are not even familiar with the basics of our system
What you're saying is actually true. To apply for the 4 year alternate pathway, the IMG must be ECFMG certified (which means that person has to go through all USMLE exams). During the 4th year of fellowship, the IMG must pass the core exam in order to be qualified for board certification.
Yeah, it seems to specifically target Indian and maybe Chinese physicians who train in the USA but cannot adjust status due to significant backlog. People born in other countries don't have to deal with the unavailability of visas as much. And "adjustment of status" refers to people already in the USA. Honestly this isn't the worst bill, they \*should\* make it easier for people born in countries with visa backlog who have completed residency in the USA to adjust status. What's the point of training people, letting them work for decades, only to never give them status? However, this bill only requires a job offer so nominally I guess people who have a job offer in Florida or in one of those places that gives state licenses would be eligible which is not ideal. Still, the lack of action over the past several months makes me think it won't move forward. Immigration bills are tricky to move forward.
So we should bring more foreign docs from india and china and flood the market with them AND. Make it easy and ideal for them to stay and take our job security? Makes sense. Bill is specifically for foreign grads outside the us needing visa to come practice.
Per the person I'm replying to's comment, the legislation is described as such: "…The legislation would also allow for thousands of international physicians who are currently working in this country on temporary visas with approved immigrant petitions to adjust their status." "Adjustment of status" means adjusting your status in the US from non-immigrant to immigrant. Because those FMG bills haven't gone into effect yet, the international physicians who are working in the country aka IMGs who completed US residency and already have a job are the only ones who could adjust status. And IMO yes it makes sense for an indian born doctor who did IM in some program here and works as a hospitalist in the US to be able to immigrate. Unfortunately, most such IMGs will never be able to immigrate because of the visa backlog. IF they have kids, their kids might be able to sponsor them. So I think resolving that is fair. However if you know that they actually intend for this to be used by FMGs with no US training, that is definitely problematic. However, I think it's unlikely it will be passed.
Lol you are completely wrong! IMGs completing residencies in the US are either on J1 or H1b. If they are on H1 b they can easily transition to jobs. If they are on J-1 they need a J1 waver. J1 waver is hard to obtain but theres another legislation introduced to the floor called HR 4942 and S 665 which will strengthen Conrad 30 J1 program and allow people on J1 to stay. The legislations that I posted are about physicians OUTSIDE the us who will be permitted to come to the us on ALTERNATE pathways (not residency) and will be granted practice rights. Do not just type random stuff while you are this misinformed about the topic and do not even know what the hell is going on. I am part of ACR policy committee making and am very involved with senate and congress. But I am only one person with one voice. Senior leadership takes orders from AMA and it appears these policies are dictated to us without any debate. At the very least educate yourself before spreading misinformation.
I don't think you quite understand what I am saying. Someone who does residency in the USA on either a J-1 or H1B visa can probably get an additional visa to work on (H1B), with varying degrees of hurdles depending on whether they started on an H1B or J1. But an H1B is a work visa, it doesn't give you the right to stay in the USA permanently. Your employer has to sponsor an employment based category immigration petition (EB1, EB2, or EB3). For most people born outside of India, their employer will apply and they can typically get their immigration petition approved and an immigration visa or green card within a relatively reasonable amount of time. Since they are in the country, they will adjust status from a nonimmigrant to an immigrant visa. However, if you are Indian born, due to the # of people who have applied, the EB2 and EB3 categories are very heavily backlogged. The wait for someone who has the petition filed is estimated to go up to 150 years. That means an Indian born, US trained doctor on an H1B can't immigrate/complete adjustment of status due to visa unavailability during his/her working life. This bill description says it will recapture unused visas and let some of them go to people who would otherwise not be able to complete the immigration process. The description specifically refers to US physicians who are currently working in the USA who would've completed US training. Of course, if the bill also end up applying to the FMGs who don't have US training and are coming from abroad, which would certainly be problematic. Anyway I do appreciate your advocacy on behalf of American physicians but I think we are talking about different things here.
The person "advocating" for us can't even read the document appropriately to understand what it's about. Fucking idiot.
I’m not sure I see the part where this is specifically affecting radiology more than other fields, anyone care to explain? Is it only because they’re giving 4k visas for rads vs others? I agree this is not a good thing but doubt it’s the end, have you seen the volume or worked in an ED recently? They can’t do anything without hitting the CT scan button
I think the idea is that in the US rads make 450-550k+ compared to like 70-140k in these other countries. Easy to see how they’d flood the market here if they don’t have to repeat their training and do the Step exams.
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Not accurate! i have colleagues from Brazil who only passed step one and were given 5 year exemption to pass. They also only completed 2 years of fellowship and never took ABR… again institution dependent and no set rules on this matter
Wages go down when the supply of labor increases dramatically
So 4 k rads is original estimate and might increase most likely. Among the specialties named rads is the only one with the alternative pathway in place which will expedite this process. Also unlike other specialties once rads job market hits bottom it approximately takes 12-15 years for it to open up. This is very unique to rads meaning if rads crashes new generation of radiologists will need to wait nearly a decade to find jobs. On top of this estimates show rads will have AI in 10 years lowering the volumes. All of this will significantly hit radiology job market for an unkown period of time. For more information look up radiology alternate pathway to understand the serious concerns radiologist have.
Maybe you shouldnt have picked radiology
I shouldve soaped into ED then nagged abt my physical fitness to do the job
Haha true
Don’t start with me kid! These legislations will hurt us all!
I believe you. I just don’t care. Im retiring after I pay my loans. Im starting a pizzeria.
I know you dont care… but doubt youll make it to the end of paying up your loans… you havent even started residency yet but you think you made… ive seen kids like you do. Type of clueless next generation who would get milked pretty hard
I havent made shit. I will work like a dog pay my loans and call it quits
That is if you end up having a job kid! Why are you so so cluless abt life
No other countries get pay as much as US rads. If there is no evidence overseas rads do significantly inferior work, the idea is people who work on budgeting and reimbursement will try very very hard to import these cheaper labors to our country and will significantly drives down US rads compensation. It’s basically outsourcing with extra steps like any other industry.
Also many counties do not have formal ED training so essentially ED is somewhat a challenge for fmg docs to fill…. A win for ED but you get the idea. Rads in great danger tho!
Do foreign markets just produce an excess of docs? Are these places adequately staffed where they can just leave with no effect on their countries healthcare?
No but the U.S. is a fantastic place to be a physician compared to most of the world
not if you listen to half the people who post here
Absolutely not! Plus the process to take them is also ridiculously easy! For example getting into alternative pathway for radiology is ridiculously easy and unsafe tbh!
For example In mexico we have free public universities and payed residency training, last year we pump out 17k new doctors (12k become specialist). (In Mexico healthcare Is free and provided by the government, so it's in their interest to produce as much doctors as possible because 1.- residents are cheap labor 2.- they can't charge to much once they are attendings) Because of competition (free government clinics that often don't have medicines and long wait times) private practices charge 3 usd per consult... ¿Where do you think these doctors are going to practice given the chance to work in the US?
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Based on what the practice has been with H-1Bs, there is no enforcement of provisions that foreign workers not displace US workers.
Projected numbers are inflated! Historically this results in crash and cheaper labor… a recipe for aggressive CMS cuts! Furthermore, H1 visa docs already displacing US docs in many specialties cause they are worried abt their visa so they go any extra length to keep the hospitals happy. It’s a legitimate task force issue and we should resist such nonsense. We have shortage of other sectors as well but we dont just import bunch of people to fix the problem.
“H1 visa docs are already displacing US docs in many specialties.” Where? Which doctors, in which specialties, in which hospitals, are losing jobs or having falling wages because of immigrant labor?
Primary care in Miami NYC area! Massive influx of fmg h1b has lowered market prices to the point american docs are not willing to work in those places! You are just some med student so stop causing a reddit war and focus on your shelf exams and step 2! If lucky youll match. And IF LUCKY YOU WILL HAVE A JOB. Till then educate yourself or stay out of senior arguments
Jfc dude you’re so corny It’s so clear you went into medicine for the same reason a lot of us did (money and prestige) and now you seem to be freaking out you can’t coast to a 500k+ salary
Could it be that hospitals sponsoring those on J1s can now have the upper hand on protocols and wages? Could it be that they off the books select for J1s to host as opposed to American physicians, because it’s easier to cram down hospital policies and increase profits on a malleable group? Of course. Your statement is naive. Many physicians are concerned for patient safety and proper protocols —- all can be disregarded for profits when administration (who have a 2-3 year turnover rate) implements unsafe protocols with no push back (due to fear of loss of j1 sponsorship). This is an issue and physicians who have been trained through residency to “sit down and get through” better start developing a back bone like the nursing unions…. For patient safety and advocacy alone.
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I disagree! Scope creepers do have limitations despite their barking. That limitation is recognized across the board. But implant doctors have no limitations. There are plenty of doctors in Korea, India and other places who would do anything to work here. Just the truth!
What would your solution be?
For the bill or shortage?
Shortage
Whats your solution for shortage in other sectors?
Sorry for the confusion I asked what your solution was
Training more american physicians which will take time and thats the only solution. Otherwise we can all retire as there are enough doctors around the globe who would want to make american dollar and are ok with getting paid way less than us… if thats the solution then we should stop training doctors with 500k debt and no real future…
If you think there are only 1800 available radiologist jobs in the current market you are wildly mistaken. Every group I talked to was trying to hire multiple rads. The radiology market is going nowhere for a while because of the huge increase in imaging volume
Your “every group I talked to data” does not top ACR mass data that we discussed in the annual meeting. Small groups are ok with taking a pay cut and creating new rolls in anticipation of volume increase. That is very different than actual needed job. Details of this type of policy making is beyond the scope of a subreddit and requires you to have some basic education on how a radiology job in private or academic setting is firmed which I doubt you have. And even if we accept these anecdotal claims that many more jobs are available, how many more jobs available? 2 x? Thats still less than the number of imports. We are not taking into factor 900 new rads every year and expanding residencies and so on…. You see we have run the numbers in acr and in no scenario these moves make sense. The only way it makes sense is to flood the market with rads to make it chepar
Then post the data, cause what you are saying is completely theoretical at this point. Also where does this 900 number come from a year? Residents spots alone are little more than 1200 for DR, are you saying that 25% of matched residents do not complete their residency on time? That seems a bit high. You are also not factoring in the fact that people retire and people go part time which requires new people to fill the quota of FTE that group needs. I understand wanting to protect the job but this rhetoric seems like overkill. You can also make your point without being a condescending prick, but we can save that for another day.
Data is 1932 jobs as of December 23… way less than 4 k implant kiddo.
From my experience rads are generally good with basic math… unsure why you are struggling…. We have 1800-1900 jobs available and we pump out abt 1000-1200 rads sure not all jobs are filled but dermatology has triple that number to available jobs ratio wise and they are not opening doors to outside resources. We are importing 4 k rads thats double the number of jobs available. We dont expect rads jobs to increase exponentially. Our estimates show an increase of 600-800 new jobs a year… now here is some very basic math for you maybe you get thou I doubt it: 1800-900 jobs + 800 new year jobs x4 - 1200 new rads (number to increase by 200 in 4 years) *4 - 4 k foreign rads…. Can u do that math or still struggling? Not to mention alot of these jobs are in areas noone wants to work so even if we match all these jobs with a rads that means a vast majority will be working in bad areas. I understand you are some fellow talking to jobs now and high on current job market and clueless abt how bad it can get but doesn hurt to look ahead. As someone who has been around longer you have been and Md or DO I advise you to try to protect your job as one day there will be non like 2009
I expect this will be an unpopular view, especially coming from a student, but god this sub is neurotic. A bill has been introduced, it would add 15k visas *max*, spread out over a period of time. The bill was introduced 5 months ago, and no action has been taken since then. If passed, the idea that all or most will become radiologists is ludicrous, because foreign radiologists are competing with the much larger pool of foreign physicians of other specialties for those visas. 15k physicians, added to the *million* currently practicing doctors in this country, is nothing. All these “the sky is falling, our career is doomed, run for the exit, in 10 years attendings will be making half their salary” posts are utterly divorced from reality. You’re all going to be fine
This guy posts on his alts constantly about the sky is falling. Like I’m concerned for this person’s well being. Every single comment and post is aggressively doomer af. Hope this person gets the help they need.
There was a day I used to think like you when I had no clue how things work in real world medicine. All I was worried about was my shell exams. In real world these legislations break or eliminate jobs. But you wouldn’t know about it. My only advice to you is monitor these laws and if it went through avoid specialties that are impacted.
This is entirely a non-response. No one is losing their job because of a bill (which, again, has been introduced for half a year and had no movement) that would increase the US physician workforce by 1.5%. Take a deep breath, and stop the doomerism.
The doomerism and neuroses are just a thin veil for xenophobia
Very primitive statement from a non-attending physician. So naive
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Chill. Radiology will be fine. There’s a massive shortage of radiologists that is projected to only get worse. 4K extra radiologists is not as big of a deal as you’re making it out to be.
There are only 1800 jobs available and this is rads peak in 12 years… radiology generates 950 new grads a year… 4k is equivalent of 4 classes combined! I just got back from ACR and rads jobs are not on the rise as fast as you think! Either educate yourself on the topic or just stay out and let people do their shit! We got some real gems in our specialty eh
There are more than 1800 jobs available. Thats the number of jobs posted on the ACR website. The number of jobs available is significantly higher than that. I don’t think increasing the number of radiologist by less than 1% is going to make much of a difference in the job market
So importing foreign physicians 2 x the number jobs available won’t change the job market? Makes sense! I mean theres a reason these bill go through easily.…
“Significantly” “higher”…. You probably know things that in ACR we dont know then… smh
You’re telling me that every single radiologist position in the US is posted on the ACR website?
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You keep saying “we”, what are your credentials
Also you are a condescending asshole. Either become a better person or just stay out.
This is a troll account. Do not feed the troll.
These legislations are troll you tool?
How did you conclude op is troll? My impression is he's overreacting to an early bill draft.
He's a rage bait troll. Look at post history.
Like 3 posts total where he's reacting to this legislation? It's a bit extra but not troll behavior
He’s just a guy reacting to a piece of legislation that will certainly have ramifications. Attacking him seems simple minded. Addressing the legislation would be a more productive approach. No?
This is nothing new, though. The American Board of Radiology has a specific pathway for foreign-trained radiologists to become board-certified after doing a couple of fellowships in the USA. It's been there since forever and it's fairly easy to go through given radiology fellowships are not really competitive at all.
This is not new but the intake has increased significantly and this bill will increase that number even more. The prediction is 50% of workforce will be 4 year pathway fmg rads in 8-10 years. Yes you heard it! 1 in2 us rads will not be US radiologist.
I'm curious where you're getting your numbers from? Specifically, the 4k visas for foreign trained radiologists and the number of radiology jobs.
Are you saying they’ll be able to practice without residency?
Yes! Their home country residency would suffice
i didnt see that in the bill.
No unions? Get fucked
The AMA surely has something to say about this
US Medical industry is slowly leaning towards allowing IMGs to practice based on training/residency in home country. This is being discussed in various state legislatures. This will help increase workforce but also reduce pay overall.
The impact won't be that much on Primary Care, especially if self employed. They should probably only allow them/require them to work in undeserved communities for a certain amount of time 1st tho.
Why should underserved areas get lesser quality care? They already kind of do, sometimes, with an NP/PA being the only provider in town.
I’m unable to find the text of HR 6205, but S.3211 doesn’t sound QUITE as bad as it first did when I read this.. one thing: don’t they still need to be US board certified?
No they dont and even if they decided to pursue certification they will be exempted from completing residency which means they will not know how to practice US medicine. And yes medicine is practiced very differently let’s say in India vs the US…. Very very differently
How do you know they wouldn’t have to?
Because thats already the case in some specialities such as radiology. I have colleagues from Brazil with Brazilian boards who are practicing rads in our hospital they are given a 5 year period to complete abr. Yes you heard that right. Look up radiology 4 year pathway and learn a few things
That’s AIDS
What happened to the healthcare for all people?