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Recruitment of International Medical Graduates: Contributions, Trends and Challenges Ahead

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Graduate Medical Education in Psychiatry

Abstract

International medical graduates (IMGs) play a significant and unique role in the delivery of mental health services in the United States. Recruitment of IMG applicants in psychiatry residency programs is on the decline for a variety of reasons. This chapter explores strategies to enhance and preserve the recruitment of IMG applicants. The authors discuss the importance of creating a welcoming environment for IMGs while acknowledging the specific challenges they face and amplifying their strengths. The role of mentorship and sponsorship in the development of an IMG’s career is also highlighted. Lastly, anticipated changes and future directions are discussed.

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References

  1. Murphy B. How IMGs have changed the face of American medicine. 2019 [cited 2021 July 26]. Available from: https://www.ama-assn.org/education/international-medicaleducation/how-imgs-have-changed-face-american-medicine

  2. Rao N, Ahmed S, Sangha J. Navigating psychiatry residency in the United States. 2018 [cited 2021 July 26]. Available from: https://www.psychiatry.org/psychiatrists/international/international-trainees/internationalmedical-graduates-guide-to-u-s-residency

  3. American Psychiatric Association. 2019 resident/fellow census. Published 2020. Available from: https://www.psychiatry.org/File%20Library/Residents-MedicalStudents/Residents/APA-Resident-Census-2019.pdf. Accessed 13 Nov 2021.

  4. Blanco C, et al. Practice patterns of international and U.S. medical graduate psychiatrists. Am J Psychiatry. 1999;156(3):445–50.

    CAS  PubMed  Google Scholar 

  5. Ahmed AA, et al. International medical graduates in the US physician workforce and graduate medical education: current and historical trends. J Grad Med Educ. 2018;10(2):214–8.

    Article  Google Scholar 

  6. Virani S, Mitra S, Grullón MA, Khan A, Kovach J, Cotes RO. International medical graduate resident physicians in psychiatry: decreasing numbers, geographic variation, community correlations, and implications. Acad Psychiatry. 2021;45(1):7–12.

    Article  Google Scholar 

  7. Balon R. Subspecialty training: time for change. Acad Psychiatry. 2017;41(4):558–60.

    Article  Google Scholar 

  8. Laurencin CT, McClinton A. The COVID-19 pandemic: a call to action to identify and address racial and ethnic disparities. J Racial Ethn Health Disparities. 2020;7(3):398–402.

    Article  Google Scholar 

  9. Laditka JN. Physician supply, physician diversity, and outcomes of primary health care for older persons in the United States. Health Place. 2004;10(3):231–44.

    Article  Google Scholar 

  10. Barceló NE, Shadravan S, Wells CR, et al. Reimagining merit and representation: promoting equity and reducing bias in GME through holistic review. Acad Psychiatry. 2021;45:34–42. https://doi.org/10.1007/s40596-020-01327-5.

    Article  PubMed  Google Scholar 

  11. Kirmayer LJ, Sockalingam S, Fung KP, Fleisher WP, Adeponle A, Bhat V, Munshi A, Ganesan S. International medical graduates in psychiatry: cultural issues in training and continuing professional development. Can J Psychiatry. 2018;63(4):258–80.

    Article  Google Scholar 

  12. Dave S. It is time to accentuate overseas doctors’ positives. BMJ. 2016;353:i2148.

    Article  Google Scholar 

  13. Radjou N, Prabhu J, Ahuja S. Jugaad innovation: think frugal, be flexible, generate breakthrough growth. Wiley; 2012.

    Google Scholar 

  14. Majeed MH, Ali AA, Sudak DM. International medical graduates and American psychiatry: the past, present, and future. Acad Psychiatry. 2017;41(6):849–51.

    Article  Google Scholar 

  15. Mohl PC. Psychiatry and international medical graduates. Acad Psychiatry. 2001;25(3):133.

    Article  Google Scholar 

  16. Kramer M. Educational challenges of international medical graduates in psychiatric residencies. J Am Acad Psychoanal Dyn Psychiatry. 2006;34(1):163–71.

    Article  Google Scholar 

  17. Moran M. Psychiatry residency match numbers climb again after unprecedented year in medical education. 2021. [cited 2021 July 30]. Available from: https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2021.5.27

  18. Boyle P. Medical school enrollments grow, but residency slots haven’t kept pace. 2020. [cited 2021 July 30]. Available from: https://www.aamc.org/news-insights/medical-school-enrollments-grow-residency-slots-haven-t-kept-pace

  19. Desbiens NA, Vidaillet HJ. Discrimination against international medical graduates in the United States residency program selection process. BMC Med Educ. 2010;10(1):1–5.

    Article  Google Scholar 

  20. Coleman AL, Lipper KE, Taylor TE, Palmer SR. Roadmap to diversity and educational excellence: key legal and educational policy foundations for medical schools. Washington, DC: A Report for the Association of American Medical Colleges; 2014. Available from: https://store.aamc.org/downloadable/download/sample/sample_id/192

    Google Scholar 

  21. Shim RS. Dismantling structural racism in psychiatry: a path to mental health equity. Am J Psychiatr. 2021;178(7):592–8.

    Article  Google Scholar 

  22. Capers Q, McDougle L, Clinchot DM. Strategies for achieving diversity through medical school admissions. J Health Care Poor Underserved. 2018;29(1):9–18. https://doi.org/10.1353/hpu.2018.0002.

    Article  PubMed  Google Scholar 

  23. Driver TH, Loh AR, Joseph D, Keenan JD, Naseri A. Predictors of matching in ophthalmology residency for international medical graduates. Ophthalmology. 2014;121(4):974–5.

    Article  Google Scholar 

  24. Pham DQ, et al. The impact of telehealth on clinical education in adolescent medicine during the COVID-19 pandemic: positive preliminary findings. Front Pediatr. 2021;9:642279.

    Article  Google Scholar 

  25. Al Ashry HS, Kaul V, Richards JB. The implications of the current visa system for foreign medical graduates during and after graduate medical education training. J Gen Intern Med. 2019;34(7):1337–41.

    Article  Google Scholar 

  26. Alweis R, Khan MS, Kuehl S, Wasser T, Donato A. Internal medicine program directors’ perceptions of the “all in” match rule: a cross-sectional survey. J Grad Med Educ. 2017;9(2):173–7.

    Article  Google Scholar 

  27. Jena AB, Olenski A, Blumenthal DM, Khullar D. Trump’s immigration order could make it harder to find a psychiatrist or pediatrician. FiveThirtyEight. 2017. https://fivethirtyeight.com/features/trumps-immigration-order-could-make-it-harder-to-find-a-psychiatrist-or-pediatrician/. Accessed 12 Aug 2021.

  28. Ramani G, Rutkofsky IH. Visa hurdles faced by IMGs. In: International medical graduates in the United States. Cham: Springer; 2021. p. 443–56.

    Chapter  Google Scholar 

  29. Jasinskaja-Lahti I, Liebkind K, Jaakkola M, Reuter A. Perceived discrimination, social support networks, and psychological well-being among three immigrant groups. J Cross-Cult Psychol. 2006;37(3):293–311.

    Article  Google Scholar 

  30. McGrath P, Henderson D, Phillips E. Integration into the Australian health care system: insights from international medical graduates. Aust Fam Physician. 2009;38(10):844–8.

    PubMed  Google Scholar 

  31. De Lew N, Greenberg G, Kinchen K. A layman’s guide to the US health care system. Health Care Financ Rev. 1992;14(1):151.

    PubMed  PubMed Central  Google Scholar 

  32. Guide AC, Tohid H, Maibach H. International medical graduates in the United States.

    Google Scholar 

  33. Zaidi Z, Dewan M, Norcini J. International medical graduates: promoting equity and belonging. Acad Med. 2020;95(12S):S82–7.

    Article  Google Scholar 

  34. Zulla R, Baerlocher MO, Verma S. International medical graduates (IMGs) needs assessment study: comparison between current IMG trainees and program directors. BMC Med Educ. 2008;8(1):1–5.

    Article  Google Scholar 

  35. Sockalingam S, Hawa R, Al-Battran M, Abbey SE, Zaretsky A. Preparing international medical graduates for psychiatry residency: a multi-site needs assessment. Acad Psychiatry. 2012;36(4):277–81.

    Article  Google Scholar 

  36. Horvath K, Coluccio G, Foy H, Pellegrini C. A program for successful integration of international medical graduates (IMGs) into US surgical residency training. Curr Surg. 2004;61(5):492–8.

    Article  Google Scholar 

  37. Porter J, Townley T, Huggett K, Warrier R. An acculturization curriculum: orienting international medical graduates to an internal medicine residency program. Teach Learn Med. 2008;20(1):37–43.

    Article  Google Scholar 

  38. https://www.uab.edu/medicine/peds/images/Faculty_Development/Mentoring/ARTICLE-TruthAboutMentoringMinorities-RaceMatters-HBR.pdf by David Thomas. Accessed Aug 2021.

  39. Najeeb U, Wong B, Hollenberg E, Stroud L, Edwards S, Kuper A. Moving beyond orientations: a multiple case study of the residency experiences of Canadian-born and immigrant international medical graduates. Adv Health Sci Educ. 2019;24(1):103–23.

    Article  Google Scholar 

  40. Kehoe A, Metcalf J, Carter M, McLachlan JC, Forrest S, Illing J. Supporting international graduates to success. Clin Teach. 2018;15(5):361–5.

    Article  Google Scholar 

  41. Ojo E, Hairston D. Recruiting underrepresented minority students into psychiatry residency: a virtual diversity initiative. Acad Psychiatry. 2021;12:1–5.

    Google Scholar 

  42. Lee MS, Nambudiri VE. Sources of support for IMGs. In: International medical graduates in the United States. Cham: Springer; 2021. p. 357–63.

    Chapter  Google Scholar 

  43. DeCastro R, Griffith KA, Ubel PA, Stewart A, Jagsi R. Mentoring and the career satisfaction of male and female academic medical faculty. Acad Med. 2014;89(2):301.

    Article  Google Scholar 

  44. Bonifacino E, Ufomata EO, Farkas AH, Turner R, Corbelli JA. Mentorship of underrepresented physicians and trainees in academic medicine: a systematic review. J Gen Intern Med. 2021;2:1–2.

    Google Scholar 

  45. United States Medical Licensing Examination [Internet]. Usmle.org. [cited 2021 Aug 23]. Available from: https://www.usmle.org/incus

  46. Boulet JR, Pinsky WW. Reporting a pass/fail outcome for USMLE Step 1: consequences and challenges for international medical graduates. Acad Med. 2020;95(9):1322–4.

    Article  Google Scholar 

  47. National Resident Matching Program, editor. Charting Outcomes in the Match: International Medical Graduates. 3rd ed. National Resident Matching Program; 2020. Accessed 23 Aug 2021.

    Google Scholar 

  48. Desai A, Hegde A, Das D. Change in reporting of USMLE Step 1 scores and potential implications for international medical graduates. JAMA. 2020;323(20):2015–6.

    Article  Google Scholar 

  49. United States Medical Licensing Examination [Internet]. Usmle.org. [cited 2021 Aug 23]. Available from: https://www.usmle.org/announcements/?ContentId=30

  50. World Federation for Medical Education (WFME). https://wfme.org. Accessed 23 Aug 2021.

  51. House approves bill on limited licenses for foreign physicians [Internet]. Columbiabasinherald.com. [cited 2021 Aug 24]. Available from: https://columbiabasinherald.com/news/2021/feb/28/house-approves-bill-limited-licenses-foreign-physi/

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Author information

Authors and Affiliations

  1. University of California Los Angeles, Los Angeles, CA, USA

    Manal Khan

  2. Stanford University School of Medicine, Stanford, CA, USA

    Isheeta Zalpuri

  3. University of Virginia, Charlottesville, VA, USA

    Vishal Madaan

Authors
  1. Manal Khan
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  2. Isheeta Zalpuri
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  3. Vishal Madaan
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Corresponding author

Correspondence to Vishal Madaan .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA

    Matthew Macaluso

  2. Department of Psychiatry, Neuroscience Institute Southern Illinois University School of Medicine, Springfield, IL, USA

    L. Joy Houston

  3. Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA

    J. Mark Kinzie

  4. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    Deborah S. Cowley

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Khan, M., Zalpuri, I., Madaan, V. (2022). Recruitment of International Medical Graduates: Contributions, Trends and Challenges Ahead. In: Macaluso, M., Houston, L.J., Kinzie, J.M., Cowley, D.S. (eds) Graduate Medical Education in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-00836-8_9

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  • DOI: https://doi.org/10.1007/978-3-031-00836-8_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-00835-1

  • Online ISBN: 978-3-031-00836-8

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