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IMGs in the United States

Below is a profile of the IMG population and significant dates in U.S. immigration policy affecting IMGs. Additional information is also available in IMGs in the U.S. Physician Workforce Discussion Paper - 2009 edition. This document provides information on IMG workforce related issues including: the role of IMGs in the U.S. physician workforce, statistics on IMGs, IMG contributions to the delivery of health care in the U.S. and much more. Additional information on IMG workforce issues is also available in a slide presentation given by Nyapati R. Rao, MD, MS in June 2007.

Profile of the IMG population

  • In 2009, a total of 10,406 ECFMG certificates were issued. A total of 26,839 medical diplomas and transcripts were verified for ECFMG certification.
  • In 2009, a total of 29,774 ECFMG certificates were issued in the top ten countries (India, Dominica, Grenada, Pakistan, Netherlands Antilles, China, Philippines, Cayman Islands, Iran, and Israel) according to their medical school.
  • In 2006, out of 902,053 physicians, 228,665 IMGs received medical degrees from 127 different countries, accounting for 25.3% of the total physician count.
  • IMGs make up approximately 25% of the U.S. physician population.
  • The heaviest concentration of IMGs is in New Jersey (45% of doctors); New York (42%); Florida (37%); and Illinois (34%).
  • The largest national group is from India (20.7% of total).
  • Among the top four primary specialties, the IMG population represents 37% of total physicians in internal medicine; 28% anesthesiology; 32% in psychiatry; and 28% in pediatrics.
  • The total physician population increased by 350,386 between 1970 and 1994 (or 104.9%), while IMGs accounted for over one fourth (27.8%) of this increase by gaining 97,359 physicians.
  • In this 24-year period, non-IMGs grew by 91.4%, while IMGs increased by 170.2%.
  • In 1980, IMGs accounted for 20.9% of the total physician count of 467,679, while that percent climbed to 22.6% of the total count of 684,414 physicians in 1994.

Significant dates in U.S. immigration policy affecting IMGs

  • 1933-1948 - European IMGs immigrate as refugees in relatively small numbers.
  • 1948 - Exchange visitor program lets IMGs train in the United States. Many stay.
  • 1956 - AMA and others create IMG-certification system; the ECFMG.
  • 1965 - Easily obtainable visas in some specialties attract Third World IMGs.
  • 1971 - IMGs get quicker job clearances for permanent residency status.
  • 1976 - Congress raises immigration barriers against IMGs.
  • 1980 - Federal study recommends IMG limits.
  • 1985 - Federal legislation proposed to cut off GME funding for IMGs. Fails.
  • 1990s - Steep rise in incoming IMGs attributed to breakup of Soviet Union, changes in licensing exam and new immigration laws.
  • 2001 - Attacks on the World Trade Center in New York City
  • 2002 - President of the U. S. signs Border Security & Visa Entry Reform Act
  • 2003 - Department of Homeland Security established - imposing stricter immigration policies, particularly in certain areas of the world.
  • 2006 - Senate and House bills on reforming immigration policies spark national controversy and debate.
  • 2006 - J-1 Visa waiver legislation is reauthorized.
  • 2007 - President Bush announces modifications to visa waiver program with an accelerated process for admissions to include central and eastern Europe and Republic of China.
  • 2008 - Visa waiver program expanded to include Czech Republic, Estonia, Latvia, Lithuania, Hungary, Republic of Korea and Slovak Republic.
  • 2008 - President Bush signs Conrad 30 reauthorization.
  • 2009 - President Obama releases a presidential memo for the Secretary of Homeland Security extending deferred enforced departure for Liberians.
  • 2012 - President Obama signs the bill for reauthorization of the Conrad 30 program.

IMGs by state
Demographic information of practicing IMGs by state.

IMGs and the AMA
AMA membership information related to International medical graduates.

Directory of ethnic medical associations
An extensive list of ethnic medical associations.