If you want to know exactly why so many doctors are leaving the Philippines and heading elsewhere for greener pastures, even if it's just to work as a nurse, look up the prescriptions section of FAKING IT, HARD, where you'll find the very informative comments of The Doctor. He has graciously been answering my questions back and forth regarding the situation of Medicine in the States, and I feel that his insights should be shared with the world (This is dedicated to my friends who are wondering what to do with their lives--like me).
This is his reply when I asked him about the compensation of physicians in the US, social medicine (which I'm not even familiar with, but maybe that's just me), the starting salary for a GP MD in a government hospital, and the starting salary in private practice:
"Well, as most of the world knows, MDs in the US are the best paid. Our licensing requirements are also the most strengent. First, a 4 year BS or BA is required to enter. Then you have the 4 years med school, where you must pass the NBME Parts I (end of 2nd year), II (4th year). Residence is from 3 to 7 years depending the area you choose (mine was 5) and the school. I have yet to see a 3 year Res, but they are out there. Then you must pass the NBME, Part III, and pass it every 5 years too! Then each state requires its own exam.
The pass rate for US graduates is around 95% for step 2 and 3. Where as the pass rates for foriegn graduates for each step is around 50% which translates into a total of 12.5% of applicants. I have met a number of filipino immigrant nurses here that went to med school or pharmacy school in the phillipines, but couldnt pass the required exam, but they say they dont mind as the nurse's salary of $40,000 is so much nore than the MD's salary in their country. (how far would 2.24 million pesos/year go in your country?)
You are paid during residency depending on the place you choose (or chooses you) the minimum was $2o,ooo when I graduated University and U of Michigan paid me $35,900. Now, the residencies pay about $40,000. When I finished, the starting Salary was about $125,000/ year for a Government Job and about $150,000 in the private sector (90% are private here). Last year, a Cardiogist started around $200,000. IM is much lower, at about $125,000.
Social medicine is free medicine. It is not based on income. Here we have both private as well as government sponsored health care (for the poor). If you meet poverty levels, your health care is free, but generally of lower quality (not the practioners, but this health care is acute, not preventative)."
This is my reply. I bid my Filipino/non-Filipino friends to share their own thoughts, opinions, and experiences.
"Wow. The requirements are stringent indeed. In our case, we have to go through a 4-year Science-related course, although i know some med students who graduated from extremely unrelated courses, like Hotel and Restaurant Management. They had to take extra science subjects, of course, but still...
Anyway, the most popular pre-med course is still BS Biology, though I have no idea why since it appears to be the most useless! The only skill I learned that I was still able to use in Medicine was how to operate a microscope--duh. Like that's such a big help. That's why I tell my younger friends who want to go into medicine to take up either Med Tech or Nursing, as these are lucrative fallbacks, with emphasis on practical expertise.
After Pre-Med, there's four years of Medicine, with the fourth year being mostly clinical rotations. The fourth year culminates with an Integrated Test encompassing all three years, and an Oral Revalida. This oral revalida is the killer, and it's only given now in the university where I graduated from, as it's been shown to be subjective and unfair (the admi in our university just feigns ignorance of this, I guess).
Consider: if you're an honor student and you don't get the required marks, you don't get your award. If you don't pass it at all, you don't graduate with your batch. Last year, the panel failed a student who was supposed to graduate MAGNA CUM LAUDE, so she wasn't even able to graduate with everyone else. That student took a leave of absence (If that were me, I might have tried to kill myself). She and about five others who thought that they had been unfairly failed eventually sued the university just before graduation, intending to postpone the commencement exercises. The court quickly denied their claim so the graduation was able to proceed as planned, but I think it was because the court was afraid of the uproar that the other 400 graduating students could create.
Anyway, there's one-year internship after that, then 3-6 years of residency depending on the field. Here, IM can be taken for as short as 3 years. The funny (sad) thing is that residents are generally paid so poorly that they still have to rely on their parents (like I mentioned before, the salary can be as low as P8,000/month or $142 dollars a month! Pathetic!). Of course at this point, a lot of them (us) are already old enough (too old!) to start their own families (Biological clock ticking!!). Imagine how hard it is to marry, rent/buy a place, raise a kid, and go through residency at once, all the while relying on your aging parents.
That's why a lot of would-be doctors hesitate at this point, and go on to nursing instead (thus foregoing all those years of hard work), or study for the MLE so they can work in the States. Why? That salary you quoted for nurses--$40,000.00 a year or P2,240,000/year (translating to about P186,000.00/month!!) is already the salary of a well-paid cardiologist/cardiac surgeon here!!
Imagine! That's a lot; more than the average person here could dream of! If a Filipino nurse didn't intend to stay away forever, she could just work in the US for 10-15 years, save up, and come home a multi-millionnaire. Or if she did intend to stay, she could petition for the rest of her family to join her, and so ensure a good future for them. (This conversation is making me faint. Maybe I should just go over there...dear, dear...)
"Wow. The requirements are stringent indeed. In our case, we have to go through a 4-year Science-related course, although i know some med students who graduated from extremely unrelated courses, like Hotel and Restaurant Management. They had to take extra science subjects, of course, but still...
Anyway, the most popular pre-med course is still BS Biology, though I have no idea why since it appears to be the most useless! The only skill I learned that I was still able to use in Medicine was how to operate a microscope--duh. Like that's such a big help. That's why I tell my younger friends who want to go into medicine to take up either Med Tech or Nursing, as these are lucrative fallbacks, with emphasis on practical expertise.
After Pre-Med, there's four years of Medicine, with the fourth year being mostly clinical rotations. The fourth year culminates with an Integrated Test encompassing all three years, and an Oral Revalida. This oral revalida is the killer, and it's only given now in the university where I graduated from, as it's been shown to be subjective and unfair (the admi in our university just feigns ignorance of this, I guess).
Consider: if you're an honor student and you don't get the required marks, you don't get your award. If you don't pass it at all, you don't graduate with your batch. Last year, the panel failed a student who was supposed to graduate MAGNA CUM LAUDE, so she wasn't even able to graduate with everyone else. That student took a leave of absence (If that were me, I might have tried to kill myself). She and about five others who thought that they had been unfairly failed eventually sued the university just before graduation, intending to postpone the commencement exercises. The court quickly denied their claim so the graduation was able to proceed as planned, but I think it was because the court was afraid of the uproar that the other 400 graduating students could create.
Anyway, there's one-year internship after that, then 3-6 years of residency depending on the field. Here, IM can be taken for as short as 3 years. The funny (sad) thing is that residents are generally paid so poorly that they still have to rely on their parents (like I mentioned before, the salary can be as low as P8,000/month or $142 dollars a month! Pathetic!). Of course at this point, a lot of them (us) are already old enough (too old!) to start their own families (Biological clock ticking!!). Imagine how hard it is to marry, rent/buy a place, raise a kid, and go through residency at once, all the while relying on your aging parents.
That's why a lot of would-be doctors hesitate at this point, and go on to nursing instead (thus foregoing all those years of hard work), or study for the MLE so they can work in the States. Why? That salary you quoted for nurses--$40,000.00 a year or P2,240,000/year (translating to about P186,000.00/month!!) is already the salary of a well-paid cardiologist/cardiac surgeon here!!
Imagine! That's a lot; more than the average person here could dream of! If a Filipino nurse didn't intend to stay away forever, she could just work in the US for 10-15 years, save up, and come home a multi-millionnaire. Or if she did intend to stay, she could petition for the rest of her family to join her, and so ensure a good future for them. (This conversation is making me faint. Maybe I should just go over there...dear, dear...)
Your figures for specialists are even more staggering. A cardiogist starting out at around $200,000 and an internist earning about $125,000?? I want to be a cardiologist, as it's one of the most lucrative fields, but I'd only expect to earn as much as...A NURSE working there in the US!
I don't even want to convert the figures that you quoted into pesos anymore. I might go into hysterics.
Social medicine...well we have government hospitals here, but they're extremely underfunded, understaffed, under...everything. Oh, my mistake; they're overcrowded. That's why if you're not that sick, it's a mistake to get yourself confined because you might just contract something really virulent.
The state of the "free" government hospitals are pitiful. And pathetic. Our foremost government hospital--PGH or Philippine General Hospital--is always crammed with patients. And when I say crammed, I mean crammed, like two patients per bed, etc. And they reuse equipment that are supposed to be disposable because of lack of funds. When you walk in there, it's like you're walking through purgatory, or hell. The patients stay in the emergency room for three days and die there of neglect--because the doctors are too few and at the point of collapse!
The government allots so little funds to healthcare that it's laughable. More money goes into the pork barrels that just disappear into the pockets of corrupt politicians.
Sorry. Am I ranting? Of course I am. When I think of how this country used to be before we ended up with such thieving and inept leaders (whom we ourselves voted into position, don't forget)--
*Sigh* To think that I'm already one of the lucky few who has a good chance of a future. I wonder how everyone else feels?
I don't even want to convert the figures that you quoted into pesos anymore. I might go into hysterics.
Social medicine...well we have government hospitals here, but they're extremely underfunded, understaffed, under...everything. Oh, my mistake; they're overcrowded. That's why if you're not that sick, it's a mistake to get yourself confined because you might just contract something really virulent.
The state of the "free" government hospitals are pitiful. And pathetic. Our foremost government hospital--PGH or Philippine General Hospital--is always crammed with patients. And when I say crammed, I mean crammed, like two patients per bed, etc. And they reuse equipment that are supposed to be disposable because of lack of funds. When you walk in there, it's like you're walking through purgatory, or hell. The patients stay in the emergency room for three days and die there of neglect--because the doctors are too few and at the point of collapse!
The government allots so little funds to healthcare that it's laughable. More money goes into the pork barrels that just disappear into the pockets of corrupt politicians.
Sorry. Am I ranting? Of course I am. When I think of how this country used to be before we ended up with such thieving and inept leaders (whom we ourselves voted into position, don't forget)--
*Sigh* To think that I'm already one of the lucky few who has a good chance of a future. I wonder how everyone else feels?
