Foreign MDs becoming US CRNAs

[calgal]

I had a very interesting conversation with an RN the other day. Her sister is a physician in another country and could not get into the US as a practicing physician. Instead, she went to nursing school in her home country (Lansing College), got her BSN and was accepted with open arms into the United States.

She worked in an ICU for 2 years, applied to CRNA school, and is now a CRNA in the US. The school was not aware that she was a physician in another country and that the general "practice" among foreign physicians-turned-RNs is not to announce that they were physicians in another country. I am told that foreign nursing schools are just inundated with former physicians who plan to come to the USA with similiar plans to attend CRNA school in the US in mind. With the salary that US CRNAs have to offer, it must be lucrative compared to a physician's salary outside of the US.

I guess this adds to the fierce competition to CRNA schools, but doesn't this seem deceptive???......

[nilepoc]

Thinkingaboutit, I hope you are not saying that nurses have good representation at the federal level. Because it just isn't so. The lobby driving the admittance of foriegn trained nurses, is not the ANA. Most likely it is the hospitals that drive that demand. I would hope that the ANA would lobby for more education oportunities, not more foriegn nurses. Bringing in nurses, only patches a hole that we have now, it does nothing for the future.

[ThinkingAboutIt]

Nilepoc,

I am saying that nurses have very little clout in politics which is one the problems with nursing. The AMA has sets the policies and direction for Health Care in the US, and if you notice the wages of doctors has always went up. You don't see a flood of doctors from other countries coming to the US do you? Why? Do you think that there are millions of doctors who would love to make $200,000/year instead of making $10,000/year? The AMA has erected all sorts of barriers to keep them out! They can't get visas, thier education is not applicable, and even their years of experience do not count. It is the AMA's position that foriegners practice medicine with voodoo dolls or something.

Go to INS.GOV and you will see that you get the express track to get a visa if your a nurse, because there is a shortage of nurses. To become a nurse all they have to do is pass an english test and the RN test in that state. No barriers there, just a paved highway!

There is a shortage of nurses. The million dollar question is why is there a shortage of nurses? Is it some skill that foriegners are necessary to fill the vacancies?

The main reason that there is a shortage of nurses is that nursing has had historically low wages! Once women could choose any occupation they wanted they no longer choose nursing, because there are many higher paying occupations that have less stress. If you allow thousands of foriegn nurses to fill the vacant slots what will happen? Wages will fall or stay stagnant. Will Americans want to spend $50,000 to go get a BSN? No.

In my opinion, the current shortage is a good thing it will drive up the salary of nursing. As the salaries go up you get more talented people, and more educational and professional options for people interested in nursing.

I think that there should immigration to the US, and particularly immigration of talented people. But it seems that occupations like interests of nursing have been adequately represented in US policy.

[deepz]

......The main reason that there is a shortage of nurses is that nursing has had historically low wages! Once women could choose any occupation they wanted they no longer choose nursing....

Yes. And beyond the economics is the sea change in the social status of American women in general. Why should they subject themselves to a role like the doctor's handmaiden when they have the power to become doctors themselves? When I was a 17 y/o freshman SN (don't ask when), the wonderful old maid instructors just loved to tell us how lucky we sprouts were, not to have to shine the interns' and residents' shoes for them, or cook their meals, do the doctors' laundry, haul in buckets of coal, etc. And for us to get a whole weekend off -- scandalous. Times have changed.

Still, America may be the only nation where physicians admit private patients and then treat the hospital staff as if the doctors themselves paid the staff. Higher salaries will HELP attract new nurses, but will they stay? There seems to be STILL a long, long way to go to improve the social status of nurses within hospitals. More control of nursing roles and duties by nurses might help. ...That power shift is still over the horizon, seems to me.

deepz

[Brenna's Dad]

I am a Canadian born and educated RN.

I came to the US knowing nothing about nurse Anesthesia.

What I can tell you, is that there is a SERIOUS shortage of RNs in this country. There is such a shortage, that Registered Nurses (along with Physical therapists) are considered a Schedule A occupation. Meaning that potential employers do not have to meet Labour requirements as EVERY other occupation does. In almost every other circumstance, if a USA employer wants to hire a foreign employee they have to prove that there is not a qualified US citizen for the job. They prove this by running classifieds in journals, newspapers, etc.

However, as someone who has navigated the emmense beauracracy of the Immigration and Nationalization service, I can tell you with absolute certainty, that gaining access into the USA is an extremely difficult proposition, even for nurses. Despite, RNs being listed as a schedule A occupation.

[Rep]

Sure, but it is almost impossible for them to get a visa to get here and take the test, and even then they aren't allowed to just to take the USMLE to become a doctor. It's hard to pass a test that you are not allowed to take. And very few foriegner doctors can afford to go med school in the US, because of the cost. The AMA has convinced everyone that the foreign doctors have all gotten substandard training, but the training the nurses from these same foreign countries have received is O.K.

What is happening here in the Philippines is that most of these doctors have no plan to take the USMLE so that they can start and practice as doctors. What they are doing is going back to nursing schools so they can work as nurses in the States. Very pathetic indeed when these same Filipino doctors practicing here in the Philippines treat their fellow nurses as slaves. Here in the Philippines, nurses were not encourage to voiced out their concern regarding patients care and to treat doctors as gods. . Unlike in the US where nurses are one of the important members in the health team.

[ethelbsnrn]

REP,

Are you practising nursing in the US? If not, how could you compare the atmosphere here in the US with that in the Phils? Please, don't make it appear that foreign nurses are not as good as the US-educated nurses. We are allowed to voice out our opinions re: patient care. We have freedom of speech and opinion. And that is true whether you are in USA or in a foreign land.

[jax]

I believe that Rep was discussing the cultural differences between your two countries - I didn't see anything offensive in her/his post.

jax

[geecue]

There are quite a few Philippinos that were 'physicians' in their homeland and are now practicing RN's at my hospital. I'm not going to speak for all the foreign to US RN's, but I asked them personally why in the world would they become an RN instead of an MD. Simply put: 'lack of ambition' was what they told me. I see your point CalGal about the deception but from the few I talked too...maybe they aren't cut out to practice here. The UCMLE exam is extremely difficult (my father took it and is practicing Dermatology in the East Coast). What I'm seeing more now in different hospitals is a a large influx of RN's from other countries (Phillipines, India etc) that are getting hired on (ICU even!) without any prior experience. With the huge nursing shortage we are experiencing....it makes me wonder where we're heading when theyre paying these nurses 18 bucks an hour, thus forcing the qualified and experienced RN's to look elsewhere for work because they can't get inhouse or overtime pay. Is the dollar more important to management these days instead of quality of care?

[Hellllllo Nurse, BSN, RN]

I do not buy the thinking that foreign doctors have it so bad in their own countries. It takes a lot of money to become a physician, in any country. If they could do it in their country of origin, they don't have it that rough.

[Benton]

This subject matter reminds me of an interesting thing that happened to me. I had a CNA come to me and tell me that one of my pts was starting to cardiac tamponade. I assessed my pt and sure enough. Later, I thanked the CNA and asked him how he came about the excellent assessment skills. He told me he was a practicing MD in Cuba and he couldn't pass the USMLE. His younger brother passed the USMLE and works as a OB/Gyn in the states...the CNA has his income supplemented by his MD brother. It just shows you never really know the qualifications or background of who you are working with.

On the other hand, I once worked with a non-US trained nurse who I watched trying to do deep nasal-suctioning with a Yankuer. The poor pt was in four-way restraints and thrashing his head from side-to-side while she shoved this very nasal-unfriendly tool up his nose. When I stopped her and asked her what she was doing, she said, "No, I need to do this, doctor ordered deep nasal suctioning."

Then again, I witnessed a US trained RN, in an attempt to adm heparin, stab a pt in the gut with a 1 1/2 inch, 18 gauge needle. She really used a stabbing motion and this is what caught my attention. The injection cored the pt and punctured her intestines, resulting in sx for the pt. The RN's reason for the 18 gauge needle, the cart in the pt's room was out of smaller needles and she thought it wouldn't hurt to use a larger needle. The larger needle, per the stabbing/injecting nurse, made it necessary for her to put a little more muscle behind it. This same nurse was in the process of applying to grad-school for her ARNP.

Bottom line for me...if I'm working with a nurse who is also trained as a MD, I don't care or need to know. A person's credentials, no matter where obtained, are only as good as the person they are pinned to.

[susanna]

I do not buy the thinking that foreign doctors have it so bad in their own countries. It takes a lot of money to become a physician, in any country. If they could do it in their country of origin, they don't have it that rough.

I have no idea how all foreign docs have it but I do know that becoming a physician is not expensive everywhere. In France, medical schools are all practically free for undergrad and grad(they combine the two and tuition is about 200Euros per semester=200 dollars a semester) and in Taiwain, not all, but the best medical schools are federally-funded and free.

[suzanne4, RN]

Tuition for many foreign doctors is actually paid for by their government.

They just agree to work so many years as a pay back. Definitely is not expensive, not like the US.

Same thing for nurses, also.............. :balloons: