This is one in a series of occasional updates on the lives of people featured by STAT during our first year.

They have MDs to their names, but they can’t treat patients. Now Dr. Heidi Schmidt — and others like her — are heading to nursing school to fulfill the dreams that were quashed when they failed to match with a residency program after medical school.

Schmidt, who’s 47, is one of thousands who have graduated from medical school yet failed to match with a residency, the post-graduate training doctors need in order to practice medicine in the United States. STAT wrote about her in March, when more than 29,000 applicants matched to a residency but 8,640 applicants failed to get an offer through the main matching process. This number includes hundreds of students in their final year at US medical schools, as well as foreign nationals and US citizens from international medical schools.

advertisement

Many failed applicants reapply after spending a year doing research or a fifth year in medical school. Others join the “Dropout Club,” a group for doctors and scientists who leave their intended professions for alternate paths.

Though they have medical degrees, doctors who don’t do residencies can’t treat patients, or even work as nurses or medical assistants, without further training. Some in the medical profession say that’s a good thing, because there’s a reason — such as poor performance on board exams — that these new MDs didn’t make the cut. But others call it an outrage that doctors’ skills are going to waste amid a shortage of primary care physicians, just because there aren’t enough residency spots to go around.

Schmidt, who graduated from American University of the Caribbean School of Medicine in 2010, had been hoping to take advantage of a 2014 Missouri law that will allow unmatched medical school graduates to work with a collaborating physician in medically underserved areas. But implementation has dragged: The Missouri Board of Registration for the Healing Arts doesn’t anticipate accepting applications until early 2017, according to a spokesman.

Kansas and Arkansas have passed similar laws — over the objection of groups such as the Association of American Medical Colleges, which contends that it’s not safe to let doctors bypass the traditional residency, which lasts at least three years. Kansas, whose special permits are restricted to graduates of the University of Kansas School of Medicine, has not had any takers so far. Arkansas, which limits applicants to those with ties to the state, just issued its first two special permits in October.

Newsletters

Sign up for our hospitals newsletter, On Call

Please enter a valid email address.

Schmidt isn’t waiting around. She is back studying chemistry 101 and human anatomy, as she begins a three-year journey to become a nurse practitioner. She has been accepted into a bachelor’s of nursing program in Indianapolis, where she lives, and plans to use loans and scholarships to pay the approximately $140,000 in total costs.

Volunteering in a free medical clinic in Indianapolis has rekindled her passion to practice medicine, she said.

But Schmidt said she’s frustrated that there isn’t a faster — and less costly — track from an MD to a master’s in nursing.

“My schedule is insane,” she said. “I stay up half the night taking online classes.”

Leave a Comment

Please enter your name.
Please enter a comment.

  • Sad to see a degree is wasted. I wonder what did she do in the past seven years to strength her application. If she apply broadly she should be able to match some rural area family medicine program.

  • There is more to the story, of course. There are unfilled residency spots every year, all over the country. There is also a way to get into the unfilled spots after the residency match. Abandoning your whole MD degree is not a reasonable option. I am sure there is a good reason why she has not secured a residency spot. Has she passed the USMLE exams? Is she shooting for a super-competitive specialty? This article is very incomplete.

    • you are not a md for sure. otherwise, you should know that all applicants must pass their usmle exams before they can apply for a residency. and for anyone who graduated from a caribbean med school, they already know not to apply for competitive positions.

      she graduated in 2010, so obviously she must have tried to apply all over the country, including those unfilled spots which really don’t exist.

      Dr. Heidi Schmidt, a Juilliard-trained opera singer and entrepreneur who graduated from American University of the Caribbean School of Medicine on the island of St. Maarten. She received honors in clinical coursework, but struggled with standardized tests and had to make multiple attempts to pass two national board exams.

    • You’re right about there being a reason for her not being accepted. There are always 1 year programs that will accept applicants – often in very undesirable locations/environments. Still, she could use that 1 year program to finally pass step 3 (the easiest exam) and get on more equal footing for matching to residency.

      Perhaps she isn’t doing this due to another issue… professionalism perhaps? If she has numerous professionalism issues she won’t even get in a one year program because there are concerns about ethics and protecting patients.

  • I sent my comment to the wrong address.
    I found the psychoanalytic model excellent for treating patients with severe, long term psychoses. I am writing a blog about this for the Mad in America website.
    I could also send you a paper I gave to the Canadian Psychiatric Association.

  • It’s sheer insanity and likely driven by some sort of profit incentive that there are thousands of educated physicians in the United States and a severe physician shortage and yet these doctors are allowed no meaningful means of utilizing their education or procuring a living at their trade. Why would only “physician assistants” trained in physician assistant schools be allowed to assist physicians? Physician assistants often have far less rigorous undergraduate coursework and a shorter didactic and practical medical education and yet they can practice right out of school. These students didn’t have to compete with each other on national boards like the MCAT and USMLE’s and the preclinical experience, the thousand hours of experience can be met in a variety of ways,including as a medical assistant with no formal education or training. The PA profession has protected their own with legislation in all 50 states preventing MD’s from working as PA’s, yet the AMA makes no such attempts to protect the interests of medical doctors who for whatever myriad of reasons cannot complete residency training. In the UK for instance there are alternative tracks for physicians, allowing them to provide generalized medical care as GP’s and even foreign grads can be sponsored and practice under the supervision of licensed physicians. It is a hoax to try to convince the public that a newly graduated PA is of more value and safer than a medical school graduate. Why not let MD’s who have not completed residency work as PA’s under the supervision of licensed doctors? By the way, perhaps its time to address the fact that the USMLE summarily denies accommodations for licensing examinees, even to people who have previously been granted accommodations, a factor that might account for some not getting the scores competitive for residency in their chosen specialty.

  • I have the perfect solution for all the problems. How about a fast track route from a NP to MD/DO or vice versa in regards to primary care? If someone is an NP, let some of their clinical rotations in count in regard to residency requirements for primary care. It becomes an issue though in specialty residencies, but as for primary care, it seems reasonable.

    • it is those greedy doctors who don’t want others to make more money. of course, if you were one of the doctors, then you would like to keep all other competitors away as well. it is all about money.

  • Thats why you dont go to a carribean medical school. The programs aren’t rigorus unough to match into a US residency.

    • So proud of you Heidi for doing everything you can to serve people…regarding the comment by Rachel Hansen, Caribbean med schools put students through just as rigorous of a curriculum as the programs in the states but there are not enough residency slots for everyone that applies to the match.

    • Americans competing for residency positions with docs from all over the world with special visas and the step test. America first.

    • You clearly don’t know what you’re talking about. Making a general statement about the rigor of Caribbean medical schools shows how ignorant you are of the standards of training that top-notch Caribbean schools must maintain. I went to American University of Antigua. Ask anyone who went there and you’ll know it is “rigorous enough”. I don’t know if you’re an MD. If you were, you wouldn’t make such loose comments. It’s attitude like yours that furthers the institutional discrimination Caribbean MDs have to face in order to get into residency.

Sign up for our Biotech newsletter — The Readout

Your daily guide to what’s new in biotech.