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PubMed1989

The hidden future supply of foreign medical graduates.

The number of foreign medical graduates (FMGs) as reported by the American Medical Association (AMA) has registered increases in recent years far exceeding the Department of Health and Human Services' (DHHS) published forecasts. The DHHS projections of new entrants have been derived from the number of postgraduate year-one positions filled by FMGs. Apparently, the FMG supply is augmented by physicians who enter by other paths. By using AMA data, this study takes the first step in attempting to shed light on the characteristics of these recent FMG additions. It then uses the DHHS model to forecast FMG supply based on a short-run continuation of the AMA-reported changes. The paper also forecasts FMG supply assuming that no new foreign national FMGs (FNFMGs) will enter the pool. The analysis suggests that some FNFMGs may be entering this country with visas granted to family members of United States citizens or permanent immigrants and then establishing practices without exiting directly from graduate medical education (GME). Further restrictions on GME participation for FMGs likely are not going to severely curtail FMG entrance into the medical care delivery system. Rather, they will likely restrict their entrance by way of the most traditional route.

Education, Medical, Graduate↗
PubMed1979

American foreign medical graduates. Performance after a year of supervised clinical clerkships (fifth pathway).

The performance during graduate medical education of Americans who have studied medicine abroad and who have taken a year of intense and closely supervised clinical clerkships (fifth pathway program) was assessed. Only 14% of such house officers were given inadequate or below-average ratings in overall clinical performance by residency program directors. Ninety percent or more received average, good, very good, or excellent evaluations in their ability to take medical histories and perform physical examinations, in their response to instruction, in behavior and interpersonal relationships, and in appearance and emotional stability. Seventy percent were said to be as good as or better than house staff in general. Carefully selected and properly motivated Americans who have studied medicine in a foreign country can become good physicians following a well-organized, comprehensive closely supervised year of clinical clerkship education.

Asia↗
PubMed1975

Licensure, competence, and manpower distribution. A follow-up study of foreign medical graduates.

Medical statistics report United States medical graduates licensed at higher rates than foreign medical graduates. This difference is often interpreted to show greater medical competence of United States graduates. This study questions this interpretation by analyzing 1971 licensure rates for both groups who had been interns and residents in 1963. We found that factors unrelated to competence--namely, visa-citizenship status and state of examination--are associated with holding a license. Moreover, quality of medical education is not an accurate predictor of licensure. It follows that the use of licensure rates as measures of medical competence distorts understanding of the quality of medical care in the United States. More probably, the difficulties in obtaining medical licensure experienced by foreign graduates result from the use of such graduates to relieve specific medical-manpower shortages.

Clinical Competence↗