Studies show that international medical graduates (IMGs) see a disproportionally high number of Medicaid patients when compared to their American counterparts.
Like most doctors, if they had a choice, the incentives are such that they too would choose to practice in cities rather than in rural areas.
Less-restrictive visa requirements are making it harder to recruit IMGs to rural areas, and compounded by the fact that American graduates tend to gravitate towards becoming specialists, there’s talk of tightening up the visa requirements to force more foreign doctors to fill the primary care gap in rural America.
However, relying on foreign doctors is only a stop-gap measure for two reasons: i) once their commitment is complete, they likely will pack up and move to a city; and, ii) there is a finite number of IMGs, and often times, the countries they leave are more in need of their physician services than the United States.
Related posts:
- Are foreign medical graduates the answer to primary care?
- Foreign medical graduates and mid-levels will provide the majority of tomorrow’s primary care
- My take: Mid-levels, cost-shifting, IMGs
- Foreign doctors and primary care
- Primary care is supported by international medical graduates
- IMGs: Get used to it
- Medicine in rural areas: "It’s like serving jail time"
{ 7 comments }
This is a mute point. Residency numbers are stagnant. MDs have been increasing their class numbers for several years now. DOs are continually opening up more schools without an increase in their Osteopathic GME. As these numbers swell, IMGs are being pushed out and DOs will fill these positions, until about 4 years from now (+ or -) there will be more American graduates then there are combined ACGME and AOA programs.
Residencies are the limiting factor of physicians in this country.
IMG’s entering these J-1 waiver programs serve their time and shoot right out to a suburban practice. From there, their practice demographics are virtually the same as an american graduate, and they are, in fact, more likely to specialize and subspecialize compared to an American citizen graduate.
Now some countries take foreign docs, but give these foreign docs limited licensure that limits their practice to a particular hospital or similar practice setting. If the doc leaves that setting, no more license. With that, the doc usually loses the visa as well, so kicked out of the ocuntry.
If you want to do that, fine I suppose. You will get people in those underserved areas. Seems to me, though, is that’s a good way to screw the doctor. If they do it to the IME doctor today, they’ll do it to me tomorrow.
Bad Medicine, Good Solutions (8:44 PM) – “……about 4 years from now (+ or -) there will be more American graduates then there are combined ACGME and AOA programs…….”
Do you have a reference/link for that? Don’t doubt you, but I find this disturbing news and would like to look into it.
I agree with Bad Medicine, Good Solutions’s comment. I know in Texas medical schools, the total number of seats is slowly going up. In fact, they just opened up a new school in El Paso as part of the University of Texas system. However, residency programs are still competitive as ever. I know the program I’m interested in, neurosurgery at Baylor College of Medicine, takes about 3 people every year. With over a 100 of the nation’s best applicants… well… I’m nervous, heh. In a way, this is a good measure to uphold the quality of physicians in spite of a need to focus on quantity.
This comment is not a criticism against FMG’s. There are some excellent medical schools outside the US, and many non-US trained physicians are outstanding doctors. However, last year there were more FMG’s than US graduates that filled Family Medicine residency programs. Fewer and fewer US grads are going into primary care. I don’t think that Harry and Louise (and their children) realize that if something doesn’t change quickly, their primary care physicians will not be US graduates.
RE: Anon 8:17AM
No, you are wrong. The whole point to what I just said is that EVERY family medicine spot ACGME and AOA will be filled in a few short years by students in American schools. The days of IMGs are quickly numbered. We will have American family physicians who are profecient in English. Give it time.
But to counter the previous point, quality will still be an issue, because our country hates physicians and doesn’t want to pay a single penny for medical care. With out adequate salaries gifted students will no longer enter medicine. Quality is going to be more of an issue in the coming years, especially as Obamessiah deals the final blows.
None of this matters. NP’s and PA’s and nurse doctors and all kinds of diluted health “practitioners” will be running primary care. And they’ll get paid dog crap to do it. IMG’s don’t want those jobs anyway. Primary Care will be over for doctors soon, because as pointed out above, it isn’t valued.
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