April 20, 2006

Why Are So Many Psychiatrists From India?

Because they're not. 

Odd article in Clinical Psychiatry News about the Match.

Although it doesn't come out and say it, it basically laments the fact that there are so many foreign medical graduates in psychiatry.  Which is weird, because there aren't. 


As the article correctly indicates, there were 1037 slots available.  983 (95%) were filled.  U.S.  med school graduates  comprised 62%.


The article says:

Another issue that concerns some psychiatrists is "a continued and sustained reliance" on international medical graduates to fill residency slots.

What's so wrong about this perspective is that it misses how slots get filled.  The slots don't "exist" and need filling.  Slots exist because there's a demand for them.  And they get filled by FMGs because they had been filled by FMGs the year before.  For example: in 2005, U.S. grads filled 63.6% of the slots.  In 2006, it is 62%. 


So the question isn't why so many FMGs go into psychiatry.  It is a) what is it about U.S. medical education that doesn't prompt U.S. grads to go into psychiatry; and b) do we really need this many psychiatrists?


What we should be thankful for, and Dr. Weissman indicates this, is that by taking in FMGs to residency slots, we don't have to pay to educate them in U.S. medical schools.     Basically, it's free money: some other country paid to educate them, and now they work here.  Good for us.


But this should lead us to the next question: why send them to medical school at all?  Many argue that foreign medical schools are not as good as U.S. ones.  Fine-- then why are they allowed in residencies?  And if they are, then you can't say you need a U.S. "level" of education, either.     And if an NP can prescribe, and a psychologist can prescribe, you similarly can't obligate we all go to medical school.


So either we need U.S. med schools, or we don't.  There are ramifications to either choice.  Choose.

You can find the distribution of residency matches here