America may be too dependent on physician graduates from foreign countries
Introduction
The United States is a country of immigrants. It is significant to note that spirit and virtually brought by the immigrants have added to the texture of American life. The stance of diversity has created a mosaic of challenges and complexity for those who are using healthcare facilities. It is assumed that International Medical Graduates (IMGs) has brought a profound wealth of knowledge of the disease that is not actually found in the practical and theoretical frameworks of the native land. Side by side there is a diverse exposure of transcultural and transnational attitude that empowers catering to the desires of patients. It is significant to note that foreign graduates have incorporated the stance of “belief systems” of cultures from different parts of the world, taking into account that belief system has an impact on the health and treatment of disease. There are certain complications as well, taking into account that the Healthcare System of America is threatened by the stance of foreign programs. Such paradigms include biased perception in terms of students, staff, patients and physicians. There is a gap in the platform of communication skills, taking into account that communication channels are distorted and hampered because of the foreign students. The relationship between patient and doctor is deteriorated because there is a lack of understanding. It is also asserted that foreign students have inferred professional and social acculturation. These baselines refer to an interactive approach that, there could be a lack of positivity and understanding in terms of the general population. It is significant to note that, America may be too dependent on physician graduates from foreign countries, taking into account that there are several pons and cons associated with it.
Discussion
Different countries invite “foreign medical graduates” so that positive statistics in demographics in health care can be maintained. In order to address the above-mentioned issues, the American government has relied on a surprising and increasing extent of the medical graduated from foreign land; most of the specialists are the citizens of other countries. It would not be wrong to say that the quarter of medical specialists in the United States are foreign medical graduates. More than 40 per cent of the primary healthcare workers is trained in other countries and then moved to America for practical implications. About half of this forty per cent is concerned with the caring of the older people. (Motala, et, al. 2019). Another population is interceded in providing Medicaid, adhering to their geographical associations. In accordance with the study of Health Affairs 2018, it has been brought into insight that the patients who are suffering from myocardial infarction and congestive heart failure are assumed and reported to have low mortality rate when they are treated by the doctors who are foreign medical graduates.
Another study by BMJ has inferred that the patients who were treated by the foreign medical specialists also have low mortality rate although they seemed to be sicker in general, with no specific disorder. (Dayratna, et, al. 2019). Another study by “Annals of Internal Medicine” has highlighted that among 80,000 or more than this physician in the country are foreign students, making up to 18% of the total medical staff. It is asserted that more than 15% of the full professors and the practitioners in the medical schools in the United States behold a different educational background as compared to the occupational demographics (Schühle, et, al. 2018). Many of these professors and other attendants belong to Western Europe, Latin America, Asia, the Middle East and the Caribbean. A study by Dhruv Khullar, a physician at New York Presbyterian has inferred that the diversity of the American medicine and the conventional stance of ideas conversation and thoughts has been the reason of one of the competitiveness as a global leader on innovation and Biomedical research.” (Ranasinghe, et, al. 2015).
It is significant to note that there are several other countries other than the united states that are relying on foreign medical specialist in order to address the needs of the patient. In accordance with the data collected from Organization for Economic Cooperation and Development, it has been highlighted that about 58% of the physicians who are serving in USA are foreign medical graduates, 40% doctors in New Zealand and the same ratio of medical graduates in Ireland are trained outside their countries. In 2015, OECD asserted that the United States has more than 213,000 foreign-trained doctors and none of the countries has this much ratio. According to an article that was published in the "The Upshot”, it has been brought into insight that many people think, the healthcare system of the United States has a lot of problems. There are different approaches associated with the problems, taking into account that people think there is a lack of doctors, available ratio of doctors is not fulfilling the required healthcare outcomes.
It is also brought into insight that the healthcare system of America is facing crucial issues in terms of “patient caring approaches”, asserting that there are a number of diseases that are left unaddressed. The healthcare education system has not imparted versatility in accordance with the requirements. (Jimenez-Gomez, et, al. 2019). Many of the researchers believe that having a great ratio of immigrants, America is facing a major issue associated with catering to the needs of the patient taking into account that the doctors are failed to interact with the patients, a major role is played by the interference of cultural association and the belief system that is associated with disease. It is also lamented that communication is also one of the gaps that need to be addressed in order to ensure quality health. An analysis of the ratio of doctors asserts that there are several pros and cons associated with foreign medical graduates. (Ahmed, et, al. 2018)
Pros of foreign medical graduates
Acceptance rates are comparatively higher than average
It is significant to note that there are a lot of people who have a dream of becoming a doctor and there is a lack of "academic excellence" and "financial crisis". There are a lot of people who are a victim of these circumstances, taking into account that the United States of America is acting as homage for the students. It is a two-way process in which countries are exchanging students in order to get medical education and serve the country. The reality of this fact can be traced in George Washington School of Medicine who is accepting a ratio of 3.6 applications, acting as a representative of an active future of medical specialists. Ross University School of Medicine and the Caribbean Island of Dominica is also acting as a source of educational development. This avenue of exchanged education can act as a tribute to the increasing ratio of medical specialists, adhering to the fact that it is posing strong incentives for students. It would not be wrong to say that this stance of exchanged education not only facilitates students, but it is also a great tool to empower the healthcare baseline of the country as well. (Duvivier, et, al. 2019). Healthcare needs are acting as a home to the implication of creative strategies that can impart a greater success to foreign health systems. Such aspects could be any of social, political and moral paradigms, taking into account that there are a lot of people who are having sheer psychological and moral associations with diseases. In this case, foreign medical graduates are one of the greatest incentives and approaches towards adequate and better health in the United States, mitigating all social and ethical barriers in the passage of good health.
Addressing shortage of doctors
It is asserted that the United States of America is having a sheer shortage of doctors in the last few years taking into account the increase in population and a systematic approach towards the maintenance of healthcare. According to Monavvari, (2015), research has highlighted that America will be facing a shortage of 120.000 physicians by 2030. This data has been collected by the Association of American medical colleges. It is significant to note that the foreign medical specialists have maintained the number of “shortages”. (Monavvari, et, al. 2015). It is important to note that foreign medical graduate makes up about a quarter of the entire medical system in United States and foreign doctors are acting as a cure to the continuous decline in the ratio of doctors. Research has highlighted that many of the foreign doctors try to approach the deprived public and it is an ultimate way of fulfilling the desires of the patients. Many of the foreign medical graduates try to practice their education in the rural and the deprived areas, taking into account that it not only increases their exposure to the patients, but it is also an action that facilitates general public as well.
Foreign medical specialists are always available in the hour of need, taking into account that they are seen in lots of highlighted scenarios. The availability of foreign medical graduates in hospitals has empowered healthcare system by taking radical steps in order to adjust and cater to any emergency situation. (Ranasinghe, et, al. 2015). In the subject issue, American Association of Medical Colleges has highlighted that the stance of shortage of doctors is expected to grow with each year. Side by side it is an increasing flow because there are a lot of doctors who have moved to urban areas and other countries leaving empty seats in rural and unpopulated localities. As the population is estimate to grow with an expected ratio of 11% by 2030, asserting that the number of people greater than 65 years of age will make half of the population and this number is more vulnerable to diseases. So, foreign medical graduates are a great option to overcome future devastations and provide basic needs. (Pinsky, et, al. 2017).
Social Paradigms
Foreign medical specialists are one of the major factors to address social paradigms. It is significant to note that foreign medical specialist belongs to different areas and, America itself has a major section of people who are migrated from other countries. According to the research by American Association of medical colleges, it has been brought into highlight that foreign medical students are a positive approach to incorporate health resources that can impact long term health goals because foreign medical graduates are better at understanding people who belong to their race and religion. Social paradigms refer to a number of other aspects such as cultural, moral and religious approaches. (Schühle, et, al. 2018).
Cultural aspects
Foreign medical graduates are one of the major tools to cater to "cultural aspects” of immigrants because culture act as an identity and it is hard for immigrants to compromise their identity. There are several cultures that are using self-formulated medical strategies to address their issues and this stance is posing a serious threat to the overall healthcare baseline of a country. Research by “Upshot” has highlighted that there are many people who have certain traditional remedies towards specific disease and people practice such actions with great punctuality, taking into account that those remedies are doing more harm than good. (Armstrong, et, al. 2017). There are several cases that are reported in the context of unsafe and unusual practices that had more severe reactions than expected. Foreign medical graduates are representatives that can motivate people to shun their cultural actions and adopt healthy and safe practices. If such suggestions are passed by any of the local doctors, the patient will take it like a lunatic quote or a for-granted discourse but the same conversation with same cultural representative doctor will have a better influence and more appealing effect. (Dayratna, et, al. 2019).
Moral Aspect
Moral aspects play a major role in healthcare system. As morals are directed by cultural and religious sources so it would not be wrong to say that moral aspects are the amalgamation of both religious and cultural practices. In accordance with the benefits of foreign medical graduates, it can be asserted that they are good at making people realise the difference between good and evil. It is significant to note that patients are more influenced with the one who has the same religious or cultural approach, taking into account that a foreign medical graduate will demonstrate better understanding. (Ahmed, et, al. 2018). It is also significant to note that history is full of cases where hybrid identities and tilted beliefs have made a sheer loss. It can be found that those case studies not only act as a tool to analyse the importance of moral and spiritual understanding, but it is also a stance that can allow the medical graduate to better understand what is required of them. Many people have racist beliefs and they think that White people are not their will wishers. An intellectual and interactive approach can act as a major tool to let the patients understand the difference between right and wrong. (Armstrong, et, al. 2017)
Religious Approaches
Religion is one of the prime factors that have played a significant role in regarding or disregarding the attitude and identities of people. Although there are certain areas at which, religion contrast with the scientific approach and it is the point of conflict that compromise the life of a number of people. It is important to note that Monavarri’s research has brought into consideration several cases in which religious approach is misunderstood by people and it is an ultimate threat to the life of an innocent being. (Monavvari, et, al. 2015).Usually, parents make unethical choices adhering to the misunderstood beliefs and it paves the way for social destruction. Many of the foreign medical graduates have different religious backgrounds and they can act as major tools for highlighting the facts and figures both valid and invalid that should be practiced in terms of medical framework. It is important to note that foreign medical graduates try to convince patients in terms of their best interest by adhering to the religious beliefs. Religious identity of the foreign medical graduate acts as a reinforcement of better healthcare standards by convincing patients to opt for healthy activities and suitable medications. (Duvivier, et, al. 2019).
Source of innovation
Foreign education is always different, taking into account the variation in methodologies, modules and the approaches towards understanding. It is important to note that the foreign medical graduates when migrating to the United States bring with them all the novelties they have learned throughout their course. It allows a great modification and change in the actual stance of traditional medical approaches. Research has proven that foreign medical graduates incorporate certain novel technologies and techniques that are not only unique but they are a source of great benefit for the general public. It is asserted that the foreign medical graduate empowers healthcare system by incorporating the positivity of innovation and negating the risk attitudes. In a nutshell, it is assumed that the inclusion of foreign medical graduate is a source of upgrading the present scenario, taking into account the reflection students have brought with them by learning in a well-equipped environment. (Monavvari, et, al. 2015).
Adhering to “better than”
Comparison is one of the approaches that facilitate and treats patients. Having a lot of options is one of the approaches that strengthen patient-doctor relationship. In accordance with the learning attributes and academic outcomes of foreign medical graduates, there is an evident option of “better and choice". A patient, as well as a doctor, has an option to choose one strategy or tool that can facilitate patient at first end. Foreign medical graduates bring several novel and unique things that may be more appealing to the patient and it allows them to be satisfied with the treatment they are given and environment they are provided. Moreover, foreign medical graduates allow people to incorporate their will as well, in the last few centuries there is a greater approach of using foreign medicines and doses that are bound to core standards of patient-oriented outcomes. (Ranasinghe, et, al. 2015).
Incorporation of better understanding
Racism is one of the dilemmas that United States has failed to address and it is a serious threat to the economy and demographics of country. In accordance with the research by Pinsky, (2017), it has been highlighted that doctors belonging to a different race and religion are one of the major attractors for people. It is a common observation that people try to approach that doctor who has some kind of similarity with the patient because it is a mode of satisfaction for them. People believe those doctors with same cultural or religious backgrounds more as compared to others. There is a comparatively stronger bond of interaction between patient and doctor; it is a greater approach towards fast understanding. It is one of the solutions to ever prevailing "communication barriers", taking into account that there is less comprehensibility. (Pinsky, et, al. 2017).
Eradication of mocked traditions
There are a lot of people who are a victim of traditions that are unacceptable and highly remote in terms of contemporary times. Foreign medical graduates are eradicating the lineage of stereotypes associated with medicine and diagnosis. It is assertive that even in the present time, there are a lot of people who think herbal medicine and self-medication is an approach towards adequate health. In reality, it is a sheer and apparent drift from the scientific code of conduct, taking into account that people are becoming a victim of severe issues that were not known before. (Jimenez-Gomez, et, al. 2019).
Sustenance of core medical values with the economy
It is significant to note that foreign medical graduates are one of the factors that can empower the economy because they are playing a major role in the support of the national economy. It is significant to note that foreign medical graduates are becoming a major source of adhering to core medical values. These core medical values refer to honesty, convenience, sustainability and adhering to the standardised values of mechanics and science. Other spectrum highlights that the sustenance of core values of medical are also empowering economy. The use of certain machinery and scientific approach has allowed people to empower and enhance medical standards by adhering to those paradigms that are benefitting for both state as well as people. (Duvivier, et, al. 2019).
Cons of foreign medical graduates
There are several cons associated with foreign medical graduates as well. These cons have different approaches to medical and healthcare paradigms.
Concerns regarding professionalism
Professionalism is treated as one of the major baselines in each profession. It is significant to note that the ratio of foreign medical graduates is no doubt great support for the people and state side by side, it is a stance of “lack of professionalism”. It is evident that each of the countries has a different approach towards working. When foreign graduates are brought into the realms of another country, their skills are either praised or criticised. In case of United States, when student migrates, they are exposed to an entirely new framework of healthcare system and the context of “advanced medical approach”, such students are termed as inexperienced and unskilled. It is also important, not all the countries have a standardised educational system. The medical graduates from such institutions distort the actual working timeline of hospitals because they are failed to cater to their job requirements. Research has highlighted that there is a ratio of 4% professional associated with foreign medical graduates that are working in the United States but they are equally unskilled and untrained, acting as a serious threat to the life of patients. (Ahmed, et, al. 2018).
Distorted doctor-patient relationship
As foreign medical graduates belong to a different nationality, they have a different approach towards life and diseases. Usually, a disease is a result of a certain environmental conditions, bound to specific realms. A doctor brought up in that locality will have the same vision towards the diseases. According to Schuhle, (2018), it has been highlighted that foreign medical graduates are one of the reasons for the distorted patient-doctor relationship. Although such graduates are much understandable for the people having similar identity at the same time, they are the stance of unhealthy relationship with patient. There are several cases reported to assert that a patient has been treated with an unsuitable dose and approach leading to unfavourable results. It is also highlighted that the teaching approach also plays a significant role in maintaining the relationship between patient and a doctor, usually prescribed medicines and treatments are not adequate in terms of geographical circumstances. (Schühle, et, al. 2018).
The significance of adopted and enforced
The analysis of the foreign medical specialist has paved the way for “clash between enforced and adopted skills”. When a medical graduate is forced into another place, there is an evident stance of adopted circumstances because a doctor takes time in adjusting to the requirements of a particular realm. This difference of ideology is a serious threat to the analysis of the healthcare system, taking into account that adopted strategies take a comparatively long time to be brought into practice as compared to the enforced approaches. There are a lot of cases in which doctors are facing serious issues in using the machinery and applying the basic strategies for patient management because of the difference in their learning and exposed environment. The stretch between adopted and enforced is highlighted because it is not only a difference of approach but a clash of ideologies because not all the graduates are easily adapted to the exposed scenarios, till then they are a threat to the country. (Motala, et, al. 2019).
Ethical concerns
It is said, “Every picture has two faces”. The same tool of analysis can be applied to medical sciences in terms of foreign graduate. At a stance where foreign graduates are catering to the concerns and issues of the racist and discrimination people, on the same baseline they are themselves becoming the mode of discrimination. It has been observed that doctors are becoming biased and racist, taking into account that not all the patients are treated with equal attention and support. Foreign doctors try to accommodate their race and identity first. This scenario is acting as a serious threat for the people who are living in rural areas and other areas where foreign medical graduates are employed for community reforms. (Pinsky, et, al. 2017).
Communication barriers
Among the major challenges and threats, foreign medical graduates are posing to the United States; one of the major barriers is communication barriers. Although it is asserted that English is a global language and it is the means of communication, still there are a lot of foreign graduates who are not good at English. It is significant to note that communication barriers are a serious threat because it mitigates understanding that leads to several other gaps. It can even threaten the life of a patient, compromising the stance of the normal and balanced life. It is important to note that communication ability is something that goes beyond the realms of speaking and writing English. It also includes an approach towards street language, idioms and the use of specific terminologies. (Schühle, et, al. 2018).
Non-verbal communication plays an equally important role in it. Taking into account that body language is more sophisticated yet powerful and attractive rather than the medium that obstructs and facilitates the relationship that exists between the patient and a doctor. It is inferred that there are a number of healthcare institutions where less questioning is preferred while there are institutions in which adequate and detailed questioning is necessary to know the cause of problem. The same scenario is implied on the patients as well, many of the patients think that more questioning from doctor means they are more concerned and careful about their health while many patients think that more questioning shows the inability of the doctor to cater to the concerns of the patient.
Health Standards
Health standards play a major role when it comes to the threats that are posed by the employment and recruiting of foreign medical graduates. A difference in the type of education adheres to the difference of standards as well. It is inferred that the medical graduates who belong to other area or location have a different approach towards the health needs of the patients and standards of health. In a number of approaches, it is the consent of the patient that is the main focus of the doctor while in other cases; “saving life” is the catch line of patients. It is critical to think about the devastation this change of priority can impart. (Motala, et, al. 2019).
Lack of comprehension
Comprehension is one of the characteristics that play a significant role in the analysis of the facts and figures that can strengthen or distorts the relationship between a patient and a doctor. It is assertive that “foreignness” is an apparent word that strengthens the bonds of segregation for the natives. It would not be wrong to say that comprehension is an abstraction that is acting as a stance of assumed and expected results. Research has highlighted that the lack of comprehension between the patient and doctor is creating a range of issues in terms of long term goals, taking into account that patient does not get the subject of doctors and doctors are unable to understand the patient wants to say. (Jimenez-Gomez, et, al. 2019).
Settlement challenges
It is asserted that the feeling of “being new and foreign” is an approach that hampers and impact the professional attitude of a doctor. In a simplified form, it is the complications of personal life that distract doctors and tilt them to unprofessional attitude. It is important to note that foreign students face a number of challenges in terms of residence, settlement and access towards insurances and legitimized policies. Although it is not an apparent factor still it is one of the background factors that play a major role in shaping the attitude of doctors towards patients. Research has highlighted that the performance of a doctor is linked with the background factors that are acting as a tool to highlight or mitigate passion and courage. (Duvivier, et, al. 2019).
Conclusion
In accordance with an analytical view towards migration and recruitment of foreign medical graduates, it has been highlighted that America is too dependent on the physician graduates from foreign countries, stressing that they are doing more harm than good. Although foreign graduates are empowering economy and technology along with cultural stability it is also cutting off the staunch backbone of "trust in doctors" and "positive relationship between patients and doctors". People are becoming resistant and reluctant taking into account that the impact of destruction is more prominent in terms of lack of adequate education, lack of skill, communication barrier, biases and racism. Moreover, the gap in understanding is compromising lives of people, saviours are assumed to be warriors because they are trying to cater to identity rather than the necessity of patient. In a nutshell, a large number of foreign graduates are a threat because they are hampering the code of set standards by compromising health, taking into account that healthy America will address the shortage of doctors and economic gaols itself. In a nutshell, the approach towards foreign medical graduates should be treated as a choice not as a compulsion because anything that has long term distractions should be mitigated.
References
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