White Paper: The Role of International Medical Graduates in the U.S. Physician Workforce

White Paper: The Role of International Medical Graduates in the U.S. Physician Workforce

Of all physicians practicing in America today, about one in every four is an international medical graduate (IMG) — a professional who immigrated originally from another country to practice medicine in the United States.

And that number is even higher among a certain group of specialists. For instance, 48 percent of all nephrologists are international medical graduates, as are 42 percent of hematology/oncology specialists, 40 percent of internal medicine physicians and 33 percent of neurologists.

Those are figures from Staff Care's latest white paper, which examines the role that international medical graduates play in the fulfillment of America's physician workforce needs, including their processes for credentialing, motivations for working in the U.S., and general impact on physician supply.

It's a topic that's more relevant than ever, as the nation's physician shortage continues to reverberate throughout the industry, and as the U.S. government's much-discussed travel ban threatens to exacerbate that shortage by restricting the number of international physicians practicing here.

With this in mind, it may be a good time to pay closer attention to America's international physician. Let's take a brief look at Staff Care's latest white paper, then, which does just that.

Read the White Paper

International Medical Graduates: Credentialing, Motivation, Supply & Other Considerations

Though international physicians, by definition, originate from outside of the U.S., they're subject to the same rigorous credentialing standards as any other doctor — and then some. As the white paper points out, before being allowed to practice, international medical graduates must first:

  • Graduate from a medical school (in their country of origin)
  • Pass levels I and II of the U.S. Medical Licensing Examination® (USMLE®), the rigorous medical licensure examination applicable to all U.S. physicians (administered in English)
  • Acquisition of an Educational Council of Foreign Medical Graduates (ECFMG) Certificate "showing equivalent knowledge to U.S./Canadian med school graduates"
  • Completion of a residency program (which sometimes requires completion of USMLE Part III)

"After completion of their residency programs, IMGs may apply for state medical licenses," the white paper authors note. "Physicians who want to enter the U.S. on H-1B visas to do their residencies must have taken and passed USMLE I, II and III and received their ECFMG certification

However, completing a residency may be a stumbling block for some international medical graduates. Only about half of those who apply being matched, even though "U.S. residency programs have more positions than there are U.S. medical school graduates to fill them," as the white paper points out. (Read more about growing concerns over the residency matching process' perceived inability to supply the nation with the adequate amount of physicians here.)

"For decades, IMGs have filled many residency slots not filled by U.S. graduates," the authors add. "IMGs are motivated to fill these positions, even if they are already practicing medicine in their home countries, by the opportunity to obtain advanced medical training that they can take back to their home countries, or by the opportunity to practice medicine and live in the U.S."

In addition to qualifications and motivations of international medical graduates, the white paper also takes a look at international physicians' countries of origins. Of note is the fact that, although most IMGs are from India, a sizable amount have also originated from China, Pakistan and Iran — the latter two countries of which are included in a travel ban that's currently being decided in U.S. courts. Also worth noting is that our white paper authors consider that the ultimate effect of the travel ban on America's supply of international physicians is "likely to be somewhat limited."

Finally, the white paper also covers the prevalence and acceptance of IMGs working locum tenens assignments. Noting that international physicians aren't all that common in locum tenens staffing — often, the nature of their visas ties them to permanent employment of some type — the authors explain that this is slowly changing, as are the general perception of locum IMGs in the workplace.

"When Staff Care was founded approximately 26 years ago, there was still considerable resistance" in the industry to recruiting IMGs "based in part on perceptions about the quality of training," they write. "These perceptions have largely abated due to the track record many IMGs have established in the U.S. and because it is more widely understood that IMGs often represent the 'best of the best' their countries have to offer."

Read the White Paper

If you're interested in discussing your physician staffing needs with a qualified expert, we urge you to contact us today. You can also fill out a locum tenens request form here.

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