Getting into a surgical residency from a Caribbean school is an uphill climb - so I wouldn’t worry about it.
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It personally doesn’t matter to me where my physician went to school.
For those trying to get an “inside scoop” you might want to check out Castle Connolly’s “Top Doctor” recognition. The awards are distributed based on votes by other physicians. It’s one (imperfect) way to get a hint of who other docs think excel at their job.
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Yeah, just speculating, but I would guess my oncologist really got a boost in his subspecialty career track from the fellowship he did at the University of Washington/Fred Hutch–again, my understanding is that is a top tier place for his subspecialty.
So to the extent there was important filtering going on during that phase of his career development, I would guess that was the most important such filter for him to get through.
Ask nurses. They know.
Every year it seems there’s some scandal about a surgeon who habitually shows up impaired; an anesthesiologist who leaves mid-procedure to take phone calls from his/her kids; the gynecologist abusing patients. And then it turns out that there have been complaints filed by the nurses who have seen the issue, reported it to HR, reported it to their own supervisors; watched as nothing happened. And then on further investigation, it turns out that a few nurses have actually reported the doc to the relevant licensing bureau which “investigated” and found nothing “conclusive”. I remember the case of a patient who developed sepsis when some piece of equipment was left inside her abdomen…. and the nurses in the OR kept telling the doctor “you can’t suture yet”. One diligent nurse recorded the conversations in her notes– which was helpful when the family sued the hospital.
It takes a LOT to get a medical license revoked- even with nurses willing to go on record that they were present at a procedure where the doctor engaged in risky/negligent/abusive behavior.
But the nurses know.
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Agree. I am a physician and when I was in a new city and pregnant I called the charge nurse on labor and delivery and asked her for recs.
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I’m fortunate that I’ve not needed much medical care outside of my PCP and dermatologist. But, we’ve been through several orthopedic surgeries in this household and yes, I look everyone up and know UG, medical school, residencies and fellowships. I do it more though to get a background on the person as in every case I’ve sought a recommendation- oftentimes from the several medical professionals in our extended family.
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My (late) father always checked (and mentioned) where docs had gone to school unless there was a personal recommendation (and even then he’d look it up). Neither of his parents had higher education which they both regretted and education was a big deal in their family.
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But how many oncologists are out there treating people successfully each and every day. Certainly, they haven’t all gone to the “elite” or high name schools.
Today, you often don’t have a choice because of insurance - it’s unlike years ago. And when you have something like cancer, the perceived top guy may not be able to see you.
I only got the Dr. I got because my wife was calling 2x a day and I got a last minute cancel or I’d not have been with my Dr. Couldn’t wait…and that was just for a consult.
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I agree this is the primary determinant in what doc one goes too. It doesn’t matter what the nurses or docs or outside ratings agencies say, or where the doc got any part of their education…generally if the doc isn’t covered by one’s insurance the patient isn’t choosing that doc.
The affluent may make the choice to see a doc not covered by insurance, but that’s usually not an option for the masses. Another area where CC seems quite out of touch with reality.
For our family when a specialist is needed we do our own research (both H and I worked long careers in pharma consulting) and choose key opinion leaders. Those docs often went to top med schools but not always. It doesn’t matter where the doc went to school if they are the premier Tommy John surgeon in the country or X country’s national team orthopedic surgeon or wrote X cancer international guidelines (All doctors our family has personally used.) Luckily we always had excellent insurance that all those docs accepted, so we didn’t have to make that difficult choice.
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Interesting topic.
I have 2 children who are physicians. I’ve learned a lot about how medicine works from them. Also from husband’s cancer journey. I also worked in a medicine-adjacent field (biomedical research librarian at a medical research center where I worked with MDs, as well as PhDs and DVMs.)
(One thing I learned–never get a rare cancer. The type of cancer DH had only ~8-10 people/year are diagnosed with. Few physicians have ever seen a case and even fewer have treated a case.)
I have met, worked with and been treated by (or had family members treated by) a lot of physicians. Where they go to undergrad is meaningless. Where they go to med school is fairly meaningless. Where they do residency and/or fellowship is much more important.
But physicians continue to grow, gain experience, mature in their judgment and skills long after they finished residency/fellowship. D2 talks about how one of her partners her medical practice group has her assist him during his surgeries to help her refine her robotic surgery skills. My former PCP who was chair of large IM department recommend to me that when choosing a new PCP after I moved that I pick a doctor who has been out of residency/fellowship about 5-8 years. Long enough, he said, to have seen all the weird stuff & unusual presentations at least once, but not long enough to become jaded and blasé about the profession.
My current PCP is a Caribbean med school grad and an international. Her residency was done at an unimpressive program and she did a unaccredited fellowship in “lifestyle medicine”. However she is a military spouse and as trailing spouse, she doesn’t get a lot of consideration when it comes time for her husband’s superiors to reassign him. She has to go where he goes. She seems reasonable and is a good listener. We are able to communicate well and she is responsive to email questions. I can get into see her on relatively short notice. (Often less than 48 hours.) I am healthy for my age and have few long term health issues that need managing. So she’s a fine doctor for me. If I need more specialized care, I just make an appointment with the necessary specialist. If I think something a physician recommends for me is questionable….I will push back with them, research the issue myself and talk with my daughters. (Who are both objectively very good physicians–and that’s not just their mom speaking. They have the professional and peer recognitions to back that up.)
As someone said above–medicine is as much as art as it a science. Different physicians have differing opinions about how a condition should be treated –and they all may be correct. Or they all may be wrong. What works for one patient doesn’t necessarily work on another.
As a patient, you need to be able to work in partnership with your treating physicians/medical team. Some of the responsibility is on the patient too.
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In the old days we chose doctors mostly through word of mouth - recommendations from friends. This is no longer useful as those doctors frequently are not accepting new patients.
I now start choosing a doctor based upon their current practice affiliation. I do click on the doctor’s profile, just to make sure their specialties align with my care needs. My husband has needed several Mohs surgeries, so when picking a new dermatologist I made sure this one had Mohs on their list of specialties. I have no idea where any of our doctors went to school (at any level). I occasionally click on a doctor’s profile and say “oh how interesting they have an undergraduate degree in English”, but that doesn’t affect my decision.
My husband had Lymphoma. We picked his initial oncologist based upon who was in the large medical practice that his other doctors were already in, and the fact that she was affiliated with Memorial Sloan Kettering Cancer Center. We have since moved to outside Boston and picked his new oncologist based upon their affiliation with Dana Farber.
Another thing to keep in mind is that even when you have chosen a doctor, you will oftentimes end up seeing somebody else who covers their practice. My husband has now seen 3-4 different oncologists who work as a team at Dana Farber (all with various credentials - NP, MD, PA, etc.)
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I read reviews and of course have to go by availability. My PCP happened to go to Harvard Med and got great reviews. But I avoid her after she directed me (no ability to discuss) to do CT with oral contrast for what was a simple gas pain from eating too many cherries. I use the NP’s in the practice who understand I am older, fragile and need “slow medicine.” They also know that I am well-educated about my health issues and know my own body. We collaborate. (My specialists are also great.) Have no idea where the NP’s went to school. There is now a new PA and look forward to using him too as I continue to avoid my MD. I don’t want to switch because I have now seen the NP’s for 15 years (and tough to get into practices anyway).
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I have a friend who lives in the tri-state area. Every time she has a a family member who needs medical care she tells me how she picked the top “fill in the blank” doctor in the world who practices in the city. I honestly don’t think it has meant that over the course of probably more than 40 years her family has gotten any better medical care than mine has.
I do think you need to get along with your doctor. I saw an endocrinologist a few times who I hated, it didn’t matter what her credentials were, I did not want her treating me.
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I think once you meet or use or are assigned to a Caribbean med school grad, you adjust your thinking of their training and skills. A good friend from hs always wanted to be a doctor and she tried for admission to US schools but went with a Caribbean one, then did her 3rd year in England and then her residency in NYC. In fact, two residencies, the first in psychology and the second in neurology. I think she’s very good at what she does, EST, and I hope I NEVER need EST! My daughter’s BIL is a DO from Idaho, did his internship in Montana, residency in Augusta GA and is now heading to a fellowship in Houston. I’m sure he’s very good at brain surgery and hope to NEVER need his services either.
I use a NP as a PCP and have no idea where she went to school. Also use a NP as a dermatologist and same story, no idea where she was trained.
I’ll admit I’m a snob in one area, and that’s for therapy. I was looking for a therapist/counselor and the referring physician gave me 3 names. I talked to one and liked her, but then realized she didn’t take my insurance. The other two went to Naropa in Boulder and no, I didn’t think we’d be a good match (I went to school in Boulder and thought Naropa was too new wave for me, even when I was 20 years old). So what did I do? Nothing. Decided I’d just deal with issues on my own. But I did look up where they all went to school.
Oh, and I also like dentists with skinny fingers. Had a great one (he was the dentist to a lot of the Denver Broncos including John Elway) but he had big fat fingers and with his two hands and the asst’s two hands all in my rather small mouth, it was uncomfortable. So now I look for dentists with small hands (often female).
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Well, maybe not education but perhaps lifestyle or whether I will vibe with them.
I live in a smaller city and my husband was referred to a cardiology practice with two doctors. They gave me the choice between the two. I chose the one that is NOT at least 80 pounds overweight carrying most of it on his stomach (from pictures I’ve seen on social media). I knew if he walked into the room we’d both have a hard time taking him seriously about heart health.
Judge me all you want, lol. Maybe it’s not a factor for others.
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The other thing - when I had my cancer, there are two types of radiation. IMRT and Proton (there’s a more formal name). Proton is newer, supposedly has less side effects, and less impact on other tissue.
But there’s not data that shows it’s more effective for living longer. So insurance won’t cover.
I thought of doing it out of pocket - they quoted me $80K - because - well it’s life or death -and even if not, you think that when you hear you have the big C. Then they said, insurance will cover it if we do it in 5 sessions instead of however many (15 or 20) - but it will be high dose. But on you it could work.
I didn’t choose him because I preferred another doctor, who offered inclusion in a phase 3 drug trial and who was like doogie howser - young, personable, well connected. He was an MD/PHD so very passionate. Thank goodness I got in. He couldn’t promise me the phase 3 drug (which i did get) but inclusion. Fortunately, I was selected for the drug.
But the way he offered up - even though he was probably trying to do me a solid - yeah, we’ll jam it in in lesser sessions - even though the technology was more advanced - sort of turned me off like he was a sleazy sales guy.
Insurance sucks. They really try not to pay. Pharmaceutical - not medical but - My wife needed a pill. If she took the pill, it was 100% covered because I was over the max. But - she’s lactose intolerant and many pills have lactose. So they prescribed her a liquid. $113, not covered - because she made a choice. Yeah, a choice not to get sick from the pill.
I’m thankful for insurance - but like any business, they don’t always have our best interests in mind.
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If I had the choice I would also not choose an overweight cardiologist. Same for overweight docs or nurses who council patients on weight loss and/or lifestyle management choices.
I agree health insurance companies have many competing priorities that can lead to poor decision making regarding coverage and treatment. There are many other perverse incentives in medicine too, for example, doctors who are paid to do procedures and/or other types of treatment. Of course they are predisposed to recommending surgery/intervention/treatment when it means more money in their pockets.
Just fyi, as you have made your treatment decision, but many insurance companies, including Medicare, do cover Proton radiation for prostate cancer. If the radiation facility/docs/staff aren’t facile at seeking pre-approval, best to go elsewhere.
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I was receiving care at the city hospital. I was disturbed by the number of smokers out on the street in their various scrubs (different colors for different positions). They couldn’t smoke on the complex grounds so had to cross the street and stand on the sidewalk (an area with a lot of homeless camps).
Dedicated to smoking on some snowy or very hot days.
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This hits a nerve with me. My husband when to a PCP who was very overweight and was trying to talk him into taking statins. He never went back to him. He also tried a dermatologist, who he thought looked sloppy. He never went back to him either.
Just looking at the answers in this thread - there are so many factors to selecting a doctor - insurance, appointment availability, physical attributes, bedside manner, references from friends or other medical professionals, access to types of treatment, location of practice (easy to get to), specializations, etc. Even if you used med school as one of your criteria, it would be one of many, many criteria.
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