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Notes -
Raising the Price of Admission
I find myself immensely frustrated by Trump's recent moves to cut down on immigration, especially replacing the EB5 with his new golden ticket scheme.
I've always wanted to move to the States, but by virtue of being Indian, and in a profession with strict regulatory requirements, it was never easy. As of right now, I can't sit for the USMLE if I wanted to, but I believe that is a problem my uni could solve, unfortunately I'm locked into the UK for at least 3 more years and don't have the time to breathe down their necks.
If I wanted to spend $1 million for the old EB5, I'd probably have to sell a significant fraction of my familial assets, and they're not mine yet, I have a sibling and parents to think of. The fact that we even have that much, when my father made $50k at the peak of his career as a OBGYN surgeon, represents a lifetime of my parents being frugal and living beneath their means. My dad started out from scratch, a penniless refugee, and all his life he worked tirelessly to make sure his kids wouldn't have to work as hard as he did. To a degree, he's succeeded. I nearly make as much as he does, but that's virtue of grinding my ass off to escape India. I had to settle for the UK, whereas I'd much rather be in the States.
The EB-5 program already functioned as a high barrier to entry, requiring not just capital but also the ability to invest in ways that met the job creation criteria. By raising the price to $5 million, the U.S. is effectively signaling that it no longer wants "entrepreneurial upper-middle-class" immigrants - it only wants the ultra-wealthy. The problem, is that the truly ultra-wealthy already have multiple options. The US is relatively unique in dual-taxation, and has heavier taxes overall when compared to some of the alternatives. They can buy citizenship in other countries (Malta, St. Kitts, etc.), take advantage of residence-by-investment programs in the EU, or just maintain an arsenal of visas that allow them to live anywhere they please. The U.S. loses out on exactly the kind of people who were willing to put down roots and contribute significantly to the economy while still needing the opportunities that U.S. citizenship provides.
If Trump (or any administration) wanted a truly meritocratic system, they should be auctioning off a limited number of economic immigrant slots each year. That would at least allow market forces to determine the actual value of U.S. residency. A points-based system, like Canada’s or Australia’s, could also make more sense: prioritizing skilled professionals over sheer wealth. A million already strongly filters would-be immigrants. Five is exorbitant, especially if it's a flat sum.
(Let's leave aside the other requirements, such as running a business that creates a certain number of jobs)
Jevon's paradoxmakes us expect that increasing the price of a good by 5 times will not 5x the revenue. It'll decrease it in expectation. If Trump prizes himself as a businessman, this should be clear to him.
Even the abolition of birthright citizenship strikes me as a violation of the American ethos. It was certainly being abused, anchor babies being a case in point, but when even green cards are this hard to get, prospective skilled migrants greatly appreciate the peace of mind that their kids are entitled to citizenship provides.
End it for illegal immigrants if you have to, why lump in everyone else there legitimately? I wouldn't mind people using their visitor visas to get a fast one in being debarred too, but I look at the current state of affairs with great dismay.
At any rate, I'm not an American. I do wish I was, and my impression is that most of you would be happy to have me. Well, I'm used to life being rough, and the UK isn't the worst place I could be. I still think that even from an absolutely monetary point of view, this is a bad plan.
I hope I've made a decent case for why you're not getting much out filtering the immigrants for quality at that point, and the ones who are that loaded are probably not nearly as keen. They're easily Global Citizens for whom nationality is a formality.
Well, I'm still going to see if I manage to figure out the USMLE thing by the time my training in the UK ends, but there must be thousands of skilled immigrants in a similar boat, just noticing a rather significant leak in it. Then they're confronted by a sign at Eliis Island that just any ocean-crossing vessel won't do, they need a yacht. We don't deserve to be clubbed in with those who break the rules.
Yes.
Are you single? Have you considered a sham marriage to an American woman (or man)? I've seen that work fairly well.
I think we both know that even if I was willing to go to any lengths to get in, admitting to fraudulent intent in an online forum is a bad idea haha. Even a pseudonymous one.
I think it's nigh inevitable that we're all unmasked by AI doing stylometry. My OP-sec is far from perfect, and there's enough unique information about me out there that a determined human adversary could manage. I even nurse minor ambitions of becoming a Proper Blogger some day, and that just increases the attack surface.
In all honesty, I want it to be as legal as I can make it. I could certainly afford a flight to Guatemala or Nicaragua and find a mule, but I don't want to live the life of an illegal immigrant. The medical profession in UK might not be ideal, but it beats that as far as I'm concerned!
As for finding a legitimate American wife, the easiest way is to be in America. Most Americans are sensible enough not to move to either the UK or India. Most of them would also prefer that their husband be gainfully employed.
To practise as a doctor in the States requires me to be eligible for the USMLE and then pass it. I've been keeping a close eye on the recent trend of many individual US states waiving the residency requirement, but to my dismay, there isn't one that does away with the USMLE altogether, not even if I were a senior clinician who had finished their higher training in a peer medical system like the UK. They usually ask that such candidates work in under-served rural areas, but I can deal with that.
(This is true, the bit about being peers. The NHS is certainly poorer, but not to that extent. We've got the same things you do in your private hospitals, we just have to dole the expensive stuff out much more begrudgingly. And psychiatry? You can't get away with just a pen and paper these days, but it isn't a very demanding field in terms of equipment)
I'd strongly prefer to continue working as a doctor. I haven't entirely ruled out a pivot to something that is non-clinical, which would let me work in the States, but many options take additional degrees and loads of time. Time I don't think I have, with the pace of progress in AI.
A friend of mine, from the same med school, ended up doing a PhD in Public Health in Texas and now works with the big names, but the ideal time for me to have done that would have been 3 years in the past.
If I did so now, not only would I be taking up educational debt, I'd be losing out on several years of earnings. This wouldn't mean shit in India, but since I'm already in the UK..
You can see how complicated things are. If I had to rank my options:
1.5) If that USMLE issue is fixed, I would also be able to go to countries that are better off than the UK and pay doctors well. Think Canada or NZ, the same obstacle blocks all of them. Slightly lower payoff than the States, but I'd be happy with it.
Continue training in the UK and resign myself to life here. It beats India. This is more or less something I can count on.
Discard clinical medicine and do something that doesn't have so much regulatory red tape, and try to get into the States that way. Uncertain odds, massive opportunity costs if I have to quit my job and training program.
Now, if some lovely lady becomes so enamored by my hobby of arguing with strangers online that she wants to marry me, I might not say no haha. If I was a US citizen, then I could apply for jobs that think that even if my medical credentials aren't directly applicable, it's proof of general competence.
Thank you. I'd have linked to the same post on the Motte if I wasn't too tired to dig through my profile. If you were one of the people who had said it back then, I appreciate you, and I do now.
I think I'd be a fine American. Let's see if that pans out, my life hasn't been entirely terrible outside of it.
You also have the option of completing training in the UK and then moving to a country like Australia that wants to poach British-trained doctors.
I would if I could! The same American NGO that certifies international doctors as being eligible for the USMLE, is also relied upon by other Commonwealth countries to vet applicants.
The UK still has delusions of grandeur, and has their own certification pathway without entirely outsourcing that bit to an American org. Unfortunately, this doesn't provide a way to side-step the issues with my original med school, even if my higher training is recognized by Australia and New Zealand.
Otherwise I'd probably be replying back at an awkward time zone, as soon as I was safe from drop bear attack.
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