Abstract
BackgroundAvailable evidence suggests that international medical graduates have improved the availability of U.S. health care while maintaining academic standards. We wondered whether studies had been conducted to address how international graduates were treated in the post-graduate selection process compared to U.S. graduates.MethodsWe conducted a Medline search for research on the selection process.ResultsTwo studies provide strong evidence that psychiatry and family practice programs respond to identical requests for applications at least 80% more often for U.S. medical graduates than for international graduates. In a third study, a survey of surgical program directors, over 70% perceived that there was discrimination against international graduates in the selection process.ConclusionsThere is sufficient evidence to support action against discrimination in the selection process. Medical organizations should publish explicit proscriptions of discrimination against international medical graduates (as the American Psychiatric Association has done) and promote them in diversity statements. They should develop uniform and transparent policies for program directors to use to select applicants that minimize the possibility of non-academic discrimination, and the accreditation organization should monitor whether it is occurring. Whether there should be protectionism for U.S. graduates or whether post-graduate medical education should be an unfettered meritocracy needs to be openly discussed by medicine and society.
Highlights
Available evidence suggests that international medical graduates have improved the availability of U
We found two papers that used paired data designs to determine whether U.S graduate medical educational programs responded to requests for applications by U.S and international medical graduates differently
We used the “related articles” feature on each of these papers which led us to another paper that surveyed surgical program directors about international medical graduates which we used in the discussion section
Summary
Available evidence suggests that international medical graduates have improved the availability of U. The United States owes a huge debt of gratitude to its physicians who graduated from non-U.S medical schools [1]. In a recent article that praises international medical graduates (IMGs) one leader states that his program chooses that IMGs comprise 10 percent of his residents - a quota system that belies his later assertion that “U.S academic medicine is ... The proportion of U.S physicians who themselves are immigrants or who are the children or grandchildren of immigrants is even greater [4]. The U.S is a nation of immigrants that has always been dependent on those from other countries to make it an economic and intellectual powerhouse
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