Robert H. Moser

The Guadalajara Dilemma

So much has been written about the FMG [foreign medical graduate] Situation that I hesitate to enter these formidable lists. Even the phrase FMG evokes emotion and suggests dichotomy. I dislike the phrase, but substitution of a euphemism will not make the problem go away. Clinicians of my generation have all worked with physicians educated abroad. I recall my days of residency and fellowship, enjoying felicitous association with young physicians from Greece, the Netherlands, the Philippines, Italy, the British Isles, Taiwan, France, and Mexico. Later, in the army we trained military medical officers from virtually every country friendly to the United States. I cannot recall any sense of concern about where a physician had trained; our chief interest was the man. Perhaps physicians educated abroad were more varied in background and clinical experience than a comparable group of US-educated physicians. But after a time, differences became less perceptible; I can

People Aren't Diseases

For many years I have carried on a lonely, futile (admittedly desultory) campaign to combat the depersonalization of sick people through careless language that refers to them by their disease. I have long since come to realize that it is a forlorn task, since most of these dreadful words are so deeply embedded in our medical patois that no editorial crowbar can pry them loose. Some of the words sound more terrible than others, but all are offensive, especially to the hapless patient. Not only must he endure the somatic injury of his disease, but he must suffer the dehumanizing insult of the thoughtless jargon that flows between the White Coats—towering over his bed. He is no longer a sick person; he has become just a sick organ. So loathesome was the term leper that popular pressure expunged it from the scientific literature and most of the literate press. It