Everything You Need To Know About
What RW’s Who Are Doctor’s Will Adapt To Life In The West
From Ron Morgan, Austin Texas April 25,
2001
I’m going to a LOT of trouble to type all
this, so please, if you’re involved with a Russian doctor,
please read it carefully. It is absolutely, critically
important. At the end of this message, I’ll post some
links to important information on this topic.
My wife, Larisa, was a very successful
physician in Russia for 10 years before coming to the
U.S. She was a chief physician in a pediatric hospital,
professor in a medical university, and a bunch of other
things. She was immensely well-known and respected in her
professional field.
Then she came here. I can’t begin to
describe what it has been like for her, with regard to her
profession. Remember, in a socialist country, your job is
YOU. Here, the doctor’s license is as worthless as
toilet paper. She might as well have a degree in basket
weaving. Well, that’s an exaggeration - her foreign
medical studies ARE recognized, but not for the purpose of
practicing medicine here. They’re “accepted” for the
purpose of making her eligible to take the medical exams.
In any case, the complete, total
destruction of her life’s work and career have been
incredibly traumatic and painful. She presently works as
an “uncertified nurse” in a clinic, for a very low wage.
She can’t make as much as an LVN or RN, because she
doesn’t have that all-important “piece of paper.” The
only medical jobs she can get are as a “medical assistant”
just cleaning the exam rooms, wiping tables, maybe taking
patients back.
The doctors she works with quickly realized
her abilities, however, and address her as “Dr.” and have
asked her opinions on many medical cases. They have a HUGE
respect for her knowledge of medicine. Still, it doesn’t
really change anything. They have been pushing her to “go
for it” and try to earn a license here.
The controlling authority for foreign
medical graduates who want to practice in this country is
a branch of the USMLE called the ECFMG, the Educational
Commission for Foreign Medical Graduates. For an FMG
(foreign medical graduate) to practice in the U.S., he or
she must be “ECFMG certified.” To become ECFMG certified,
the FMG must meet the following requirements:
1. Pass the USMLE Step 1 Exam. This is
the standard medical exam given to fresh medical school
graduates who have just finished their internships. It is
a huge, difficult test, consisting of 350 multiple-choice
questions. It takes 8 hours to complete. It is an
absolute MONSTER. The Step 1 focuses mainly on body and
disease processes, as well as pharmacology, biochemistry,
neurophysiology, etc. Next time you’re in Barnes & Noble,
thumb through one of those 5-inch-thick medical textbooks;
that will give you a picture of what’s involved.
2. Pass the USMLE Step 2 Exam. The second
monster, but focuses more on diagnosis and treatment
issues.
We have one friend, a doctor from Ukraine,
whose AM spent thousands of dollars helping her pay for
studying for her Step 1. She didn’t work, and spent 10-12
hours a day cramming for it, attending KAPLAN test prep
tutoring, the whole nine yards, for about 8 months. She
finally took the test... and made a 72. Then she went
through that whole process AGAIN.... and made a 71. And
if you’re an FMG and don’t score in at least the low 90’s,
you’re dead meat.
3. Obtain and complete a residency
program, from 3 to 5 years. Now, getting a residency in
this country is NOT a piece of cake. It’s not unusual for
medical graduates to apply to over 100 programs and not be
accepted by a single one. With FMG’s it’s even more
difficult. In general, if their Step 1/Step 2 scores are
anything below the high 80’s, they’re wasting their time,
with the POSSIBLE exception of getting a residency in
Hillbilly Hospital in Backwoods, Tennessee, if you get my
drift. And that’s not all - it’s not just exam scores.
You also have to go through an extensive all-day interview
with the program’s medical staff, and have several
excellent professional recommendations. And no,
recommendations from her FSU colleagues are NOT
acceptable.
4. Pass the Clinical Skills Assessment.
Another EXTREMELY difficult exam, given only a few times a
year in Pennyslvania. In this exam, the candidate is
placed in a fully-equipped exam room and presented with a
series of patients, portrayed by trained actors. They are
videotaped and graded on everything: facial statement,
what they say and do, their touch, the notes they take,
their diagnoses and prescriptions, everything. Many FMG’s
have struggled through the ordeal of step exams and
residency, only to fail the CSA.
5. Finally, the Step 3. The biggest,
most difficult exam of them all. This focuses on the
skills and knowledge necessary to practice medicine
independently and completely.
There’s an English test in there somewhere,
but that’s a given - if she can’t master English at nearly
the native-speaker level, she’ll never survive this
process, anyway. Just getting STARTED on this process
requires an extremely high level of written, spoken and
hearing English ability, which alone can be an
overwhelming challenge.
Overall, it’s do-able. It requires that
the FMG be very mature, efficient and focused. Some
financial resources are necessary - nobody’s going to flip
hamburgers at MacDonald’s 8 hours a day, then come home to
a dirty house and a couple of screaming kids, not to
mention a hungry and horny husband, and then study for the
USMLE exams. It just isn’t going to happen. Personal
motivation is crucial, but there ARE certain basic
elements that have to be in place.
There will be some variance in
opportunities, depending on where you live. Obviously
there will be more in a large city. But if you live in
Dry Gulch, Nevada and your RW wants to come here and be a
doctor, she’s in for a world of pain. If none of this
sounds feasible to you, be SURE you explain to your RW
that when she comes here, she will NOT be a doctor - she
will be, functionally speaking, an uneducated,
unemployable nobody, and will probably end up working in a
store or something.
Again, opportunities can vary. We know yet
another doctor, also from Ukraine, who just finished
medical school in Ukraine, then immigrated to the U.S.
She just HAPPENED have excellent English, and she just
HAPPENED to run into a doctor here who saw her for what
she was and appreciated her talent, especially compared to
the typical bubblehead American LVN he would have normally
hired. He took her in and trained her to be his own
private surgical assistant, at a salary of $40,000 a
year. But even that story doesn’t have a happy ending:
he’s old, and is retiring in a year or two. She has been
scraping the bottom of the barrel for SOME kind of
comparable job, and has had no luck at all. Without a “piece of paper,” she’s nothing, and the best she can find
is a $9 Medical Assistant position.
Here are some links that have more detailed
information about this process. Contact me in email if you
and/or your RW are seriously pursuing this objective.
Please save this message and distribute it to others who
inquire, so I won’t have to type all this over again, OK?
Maybe put it on the list’s FAQ page or something....
(gasp, pant....)
Thanks, and good luck Ron M.
ECFMG web site: http://www.ecfmg.org/
USMLE web site: http://www.usmle.org/
50 example Step 1 questions, in .pdf format
http://www.usmle.org/step1/S1gi.pdf
50 example Step 2 questions, in .pdf format
http://www.usmle.org/step2/S2gi.pdf
50 example Step 3 questions, in .pdf format
http://www.usmle.org/step3/S3gi.PDF
