U.S. medical school graduates face a competitive environment when it comes to securing residency placements, and the perceived graduate medical education squeeze is being closely monitored and debated.
A predicted physician shortage has medical schools producing more graduates, but residency slots aren’t increasing proportionally. Throw international medical graduates (IMG) into the mix, particularly ones from offshore medical schools, and the competition becomes a whole lot tighter.
One in four practicing U.S. physicians is an IMG, according to a 2010 Health Affairs report. International grads provide much-needed patient care and often work in underserved areas, practicing as primary care physicians.
“Without IMGs, thousands of patients would be lacking access to a physician,” a 2013 report from the AMA Council on Medical Education (CME) noted. “They play a critical role in caring for the country’s neediest patients.”
At the same time, there have been questions about how prepared some graduates of “offshore” medical schools, specifically Caribbean schools, are for U.S. clinical clerkships.
Caribbean medical schools train the largest numbers of U.S. citizens graduating from international medical schools, who eventually become certified by the Educational Commission for Foreign Medical Graduates (ECFMG), the 2013 CME report noted.
Meanwhile, according to a 2012 survey from the Liaison Committee on Medical Education (LCME), about 52 percent of U.S. medical schools have found it more difficult to find inpatient clinical placements for students in core clinical clerkships, and about 18 percent attribute that difficulty to increased competition for placement sites from offshore medical schools.
The AMA in 2013 reaffirmed its policy that more options for IMG students who want U.S. clerkships should be investigated. Further, the association stated its continued advocacy for regulations to ensure that IMGs who take on clinical clerkships in the United States come from approved medical schools, accredited by the LCME or other similar organizations.
The AMA continues to work for high-quality medical education for everyone, while recognizing that clinical resources are limited.
