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PubMed1986

Predictors of the performance of foreign medical graduates on the 1982 certifying examination in internal medicine.

This study describes a cohort of foreign medical school graduates (FMGs) who first sat for the American Board of Internal Medicine's (ABIM) 1982 certifying examination, compares their performance with that of US medical school graduates, describes differences between US citizen FMGs and alien FMGs, and examines which background factors predict success on the ABIM examination. Data for this study were derived by combining information retained by the Educational Commission for Foreign Medical Graduates with ABIM data. Most FMGs who took the 1982 ABIM certifying examination for the first time were educated in and citizens of Asia, but a sizable minority were US citizens educated in Europe. Scores and program directors' ratings were lower for FMGs than US medical school graduates, and they attended different types of training programs. United States citizen FMGs were very similar to alien FMGs. Foreign medical school graduates who did well on the ABIM examination had done well on the Educational Commission for Foreign Medical Graduates examination and were rated highly by their residency program director.

Achievement↗
PubMed1977

Licensure of foreign medical graduates: an historical perspective.

Today, one out of five practicing physicians in the U.S. is a graduate of a foreign medical school. The sixfold growth in their number over the past two decades results from national policy; but the place and conditions of practice have been controlled by state governments. The several states have used their jurisdiction over licensure in ways that have often been unfair and irrational. Recent trends toward uniform standards, however, may lead to more equitable assurance of professional competence, and to interstate mobility related to local and national needs.

Certification↗
PubMed1977

Foreign medical graduate performance--a review.

Numerous factors have adversely influenced appraisals of the competence of foreign medical graduates. The statistical design of some comparative studies has been weak. Language and cultural backgrounds of foreign graduates have varied. Foreign physicians who have complete school at various times in the past have been graded according to a test designed to be taken during the fourth year of American medical schools. Licensing examinations and grading have varied from state to state. To reach reliable conclusions, matched samples of adequate size must be studied under controlled conditions.

Clinical Competence↗
PubMed2005

U.S. citizens who graduated from medical schools outside the United States and Canada and received certification from the Educational Commission for Foreign Medical Graduates, 1983-2002.

PURPOSE: To provide a descriptive overview of international medical school graduates (IMGs), U.S. and non-U.S. citizens, who obtained their medical degrees outside of the United States and Canada, with a focus on where U.S. citizens received their medical education and how this choice has changed over time. METHOD: The study group included all IMGs (n = 143,926) certified by the Educational Commission for Foreign Medical Graduates (ECFMG) from 1983-2002. Descriptive statistics were calculated, including historical certification rates for non-U.S. citizen and U.S. citizen IMGs. For IMGs who were U.S. citizens (n = 18,762), the data were summarized by medical school and country of medical school. RESULTS: U.S. citizens who attended medical schools abroad were more likely to attend schools in Central America and the Caribbean than in any other geographic region. There was a steady decrease in the number of U.S. citizens graduating from European medical schools. Conversely, the number graduating from medical schools in India and Israel rose. Over the period studied, the regions of Africa, Oceania, and South America graduated relatively few U.S. citizens. CONCLUSIONS: From 1983-2002, U.S. citizens graduated from medical schools in Central America and the Caribbean more than any other geographic region. Studying the characteristics of medical schools in this region and their similarities to U.S. medical schools, such as a four-year curriculum, may explain why U.S. citizens are attracted to this region in large numbers. Additional studies focusing on the characteristics of medical schools that train IMGs, the performance of the graduates, and their posttraining practice patterns are warranted.

Canada↗
PubMed1984

Foreign medical graduates in the 1980s: trends in specialization.

Secondary analysis of data collected by the American Medical Association and the Graduate Medical Education National Advisory Committee (GMENAC) suggests that measures to diminish the flow of alien Foreign Medical Graduates (FMGs) into the United States have been less effective than planned. Declining trends in the proportion of FMG house officers in the mid- to late-1970s have recently stabilized around 19 per cent. There has also been a dramatic increase in the number of US citizen Foreign Medical Graduates ( USFMGs ) in house officer positions. A pattern of alien FMG and USFMG house officer specialization correlates with specialties designated by the GMENAC as shortage areas by 1990 (r = -.49, p less than .05). Despite the GMENAC prediction of a surplus of physicians by 1990, differential selection of alien FMGs and USFMGs into shortage specialties may assure their substantial future presence in the US health care system.

Foreign Medical Graduates↗
PubMed1977

Foreign medical graduates in rural primary care: the case of western New York State.

To determine whether foreign medical graduates (FMGs) provide a disproportionate and increasing share of primary care in some rural areas, changes in physician distribution in a rural section of upstate New York over a 20-year period (1953-1973) were evaluated by country of medical education and type of practice. A contiguous urban area was examined for comparison. In 1953, FMGs accounted for a higher proportion of primary care physicians in rural areas (11%) than in urban practice (6%) (p less than 0.01). By 1973, this distribution had increased to 26% rural and 14% urban (p less than 0.001). During the two decades, the number of U.S. medical graduates in primary care declined by 15% in the rural areas but increased by 13% in the urban center. The number of primary care FMGs in this same period increased 88% in the rural area. With a 10% decline in (rural) FMGs trained in developed countries, this net increase in FMGs was accounted for by physicians from developing countries. Primary care physicians trained in the U.S. or in developed countries increased more in the urban center, while physicians from developing countries increased more in rural (53%) than urban (47%) practices. Finally, by 1973, rural primary care physicians were more likely than urban primary care physicians to be from developing countries (p less than 0.001).

Developing Countries↗
PubMed1992

[Projected supply and geographic distribution of physicians in Taiwan for the year 2000].

Using the data from the Physician Masterfile of the Department of Health, Executive Yuan, and reports from all of the medical colleges in Taiwan and the Ministry of Defense, this study projects the future supply of physicians as well as their geographic distribution. The components of the projection include a study of current supply, future increments and losses. Three sources of future increments are identified: new native medical graduates, foreign medical graduates and medical transfers from the military. Age-specific and year-of-graduation-specific active rates are used to estimate losses. The results of this study show: There will be 25,956 active physicians in Taiwan by the year 2000, or 118 physicians per 100,000 people; and the ratio of the highest to the lowest (Taipei city vs Yunlin county) in terms of the physician-population ratio will become worse from 4.5 in 1990 to 5.4 in 2000, ceteris paribus. Finally, this study discusses the projection process as well as the implications for the physician manpower policy in Taiwan.

Adult↗
PubMed1993

Foreign medical graduates and U.S. physician supply: old issues and new questions.

Recent increases in the number of foreign medical graduates (FMGs) in U.S. hospital-training positions raise new questions about the future role of FMGs in U.S. medicine. Despite an historical surplus of physicians, forces such as greater demand for resident house officers, stabilization in undergraduate medical education enrollment, increase in demand for medical services, growth in both the number of women in medicine and physician employment in group practices, and continuing imbalances in the distribution of physicians favor FMG migration to the United States. Health system reform must be sensitive to the historical, current, and future role FMGs play in medical care delivery, especially in regard to service in underserved areas, specialties, and employment settings.

Data Collection↗
PubMed1975

Foreign medical graduates who return home after U.S. residency training: the Peruvian case.

With few exceptions, reports on foreign medical graduates (FMGs) are concerned with their academic, clinical, and adaptational problems during their training at American hospitals and universities. This report, part of a study of FMGs from Peru who have completed postgraduate training in the United States in the past 10 years, is concerned with the psychosocial and professional stresses of adaptation experienced by a group of 21 Peruvian doctors who have returned home to practice. The authors discuss the "push" factors and "pull" factors that motivated these physicians to return to Peru to pursue careers in academic medicine, private practice, and government service in contrast to many of their colleagues who have remained in the United States.

Adaptation, Psychological↗