International Medical Education

How IMGs have changed the face of American medicine

Today marks the start of the AMA’s inaugural IMG Recognition Week, a time to take special note of the tremendous contributions that international medical graduates (IMGs) make to U.S. medicine, its physician workforce and to patient care. Here are some key facts that you should know about how IMGs are remaking American health care.

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22.7% of licensed U.S. doctors—about 216,000—are IMGs. That share has grown by half a percentage point since 2010, but what the figure means in raw terms is even more impressive.

The number of IMGs in practice has grown by nearly 28,000 since 2010, a 14.6% rise. That figure is bigger than the 12% rise in U.S. medical graduates over that same time period.

98% of IMGs speak two or more languages fluently, helping patients overcome linguistic and cultural barriers that can impede care.

62% are primary care physicians. That’s about double the 31% of all U.S. physicians who work in a primary care specialty, helping to meet a critical workforce need.

The share of female IMGs is on the rise. First-time medical licenses issued to female IMGs rose from 25% to 45% between 1990 and 2014. That only slightly trails the 47% issued to female U.S. medical grads in 2014.

About one in three IMGs calls the sweet, sunny South their practice home. 32% of IMGs work in the South, while 28% work in the Northeast, 20% in the Midwest, 17% in the West, and 3% in territories and military bases.

33% of IMGs work in a hospital setting. That’s the most popular setting for these doctors. Group practice follows at 31%, solo- or two-doctor practice is next at 20%, while the rest work in managed care, academic or unclassified settings.

27% of IMGs are from India, a much larger share than any other single country. But large numbers of IMGs also hail from the Philippines, Pakistan, Syria, Nigeria, China, Lebanon, the U.K. and Germany.

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58% of IMGs were born outside the U.S. This group, dubbed non-U.S. IMGs, also accounts for the same proportion of active IMG applicants in the National Resident Matching Program. The other 42% of IMGs were born in the U.S. but obtained their medical school degrees in another country.

Among them is AMA member Kevin King, MD, who was trained in Ireland but also obtained a U.S. medical degree. Dr. King is chair of the AMA IMG Section and is involved as a program director in resident and student education in emergency medicine. In an interview, Dr. King said he became involved with the AMA principally because of its outstanding work on behalf of IMGs. The Association strongly advocates on vital issues such as:

  • Expansion of the J-1 visa waiver program to more than 30 slots per state.
  • Deselection of medical schools by licensing boards and residency programs.
  • Immigration and green-card delays.
  • State licensure parity.
  • Discrimination.
  • Racial and ethnic disparities.
  • GME funding for more residency positions.

Dr. King has faced and overcome the misconceptions that IMGs have less to offer the U.S. health care system by demonstrating “the excellence in practice and advocacy that we all strive for as health care providers,” he said. One trait that unites IMGs and all physicians, he said, is their determination to succeed as high-quality physicians in the United States. Dr. King also believes that IMGs also bring a valuable perspective to considerations of health care policy.

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IMGs have “learned how to work in different environments, and there’s an opportunity to leverage our experiences and add to the expertise of our colleagues in the U.S. to build a better health care system,” he said.

“As a nation, we can’t continue to support our growing health care expenditures,” Dr. King said. “As foreign graduates who have worked and trained in resource-constrained environments, we can potentially provide different ideas and solutions to help sustain high-quality care. We may not have all the answers, but we may have some of the key questions to help define a better answer for us all.”