non-US Citizens Research Articles

Primary Care as Part of US Health Services Reform

To the Editor. —The 12-avenue approach of Starfield and Simpson 1 to upgrade primary care in US health services is innovative. Maldistribution of physicians still leads to a significant shortage of primary care physicians across the United States. The role of international medical graduates (IMGs) needs to be emphasized. Their numbers are almost equivalent to the the graduate output of approximately 17 US medical schools, with as many as 58% of these IMGs in 1988 alone being non-US citizens. 2 The bulk of them enter the United States on the exchange visitor's (J-1) program and receive their training at the expense of the United States for periods ranging from 3 to 5 years. They return to their home countries where they often find that their acquired expertise is inappropriate owing to lack of facilities and resources. Hence, the magnanimity of the United States and the well-intended purpose of the J-1

CDC Minority Health Office: 'Social Epidemiology'

THE CDC's newly established Office of Assistant Director for Minority Health marks an expansion from the federal centers' traditional approach to health and disease into the less familiar realm of social epidemiology. This, in my view, is the CDC's new frontier, says Rueben Warren, DDS, MPH, DrPH, the CDC's assistant director for minority health. The office, set up in August 1988, strives to improve the health of all African-American, Hispanic-American, Native American, and Asian-American citizens, and the health of non-US citizens of similar ethnic and racial backgrounds where appropriate, such as migrant farm workers in the border states. People from these diverse groups suffer the highest incidence and prevalence of the most common preventable diseases, yet they remain the most difficult populations to reach. Gap Is Clear, Reasons Hazy A recent CDC study of excess mortality among black adults in the United States illustrates the striking gap between the black

Foreign Medical Graduates in US Postdoctoral Programs: Concern Rises as Total Declines

HASAN M. KATTAN, MD, of Amman, Jordan is a second-year resident in ophthalmology at Georgetown University School of Medicine, Washington, DC. He is a student exchange visitor and is in the United States on what is known as a J-1 visa, which permits him to remain in this country until his training is completed. Kattan holds an MD degree from the American University in Beirut. Next year, unless he succeeds in his present plan for obtaining an additional two-year fellowship in advanced studies in corneal and external eye diseases, he will return to his native Jordan to practice and perhaps also to teach ophthalmology. Even if he does obtain the fellowship, he still plans to go back to Jordan when that additional training has been completed. As a foreign exchange visitor, Kattan represents a disappearing species on the US medical scene. Not much more than a decade ago, non-US citizens