Medical Migration and the Physician Workforce

Abstract

In recent years, participation of IMGs in GME and practice has increased significantly. Most IMGs in GME are not exchange visitors, but are either permanent residents or US citizens. Patterns of specialization and location of IMGs ultimately mirror those of USMGs. National IMG policy must be examined in light of the projected surplus of physicians in the United States. The best option for long-term control of the number of physicians in practice, USMG or IMG, is a system of specifying the number of GME positions nationally.

Credentialing and retention of visa trainees in post-graduate medical education programs in Canada

“…Research conducted in other countries reflect similar difficulties in regard to costs, an influx of physicians in the training country, and difficulties maintaining a balance between the needs of both the training and source countries [21, 22]. For example, a study from the USA reported that a significant proportion of visa trainees ultimately entered into permanent practice in the country, which is contrary to the original purpose of the visa exchange program [23]. The United Kingdom changed regulations for Medical Training Initiative visa holders, requiring them to leave the United Kingdom at the end of their training and to spend a minimum of 12 months outside the country before applying for a work permit to return to the United Kingdom [22].…”

Comparing United States versus International Medical School Graduate Physicians Who Serve African‐ American and White Elderly

“…An examination of the American Medical Association Masterfile reveals that during the period between 1981 and 2001, almost 125,000 IMGs entered the U.S. medical workforce (Mullan, Politzer, and Davis 1995; AMA 1996; Lohr, Vanselow, and Detmer 1996; Mullan 1996, 1997; Cooper 2003). North Carolina has experienced a similar influx of IMGs.…”

“…In the United States, every year there are at least 5,000 more openings for first year residency trainees than there are graduates of U.S. medical schools (Barzanzky and Etzel 2005; Brotherton, Rockey, and Etzel 2005). Many of these training slots filled by IMGs are in teaching hospitals in large urban areas that have traditionally served large numbers of minorities, uninsured, and low‐income patients (Mullan, Politzer, and Davis 1995).…”

“…Many IMGs who are foreign nationals come to the United States to obtain graduate medical education with the professed intention of returning to their home countries, and obtain J‐1 Visas as a result (Mullan, Politzer, and Davis 1995; Mullan 1996). Despite the requirement that enjoins J‐1 visa holders to return to their home country for at least 2 years upon completion of their education, it has been estimated that as many as 80 percent of these physicians actually stay in the United States (Mullan 1996; 2000).…”

“…The existing literature on IMGs, however, presents a muddled picture about IMGs in rural, underserved areas, with theories and countervailing theories, incomplete empirical evidence, and implications that “rural” and “underserved” have the same meaning. A comprehensive literature review by Mick and Pfahler (1995) and a subsequent study by Mullan, Politzer, and Davis (1995) found no conclusive work examining whether IMGs help remedy physician shortages in rural, underserved areas. Mick and Lee (1997) showed that IMGs do “fill gaps” for physician shortages, but the term “gap‐filling” is difficult to define and can be interpreted numerous ways.…”