Letters to the Editor - Jan. 15, 2007

IMG's knowledge of U.S. medicine and culture came by trial and error

Regarding "Classes teach new IMGs American-style medicine" (Article, Dec. 11, 2006): I immigrated to United States from Rajasthan in India in 1977. I was going to take a cab from Chicago to Peoria [distance 154 miles] for my internship interview because on map it looked so close. I did not know about banks and checks and checking accounts, did not know that every one gets addressed by his or her first name, did not know that no one needs to be addressed "sir," did not know to visit library on an ongoing basis, did not know that one has to keep up by reading journals.

Learning was an error and trial process. My American colleagues were frustrated assuming I should have known, and I was frustrated that they should know that I didn't know.

Since I was stuck in deep Midwest, there was an extreme social isolation at work and after work leading to regression and depression. One time I got out of the car and my date would not and, confused, I went back in the car asking what was wrong. She figured out my hopelessness and, with grin, came out. Later on I learned that I was supposed to open the door for her.

Contrary to the comment by internal medicine program director Nayan Kothari, MD, that "Most foreign graduates don't have any respect for nurses, and that shows in their interactions," I recall we heavily depended on nurses and to the extent we were at their mercy in interacting with patients, learning injections and other routine procedures.

The one advantage of being trained in India is the ability to make diagnosis mostly by listening, followed by limited exam and very little reliance on technologies. The reverse is a disadvantage of the American system where CT scan is done before patient is seen to tell that CT scan was normal. We have lost the art of medicine.

We need a broader and mutual social as well as professional interaction at initial stages to prevent embarrassments, humiliations, frustrations and to encourage camaraderie.

--Amar Dave, MD, Ottawa, Ill.

Vote refines AMA stance on health reform
The AMA House of Delegates rejected attempts to rescind support of a U.S. House health reform bill and any new government-sponsored health insurance plan during the 2009 Interim Meeting.
Story - AMA House - Slideshow