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PubMed1977

Predicting success in psychiatric training for foreign medical graduates: II. Patterns in course.

Faculty ratings of 22 foreign medical graduates ('FMGs'), all of whom entered psychiatric residency training at the University of Missouri-Columbia from 1966 through 1973, were compared with those of a similar group of North American medical graduates ('AMGs'). An on-going evaluation programme provided data for a variety of parameters ranging from 'theoretical knowledge' to 'clinical skills'. Results indicated that in most of performance the median FMG started at a level substantially lower than that of the median AMG and very slowly caught up. When achievement criteria were utilized it became apparent that, at least by the third year of training, 'superior' FMGs could equal or surpass the median performance of 'superior' AMGs, whereas 'marginal' residents, whether foreign or native-born, seldom attained even competence in most major spheres of functioning. Implications of these findings and those in related studies are discussed.

Clinical Competence↗
PubMed1975

Fifth pathway in New Jersey. House officer preparatory course for US foreign medical graduates.

The Fifth Channel in New Jersey is a Fifth Pathway program for US foreign medical graduates. In its third year, 83 percent of its 81 graduates are house officers at 18 US medical school-affiliated hospitals. Performance as house officers is characterized as competitive with peers, including US graduates. Positive attitudes toward work load, fellow workers, and patients compared with those of fellow house staff are noted. Quality of performance as house officers correlates most strongly with the change in mean scores of two batteries of clinical National Board examinations taken during the Fifth Pathway and less strongly with mean scores of single batteries of National Boards, Intelligence quotient, Educational Council for Foreign Medical Graduates (ECFMG) examination, ang age. Recommendations concerning the implementing of similar programs in other states are presented.

Adult↗
PubMed1990

Foreign medical graduates. The experience of the Australian Medical Examining Council and the Australian Medical Council, 1978-1989: implications for medical immigration and the medical workforce.

From July 1978 to March 1989, 1703 foreign medical graduates who entered Australia as immigrants took the examinations of the Australian Medical Examining Council (AMEC) and its successor since 1986, the Australian Medical Council (AMC). Of these, 821 (48.2%) passed the multiple choice question examinations and, of these, 627 (76.3%) passed the clinical examinations. The overall pass rate was 36.8%. The majority of those who passed required more than one attempt to do so. Graduates of medical schools from South Africa, Canada and the United States were, in general, more successful than those from other countries by a large margin. Most candidates were graduates of medical schools in third-world countries and Eastern Europe, and although substantial numbers ultimately passed, few of them had reached the same level of competence as graduates from South Africa and North America. There are many probable reasons for their generally poor performance, the most likely being the quality of their medical education in preclinical and clinical sciences and their lack of substantial postgraduate experience. A second factor for some is their inadequate command of English. A third factor is age. Of 547 candidates who presented for the first time in 1988 and 1989, 258 (47%) were 35 or more years old. Since 1984 medical immigration has trebled and is still rising. At the present rate of growth, foreign graduates sitting the AMC examinations for the first time in 1994 will number approximately 482, which (assuming all pass) will be equivalent to 40% of doctors expected to graduate from the 10 Australian medical schools in that year. In spite of a more than adequate supply of locally qualified doctors, Australia, through easy immigration, has become a target country for foreign medical graduates. The high failure rate in the AMC examinations has led to immigrant-activated political pressure for bridging courses and other concessions. If, as a result, the majority of the immigrants were to pass the AMC examinations and so enter general practice, medical immigration will increase at an even faster rate than it has since 1984, with significant changes in the medical workforce. Some reforms which might avert this are suggested.

Adult↗
PubMed1983

Foreign medical graduates and board certification: myths and realities.

The participation of foreign medical graduates (FMGs) in American medicine is a longstanding phenomenon, yet the documentation of their role has been mainly impressionistic and anecdotal, particularly in psychiatry. Using the results of a survey on Board certification, the authors compared FMGs with U.S. medical graduates (USMGs) on several variables: demographic characteristics, attitudes toward certification, performance, and personal experience with the examination process. They found that FMGs are more similar than dissimilar to USMGs in attitudes, values, and opinions about certification. The authors conclude that the differences are not sufficiently remarkable to warrant some of the prevalent misconceptions about FMGs.

Attitude of Health Personnel↗
PubMed1995

Waiver of the two-year home country physical presence requirement for certain foreign medical graduates--INS. Interim rule with request for comments.

This rule amends the Immigration and Naturalization Service (Service) regulations by allowing certain foreign medical graduates who entered the United States in J-1 status, or who acquired J-1 status after arrival in the United States, to obtain a waiver of the 2-year home country residence and physical presence requirement under section 212(e)(iii) of the Immigration and Nationality Act (Act) pursuant to a request by a State Department of Public Health, or its equivalent. The waiver is intended to permit these foreign medical graduates to work at a health care facility in an area designated by the Secretary, Health and Human Services (HHS), as having a shortage of health care professionals ("HHS-designated shortage area"). This interim rule also contains provisions which will permit these foreign medical graduates to change their nonimmigrant status in the United States from J-1 exchange visitor to H-1B specialty occupation worker.

Emigration and Immigration↗
PubMed1991

Residency directors' assessments of which selection criteria best predict the performances of foreign-born foreign medical graduates during internal medicine residencies.

In the summer of 1990, 102 directors of internal medicine residency programs from nine areas of the country with the largest numbers of foreign-born foreign medical graduates (FFMGs) were surveyed by mail to determine what criteria used to select FFMGs for residency positions best predicted performance. The directors felt that the most important predictors were performance on the Foreign Medical Graduate Examination in the Medical Sciences or the National Board of Medical Examiners examinations; performance during the interview; and postgraduate clinical experience in the United States. Recent graduation from medical school was felt to be a better predictor than postgraduate clinical experience in a foreign country. Seventy-three percent of the directors found letters of recommendation from a foreign country to be useless. The author suggests the results of this study may be useful to residency programs in evaluating FFMG applicants and to FFMGs in assessing their own credentials.

Attitude of Health Personnel↗
PubMed2001

Validation of the doctor-patient communication component of the Educational Commission for Foreign Medical Graduates Clinical Skills Assessment.

BACKGROUND: The pivotal role of doctor-patient communication in effective health care delivery led the Educational Commission for Foreign Medical Graduates (ECFMG) to incorporate the assessment of interpersonal skills and spoken English proficiency into its Clinical Skills Assessment (CSA). Furthermore, it was decided that to pass the CSA, a candidate would need to meet or surpass defined performance standards for doctor-patient communication as a discrete component. This requirement, among others, is designed to ensure the readiness of graduates of foreign medical schools (FMGs) to enter postgraduate medical education programmes in the United States. OBJECTIVE: The primary focus of this study was to determine the extent to which performance in a simulated testing environment is related to performance in the clinical setting. METHOD: Nurses were trained to rate the communication skills of residents from the patient's perspective. A total of 43 first-year residents were evaluated. The survey ratings (n=225) were compared with the residents' CSA communication scores. RESULTS: Corrected correlations between CSA ratings and those obtained from nurses ranged from 0.61 to 0.73. CONCLUSION: This study provides evidence for the validity of the communication ratings provided by standardized patients. The reasonably strong associations between ratings obtained during testing and those obtained through observation of 'real' patient interactions suggest that external observers can provide accurate evaluations of doctor-patient communication.

Clinical Competence↗
PubMed1991

The Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS). An analysis of pass rates of the July 1984 through July 1987 examinations.

This report examines the experience of 48,509 (40,393 foreign nationals and 8,116 U.S. citizens) foreign medical students and graduates (FMGs) who took any part of the first seven Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) administered by the Educational Commission for Foreign Medical Graduates. The pass rate on all three sections (basic science, clinical science, and English) was 23.0%. Almost one-half (47.2%) of all FMGEMS examinees were between 25 and 29 years of age, 73.9% were men, 71.5% took FMGEMS after medical school graduation, and 79.7% claimed as their native tongue languages other than English. Correlates of pass rates included taking FMGEMS before medical school graduation (30.0% pass) and being a native English speaker (37.5% pass). The rates for foreign national FMGs (FNFMGs) and United States FMGs (USFMGs) were 22.5% and 25.2%, respectively. Native English-speaking FNFMGs achieved a 43.3% pass rate; native English-speaking USFMGs, 32.6%; non-native English-speaking FNFMGs, 19.9%; and non-native English-speaking USFMGs, 11.2%. Whereas FMGs were educated in 114 countries, 74.2% of USFMGs were educated in just eight countries, all located in the West Indies and Mexico. Logistical regression analysis showed that the strongest factors predicting full pass rates were being both younger than 30 years of age and a native English speaker. Conclusions are that approximately 3,200 FMGs per year pass FMGEMS and that FMGs with the highest probability of passing share characteristics of U.S. and Canadian medical graduates who pass the National Board medical examinations, which suggests that the latter examinations, when offered to FMGs, may have limited effect on overall pass rates.

Achievement↗