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Ideas and Opinions |

Resident Redux

Abraham Verghese, MD, MFA, DSc (Hon)
[+] Article and Author Information

From the Center for Medical Humanities and Ethics, University of Texas Health Sciences Center, San Antonio, Texas.


Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Abraham Verghese, MD, MFA, DSc (Hon), 7703 Floyd Curl Drive, Mail Code 7730, San Antonio, TX 78229-3900.


Ann Intern Med. 2004;140(12):1034-1036. doi:10.7326/0003-4819-140-12-200406150-00014
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Shortly after reading the poignant essay published in this issue (1), I was invited to give grand rounds at a leading medical school. Later, I sat in on a residents' journal club in a cozy room in a brick building that was part of the original hospital. We were packed around a table laden with sandwiches and soda. Latecomers either stood or sat crosslegged on the floor. The paper being discussed dealt with whether there was a benefit to a “drug holiday” during antiretroviral therapy.

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Your Services are indeed needed
Posted on July 23, 2004
Buddha Basnyat
Patan Hospital
Conflict of Interest: None Declared

In a recent Perspective in this Journal, the reply by Dr. Verghese to a statement that " your services are needed by the sick and poor in your country" is intriguing. Dr. Verghese says that more than physicians, economic development and money are important in poor countries. Although true, this answer does not address the original observation. Secondly, he says that his friends who stayed back in India are looking after the rich, but I would hasten to add that there are many physicians who are also looking after the needs of the poor in South Asia. Importantly, however, the rich in South Asia need medical services too and it is indeed a good idea to look after them in their own countries without having them go abroad. Finally, like Dr. Verghese, many of us may admire Dr. Paul Farmer, but it is strongly felt that in developing countries of the world, local Paul Farmers need to be motivated,inspired, and even created. One clear cut way to help achieve this goal could be if Western trained doctors returned to their country of origin to help out in whatever way they could by incorporating the knowledge gained with the local reality.

Conflict of Interest:

None declared

An Eye opener
Posted on July 26, 2004
Anil Pandit
Patan Hospital, GPO 252, Kathmandu
Conflict of Interest: None Declared

After going through the superb perspective by Dr. Verghese, it seems that there is still an unwritten rule in U.S. as "Black and White." Still people are being discriminated on the grounds of religion, race, and ethnicity, at least in the field of medicine. Soon, this will invite untoward effects. This perspective serves primarily as an eye opener. First, it will be an eye opener for U.S. health policy makers to acknowledge the fact that foreign medical graduates account for 27% of 96,937 residents and fellows and a quarter of 853,187 physicians in the United States. Second, for those who want to go to the U.S. for residency, they will undergo hardship and mental torment

Foreign Medical Graduates can always come back to their native country and serve their people in whatever form they can. I want to disagree with Verghese when he says that people who stayed back are serving the rich and those who went to government service are at a lonely outpost. The observation is partly true; however, this situation is not so frustrating. We have seen many doctors who have come back and are excelling in their own country in terms of fame and even money. The respect they have won from the public is overwhelming. The satisfaction one gets from serving the poor and needy is more rewarding than earning millions of dollars.

And for doctors, like Verghese, who have based themselves in the U.S., they should know that they could always make a work place in their native country.

1. Physician characteristics and distribution in the US, 2004-2005. Chicago: AMA Press, 2003. 2. Verghese, A. Resident Redux. Ann Intern Med. 2004:140:1034-36.

Conflict of Interest:

None declared

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