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. 2018 Apr;10(2):214-218.
doi: 10.4300/JGME-D-17-00580.1.

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends

Awad A Ahmed, Wei-Ting Hwang, Charles R Thomas Jr, Curtiland Deville Jr

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends

Awad A Ahmed et al. J Grad Med Educ. 2018 Apr.

Abstract

Background: Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited.

Objective: We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce.

Methods: We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression.

Results: IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine.

Conclusions: IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

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Conflict of interest statement

Conflict of interest: The authors declare they have no competing interests.

Figures

Figure 1a
Figure 1a
International Medical Graduate GME Representation Abbreviation: GME, graduate medical education. figure 1b International Medical Graduate Active Practicing Physician Representation
See this image and copyright information in PMC

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