Attending: Did you bring your presentation about atrialization of the right ventricle in the setting of prenatal maternal lithium use?
Me: Yes, I brought the Ebstein files.
Attending: For the last time please stop calling it that.
Another awesome conversation with @UrologyTimes exploring the outcomes of BMG ureteroplasty, specifically evaluating potential patient and preoperative risk factors.
Thank you again for having me!
𝗝𝟭 𝗩𝗶𝘀𝗮 𝗣𝗮𝘂𝘀𝗲 𝗮𝗻𝗱 𝗶𝘁'𝘀 𝗜𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀 International medical graduates(IMGs) invest years of effort to reach U.S. residency. This includes 2–4 years of pre-med, 4–5 years of medical school, and another 2–3 years dedicated to taking the USMLE exams, completing U.S. clinical rotations, applying to programs, and attending interviews—all before finally matching into a residency.
On average, this journey costs $15,000–$20,000 USD, covering exam fees, travel, housing, and ERAS application costs. Only the most committed and qualified make it through.
Now, two sudden decisions by the U.S. Department of State—pausing new J1 visa appointments and restricting visa issuance for citizens of 19 countries—have shattered the dreams of thousands of these dedicated physicians. Many of them were scheduled to begin residency on July 1st.
These physicians are not just trainees—they are the backbone of care in underserved communities where U.S. graduates often don’t go. Halting the entry of nearly 3,000 doctors risks crippling healthcare delivery in many parts of the country.
I urge all stakeholders— @ECFMG_J1, @TheNRMP, @acgme, @AmerMedicalAssn, @Intealth and others—to amplify their advocacy. I also respectfully request the U.S. @StateDept and @SecRubio to urgently reconsider and lift the pause on J1 visa appointments for incoming physicians.
@Medscape@CNBCTV18Live@CNN@nytimes@medpagetoday@Reuters@Forbes@ABC
#Match2025 #Match2026 #NRMP #USMLE #ResidencyMatch #MedEd #MedTwitter #MedX
#J1visa #TravelBan #IMGs
i sent all my friends/family a handwritten card with a wallet sized grad photo. it was nothing crazy, just 2-3 sentences thanking them for their support and telling them i appreciate them.
i had so many people reach out and tell me how much it meant. but also..
Congratulations to @CocoGauff for an amazing championship at the French Open — the first American singles champion at @RolandGarros in a decade. You make us all proud.
The US needs to decide if it wants its doctors to also be dietitians and public health social workers or if it’s willing to fund access to those professionals for patients.
We got a whole block of nutrition education in med school. It wasn’t especially practical.
Some nutrition training for physician is great. But there are real issues this runs into:
1. Nutrition is a 4+yr degree/clinical training. Med school curriculum at most is going to add a few hours. There will never be time to adequately teach nutrition to physicians. They'll at most learn a few high level things (which is good, mostly)
2. Physicians could know a ton about nutrition and it wouldn't change the fact most get 15 minute visits to cover the entirety of the patient's medical care. Nutrition assessment (incl an adequate diet history) and counseling takes typically an hour. When will physicians have time for this? Also who will pay for it?
3. Dietitians already exist, have extensive training in nutrition, are underutilized, and ~10X cheaper than physicians. Why aren't we elevating the trained professionals we have over trying to train others to do their jobs with a few hours of education? Most RD visits still aren't covered by insurance unless you already have a chronic dz like diabetes or ckd.
4. While I think some more nutr edu for physicians could be a net good, it won't come without harm. Every RD has patients who had a nutrition enthusiast physician who took 5mins of the visit to give them a BMI targets and kcal count, told them to follow an extreme diet, and sent them on their way with no support.
5. Support - the best evidence we have for lifestyle combined multi-pronged interventions led by RDs, exercise physiologist, gives access to exercise equipment and self monitoring tools, provides healthy foods and cooking equipment, etc. These begin to address systemic failures rather than assuming a simple knowledge deficit that can be fixed with 5min of edu from a physician about nutrition during their visit.
So once physicians learn the root cause of “disease,” and we talk about diet and exercise (which already happens but for the sake of argument) and “disease” still exists, then what do we do? Do we still prescribe medicine? At what point in the process do we become pharma shills? Just trying to understand how doctoring is supposed to work.