Japheti's philosophy:
"what the heck do anyone mean by implying that an ECFMG-certified individual is more qualified than another ECFMG certified!"

Yes, all ECFMG certified people are equal, but some are more equal than others A high score does not necesarily indicate that one studied for one year instead of one week. In case you didn't notice, the exam is more about thinking rather than knowledge. Of course, since you had poor performance, you have the right to claim that those who did better in the exam studied longer and that's it. We understand you. Me, I studied for 6 mo for each step with a FULL TIME JOB (and paying taxes!) and got 99 in both steps.

If you are willing to be treated rather by a kind, no-accent-perfect grammar, Vietnam veteran and hero, American doctor who has no idea about what he's doing - fine with me. I'd take anytime that pakistani with accent who knows more medicine.

You say:
"being a physician is more of being able to deal with people than being an expert in quantum physics, or knowing all the enzymes and coenzymes of carbohydrate metabolism"
You seem to live 500 years in the past. Again, in case you haven't noticed, we are living the era of molecular biology and genetics, where you do need to know molecular details. If you want to heal your kid or wife with plant infusions and accupuncture, it's fine with me. But again, I'll choose that drug developed based on knowledge of molecular structures.

Another one:
" Another thing is that these people are being thankless to their OWN countries that educated them. Don't they own more to the country that raised them?!?! First they get cheap education (often free) in their home countries and then they expect to enter America and have everything served to them on a plate.. "

It's none of your GD business how thankless or thankfull foreigners are to their country. They come here, work their *** off twice as much as you and get paid worse than you in any line of work (including medicine). Besides, YOU KNOW NOTHING about the realities of their countries. You cannot even pinpoint them on the map, most likely. Your ignorance therefore does not allow you to preach morals to anybody.

Lastly, I'll say it again, maybe you can comprehend it once and for all: one reason America is the greatest of all is because of the bright foreigners who come and work here (and sometimes are treated like dirt). Luckily, those who run the coutry, even the republicans, can see this and decide accordingly. Therefore, you'll keep seing foreign doctors coming and practicing here - and pissing you off.

Instead of adding something new to the debate, you are simply regurgitating all old stuff. I will happily answer all your ridicules and refute all your non-sense talk. Most of your rhetoric seems to be based upon not having understood or read my original posting properly, but I guess, as you say yourself; "a kind, no-accent-perfect grammar" doesn't mean anything for a physician, so I will have to bow to your analphabetism supremacy here..

Yetanoth....
Yes, all ECFMG certified people are equal, but some are more equal than others A high score does not necesarily indicate that one studied for one year instead of one week. In case you didn't notice, the exam is more about thinking rather than knowledge.
*****I really feel at a loss to decipher what you are trying to say here. Maybe your "thinking" is so superior to my feeble mind that I cannot seem to grasp what you are trying to say here?? btw, I never implied that everyone scoring high took lotsa time off, but rather mentioned that a 99 vs. an 89, vs a 79 surely WOULD reflect upon time spent studying, something you actually confirm yourself by your 6 months spent for each step..

Yetanoth....
Of course, since you had poor performance, you have the right to claim that those who did better in the exam studied longer and that's it. We understand you. Me, I studied for 6 mo for each step with a FULL TIME JOB (and paying taxes!) and got 99 in both steps.
*****I have not "claimed" anything whether with regards to my score or anything else. You trying to discredit me by implying otherwise makes no sense, since neither my "poor performance" or your "99 on both steps" can be verified here. Likewise you studying for 6 months, despite working is still way more than most students. I have friends in clincials that studied for StepOne while they took Surgery. That's a bit more effort than you sitting in the register at Wal-Mart (to use your own mode of rhetoric here) reading First Aid by the side.

Yetanoth....
If you are willing to be treated rather by a kind, no-accent-perfect grammar, Vietnam veteran and hero, American doctor who has no idea about what he's doing - fine with me. I'd take anytime that pakistani with accent who knows more medicine.
****For being such a high (99x2) achiever, you seem to have an exceptionally poor grasp of reading. The major clue to taking standardized tests is to read the questions right. I think it is quite obvious from my entire semantics that I implied a comparison between two physicians that WERE ECFMG-certified. Also, that same Paki doctor that has never set his foot in a US hospital vs Joe with two years of US clinicals, should answer for itself. My whole concept was (repeating it to you), that out of two likely qualified candidates with regard to formal requirements (ECFMG), the US resident deserves first pick.


Yetanoth....
You seem to live 500 years in the past. Again, in case you haven't noticed, we are living the era of molecular biology and genetics, where you do need to know molecular details.
****Could you please be helpful to answer the following to me:
In which medical specialty (besides medical genetics and even there, barely) does a US physician have more help in knowing the difference between Aldolase A and Aldolase B, rather than knowing the differential diagnosis of pelvic pain?? Could you likewise explain to me how being fluent in molecular biology is going to get you any further with ANY patient if they don't understand WHAT you are saying to them??

Yetanoth....
If you want to heal your kid or wife with plant infusions and accupuncture, it's fine with me. But again, I'll choose that drug developed based on knowledge of molecular structures.

**Where have I Said anything abotu "plant infusions" or acupunture?? When that is said, especially acupunture has had several documented effects, although this really is not the issue here.. The point is; I am adhering to allopathic methodology and research and you are (again) going off the reality here, since I have nothing to do with naturopathy or acupuncture. There is enough stuff in my writings to go after (or try to) without you having to make up something new to criticize.



Yetanoth....
It's none of your GD business how thankless or thankfull foreigners are to their country.
***It sure is. I pay taxes here and expect people coming here for economic reasons to at least be accepting of this place and not act like everything should be served them on a plate and we even having to thank them for accepting it.

Yetanoth....
They come here, work their gluteal off twice as much as you and get paid worse than you in any line of work (including medicine).
****let me see here. They "work twice as much as me".. and "get paid less".. If these things are true, I am sure there are hundreds, or even THOUSANDS of anti-discrimination lawyers ready to take their cases. But of course, as always, these accusations are just another mere nonsense rhetoric filled in to paint it all in a victim-patina. if they come here for residency, I expect them to do their 80 hours/week just like me. Whether they work harder or less hard than me later is an individual issue and surely not open for your wide generalizations.

Yetanoth....
Besides, YOU KNOW NOTHING about the realities of their countries. You cannot even pinpoint them on the map, most likely. Your ignorance therefore does not allow you to preach morals to anybody.
***I "know nothing about their countries""?? How do you know so? How do you know what I can pinpoint on a map/ How do you know I am being ignorant? It is interesting how all the politically correct imbesiles in this country (and their groupies) always love to claim how ignorant we all are that are not willing to provide free lunches for everyone else? Do YOU know everything about THIS country? Do you think the average paki Doctor fresh off the boat can pinpoint there the Hoover dam is?? if you want to kick people in the butt, make sure you're own is not to big Based on your own arguments here, I DEMAND that any paki doctor here is able to pinpoint every state on map!!! Otherwise they have no say..!


Yetanoth....
Lastly, I'll say it again, maybe you can comprehend it once and for all: one reason America is the greatest of all is because of the bright foreigners who come and work here (and sometimes are treated like dirt).
***If they are "treated like dirt:" then why the heck are they coming here? Unless, of course, your statement is (again) entirely devout of realities or facts.

Yetanoth....
Luckily, those who run the country, even the republicans, can see this and decide accordingly. Therefore, you'll keep seing foreign doctors coming and practicing here - and pissing you off.
****"pissing me off" WHAT is? that people hating this coutry come here and demand everything on a plate? Yes. I never see hispanic people (even illegals) curse the US while they stay here. Therefore, I have no problem with them living here. But I DO have a problem with people that come here, demand everything and, at the end are celebrating everytime a GI is killed in Iraq, or everytime America suffers, especially if they themselves are fine.

To disappoint you further, I have nothing against anyone coming here to get jobs. What I am against is the ones coming here just to skim the milk for the cream and still complaining that the country is "discriminating them".

It is funny how fast certain immigrant groups are to scream and rant about "discrimination" and yet the same "victims" are willing to sell their grandmothers souls for entrance to this 'land of infidels".

Again, if it is so bad here, then why come here??

When in Rome, be welcome, love, enjoy, but act like a Roman..

<Thebesius>

"I have friends in clincials that studied for StepOne while they took Surgery"

Too bad for them. They did not understand that in scores size matters and they paid the price. Shoud I feel sorry for these heroes of yours or what?

"That's a bit more effort than you sitting in the register at Wal-Mart (to use your own mode of rhetoric here) reading First Aid by the side"

I really enjoyed this one!! I wish I could work for walmart. But, since I have no work permit, I cannot do that... Instead, I had to work my gluteal off for a salary (sorry, it's called "stipend") less than your walmart fellow to do the research that the smart Joe-The-American would never do (because of the dismal pay).

"... I implied a comparison between two physicians that WERE ECFMG-certified".
My friend, two cars certified by Whatever-Agency-Certifies-Cars-To-Be-Sold are NOT identical, although they are both certified. The Mercedes class S is not the same as Ford Focus, although both are certified to be driven on public roads. See the analogy here or need more explanation?


"does a US physician have more help in knowing the difference between Aldolase A and Aldolase B, rather than knowing the differential diagnosis of pelvic pain?"

Aldolase is a bad example, but who knows, five years from now it might matter. But take HLA or other molecular markers. If you don't know how they can make a clinical difference, I'll explain it to you for a small fee (Paypal accepted).

"They "work twice as much as me".. and "get paid less".. If these things are true, I am sure there are hundreds, or even THOUSANDS of anti-discrimination lawyers ready to take their cases."

If you don't know that discrimination still exists in this country (albeit much less than in others), you have no idea about the world you are living in. And me, I thought you need to PAY a lawyer to take your case, which you might not afford right off the boat, but what do I know?

"I DEMAND that any paki doctor here is able to pinpoint every state on map"

I agree with you on that one.

"But I DO have a problem with people that come here, demand everything and, at the end are celebrating everytime a GI is killed in Iraq, or everytime America suffers, especially if they themselves are fine. "

Me too. Celebrating killing of any kind is detestable to say the least. We struggle for weeks, months and even years to save that 85yo, paralyzed and demented fellow while 25 year olds blow their brains out or leave their guts on the battlefields. Now that makes me sick and makes me wonder where we are all heading.

And somebody will always be there to help you blame everyone else.

"I have friends in clincials that studied for StepOne while they took Surgery"

Too bad for them. They did not understand that in scores size matters and they paid the price. Shoud I feel sorry for these heroes of yours or what?

***Don't think you ned to feel sorry for them. They both took StepOne two weeks out of the rotation and passed.


I wish I could work for walmart. But, since I have no work permit, I cannot do that... Instead, I had to work my gluteal off for a salary (sorry, it's called "stipend") less than your walmart fellow to do the research that the smart Joe-The-American would never do (because of the dismal pay).
*******Well, that is YOUR choice, so what the heck are you whining over? Of course an american in his own country wouldn't do research for a stipend, if he had other options.


my firend, two cars certified by Whatever-Agency-Certifies-Cars-To-Be-Sold are NOT identical, although they are both certified. The Mercedes class S is not the same as Ford Focus, although both are certified to be driven on public roads. See the analogy here or need more explanation?

****First of all, I am not your friend, so Please refrain from labelling me as so. And you are very (not so) elegantly dodging the fact that one ECFMG-certified had two years fo US hospital training while the other one got a few points higher on two standardized tests. Again for being such a 'high achiever' I find it puzzling you couldn't explain this one a bit better than comparing cars!!



take HLA or other molecular markers. If you don't know how they can make a clinical difference, I'll explain it to you for a small fee (Paypal accepted).

****You are so funny. first you talk about molecular biology and when I clearly give you two examples with correlations, you jump off with your technicalities. HLA, do you really think ANYONE that did not get ECFMG-certified don't know the implications of that?? Is that another of your delusional "high-achievments" here??
First time i read about HLA was in Bio in senior high, but I am just a stupid westerner, so what do I know compared to genius from Pakistan. I am sure you guys know everything even in utero.



If you don't know that discrimination still exists in this country (albeit much less than in others), you have no idea about the world you are living in. And me, I thought you need to PAY a lawyer to take your case, which you might not afford right off the boat, but what do I know?
***
A) You confirm yourself that discrimination is less in the US than in other countries, effectively weakening your own arguments.

B) All discrimination suits are civil cases and are (most of the times) filed with economic damages as a target. Most, if not all lawyers will not charge ANY fees unless the client wins the case. So no matter your origin, status or background you have no problem.

C) don't come here and lecture me on discrimination, of which you obviously have no idea. I have family members that were shot and gassed for no other reason than their mere faith, so you coming here to the US and ranting about being discriminated does not fly.


You know what; when MY family members were discriminated and threatened, most of them LEFT the country where it happened. NEXT TIME YOU TRY TO PLAY THE DISCRIMINATED, VICTIMIZED RACECARD show some more originality. and again, if things are so extremely hard here, why are you still staying??





We struggle for weeks, months and even years to save that 85yo, paralyzed and demented fellow while 25 year olds blow their brains out or leave their guts on the battlefields. Now that makes me sick and makes me wonder where we are all heading.
*** that "85 y. o paralyzed, demented fellow" has paid for the right to be treated by quality healtcare and even the 25 year old is getting the best medical treatment in the world, so I think we can still give all our people adequate treatment. Welocme to America. that "demented 85 year old' is th reason we even accept ppl like you (although it clearly is a shame, based on your level of compassion here) to come and work at our hospitals. Is your suggestion that we all should embrace Allah and bow to Bin-laden and let him tell us what to do, and euthanize our elders in the process? Obviously, based on your last implications here. it is better than standing up to freedom-hating scumbags and avoid the same faith as people in:

Somalis
south-Sudanese (for 25 years and still)
Pakistan (if you are not of the right faith
Afghanistan (if you are a woman)
Israeli People

just to mention a few. The only future for us "infidels" in the west is to let all the thugs and grunts that only think about hurting us know we are not willing to accept it.


Welcome to the free world

"And you are very (not so) elegantly dodging the fact that one ECFMG-certified had two years fo US hospital training while the other one got a few points higher on two standardized tests"

You keep repeating the same over and over as if this would strengthen your point. What "US hospital training" are you talking about? If you compare two fresh doctors, the only experience the American has consists in his clinical clerkships. So what? You think in Pakistan they don't do that? Yeah, they might not get to play with the MRI contraption (which I'm sure you did :-) . But I inform you that apendicitis hurts in the same RLQ whether in Pakistan or Kentucky. And, did you know that in some countries medical school is 6 years or more, therefore there are 4 years of clinical clerckships and not 2 as in US? I bet you didn't know (but hey, you know where the Hoover dam is, so nothing else matters). So don't preach me about your all mighty clinical experience when you actually have less of that than me.

"First time i read about HLA was in Bio in senior high"

If that's true, how come you screwd up the step1? With the great education you received, you should have scored better than I did. But see, I lived in a tent all my life, played with chicken as toys and then came here and kicked your *** in molecular stuff and all other subjects required for the boards. This fact tells me that the exam is fair. Having a rich daddy (who paid for your medschool) did not help much in the exam, did it?

"I have family members that were shot and gassed for no other reason than their mere faith"

I feel sorry for them all, but I don't see the point. If you compare US to nazi germany then you have really low standards.

"that "85 y. o paralyzed, demented fellow" has paid for the right to be treated by quality healtcare"

You did not see my point. I don't deny the care to anybody. I simply decry the fact that we send the young to die in Irak whereas the demented 85yo lives in a small paradise with young and blonde nurses changing his diapers and feeding him all day long in an A/C room and comfortable bed. If that's fair to you I got nothing more to say.

"Is your suggestion that we all should embrace Allah and bow to Bin-laden and let him tell us what to do"

Where the hell did you get the impression that I am a muslim trying to tell you what to embrace?

"When all else fails, cry discrimination"

You claim you need be given priority over the pakistani. Now that's discrimination!

I am amazed at how much you seem to go on inflating yourself with your "board scores" and implying everyone else are idiots.




@@
You keep repeating the same over and over as if this would strengthen your point. What "US hospital training" are you talking about? If you compare two fresh doctors, the only experience the American has consists in his clinical clerkships.
****That is excactly the point here. US experience and knowing the US system. That certainly amounts to more predictive mangement and familiarity than a higher degree of factual knowledge, especially when one already IS certified by a creditation boards. Again, there are no A and B doctors based upon USMLE numismatics.

@@@
I inform you that apendicitis hurts in the same RLQ whether in Pakistan or Kentucky. And, did you know that in some countries medical school is 6 years or more, therefore there are 4 years of clinical clerckships and not 2 as in US?
****6-year programs have many courses stretched out in the third and fourth year. take pathology and pharmacology for example, are mostly taught in 3rd and 4th year. Biology and chemistry are taught in the first two years, while US medical students do these in undergrad. So in reality a 6-year program might have some more clinical time, but certainly not 2 more years.

@@@
....how come you screwd up the step1? With the great education you received, you should have scored better than I did.
***agan, who said I "screwed up". unlike you, I see no point in elaborating on my scores for two reasons:

A) They can't be verified in any case on this forum, and are therefore worthless as arguments.
B) Even the makes of USMLE have warned against using these tests for evaluation of scholastic potential in residency programs. Ehile these things are still used in many programs, more and more programs are no asking for US experience as a minimum criteria, having started to realize excactly what I and the NBME are saying.

@@@@
But see, I lived in a tent all my life, played with chicken as toys and then came here and kicked your gluteal in molecular stuff and all other subjects required for the boards. This fact tells me that the exam is fair.
*******Again, you have no grounds for saying all these things besides your unsubstantiated claims. And what "playing with chicken" has to do with this is also a mystery to me... I actualy have TWO tents. I used to love fishing and going hiking when I was smaller, it's a great life..


Having a rich daddy (who paid for your medschool) did not help much in the exam, did it?
******I am on student loans and have not received financial support from my family to any significance. Could you please enlighten me in which noble way YOU have financed your medical school, or have you simply gotten free education form your country?? NOW who is "spoiled" here, chickens and tents besides..?


If you compare US to nazi germany then you have really low standards.
****I was only making a point of that people like you are coming here and yelling and crying "discrimination" arounbd every corner, while being in the country in the world that upholds individual rights and values the most. It is SOOOO typical of far to many immigrants here to portay themselves as victims of discrimination simply because they cannot hack it..


You did not see my point. I don't deny the care to anybody. I simply decry the fact that we send the young to die in Irak whereas the demented 85yo lives in a small paradise with young and blonde nurses changing his diapers and feeding him all day long in an A/C room and comfortable bed. If that's fair to you I got nothing more to say.
***You seem to toally miss my message again. In America we give everybody medical treatment whether they are young, old or "demented'.
Also, I really don't see the clue where the "young and blond nurses" show up in this picture!?! is that your idea of American nurses? DO you prefer "blond" to darkahired here or is that your own self-projection coming out here? Who knows?? you surely are so full of bias and prejudice that I have a hard time to fathom you being able to achieve anything in the world of critical thinking, like passing USMLE. Neither do I understand wht is wrong with having hospitals with A/C's and good beds!! Maybe I have missed something here, but I understand more and more whay program directors to increasingly extent prefer people with US experience rather than people flooding here strictly for economic reasons.

Where the hell did you get the impression that I am a muslim trying to tell you what to embrace?
*****I am not sure, but my hunch is that you are the following:

Pakistani/muslim background on some kind of non-immigrant VISA status working as surgical assistant/technician or on externship while studying for StepOne/StepTwo in the process.

I might be wrong of course, but since there really is no way for you to prove your merits besides your constant boasting, I prefer my own hunch to yours any day. Note that this is just MY "impression" and nothing else.

For all I know, you could be one of those "young and blonde nurses' that have gone to medical school and done well, after growing up in a poor neighboorhood area playing with chickens and being member of the girl scouts.

Next time you enter a debate, try to fill in with anything else than me-got-99, you-stupid talk.... And drop the blonde talk next time, unles you're talking about Sweden and Germany..

I "claim" that a resident of a country has the right over any foreigner to services and right in that country. I think that was quite clear from my mesage.
Of course, I don't expect to be given priority over you in Pakistan and I expect the same to apply in the US.

"I am amazed at how much you seem to go on inflating yourself with your "board scores" and implying everyone else are idiots. "

I didn't say everyone else are idiots. Idiots are those who fail the exam or have miserable scores AND come on the forum justifying their failure or ineptitude by stating that the exam is no fair, relevant or whatever!

"US experience and knowing the US system. That certainly amounts to more predictive mangement and familiarity than a higher degree of factual knowledge, especially when one already IS certified by a creditation boards"

Pure and distilled bullcrap. "Knowing the US system" will not help you with anything if you don't know the facts and can't think on your own. Probably you are of that kind who thinks that if you know what buttons to push at that state of the MF art ECG and it will spit the diagnosis back it is enough.

" So in reality a 6-year program might have some more clinical time, but certainly not 2 more years. "

It's obvious what a nincompoop you are. You really have no idea what planet you are living on and what happens in other countries. Why am I not surprised? Moreover, you created your own "reality" and "certainties". Sweet dreams in your own world!

"in which noble way YOU have financed your medical school, or have you simply gotten free education form your country"

My country, poor as it is, thinks that people should be admited to medschool based on exams and performance, and not by what daddy can afford. Therefore education in general is given free of charge.

"I really don't see the clue where the "young and blond nurses" show up in this picture!?! is that your idea of American nurses? DO you prefer "blond" to darkahired here or is that your own self-projection coming out here?"

As a matter of fact I preffer brunettes if you really are interested. It was just a figure of speech to show to one like you with so little imagination how that old fellow was treated as oposed to a soldier. Aparently it was a waste of time from my part.

"I am not sure, but my hunch is that you are the following: Pakistani/muslim background on some kind of non-immigrant VISA status working as surgical assistant/technician or on externship while studying for StepOne/StepTwo in the process. "

You are wrong, right, wrong and wrong. See, you are 75% wrong in what you say. It's the same percentage in all your postings, so it has statistical significance. ..

"I understand more and more whay program directors to increasingly extent prefer people with US experience rather than people flooding here strictly for economic reasons. "

The situation has not changed much recently. The IMG continue to fill the crappy positions in Bronx and Detroit residencies as before and end up in Smoky Mountains or Brooklyn practice. It's obviously preferable to have a smart pakistani rather than an inept American as the Doctor Queen in the village or slum.