Internship Report On Square Pharmaceuticals Form: Fill & Download for Free

“Bad” grades is a relative term. I didnt get straight Fs, or even a majority of Ds, but I was a slacker in high school. I was really only interested in a couple classes…I seemed to excel at mechanical design and drafting, and generally got As in that class. Otherwise, I didnt even challenge myself, and probably squeaked by with a two point something GPA.This was in the early 1980s. It wasn't especially challenging to get into a decent state college or university, and I went, just like the rest of my friends.As I enjoyed mechanical design and drafting, I fancied myself in a mechanical engineering program. No one told me exactly what that was, but having “engineer” in the title sounded good.My parents didn't attend college, and we didn't really have the “college tracks” in our high school. We didn't have regular meetings with advisors and other counselors that could help coach me into a good college prep curriculum.More than anything else, my math skills were terrible. Had a bad experience in middle school with a pre-algebra teacher, and never really went back to it in high school.Once in college, I was 4 or 5 prerequisite math classes behind the very first engineering course I could take. I needed to complete Calculus I before I could take the very first materials’ course. That was at least a year and a half, if everything went well.So I started with College Algebra, unprepared for the basics. I tried, but I really didn't have good study habits. I didn't seek out tutors; I didn't go to office hours. After a while, I justified skipping out of class once or twice a week. By the time finals rolled around, there was no way I was going to pass that class…and I failed.The other basic classes I took, pretty much went the same way. I had flashes of brilliance in my composition course, but I would slack off. I had a Western Philosophies’ course and found some of the reading interesting, but I flopped on the exams. I didn't have the consistency or discipline to stay up with assignments, nor the understanding of what was needed to pass my exams.Needless to say, that first report card was not my best work. My father had a talk with me--he had been in the military, and suggested that maybe I wasn't ready for school. He suggested that I consider a branch like the Navy, if things didn't work out, school-wise.I told him in no uncertain terms, “I did not want to waste 4 years of my life in the military.”My father was a patient man, and left it at that.I returned to school, though on academic probation.It's been said that the definition of insanity is doing the same thing over and over again, and expecting different results. I don't even think I made it through the entire second semester, and I dropped out completely. I had a GPA measured in fractional amounts, and things were pretty grim.I drifted for another year or so, working odd jobs, and even going back to a technical college, to study mechanical drafting. Although I did well in my design classes, I still struggled with algebra. I struggled with physics. I might've received a C in composition.They had a drafting competition that second winter since high school. I was awarded first place, and received a gold medal for my work.I collected my award, and gathered my things. Despite the achievement, I knew I wasn't ready for college, so I didn't drive straight home. Instead, I drove to my Navy recruiter's office.Long story short, I scored well on my ASVAB, and didn't have anything in my background from getting into their Advanced Electronics’ Program. Instead of 4 years, I signed up for 6. The training and advancement opportunities were better.Shortly after signing up, I found myself on a plane, for the second time in my life. I was headed to San Diego…someplace I had never been. I was about to start Boot Camp, and who knows what afterwards.It turned out that I was a pretty decent sailor. I made in through boot camp, and went to almost another year and a half of Navy electronics’ schools. I went from an E-1, all the way to E-4, following my first Navy School. I finished at the top of my class, and got the first pick of orders. I chose a new ship on the East Coast. The ship was still being built however, so I got to do some travel, and ended up in southern Mississippi, where they were building the ship.Finally, some two and a half years after joining the Navy, we commissioned our ship, and began getting underway routinely. Oh, and did I mention? I studied a lot, was a sharp, squared-away sailor, and was advanced again to E-5.I should also add, I learned some math along the way. The Navy had some good, remedial math courses, including algebra. I needed those for some electronics’ work.We traveled all over the Caribbean, up and down the East Coast, and up into the North Atlantic. I saw the Northern Lights for the first time, and tried reindeer in Norway.In 1989, we deployed to the Mediterranean. We had 9 different ports of call (several of them more than once), and visited six different countries. I was 23 years old.I made E-6 in 1990, 5 years after joining, which is about as rapid advancement as one can receive. We did deploy to the Persian Gulf in late 1990, but after the war, I decided I wasn't going to reenlist; I wanted to go back to school.I began studies at a large university in the fall of 1991. I had to start from square one: no previous credits transferred, and I wasn't attending a school that would accept any of my Navy experience. Because of my past academic experience, I was admitted on a probationary status. I had to complete 20 credits with at least a C average. I felt certain I could do that.Almost forgot, did I mention that because I was on a probationary status, I couldn't take more than 8 credits per semester. No problem. I plowed ahead with 3 courses, including college algebra. My first semester, I finished with a 3.9 GPA.My second semester, I took 8 more credits, including trigonometry. I may have had a B+, and two As.Summer, my first year back at university, I took a 4- credit business calc class. I was very determined, and received an A+ in the class. I took linear algebra, discrete math, and a couple other math courses. I was never fluent in mathematics, but I came a long was since high school.I eventually graduated with honors, and a minor in math. I had a very good internship, and was eventually recruited by a large pharmaceutical company. I've been working as a consultant in the clinical supply chain.I've lived a great life, traveled extensive for work and pleasure. My family, friends and acquaintances see me as a very successful person. I'm happy, and look forward to continuing my career, and perhaps even applying to a Master's degree program later this year.Your high school GPA does NOT determine your success in life. YOU determine your success. There's no such thing as “starting too late.”

Q. Are there graduates of medical schools (MDs and comparable) who are unable to get into a residency program? If so, what happens to them?A. A few articles of interest:Understand Your Odds of Getting into ResidencyShortage of residency slots may have chilling effect on next generation of physiciansOptions Exist for Med Students Without Residency Matches (usnews.com)Medical Students Match Day (statnews.com)Unmatched Graduate: “Med Schools to Blame”Foreign medical graduates get a raw deal. Here's why.Understand Your Odds of Getting into ResidencyMARCH 08, 2017 Heidi Moawad, MDIn recent years, we have all been hearing more and more in the medical community about doctors who are not able to successfully get into a residency training program in the United States. Physicians in this predicament are in a difficult jam, unable to proceed with a career they have spent so much time and money working toward, while at the same time, unable to get work in most other desirable professions, which also require years of specialized education and internships.Many aspiring physicians wonder about the numbers behind this bleak situation and what it means for them. If you have been unable to match so far – or if you are apprehensive that you may have a low chance of matching – the statistics behind this problem can help you gain some insight into your chances of getting into an accredited residency program.MATCH PROGRAM FACTSThe National Residency Matching Program (NRMP) itself, which is the organization that matches physician applicants to U.S. residency training programs, provides a uniform process for all applicants, with consistent application deadlines and scheduled announcements of match results.According to the most recent NRMP results from 2016, there were more than 35,000 applicants for approximately 27,000 PGY1 positions. The gap between applicants and positions is the reason that there are so many medical school graduates who are not able to work as doctors. Of these applicants, about 20,000 are graduates of U.S. medical schools, and the remainder of physician applicants are International Medical School graduates.While there are certainly a substantial number of physicians who do not match in a residency spot, there were more available positions for PGY1 spots this past year than ever before. But, the number of applicants for the 2016 match reached an all-time high. The number of U.S. allopathic medical school and osteopathic medical school applicants was only about 20,000, which is substantially fewer than the number of residency positions available. And, it turns out that most (more than 95 percent) U.S. graduates did match in a residency program.However, there are hundreds of U.S. medical school graduates who do not match each year. U.S. medical students who were not recent graduates had a significantly lower match rate than recent graduates, for various reasons. And American students who graduated from international medical schools did not fare as well as American students who graduated from U.S. medical schools, with a slightly higher match rate than non-U.S. citizen International Medical School graduates, which was little more than 50 percent in 2016.LARGER NUMBER OF APPLICANTSThere has been a larger number of applicants than ever before because most of the applicant groups are growing. There are slightly more U.S. allopathic medical school graduates, more U.S. citizen International Medical School graduates and more Osteopathic medical school graduates, which adds up to more applicants. And, there are more non-U.S. International Medical School graduates applying for residency spots as well. Despite all of the negativity about the medical field, there are still huge numbers of people who want to work as physicians, particularly in the United States, where most doctors perceive the system to be relatively fair, uncorrupt and of high quality.Interestingly, there are also many non-U.S. International Medical School graduates who do not even apply for the match because they have not passed USMLE tests, have scored low on the examinations or have other concerns that make it impractical to apply. And a large number of non-U.S. International Medical School graduates apply for residency, but receive no interviews, and thus do not have the option to proceed with ranking programs in the match.DO YOU HAVE TO MATCH TO WORK AS A DOCTOR?While you can take USMLE parts 1 and 2, and there are special circumstances that allow for you to take USMLE part 3, each state has its own requirements for medical licensing. At least one to two years of residency or internship training is typically required in order to obtain a medical license. If you want to work as a clinical physician, it is best to try to get a position through the match, or shortly after the match during the so-called scrambling period if you do not match. In fact, there are even instances in which physicians become ill or leave training programs, opening unexpected slots that need to be urgently filled at any time during the year.Physicians who want non-clinical work can succeed without residency training, but residency training even helps open the non-clinical route to better options. Therefore it is worthwhile to continue in the process, even accepting a position in a less desirable specialty, whether your aspiration is patient care or non-clinical work.There are options for doctors who do not have residency training, however. To get the most updated information, visit Careers for Physicians Without Residency, which is regularly updated with more opportunities.Shortage of residency slots may have chilling effect on next generation of physiciansBY BRUCE KOEPPEN, M.D. — 01/22/16 11:00 AM ESTMost people are aware of America's looming physician shortage, but the shortage of residency slots for medical school graduates has received less attention.In order to practice medicine in this country, graduates of allopathic (MD) and osteopathic (DO) medical schools must complete a residency training program. In recent years the number of MD and DO graduates has increased by more than 23 percent in an effort by schools to address the country's growing physician shortage, which the American Association of Medical Colleges estimates will approach 90,000 too few physicians by 2025.While the number of medical school graduates is increasing, the number of residency training positions has not kept pace. If this imbalance is not addressed, the number of American MD and DO graduates will exceed the number of first-year residency positions, which by some estimates could occur as soon as 2017. When this happens, young physicians-who dedicated years to the pursuit of a medical education and incurred significant debt doing so-will not be able to practice medicine, and the physician shortage will persist.Part of the problem stems from the funding mechanism for Graduate Medical Education (GME). Medicare covers the majority of the cost teaching hospitals spend on training medical residents, but the Balanced Budget Act of 1997 capped the number of residency slots the federal government would fund. The shortfall-what is not covered by the Federal government-is paid for by the hospitals where residents train. While it is possible to increase the number of residents they train, to do so, hospitals must fund the entire cost of those training positions.Though patient care has shifted its emphasis to wellness and prevention, the current reimbursement system has not yet caught up. It is still based on the number of procedures performed, incentivizing hospitals to fund additional residencies in revenue-producing specialties instead of primary care.Adding to the problem, are for-profit schools that pay hospitals for medical student residency training spots-an incentive for some cash-strapped hospitals-something that is a growing concern among medical school deans. Residency slots that are taken by trainees from non-accredited schools reduce the number of slots available to trainees from accredited allopathic and osteopathic schools.Some of these non-accredited for-profit schools train as many as 1000 students a year without clinical facilities or full time faculty. According to a 2013 Bloomberg Markets investigation, many students who attend these schools incur tremendous debt and fail to complete the programs; many of those who complete the programs are unable to find a residency.The shortage of residency slots is also affecting graduates of accredited programs. Last year, more than 500 graduates from US allopathic medical schools were unable to obtain a residency training position. As more students graduate from medical school in the coming years, this number will only increase.We need to find ways to address the shortfall. There are several solutions being considered.The Foreign Medical School Accountability Fairness Act, a bi-partisan bill from the House and the Senate that would protect taxpayers and students, eliminates an exemption that entitles certain foreign medical schools to US Department of Education Title IV funding without meeting minimum requirements. The bill would ensure that 60 percent of enrollees in medical schools outside the US and Canada must be non-US citizens or permanent residents and have at least a 75 percent pass rate on the US Medical Licensing Exam.Other pending legislation includes the Training Tomorrow's Doctors Today Act, which would add 15,000 new residency training positions over the next five years; and the Resident Physicians Shortage Reduction Act of 2015, which aims to protect against the rapid shortfall of primary care physicians.The Affordable Care Act's $230 million Teaching Health Center Graduate Medical Education Program is designed to train primary care physicians mostly in non-hospital settings, which is exactly where the majority of primary medicine is practiced. Moreover, many of these new training programs serve underserved communities. These residency programs do not rely on Medicare funding, but must be self-supporting by 2017.These efforts all have merit, but the wheels are turning slowly and the clock is ticking. Training physicians doesn't happen overnight. Our lawmakers need to move quickly for the sake of patients and the physicians who have invested so much time and effort into learning how to care for them.Koeppen is founding dean of the Frank H. Netter School of Medicine at Quinnipiac University.Options Exist for Med Students Without Residency Matches (usnews.com)Few days are as important as Match Day for a medical school student.Dozens of videos on YouTube show students crying tears of joy and hugging classmates as they finally learn, this year on March 15, where they will spend the next three to seven years doing their residency. This day marks the unofficial end of medical school and the beginning of a career as a doctor.[Learn about recent changes in the matching process for residents.]On the Monday of Match Week, students learn if they were matched with a residency program. This year there were approximately 40,000 registrants. Unmatched students – this month, 963 registrants were unmatched, according to the National Resident Matching Program – are automatically entered into the Supplemental Offer and Acceptance Program, a one-week process that allows them to apply for unfilled residency positions.Residency offers through SOAP "continue through Friday of Match Week, and that process has been very efficient," says Hal Jenson, president-designate of the National Resident Matching Program.Before SOAP was created, students went through a similar process called "the scramble." But even with coordinated, last-minute efforts to place students, some still find themselves without a residency.After not matching in anesthesiology in 2010 and then failing to find a residency program through the scramble, one aspiring physician spent a year teaching anatomy, physiology and microbiology at a technical school until the next match."I still wanted to do anesthesiology, but I left it open to other fields as well. It sort of becomes a you-take-what-you-get type of deal," says the now second-year resident, who asked not to be identified. He settled for internal medicine."Initially you are disheartened, but what can you do about it? Either you sulk, or you fix it and figure out another situation," he says.[Find out how medical residency work hours can vary.]Experts say there are typically two reasons students don't match. They apply for highly competitive residencies, such as dermatology or radiology, even though their medical school performance makes them unlikely candidates for those slots, or they place too few schools on their ranking list, which they give to the National Resident Matching Program.While unmatched students can take alternative routes to residency, many in the medical field agree it's best to avoid the situation outright. One way is to rank several residency programs at which a student has interviewed."I tell medical students they should always put at least five places," says Stephen Klasko, dean of the University of South Florida Health's Morsani College of Medicine. He encourages students, particularly those who didn't initially match, to expand the number of hospitals they are willing to go within their chosen specialty, or consider choosing a different specialty.Lynn Buckvar-Keltz, associate dean for student affairs at the NYU School of Medicine, says grades and exam scores matter when applying for residency, but those aren't the only factors."Being an engaged, enthusiastic member of the clinical teams during the clinical clerkship is an important part of the student's medical school experience and therefore their residency application as well."[Follow a day in the life of a medical intern.]If an aspiring physician is unmatched, there are a few options.Students can contact their medical school and ask for a transitional slot, which mimics the fourth year of school, or seek a research fellowship."If they do a transitional year or a research fellowship, they can then become more competitive in one of those specialties or they can decide to match in family medicine or general internal medicine where it's easier to get a slot," says Klasko.Obtaining another degree could also increase a student's chances of matching in the next cycle, Klasko says."Now all of a sudden I'm a pretty cool candidate," he says. "It doesn't look like I'm somebody who failed. I'm somebody who decided to get a master's in public health or an MBA. Now I'm a differentiated candidate."Searching for a medical school? Get our complete rankings of Best Medical Schools.Corrected 4/10/13: A previous version of this article misstated the name of the National Resident Matching Program.Tags: doctors, education, graduate schools, medical school, studentsDelece Smith-Barrow is an education reporter at U.S. News, covering college admissions; she previously wrote about graduate schools.POLITICSMedical Students Match Day (statnews.com)Looming question for medical students: Will they be shut out of advanced training? By MELISSA BAILEY MARCH 17, 2016Dr. Heidi Schmidt looks on while a nurse takes the vitals of a patient in a medical clinic at the St. Vincent de Paul food pantry in Indianapolis.They’re about to graduate from medical school with an MD to their names, but hundreds of students across the US learned this week that they haven’t advanced to the next step of training — and will not be allowed to practice medicine.Most medical students found out Friday where they’re headed for their residency, where they’ll work alongside licensed doctors, gradually gaining more responsibility. But each year, a sizable group learns shortly before the official “Match Day” that they’ve been shut out of this training.This year, for instance, more than 29,000 applicants got placed in a first-year residency through the main matching process. But 8,640 did not — a number that includes international applicants and aspiring physicians who graduated from medical schools in recent years, as well as current fourth-year students.That mismatch has prompted a policy debate: Should the rural and urban clinics that struggle to find doctors be allowed to scoop up unmatched graduates so their talents don’t go to waste? Or would it be dangerous to put them in front of patients without a traditional residency, which typically lasts at least three years?Missouri, Kansas, and Arkansas have passed laws to allow unmatched graduates to work in medically underserved areas without doing a residency.Otherwise, “a lot end up wasting all of their education, because there is no place for them in the health care delivery system without having a residency,” said Dr. Edmond Cabbabe, a plastic surgeon in St. Louis who conceived of the Missouri law.Passed in 2014, but not yet implemented, the law will create an “assistant physician” license for these newly minted doctors, who will work with a collaborating physician. That physician will have to directly supervise the new doctors for at least a month before they can see patients on their own. One impetus for the law: Nearly all of Missouri’s 101 rural counties face a shortage of primary care providers.Arkansas this year approved new rules allowing recent medical school graduates with ties to the state to work as a “graduate registered physician” before residency. Kansas, too, created a special license; it’s restricted to graduates of the University of Kansas School of Medicine who strike out in the match process, and it allows them to work, under supervision, for just two years. At that point, they’re expected to move on to a residency.Related Story:Medical students demand an end to pricey exam testing patient care skillsWhile supporters hail such laws as a groundbreaking solution, the medical establishment has frowned on them.The Association of American Medical Colleges “is concerned by efforts that would bypass the experiences necessary for physicians to provide safe and effective patient care independently,” said Tannaz Rasouli, AAMC’s senior director of government relations.The American Medical Association also came out against such programs. Instead, it has called on government, insurance payers, and foundations to pitch in money to create more residency spots.So far, no one is practicing medicine under any of those new regulations.But they could help MDs like Dr. Heidi Schmidt, a Juilliard-trained opera singer and entrepreneur who graduated from American University of the Caribbean School of Medicine on the island of St. Maarten. She received honors in clinical coursework, but struggled with standardized tests and had to make multiple attempts to pass two national board exams.Residency programs often see multiple board exam attempts and degrees from foreign medical schools as red flags when evaluating candidates.Schmidt, who also has master’s degrees in public health, music, and pharmaceutical science, has the title “doctor,” but her options are limited. Without at least one year of postgraduate residency, she can’t practice medicine in the United States. To work as a nurse or a physician assistant, she’d have to go back to school and get a different degree.To stay in medicine, she volunteers in Indianapolis at Gennesaret Free Clinics for the homeless and working poor. She sees patients, but she said a licensed physician must sign off on all her work. Schmidt said she can’t get paid until she becomes a licensed physician. And she longs to treat patients on her own.“My dream has always been to be a physician for the poor,” she said.Dr. Heidi Schmidt at the St. Vincent de Paul food pantry in Indianapolis, Ind. After not being matched with a residency, Schmidt’s plans of becoming a licensed doctor are on hold, so she volunteers at a medical clinic there.LUCAS CARTER FOR STATSeniors in traditional (non-osteopathic) US medical schools have better odds than those from foreign schools: Their match rate has hovered around 94 percent. But that still means 1,130 didn’t get a residency in the main match this year.That news can be a shock. As a senior at the University of Virginia medical school last year, Dr. Daniel Harris applied to 67 general surgery residencies and landed eight interviews at residency programs. On the Monday before Match Day, he got an email letting him know that none had accepted him.Harris said he was in disbelief, but he didn’t have time to process that feeling. He had just two hours to decide which programs he would apply to through the Supplemental Offer and Acceptance Program, or SOAP, which helps unmatched applicants find open spots.Harris picked 20 programs and hit “submit.”“I maybe started crying at that point,” he said. “There was nothing more I could do.”Harris got lucky: He was one of 599 US medical school seniors who scooped up unfilled spots through SOAP last year. Other types of applicants — for instance, those from foreign schools — grabbed another 400-plus spots.That still left hundreds of seniors at US medical schools, and thousands from international schools, halted in their quest to practice medicine in the United States.Were they weeded out for good reason? That’s open for debate. Surely, some were ill-prepared. Others may have been unlucky or just played their cards wrong when picking which residencies to apply for.The most common reason for not matching is poor scores on national board exams, according to a 2005 survey by the AAMC. Other reasons include: applying to a specialty that’s too competitive for the applicant’s academic standing; poor interviewing or interpersonal skills; and having to take a board exam multiple times to pass.Some people in this situation, like Dr. Nick Milligan, decide not to pursue a medical license. Milligan graduated from St. George’s University School of Medicine, on the Caribbean island of Grenada, in 2014. He said he was disappointed not to match with a residency, but he ended up happily employed at Coachella Valley Volunteers in Medicine in California, where he has used his medical training to build a diabetes education program.Medical school grads face a staggering $183,000 in debt, on median, but they can seek relief, as Milligan does, from federal programs that limit monthly loan payments to 10 percent of income.Most graduates of US medical schools don’t give up on becoming a licensed doctor if they don’t match, said Geoffrey Young, AAMC’s senior director for student affairs and programs. They often spend a year doing research, or complete a fifth year of medical school, then apply to the match the following year.Related Story:An urgent call for diversity in medicine, ‘the profession I love’More than 99 percent of US medical school graduates do end up practicing medicine within six years of graduation, Young and coauthors found in a study published in JAMA.The new state laws might offer some of the unmatched students another route to a medical career.Missouri is expected to open enrollment for its assistant physician license this fall. Because it has the least restrictive rules, it may face a flood of applicants from around the country.Schmidt could be one of them.If Missouri opens the door for her to treat patients, she said, “I’d pack up and move in a second.”Update: The story has been updated to include statistics about the matching program for this year.Unmatched Graduate: “Med Schools to Blame”by SkepticalScalpel | Oct 17, 2016 | 30 commentsSkeptial Scalpel (click to view)The following was submitted as a series of comments on my Physician’s Weekly post about Missouri’s new law allowing medical school graduates who did not match into residency positions to work under supervision. The comments have been edited for length and clarity:I am a 38-year-old US medical graduate who has attempted to match 3 times with no success. I decided not to throw the money away again this cycle. I have half a million dollars in educational loans. I would exchange my situation with any non-US-IMG because they probably don’t have massive loans. I have seen kids coming fresh from India with no loans who match in their first attempts because they score high enough on USMLE to separate themselves from people like me.Based on USMLE scores, the matching system is fair to a lot of us. What fails US grads is the educational loan structure that allows us to borrow without any accountability of medical schools that are benefiting most. If medical schools are going to produce doctors who cannot match after genuine attempts, the schools should be blamed. They have standards that require students to pass each course in order to graduate. If they believe a student is not good enough to become a doctor, they shouldn’t graduate the student. Students would benefit more if the medical schools could determine which med students won’t be good doctors earlier on and dismiss them. Then the students will not pile up so much debt.Some graduates find that their training is not good enough to become a physician. It’s a scam. Why do medical schools get a free ride on this? Everyone who has completed medical school successfully with passing scores on USMLE Step 1 and 2 should be allowed to use that acquired knowledge. Why not let those who have demonstrated they can work under supervision get job?What fails US grads is the educational loan structure that allows us to borrow without any accountability of medical schools that are benefiting most.When I try to get a nonclinical job, they read my resume and tell me I am overqualified for the position. I have tried to hide my MD degree and use only my Bachelor of Science degree (biology) in order to get a job. But they tell me I don’t have experience, and the big gap between my undergrad education and my current situation cannot be explained. Some employers have asked me if I spent the time in jail.I applied to PA schools last year and had no success. Some of my rejection letters said as a medical doctor, I am not a good fit for PA career. Some PA programs wanted me to go back to college again to take pre-med courses.Besides medicine I have no other skills I can use to make a living. I am broke. I refuse to become homeless. Last month I applied and qualified for food stamps. Next week I am starting a $10.15/hour job as a UPS package handler while I am looking for other better opportunities.Each year about 5% of US graduates do not match to a residency and have nowhere to go. There are many reasons we did not match—most commonly because of academics. If I were a program director, I would interview the best applicants and rank them accordingly. I just believe unmatched doctors must be given other opportunities to make use of their acquired knowledge instead wasting it in a warehouse or a grocery store.If fresh college grads with 2 years in PA school can become providers under a licensed physician why can’t someone who made it through med school in 4 years function at the same level? Having an MD degree without a residency is like having a felony record. No one will give you a job. Having an MD degree without a residency dooms you to struggle in life. I wish I didn’t have the heavy weight of the MD degree on my back.I hope marginal pre-med students will read my story and make a rational decision before applying to medical school. Med schools want to fill their classes because they know the more students they have, the more money they will make. As they collect your tuition, they will tell you they are nonprofit institutions.No med schools will tell pre-med students the drawbacks such as the scarcity of postgraduate training as med school class sizes increased 30% since 2000. Most schools only publish lists of students who matched successfully and fail to mention those who don’t match. Pre-med students should be told what happens to all graduates of each med school.My story may not be relevant to pre-meds who have demonstrated great potential in medicine (GPA, MCAT, and motivation). The problem is some med schools can’t fill their classes with 100% smart kids. What they do instead is lower their standards to get more students to fill the class. Why? Because they want to make money and are not held accountable.If they can’t recruit students who can become licensed physicians in the US, the classes should be left unfilled. What is point of educating someone and giving him a piece of paper that can’t be used? These institutions should be held accountable for tuition and fees if a medical graduate attempts to match to complete his training but failed. This will force them to dismiss academically or professionally unfit students from medical schools before they accrue massive loans.I don’t see how the schools could ever be forced to do what the writer wants.Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last six years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog has had more than 2,500,000 page views, and he has over 15,500 followers on Twitter.Foreign medical graduates get a raw deal. Here's why.ERIC BEAM, MD | EDUCATION | MAY 23, 2016On my recent tour of residency programs, I had the pleasure of meeting many foreign medical graduates (a.k.a. FMGs; not to be confused with international medical graduates, who are U.S. citizens who go abroad for medical school).Almost uniformly, they struck me as confident, mature and articulate. Many were older than me, some by as much as 10 or 15 years. Most had extensive research experience, and a few had even completed residency already in another country and were here to take a shot at becoming a U.S.-licensed physician, which would require them to do it all over again. To an outsider, they would appear as competitive candidates for programs that aspire to produce first-class doctors. But I did not envy their plight. In our conversations, one thing became clear: Whereas I was hoping to match into one of my top-choice programs, they were hoping to match, period. And, in 2016, only 50 percent did.FMGs get a raw deal. With the exception of Canada, we don’t recognize international medical training as meeting our quality standards; thus, doctors licensed to practice in their home countries must start at square one if they want to work here. Before they even apply to residency, FMGs need a stamp of approval from the Educational Commission for Foreign Medical Graduates (ECFMG). Only about half succeed in getting certified.One major hurdle, apart from the written exams, is the USMLE Step 2 Clinical Skills test, which requires a high-stakes demonstration of English proficiency and a costly trip to one of the five U.S. cities where it’s offered. (Interestingly, from 1998 to 2004 this test was called the Clinical Skills Assessment, and only FMGs were required to take it.) It’s virtually impossible for a FMG to start residency directly after finishing medical school. They’re often encouraged to do a few years of research to pad their résumé, or to do a rotation or two at a U.S. hospital. This adds up to a lot of time, money and effort spent on an endeavor that is far from a sure thing.All of this is not to say that we shouldn’t have a rigorous screening process for who we allow to train and practice here. We should, and we do. But we must acknowledge that the deck is stacked firmly against FMGs. Imagine you’re a program director comparing two applicants side-by-side, one a U.S. medical graduate and the other a FMG. If, on paper, the two appear to have equivalent qualifications, there’s a good chance the FMG worked harder and sacrificed more to get there. That is an achievement worthy of recognition.But these days it’s become something of a badge of honor for residency programs to exclude FMGs from their rosters, and historically they have served as “fillers” for residency spots that remain vacant after U.S. students have matched. In 1995, the Council on Graduate Medical Education, an advisory body tasked with making recommendations to the Department of Health and Human Services, singled out FMGs in their annual report and proposed cutting federal funding for their training by 75 percent in an effort to reverse course on an impending “physician surplus” (oh, the irony). They walked back this recommendation in a subsequent report due to anticipated “legal complexities,” but even their less controversial plan carried the same aim: to severely restrict FMGs from entering the physician workforce.I have heard two arguments for keeping FMGs out. The first is that their training is substandard. While I’m sure this applies to some cases, it is certainly not a universal truth. Is it really so hard to believe that a student whose education happens outside of a glittering first-world multi-million-dollar medical complex could learn the same principles of biomedical sciences as a student in this country? Is that student not examined as rigorously, mentored as thoughtfully, challenged as intensively, as one of ours?The second argument against FMGs is the so-called “brain drain” theory; that taking FMGs will siphon much-needed talent from poorer countries where doctors are scarce. I take particular issue with this one. All people, no matter their provenance, should be allowed to use their gifts to better their own lives, especially if that means escaping poverty or conflict.And let’s be honest: When a program director rejects a FMG, is he really thinking about the physician supply in Pakistan? What if we applied the same logic within our borders? If a medical student in physician-poor Arkansas graduates at the top of her class, with all the attendant publications and honors to her name, and wants to train at Massachusetts General Hospital, we don’t say, “No, you have to stay, Arkansas needs you.” We let her go as far as her talent and ambition will take her. Will Arkansas suffer? Minimally, perhaps, but they’ll be OK.The U.S. prides itself on having the best doctors in the world, so why not bolster our ranks by welcoming some of the best students the world has to offer? It’s curious that diversity is championed in medical school and residency admissions, just not this kind of diversity. Our knee-jerk aversion to FMGs seems to be the last true sanctioned form of admissions discrimination. First, we must ask ourselves if we want our admissions process to be truly merit-based. If the answer is yes, then it’s time to start recognizing merit even when it comes from outside our borders.Eric Beam is an internal medicine resident who blogs at the Long White Coat.Image credit: Shutterstock.com

Great and very complete answer, Dylan Hettinger. I lived in New Bern, NC myself for almost three years. I kinda felt like I was moving to Mars before I settled in - I grew up in Lake Havasu City, AZ, which is essentially a far inland Southern California desert resort destination community. Then I lived in Southern California for most of my adult life until last year, when I moved to New York City (it has been 14 months now I've lived and worked in The City - love Manhattan, but the cold and the difference in the personalities of both the entire New York City Metro area as well as the individuals living within it are dramatic in their differences - not a negative statement on New York, just...a very different world than Southern California!).I'll just add one additional thing, or rather, person, New Bern, NC is known for - bestselling author and movie producer Nicholas Sparks (author, producer), several of his books actually take place in New Bern; he is extremely active in the community, and he has recently made news with the completion of his massive new home in the Trent Woods neighborhood of New Bern (close actually to where I lived!).Sparks' Original Home in New Bern, NC...My Background and Why I Spent Nearly Three Years in New BernSomehow in the middle of growing up and starting my career in Los Angeles, I spent over 2 1/2 years in New Bern, NC. I had just graduated from college when my uncle, who was a giant influence in my life as a mentor and essentially my other father (very literally, as they are Identical Twins as well!), retired fairly early from a 34-year career at Hardee's Food Systems, operators of the Hardee's chain of quick service restaurants focused on its very popular breakfast menu and burgers. My uncle had actually started working for the Sandy's chain of fast food burger restaurants at 15 years old as a "Lot Boy," ensuring the parking lot was kept clean (as had my father around the same age).While my father had gone one to become a resort operations manager and then became President of a Southern California-based resort management and development company, Transpacific Hotel Corporation, which owned and operated The Nautical Inn Resort in Lake Havasu, as well as a dozen resorts in Southern California, including Lake Arrowhead Resort and Spa, Lake Arrowhead Marina, Big Bear Resort, Ventura Marina Hotel & Conference Center, and several others. My father also served as Interim CEO for a brief time as a huge favor to Transpacific Hotel Corp.'s owner Rick Kaufman's largest holding, the Pioneer Chicken Take Out Corp., which operated the infamous California Fried Chicken Chain Pioneer Chicken.My uncle had stayed on with Sandy's, which in 1972 was acquired by the rapidly expanding Hardee's chain. He advanced young and fast into Senior Executive Leadership positions, culminating in being appointed the "#2 Man" by then Chief Executive Officer Jack Laughery. Laughery, chain's longest tenured and most popular and successful CEO in company history, named my Uncle, James A. Jensen, as the new Senior Vice President and Chief Operating Officer (COO) in the late 1980's. in 1995, Laughery had announced his retirement after many years as a company Executive.Jensen was the big favorite in the usual Wall Street and internal company speculation as being named Hardee's next CEO, but in a shocking move, Hardee's parent company at the time, Imasco (who was 1,000% the main culprit of Hardee's recent struggles - Hardee's had fallen victim to the 1980's Leveraged Buyout Fever, with the tobacco company Imasco loading up a massive amounts of high-yield corporate debt, or "Junk Bonds" as they were known then, and Hardee's, which at its zenith was the third largest fast food chain in the world with over 4,000 locations, was cash-strapped and cutting costs for over a decade by 1995...today they have just 1,951 locations but indeed are on the rebound after Carl's Jr. purchased the chain in 1995).Getting to the Point of This Answer!The point of this way-too long side story is my uncle came to terms with Hardee's and "retired" (corporate-speak for Hardee's paid my Uncle an enormous ransom so he would step down for the new CEO's team to be appointed). In additions to his very large cash compensation, my uncle was awarded ten Hardee's locations in Eastern North Carolina and the Outer Banks region. He rang both my father and me up, and we moved to New Bern and started Jensen Food Systems, Inc., with the headquarters and two very profitable Hardee's locations now ours in New Bern, North Carolina.Around that same time in 1995, another man from California - spending several years in SoCal living in Playa Del Rey, CA and Inglewood, CA before settling in the Sacramento area of Northern California. Nicholas Sparks (author, producer) had visited New Bern in 1989, to get married in the same magical North Carolina town his grandparents had married in as well (and incidentally, both his grandparents, as well as Nicholas Sparks and his wife Cathy Sparks, were married at Saint Paul's Catholic Church, North Carolina's oldest surviving Catholic Parish and the very same place I married my high school sweetheart Mariah Jensen in 1996...was a beautiful old church, though no AC in May in New Bern was no bueno!).Saint Paul's Catholic Parrish, New Bern, NCDinners with New Bern's Most Famous Resident, Nicholas SparksIn 1995, writing part-time while living with his wife in Washington DC and working as a pharmaceutical salesman, a literary agent read Sparks' unpublished novel, The Notebook, and immediately paid him a $1 million advance. In October 1996, New Bern became known as the city prominently featured in The Notebook, which debuted at #1 on the The New York Times Best Sellers List. Nicholas and Cathy Sparks moved to New Bern, NC in late 1996. My wife, a banker at the New Bern branch of BB&T (company), became their private banking representative and we got to know them a bit - extremely nice and down-to-earth folks, as anyone who has seen him in interviews and such would think.Sparks and the Family...Nicholas and Cathy Sparks, at the Premier of "Safe Haven"...After his first publishing success, he wrote several international bestsellers. Eight of his novels have been made into films: Message in a Bottle (1999 movie), A Walk to Remember (2002), The Notebook (2004 movie), Nights in Rodanthe (2008), Dear John (2010), The Last Song (2010), The Lucky One (2012), and Safe Haven (2013).Sparks continues to reside in New Bern, North Carolina with his wife, Cathy; their three sons, Miles, Ryan, and Landon; and twin daughters, Lexie and Savannah. Sparks has donated a track to New Bern High School and contributes to local and national charities. Nicholas Sparks donated $900,000 for a new, all-weather tartan track, to New Bern High School. He also donates his time to help coach the New Bern High School track team and a local club track team as a volunteer head coach. He contributes to the Creative Writing Program (MFA) at the University of Notre Dame by funding scholarships, internships and annual fellowships. In 2008, Entertainment Weekly reported that Sparks and his wife had donated "close to $10 million" to start a Christian, international, college-prep private school, The Epiphany School of Global Studies, which emphasizes travel and lifelong learning.Nights in Rodanthe Beach House Near New Bern, NCThe home made famous in the movie based on Sparks' book...Nicholas Sparks New Home in New Bern, NCNicholas Sparks began construction on his new Estate in New Bern in 2012, and recently moved in to the 12,000 square foot estate in the Trent Woods area of New Bern, NC. Needless to say, the most spectacular new build New Bern has seen since the Tryon Palace & Gardens.YouTube Video on Sparks' new Mansion in New Bern, NCNicholas Sparks Debuts Novel In New BernReading Life: What's the most famous book set in North Carolina?Nicholas Sparks to design a line of home goodsWalk to Remember TourAt Home with Nicholas Sparks: King of HeartsMore Pictures of The Sparks' New Home - A New Bern Landmark!View of the back of the estate from the Trent River...