The United States Physician Workforce and International Medical Graduates: Trends and Characteristics
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase.
To describe the historical trends and compare the characteristics of IMGs to United States medical graduates (USMGs) in the United States.
Longitudinal analysis of the American Medical Association Physicians’ Professional Data (AMA-PPD) database using the 1978–2004 files and a comparative analysis of the characteristics of a random sample of 1,000 IMGs and a random sample of 1,000 USMGs using the 2004 file.
Historical trends and characteristics of IMGs in the United States.
Over the last 26 years, the number of IMGs in the United States grew by 4,873 per year reaching a total of 215,576 in 2004, about 2.4 times its size in 1978. The proportion of IMGs increased 0.12% per year, from 22.2% in 1978 to 25.6% in 2004. In 2004, compared with USMGs, IMGs were older, less likely to be board certified [Odds ratio (OR), 0.68; 95% CI, 0.53 to 0.86], less likely to work in group practice (OR, 0.60; 95% CI, 0.37 to 0.98), more likely to have Internal Medicine as practice specialty (OR, 2.10; 95% CI, 1.62 to 2.71) and more likely to be residents (OR, 1.52; 95% CI, 1.07 to 2.16).
Over the last quarter century, the IMGs provided a significant and steady supply for the United States physician workforce that continues to grow. Policymakers should consider the consequences for both the United States and source countries.
- Grumbach, K, Lee, PR (1991) How many physicians can we afford?. JAMA 265: pp. 2369-2372 CrossRef
- Graduate Medical Education National Advisory Committee. Summary report of the Graduate Medical Education National Advisory Committee to the Secretary, Department of Health and Human Services. Washington, D.C. April 1981.
- American Association of Colleges of Osteopathic Medicine, American Medical Association, American Osteopathic Association, Association of Academic Health Centers, Association of American Medical Colleges, National Medical Association. Consensus Statement on Physician Workforce. Washington, DC; 1997.
- Cooper, RA (2004) Weighing the evidence for expanding physician supply. Ann Intern Med. 141: pp. 705-714
- Cooper, RA, Stoflet, SJ, Wartman, SA (2003) Perceptions of medical school deans and state medical society executives about physician supply. JAMA 290: pp. 2992-2995 CrossRef
- Sunshine, J (2001) Overview and Analysis of Information Regarding the Shortage. American College of Radiology, Chicago, IL
- Schubert, A, Eckhout, G, Tremper, K (2003) An updated view of national anesthesia personnel shortfall. Anesth Analg. 96: pp. 207-214 CrossRef
- Foot, DK, Lewis, RP, Pearson, TA, Beller, GA (2000) Demographics and cardiology, 1950–2050. J Am Coll Cardiol. 35: pp. 1067-1081 CrossRef
- Boyce, ST (2003) The Rochester Community Physician Workforce: Factors Affecting Recruitment and Retention. CGR, Rochester, NY
- Angus, DC, Kelly, MA, Schmitz, RJ, White, A, Popovich, J (2000) Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population?. JAMA 284: pp. 2070-2762 CrossRef
- Zerehi, R. For the Health and Public Policy Committee of the American College of Physicians. Creating a New National Workforce for Internal Medicine. A Position Paper: American College of Physicians; 2006.
- Weiner JP. Prepaid group practice staffing and U.S. physician supply: lessons for workforce policy. Health Aff. 2004;Suppl Web Exclusives:W4-43–59.
- Lurie, JD, Goodman, DC, Wennberg, JE (2002) Benchmarking the future generalist workforce. Eff Clin Pract 5: pp. 58-66
- American Medical Association. H-200.953 The Physician Workforce: Recommendations for Policy Implementation. 2003 January 18, Available at: http://web.archive.org/web/20040207002827/http://www.ama-assn.org/ama/pub/article/print/1616-8229.html. Accessed January 23, 2006.
- Association of American Medical Colleges. The physician workforce: position statement. February 2005. Available at: http://www.aamc.org/workforce/12704workforce.pdf. Accessed January 23, 2006.
- Physician Workforce Policy Guidelines for the United States, 2000–2020. Health Resources and Services Administration, Rockville, MD
- Cooper, RA (2003) Medical schools and their applicants—an analysis: if more physicians are required, can medical schools fill the gap?. Health Aff 22: pp. 71-84 CrossRef
- Blumenthal, D (2004) New steam from an old cauldron—the physician-supply debate. N Engl J Med 350: pp. 1780-1787 CrossRef
- Cooper, RA (2003) Impact of trends in primary, secondary, and postsecondary education on applications to medical school. I: Gender considerations. Acad Med 78: pp. 855-863 CrossRef
- American Medical Association. International Medical Graduates. 2005 Available at: http://www.ama-assn.org/ama/pub/category/1550.html. Accessed January 23, 2006.
- American Medical Association. AMA Physicians’ Professional Data. 2004. Available at: http://www.ama-assn.org/ama/pub/category/2673.html. Accessed January 23, 2006.
- U.S. Department of Agriculture. RUCA Codes. Available at: http://www.ers.usda.gov/Briefing/Rurality/RuralUrbanCommutingAreas/. Accessed January 23, 2006.
- Benson, JA, Meskauskas, JA, Grosso, LJ (1981) Performance of U.S. citizen–foreign medical graduates on certifying examinations in internal medicine. Am J Med 71: pp. 270-273 CrossRef
- Norcini, JJ, Boulet, JR, Whelan, GP, McKinley, DW (2005) Specialty board certification among U.S. Citizen and non-U.S. Citizen graduates of International Medical Schools. Acad Med 80: pp. S42-S45 CrossRef
- Freshnock, LJ, Goodman, LJ (1980) The organization of physician services in solo and group medical practice. Med Care 18: pp. 17-29 CrossRef
- Mullan, F, Politzer, RM, Davis, CH (1995) Medical migration and the physician workforce. International medical graduates and American medicine. JAMA 273: pp. 1521-1527 CrossRef
- Fink, KS, Phillips, RL, Fryer, GE, Koehn, N (2003) International medical graduates and the primary care workforce for rural underserved areas. Health Aff 22: pp. 255-262 CrossRef
- Mullan, F (2005) The metrics of the physician brain drain. N Engl J Med 353: pp. 1810-1818 CrossRef
- Hallock, JA, Seeling, SS, Norcini, JJ (2003) The international medical graduate pipeline. Health Aff 22: pp. 94-96 CrossRef
- Regets MC. Research and Policy Issues in High-skilled International Migration: a Perspective with Data from the United States. Arlington VG: National Science Foundation; 2001. Discussion paper 366.
- Adams, O, Kinnon, C (1998) A Public Health Perspective. International Trade in Health Services: a Developmental Perspective. World Health Organization, Geneva
- The United States Physician Workforce and International Medical Graduates: Trends and Characteristics
Journal of General Internal Medicine
Volume 22, Issue 2 , pp 264-268
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- foreign medical graduates
- health manpower
- internship and residency
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, ECMC-CC 142 462 Grider St, Buffalo, NY, 14215, USA
- 2. Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
- 3. Department of Medicine, Unity Health System, Rochester, NY, USA
- 4. INFORMA, Italian National Cancer Institute Regina Elena, Rome, Italy