If you’ve been to more than a few doctors, the chances are pretty good that you’ve been seen by a foreign-trained physician, or international medical graduate (IMG). The United States actually has such problems getting physicians to work in certain underserved areas that it has even created a special visa program to recruit IMGs to work in them. Of course, you may even have a friend who is a U.S. citizen and just happened to head down to the Caribbean for medical school. Not all IMGs are foreign-born–they’re just foreign-trained.
IMGs face some pretty stiff hurdles to getting licensed as physicians in the U.S.–a practice meant to ensure that high quality standards are maintained throughout the U.S. medical profession. Still, there’s substantial concern that IMGs provide an inferior quality of care compared to U.S.-trained physicians. Now, a study by John Norcini and colleagues finds that these concerns aren’t especially founded. The investigators found that the mortality rates of patients treated by non-U.S.-citizen IMGs were actually 16 percent lower than those of U.S.-citizen IMGs and 9 percent lower than U.S.-trained physicians. When the IMGs weren’t broken out by citizen status, there was no statistically significant difference between IMGs and U.S.-trained physicians.
What is one to make of this information? That the regulations faced by IMGs to become physicians in the U.S. are sufficient enough to ensure a high standard of quality, yes. But perhaps also that IMGs who didn’t gain acceptance to a U.S. medical school and ended up getting their training in the islands may be the ones to watch out for. Unfortunately, little data exists to track this particular population of physicians, which could be useful in further distinguishing the good physicians from the not-so-good physicians, because as U.S. medical schools expand enrollment–or as new medical schools are created–these otherwise U.S.-citizen IMGs are the ones who will be filling many of the seats, and knowing more about them seems essential.