Regional Distribution of Foreign-Born Medical Graduates in US Primary Care Specialty Residencies from 2010 to 2022.

Abstract

The United States has more foreign-born (FB) individuals than any other country and a large international medical graduate (IMG) workforce. Yet little is known about the trends of FB IMGs matching into primary care specialties residency programs or the alignment between FB individuals and FB IMGs. This study examined the recent trends in FB IMGs entry into primary care specialty residency programs and their distribution in relation to the US FB population. In this retrospective study, we used archives of National Resident Matching Program (NRMP) data on the main residency match from 2010 to 2022. We extracted match data and program directors' policies for internal medicine, pediatrics, family medicine, and internal medicine/pediatrics. We also extracted data on the total population and FB individuals from the US Census Bureau for each US state from 2010 to 2022. From 2010 to 2022, 17.2% of primary care specialty positions were filled by FB IMGs, with 22.1% for internal medicine, 11.3% for pediatrics, 10.7% for family medicine, and 3.2% for internal medicine/pediatrics. The percentage of primary care specialty positions filled by FB IMGs was significantly higher than the percentage of FB people in the US overall and 7 of 9 US regions (p < 0.001) (excepting Pacific and Mountain). The percentage of family medicine, pediatrics, and internal medicine/pediatrics positions filled by FB IMGs was significantly lower than the proportion of FB people (p < 0.001). Internal medicine had a higher proportion of positions filled by FB IMGs compared to the proportion of FB individuals in the general population (p < 0.001). Distribution of FB IMGs varies in primary care specialties compared to FB people in the US. Given the importance of aligning medical education with patients' needs, programs could take into account population demographics while assessing and admitting the applicants.