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March 11, 2012 5:14 AM   Subscribe


 
They've been complaining about the brain drain since the Seventies. Not to mention the delicious irony of the heritage of the Zambian doctor chosen to represent the brain drain.
posted by infini at 5:21 AM on March 11, 2012 [1 favorite]


Buying is a bit different from stealing.
posted by srboisvert at 5:47 AM on March 11, 2012 [6 favorites]


If there's a shortage of doctors in America, and they get one from Zambia, surely the number of people in Zambia who now go without medical care are balanced by the number of people in America who now GET medical care? Unless the "shortage" in the USA doesn't actually mean people in remote regions or places with long waiting lists are missing out on care altogether, while the shortage in Zambia does? And I guess that going without medical care in Zambia is maybe more likely to lead to death than it is in America where (I'd hope) better nutrition, better housing, better education, etc might improve health outcomes a bit anyway?

But if those are not the case - if it really is a matter of people dying from lack of healthcare in Zambia or people dying from lack of healthcare in America - I don't see why it matters where the doctor chooses to work. Especially if one place increases his own standard of living, and maybe even provides him enough salary that he can send money back home to family or charities.
posted by lollusc at 6:48 AM on March 11, 2012


It matters because the USA does NOT have a shortage of doctors compared to Zambia -- the ratio of doctors to population is something like 1 to ~400 in the US, but 1 to ~10 or 20k in Zambia (and other developing counties).

It matters because health care is not something which should be determined by the Market.

And it matters because many doctors who emmigrate had their training paid for by their home country through a public university system (the doctor profiled is an exception). I think that all countries which subsidise training should include a requirement that the trainee remain to work in that country for a certain time - at least 5 if not 10 or 20 years. Canada loses orthopaedic surgeons to the US, after paying $100,000s to train them. Either they should have to stay, or repay the subsidy to their education.

It also matters because some countries to which doctors emigrate -- notably Canada -- then, ironically, do not allow those doctors to practice as doctors. There are MDs in Canada working as orderlies and personal care attendants, as well as a taxi drivers, because our laws don't allow them to practice without very lengthy recertification. Personally, I don't know why they stay here, given the stupidity of our system. but I'm not an immigrant myself (or even the child or grandchild of immigrants), so I don't know how immigrants think about immigration.
posted by jb at 7:04 AM on March 11, 2012 [17 favorites]


Brain drain continues to cripple India's medical sector. According to the Medical Council of India (MCI), till July 27, 2011, as many as 767 doctors may have left India for foreign shores.

According to the health ministry, such a large number of doctors going abroad to work is bad news for India. The country has just one doctor for every 1,700 people. In comparison, the doctor-population ratio globally is 1.5:1,000. Somalia has one doctor for 10,000 population. China's doctor population ratio stands at 1:1063, Korea 1:951, Brazil 1:844, Singapore 1:714, Japan 1:606, Thailand 1:500, UK 1:469, US 1:350 and Germany 1:296.

MCI is now trying to reduce the gap to 1 doctor for 1,000 population by 2031. According to the Planning Commission, India is short of six lakh doctors, 10 lakh nurses and two lakh dental surgeons. The commission estimates that Indian doctors who have migrated to developed countries form nearly 5% of their medical workforce. Almost 60,000 Indian physicians are estimated to be working in countries like US, UK, Canada and Australia alone.

A recent paper in the Lancet said India had eight healthcare workers, 3.8 allopathic doctors and 2.4 nurses per 10,000 population. When compared to other countries, this is about half the WHO benchmark of 25.4 workers per 10,000 people.

According to MCI's Indian Medical Register that was last updated in April 2011, the nation supposedly boasts of 840,678 registered medical practitioners. However, the data includes names of doctors who were registered way back in 1933. Chances of these doctors being alive is dim, admits MCI.

India, meanwhile, is all set to produce over 4,400 more doctors every year. The MCI, looking at India's medical manpower shortage, has increased the number of seats for undergraduate medical education by 4,452 from this academic session (2011-12).

posted by infini at 7:14 AM on March 11, 2012 [2 favorites]


Mills E, Shabbas W, Volmink J, et al. 2008. Should Active Recruitment of Health Workers From Sub-Saharan Africa Be Viewed as a Crime? Lancet. 371: 685-88.
posted by Blasdelb at 7:19 AM on March 11, 2012 [1 favorite]


Buying is a bit different from stealing.

When the financial (and hence power) disparity between the involved parties is so dramatic, that distinction is not as clear cut as a clear conscience might require.
posted by mhoye at 7:42 AM on March 11, 2012 [15 favorites]


Desai left Zambia one year before they started with some big changes, and changes continue in an effort to improve the situation.

In 2006, Zambia used the G8 debt cancellation to provide healthcare to all its people and to invest in education. They noted then that the lack of doctors and the expected flood of new patients would be a problem.

In 2008, the World Health Organization surveyed the situation and states that brain drain is only one of the causes. Other causes include lack of investment in training, early retirement ages (55 years old), and premature mortality.

By 2010, the universities added new degree programs and training to partially address the need for more skilled doctors.

Last year, they looked at increasing the retirement age to 65 and performed a study to find where the needs are greatest in their country.

That's not to say that their healthcare system is in any way good, but the Zambians are working on the problem. The US is trying to help them: Improving Healthcare in Zambia: The United States is committing nearly $90 million to strengthen Zambia's health care system.

The article's headline ("Stealing") seems to imply that we should give back our skilled immigrants. After reading the article, I'm not sure this is a good solution to the problem. A big part of what makes America work is that we offer opportunity for a better life. The reality is, that is brain drain from other countries. As an American, I want the best and smartest, the most innovative and hardest-working, people here. Refusing them entry is not a good solution. A better solution is to help Zambia be more attractive to Zambians. Desai came to the US for surgical training. Zambia now offers more medical training in their country. He was discouraged by the lack of technology. Zambia now has more technology. The money spent by Zambia on his education is a concern, and Zambia could force doctors who leave to pay back the money spent on them (although the school he went to receives US grants).

Telling a person they can't be here, live into their 70s, and make $200,000, but instead must stay in Africa, live into their 40s, and make $24,000 because we think it's best doesn't seem right. I like these advantages but I got here first; now that I'm here, you are shut out because it's what's best for your original country?
posted by Houstonian at 7:52 AM on March 11, 2012 [7 favorites]


Zambian medicine isn't hamstrung by the U.S. taking a few doctors but by their own inability to educate doctors, which is entirely due to their political class's preference for graft over necessary social expenditures. And India has no excuse for complaining about a mere 767 people going anywhere.

There isn't any serious constraint on the number of people smart enough to become doctors. Terrance Tao has argued previously that such constraints don't even exist for mathematics and physics, but certainly brains aren't the limiting factor in medical education.

Cuba has intentionally sent 19,000 physicians abroad. Cuban doctors are very highly regarded internationally because Cuba has invested heavily in medical schools.

Zambia has about 14% more people than Cuba, making them similar in population, but Zambia possesses about 7x the land area, and probably natural resources, although Cuba has more profitable agricultural traditions. Cuba's nominal GDP is 4.3x Zambia's. Senator Kent's J-1 Visa change has added only 8500 doctor to the U.S., about 530 from Ghana, apparently far fewer from Zambia.

There is certainly a trend towards excellent education systems in virtually all communist countries, with perhaps North Korea being the only exception. Yes, we know education is better done by the state than by private enterprise. Yes, Marx foresaw the brain drain harming communism. There is no reason that merely being capitalist prevents you from creating a solid educational system though.

You simply build the medical schools for which you source faculty from ex-pat Zambian doctors or Cubans or whoever. There isn't usually any shortage of laid back idealists who'll jump at a comparatively cushy but well respected professor position either, even if the pay sucks.
posted by jeffburdges at 7:55 AM on March 11, 2012 [1 favorite]


Desai also said that poor infrastructure, poor maintenence, and the lack of commitment from hospital staff made it basically impossible for him to practice medicine in Zambia. America didn't steal him as much as Zambia forced him out. Anerica just offered a choice.
posted by three blind mice at 8:14 AM on March 11, 2012 [3 favorites]


New York based Indian born cardiac surgeon Naresh Trehan saw the opportunity and set up New Delhi's Escorts Medical Centre. He charges an arm and a leg and serves the wealthy in an environment which is familiar and comfortable by flying in for scheduled visits to the country. In addition, around the back, he sees (or has doctors available) who see economically challenged patients for Rs 300 (USD 6 or 7) a visit.

(and I note in the link my information is slightly out of date and that he's now moved on to the next medical venture, based in Gurgaon)

My father is doing extremely well after a quadruple bypass in 2000 by Dr Trehan himself in New Delhi, able to get world class surgery at a fraction of the cost in NYC.


While the numbers of doctors available to India's population remain a statistical challenge, if the increasing numbers of opportunities available for medical care are any signal, there may indeed be a return after education abroad. Medical tourism provides an economic attraction as well, pragmatically speaking, to counterbalance the disparity between US earnings and what might have been the case locally in previous years.

As was mentioned, 800 people in the context of India's population is a pinprick but the bigger challenge will be increasing the quotas and capacity of the training institutions.
posted by infini at 8:18 AM on March 11, 2012


(sorry for more but was looking up why I had the sense of the story above, found this from his website's link to a 2003 NYT article)

But this is India, where those who can afford it have been accustomed to going abroad for state-of-the-art care, often provided by Indian doctors who have migrated themselves. Dr. Trehan was one of them. He went to the United States in 1969, and by the mid-1980's was earning over $1.5 million a year as a Manhattan heart surgeon.

But then he did what few Indian doctors do: he came back, prompted largely by the Indians who kept showing up on his operating table and asking why they could not get the same quality of care back home. He was driven, he said, by ''a certain amount of arrogance -- a kind of national pride.''

''I could do things better than most of my American counterparts,'' he said.

He decided against practicing in an established hospital and found an industrialist to finance his vision of a private heart institute and research center in New Delhi.The Escorts Heart Institute and Research Center opened in 1988. Today it is among the largest of its kind in the world, with 325 beds, 9 operating theaters and satellite operating rooms in five cities -- although that means little in a nation of a billion people.

At 56, Dr. Trehan may be the most prominent heart surgeon in the country. He has won just about every award India gives for citizenship and service. He has operated on almost every major political figure or businessman and he counts many of them as friends.

Everyone wants him. One man, accused of helping to bilk the Delhi Development Authority in a land scheme, has petitioned the court to have Dr. Trehan perform his heart bypass.

Escorts also draws Indians and others from abroad to New Delhi, by bringing the most advanced technologies and techniques here. It is only the second place in Asia, after Japan, to perform robotic surgery. It has done about 50 robotic surgeries since December, moving cautiously because the procedure is costly and the technology still evolving.

On some fronts, Dr. Trehan has far outstripped the West. Most American cardiac surgeons still hesitate to perform ''beating heart'' surgery, which does not require stopping the heart or using a heart-lung machine. The procedure reduces trauma to the body but is challenging to perform. Escorts has done about 10,000 beating heart surgeries, including 4,000 last year alone, putting it in the top tier worldwide for this procedure.

The center devotes 10 percent of its income to free care for the poor and subsidizes care for government employees, members of the military and retirees. Staff members in its mobile echocardiogram van see 100,000 villagers a year.

posted by infini at 8:25 AM on March 11, 2012 [3 favorites]


Puny class sizes and overly stringent entrance requirements for med students here in the US have kept the pool of doctors, especially specialists, criminally low. This drives health care costs through the roof, negatively impacts availability of quality care, and pillages medical professionals from developing countries. Talented and intelligent students are shunted to law school as a matter of course, rather than medicine, the sciences or engineering.

The higher education system here in the US is precariously close to teetering into "negative societal impact" territory - with ludicrous tuitions, usurious loans, piddling pay for researchers, and now this as well.
posted by Slap*Happy at 8:37 AM on March 11, 2012 [5 favorites]


It also matters because some countries to which doctors emigrate -- notably Canada -- then, ironically, do not allow those doctors to practice as doctors. There are MDs in Canada working as orderlies and personal care attendants, as well as a taxi drivers, because our laws don't allow them to practice without very lengthy recertification.

A doctor from Lusaka is not as competent as one from Toronto. It's not because of intelligence, it's due to their different training environments. If a doctor is used to working with power tools in the OR they're probably going to need to train in our system before working outside of a teaching environment.
posted by Orange Pamplemousse at 8:38 AM on March 11, 2012 [1 favorite]


It matters because health care is not something which should be determined by the Market ... Canada loses orthopaedic surgeons to the US, after paying $100,000s to train them. Either they should have to stay, or repay the subsidy

While forced settlement may seem like logical solution to the problem, restricting people's right to education and freedom of movement creates more new problems more than it does solving the current one.

Instead of making certain forms of higher education less appealing, why not go at the root of the problem and offer secondary and higher education to more people?
posted by romanb at 8:54 AM on March 11, 2012


I recently spent a month or so in the hospital(s) and felt terribly guilty that most of my nurses were from sub-Sahara, Philippines, Caribbean. I had long talks with them, why they were here and how they got here and health conditions at home. The story of one Philippine nurse inspired me to donate money to a non-profit which sponsors Philippine nurses in the USA to take annual trips back home for a few weeks to provide health care to their own villagers. Laying there in bed being treated by these people I felt like a total asshole. I spoke with an American nurse who said they used to get paid well but now there is so much competition that salaries have dropped and it's not such a great career to get into anymore (if your native born American I guess). The whole thing is screwed up.
posted by stbalbach at 8:59 AM on March 11, 2012 [1 favorite]


My question is why, given that America is full of unemployed young people, we are maintaining an artificial shortage of doctors that requires them to be imported from overseas. That doctor shortage that always gets quoted is not made up of people we could not possibly train ourselves. This isn't like meat packing where it's a job nobody wants. We just don't have that many seats in our own medical schools.
posted by gracedissolved at 9:02 AM on March 11, 2012 [2 favorites]


There is usually an extremely short retraining period for people with the underlying theoretical basis in anything, after which point the one with wider experiences often win out.

There is another benefit to simply training more doctors, both in the U.S. and in Zambia, namely university hospitals are commonly among the best hospitals.

There was this joke my PhD advisor loved that 100% of published mathematics journal articles were wrong. First, he asserted that the only time you'd know if a paper was correct if it was the first article a bright young PhD student read once they started working towards a thesis, i.e. passed qualifying exams. In other words, they'd only pay such close attention once in their lifetime, but also they had experienced supervision behind them somewhere. Second, he asked various faculty if this first paper they read in grad school was wrong, all he'd asked said he it was wrong.

There is probably an enormous advantage to an attentive eager young surgeon being in the operating theatre along side an experienced one that neither alone could provide. I'd expect this enters into Dr. Naresh Trehan's success somewhat given his institution is called a "Research Center".
posted by jeffburdges at 9:04 AM on March 11, 2012


after paying $100,000s

That's why lakh is such an elegant word, one can simply restate "after paying lakhs of dollars.."
posted by infini at 9:06 AM on March 11, 2012 [4 favorites]


Headline from 1840: America Stealing Ireland's Potato Farmers.
posted by Halloween Jack at 9:23 AM on March 11, 2012 [2 favorites]


mhhh...

1. disburse $90M public money to Zambia for humanitarian project, more doctors for Zambians!

2. train a few dozen new Zambian doctors with 1. funds at Zambians costs (a fraction of USA's) or certainly less than;

3. the newly trained doctor practices a few years in Zambia, outside of the reach of multimillion lawsuits. Some lifes are saved, some are lost, whatever.

4. Hey young Zambian doctor, move to U.S., you deserve the "american dream", this private company will claim your talent can't be found in U.S. (or something along that line);

5. An handful of Zambian doctors, eager to work their asses off, afraid of being expelled for whatever reason, enter the system at a fraction of the cost;

6. Privatized Profit! (by reduced expenses).
posted by elpapacito at 9:26 AM on March 11, 2012


Since I now pay $7,000 a year for my medical insurance, I expect a little return on that investment.

Also, a big shout out to Dr. Jain (originally from India), who correctly diagnosed my strange type of chronic esophagitis. Big brains, please keep coming to the U.S!
posted by mrhappy at 9:52 AM on March 11, 2012


We've gotten this far with no one mentioning the source of the problem. Price fixing by the AMA.

They cap the number of doctors we train to keep our native supply artificially low, and while this is great for them with the high salaries it produces this is a big part of why it sucks overall. The price fixing might be arguably good for us as those salaries attract the best, but they contribute a small amount to the high cost of health care and a great deal to the rationing of doctors time.

Seriously fuck the AMA.
posted by Blasdelb at 9:55 AM on March 11, 2012 [5 favorites]


A doctor from Lusaka is not as competent as one from Toronto.

Well, what about doctors from Ukraine, Czech Republic, Iran, Nigeria or Punjab? I've met people from all of those countries who came to Canada because they were led to believe that with some retraining they'd be able to practice in Canada. Some of them were willing to bite the bullet and take a low-paying job while they upgraded their certification, which might take several years, but several said, "what the hell, I'm better off driving taxi".

It's unclear what we (Canada) are trying to achieve with this kind of policy, but it seems wasteful and insulting to the people who were encouraged to come here because we have a shortage of medical professionals.

It's not just doctors either - I've met quite a few engineers, scientists and high-end technical folks who came here believing they'd be able to work in their profession, only to find out that bureaucratic and language obstacles were insurmountable. WTF? My feeling is that this is because of protectionism on the part of professional associations, and in some cases frank racism.

Our family physician is an American who came here with her husband in the sixties. She's currently running an office where she supervises five immigrant doctors who came here with modern medical training, some of it in N. America, as a way for them to meet some of the residency requirements for work in Canada. This kind of thing should be the norm, here in one of the richest countries in the world.
posted by sneebler at 10:12 AM on March 11, 2012 [1 favorite]



While forced settlement may seem like logical solution to the problem, restricting people's right to education and freedom of movement creates more new problems more than it does solving the current one.


It's not forced settlement. They accepted a heavily subsidized education. We don't call minimum times in the military following payment for university "forced employment". If they want to go to medical school cheap, it's perfectly reasonable to expect that they serve the communities that supported that education.

That said, medical school is no longer cheap in Canada, partly because of gov't cuts, and partly because the exorbitant salaries already being paid here "justify" a high upfront cost. I would make medical school free - in exchange for a minimum time practicing in Canada.
posted by jb at 10:47 AM on March 11, 2012 [1 favorite]


What does "lahk" mean, exactly?
posted by jb at 10:49 AM on March 11, 2012 [1 favorite]


If a doctor is used to working with power tools in the OR they're probably going to need to train in our system before working outside of a teaching environment.

Journalists might not be aware of this, but orthopaedic surgeons in North America also use store-bought power tools. They do the same thing, at a fraction of the cost. We do sterilise them, of course.
posted by jb at 10:51 AM on March 11, 2012 [5 favorites]


A doctor from Lusaka is not as competent as one from Toronto.

I would debate it, but even if I accept the premise, I would ask: then why are doctors from Lusaka accepted as high-skilled immigrants?

We (i.e. Canada) are selling a false bill of goods to our liscensed immigrants. We should not be telling people to come here because we need doctors, only then to keep them trapped in low-paid work, keeping them from using their skills and training.
posted by jb at 10:54 AM on March 11, 2012 [1 favorite]


Instead of making certain forms of higher education less appealing, why not go at the root of the problem and offer secondary and higher education to more people?
posted by romanb at 11:54 AM on March 11 [+] [!]


Because then we would just be paying more money to subsidize the American health care industry.

Medical school is very expensive to run -- much more expensive than other programs. Even with the massive increases in tuition that we have had in Toronto over the last 15 years, medical students do not pay the full cost of their education.

Why should Canadians pay for the education of someone who will just go to the US to practice?
posted by jb at 10:56 AM on March 11, 2012


Seriously fuck the AMA.

I would add the OMA to that as well. They are the ones who set the qualification requirements to practice, and who strong-arm the provincial government into paying them more and more even as everyone else in the public sector is forced to do with less.

I would really like to see the pattern of increase in fees-for-service to doctors versus the general increase in health care costs in Ontario, and elsewhere.
posted by jb at 11:00 AM on March 11, 2012


Telling a person they can't be here, live into their 70s, and make $200,000, but instead must stay in Africa, live into their 40s, and make $24,000 because we think it's best doesn't seem right. I like these advantages but I got here first; now that I'm here, you are shut out because it's what's best for your original country?

Okay, but doesn't this undermine all arguments for immigration controls? Why should someone who is in even worse shape not be able to immigrate to the US to do low-skill labour at minimum wage? Why shouldn't anyone be allowed to immigrate to the US if he/she chooses to? If you say, "because it would be bad for the US," then you're invoking the same sort of reasoning you're rejecting, but privileging your own country instead.

The deeper question is: why do we regard the right to emigrate as fundamental to our liberty, but not the right to immigrate to any other country of our (rather than the country's) choosing?
posted by smorange at 11:19 AM on March 11, 2012 [4 favorites]


Lakh from wiki (you'll see its usage in the news snippet above on the Indian doctor shortage)

a unit in the South Asian numbering system equal to one hundred thousand (100,000; 105), written as 1,00,000. It is widely used both in official and other contexts in India, Pakistan, Bangladesh, Maldives, Nepal, Sri Lanka, Myanmar and is often used in Indian English.
posted by infini at 11:25 AM on March 11, 2012


Infini has it. In most South Asian languages, the large numbers use a multiplier of 100 rather than 1,000. So instead of going "a thousand thousands is a million, a thousand millions is a billion," as you would in the American system, you go "a hundred thousands is a lakh, a hundred lakhs is a crore...."
posted by nebulawindphone at 11:25 AM on March 11, 2012 [1 favorite]


Does America actually have a doctor's shortage? My understanding is that number of physicians per capita not that different compared to other developed countries, but the problem is that more med school graduates choose to specialize and leave primary care field, where the real lack is. If some one can point to some data in this regard, it would be much appreciated.
posted by Pantalaimon at 12:05 PM on March 11, 2012 [1 favorite]


Healthcare is a pernicious form of brain drain. Primary healthcare has to be practiced at site, it can't be carried out remotely, so every doctor removed from local reach reduces the medical resources available at hand. And unlike most other occupations where repatriation of overseas income can partially offset the loss of skilled labor.
posted by Gyan at 12:06 PM on March 11, 2012


Meanwhile, Dean Baker chimes in today.
posted by gimonca at 12:36 PM on March 11, 2012 [1 favorite]


Why should Canadians pay for the education of someone who will just go to the US to practice?

Not all doctors trained in Canada move out of the country. You'd be 'punishing' everyone for the actions of a few.

Many foreign doctors, trained and paid for by other people elsewhere, live and practice in Canada.

Hundreds of thousands of US citizens live in Canada and pay taxes for education there.

Many Canadians study abroad, taking advantage of free education in other countries.

Much of the money paid for educating Canadians in medicine goes back into the Canadian economy.

Because if Canadian doctors paid their education in full, there would be even more reason to leave for the US and other higher-paying countries.

Etc.
posted by romanb at 12:42 PM on March 11, 2012


My last point wasn't meant to look like an 'official list of reasons', I should have probably formatted it a bit differently. My point is that there are many reasons to educate more doctors. I don't disagree that the brain-drain is a problem, it's just that many of the ideas in this thread seem like they would have the opposite of the intended effect. The harder and more costly it is for an individual to become a doctor, the fewer there will be; the problem will just be intensified. Don't shoot yourself in the foot, Canada.
posted by romanb at 12:52 PM on March 11, 2012


orthopaedic surgeons in North America also use store-bought power tools

WOW
posted by the young rope-rider at 1:23 PM on March 11, 2012


The deeper question is: why do we regard the right to emigrate as fundamental to our liberty, but not the right to immigrate to any other country of our (rather than the country's) choosing?

The US recognizes the right to freedom of speech. You are not entitled to someone else's megaphone. You have the right to leave your house. You don't have the right to enter one else's. Swing your fists all you like, just not into my personal space.

Not sure that's a deeper question at all.
posted by codswallop at 1:48 PM on March 11, 2012


The US is short on doctors because we're stupid. We've got smart young people that would make hella doctors, but don't have a prayer of going to school because they can't afford it. Why can't we subsidize their schooling (as well as assist other kids so they don't have a shitpot load of debt afterward) and have those kids work for the public benefit for 5-8 years as GPs while they study to specialize? There's your national health care for the uninsured provided for right there. It's win-win.

Republicans: Oh poo poo. It will never work.


The center devotes 10 percent of its income to free care for the poor and subsidizes care for government employees, members of the military and retirees. Staff members in its mobile echocardiogram van see 100,000 villagers a year.

Trehan's a hero in my book.
posted by BlueHorse at 1:57 PM on March 11, 2012 [1 favorite]


Trehan's a hero in my book.

Papa still loves showing off his open heart scars 12 years later.
posted by infini at 2:01 PM on March 11, 2012


BlueHorse, medical school tuition has zero to do with the supply of US-trained doctors. Anyone who can be admitted to a US school of allopathic medicine (grants MD) can borrow an effectively unlimited amount of money to attend; no parental contribution or outside work required for those who can live a modest lifesytyle. Every medical school could fill its classes many times over with students who would need to, and would be happy to, take that debt if they weren't rejected instead.
posted by MattD at 3:23 PM on March 11, 2012 [2 favorites]


What does "lahk" mean, exactly?

lahk = 100,000.

So, if you spend 900,000 rupees, you can just say, "I paid 9 lahks". It's a standard term in India. Wiki.
posted by His thoughts were red thoughts at 3:26 PM on March 11, 2012


And the United States, with its high salaries and technological innovation, is also the world’s most powerful magnet for doctors, attracting more every year than Britain, Canada and Australia — the next most popular destinations for migrating doctors — combined.

Britain, Canada and Australia also have about a third of the population of the US, you ignoramus.
posted by ethnomethodologist at 3:29 PM on March 11, 2012 [1 favorite]


I disagree that "medical school tuition has [nothing] to do with the supply of US-trained doctors". American doctors aren't broadly speaking as good as French, German, Czech, etc. doctors because the profession attracts people who think less outside the box, less about morality, etc. in the U.S. You could certainly produce more qualified doctors by opening the gates somewhat, but you'll produce better quality doctors by reducing the tuition.
posted by jeffburdges at 5:58 PM on March 11, 2012 [1 favorite]


American doctors aren't broadly speaking as good as French, German, Czech, etc. doctors

Interesting claim. Cites?
posted by Wordwoman at 6:03 PM on March 11, 2012


BlueHorse, medical school tuition has zero to do with the supply of US-trained doctors. Anyone who can be admitted to a US school of allopathic medicine (grants MD) can borrow an effectively unlimited amount of money to attend; no parental contribution or outside work required for those who can live a modest lifesytyle. Every medical school could fill its classes many times over with students who would need to, and would be happy to, take that debt if they weren't rejected instead.

Yeah, uhhh, good luck getting into medical school without an undergrad degree.

And good luck getting that undergrad degree if you aren't a rich kid with a supportive family and/or a racial minority. I didn't have $80,000 for the "cheap" in state college when I was 18, in cash or in access to loans. (staffords maxed out around 5K/year for a "dependent student.") Instead of helping me, my college's financial aid office said that--excellent academic talent or no--they couldn't do anything to help me until I was 24, so I had to wait 5-6 years to start my undergrad degree. Medical school isn't really an option for people of my age and situation.
posted by Estraven at 7:04 PM on March 11, 2012 [1 favorite]


I think technically it's possible to enter a US medical school without an undergrad degree, but the prereqs have to be met first.
posted by ZeusHumms at 7:24 PM on March 11, 2012


Estraven said that much clearer than I did.

Additionally, let's think about all the kids who can't even get a decent high school diploma. Even if they can afford to go, they're so far behind in the sciences and math they can't do enough remedial work to catch up. We've screwed a lot of our kids out of med school before they've reached 7th grade.
posted by BlueHorse at 11:23 PM on March 11, 2012


one can't say that. actually its american policy to adopt the best. they found chinese engineers best they adopted them, they found indian IT professionals best they opened doors for them. its as simple as that.
posted by johnstendicom at 12:00 AM on March 12, 2012


Not only Stealing Doctor's ,Stealing proffessionals in every field.
posted by raheelnajmi at 12:31 AM on March 12, 2012 [1 favorite]


Are they all working as script consultants on TV medical dramas?
posted by londonmark at 6:38 AM on March 12, 2012


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