My mom was one of those lucky few doctors that was able to redo internship and residency after moving to the US. When she first arrived she cleaned houses and worked as a waitress while awaiting entrance into a program. This was the early 80s. Of her friends, she's one of the few who was able to go through the gauntlet and become a doctor in the US. Most became other types of medical workers, including my father who became a respiratory therapist.

Contrast that to my cousin who moved to Australia and was quickly accepted as a practicing physician.

If I trained at a community hospital in Nepal, am I going to need US residency standards? We don’t know. That’s why we have standard board exams and admission pathways that all US physicians need to follow. We should not compromise on that.

We can expand US MD and US DO schools and fill our thousands of unfilled Family Medicine, Internal Medicine, and Pediatric Subspecialty residency slots first!

Board exams are fine. You can sit thousands of candidates for those. The issue is residency slots which are the main bottleneck. Why should a surgeon with 20 years of experience working in Mumbai be forced to become a resident alongside fresh-faced med school grads in the US? It’s a huge problem when it’s cheaper and safer to fly to India for surgery than to get the same surgery in the US (from a less experienced surgeon).

It’s the tyranny of the status quo. Milton Friedman was complaining about this more than 50 years ago.

[1] https://youtu.be/UmVrfbfKBIk

"Why should a surgeon with 20 years of experience working in Mumbai be forced to become a resident alongside fresh-faced med school grads in the US?"

Perhaps you could have them in some accelerated program, but i think it makes a lot of sense to require doctors to train or prove themselves in the specific country/region using the standard practices, tools, etc customary there. I wouldn't want a US doctor operating on me in India since they're likely to make assumptions and recommendations for treatment that overlook local practices, resources, etc.

I think this is a fundamental disagreement, not tyranny of the status quo. We have a functional medical training pipeline already that produces (arguably) the best physician population in the world. Let’s invest there.

The surgeon from Mumbai can come in and prove their worth through a surgical residency. That’s completely fair.