International medical graduates make up a quarter of the physician workforce in the United States, United Kingdom, Canada, and Australia. It is unfortunate that being a graduate from an international medical school has become tagged with an arduous process to ever practicing medicine in the United States. But this shouldn’t be the case. Some of the most hardworking physicians I admire graduated from foreign schools. There are studies to show that the quality of care offered by IMG’s isn’t inferior to that offered by US graduates. But the stigma continues to exist. It is up to us IMG’s to begin to speak up and prove out worth in the healthcare market. We cannot practice without residency training here in the US which by default puts us in the same playing field as our respected US graduate counterparts.
Every IMG will become very familiar with the ECFMG at some point prior to residency training. They serve as the governing body that bridges the gap between the medical schools outside of the US and the US medical system. They are primarily responsible for verification of medical education and the subsequent credentialing process for US medical licensure.
I retrieved this scorecard (see image) from the ECFMG website, and my conclusion following historical data is that though it appears that approximately 1 out of every 2 IMG’s eventually matches into residency, there is evidence that the percentage of IMG’s matching is steadily increasing each year. Evidenced by the noted increase from 52% to 57% between 2016 and 2018.
Despite the statistics, the first step to not getting a spot for yourself is defining your future based solely on the past. To move that bar upward into 70% match rates, I believe IMGs ought to begin to be aggressive and optimistic in the search process. I understand that due to the stigma around the idea of being from a foreign medical school, most IMG’s cave in under fear and an inferiority complex. Instead, I urge applicants to seek out opportunities to shine. Be persistent like you will be for any other position. Do not het sucked into statistics and rumors. You are the common denominator in your story and you can redefine it however you please.There are several programs thats focus on the “whole applicant”, which offer individual IMG’s an advantage. I also encourage foreign graduates seeking US residency positions to focus on individual abilities instead of labels. I remain of the optimistic opinion that we become who we chose to be and thus in staring the “IMG Roadmap” series, I am assured that many other IMGs will learn from the examples of those portrayed here.
In a world of negative press, here are some positives about IMG’s:
- IMGs are equally QUALIFIED. Most IMG’s were highly skilled physicians who by migrating to the US have likely caused a brain drain in their respective countries of origin. For the proportion is US citizens who go to offshore medical schools, only those who pass the same board exams in a competitive manner tend to match into US residency programs on first attempt. In 2016 an observational study was published in the British Medical Journal that blew our minds. Findings of the study showed that among data on older Medicare patients admitted to hospitals in the US, patients treated by IMG Hospitalists had lower mortality than patients cared for by US graduates. Now, this does not mean US graduates do not take good care of their patients and should not be interpreted as such. It simply shows that IMG’s do not offer substandard care and as such do not pose a threat to the quality of care delivery in the US healthcare system, contrary to some limited beliefs.
- IMGs are exceedingly resilient. There is an association between intellectual interest and resilience. In my observation of most IMG doctors, repeated rejection and strife has helped them build the mental fortitude necessary to withstand even the most unpleasant working conditions. This is evidenced by the increasing proportions of IMG’s who work among the medically underserved populations. I work with several IMG’s at the moment and they are typically the most openminded group of physicians to work with.
- IMG’s fill in the gap in the physician workforce particularly in underserved areas. According to a study on the role of IMG’s in providing office-based care. Findings showed that in 2005–2006, about one-quarter (24.6%) of all visits to office-based physicians were to international medical graduates. Hispanic or Latino and Asian or Pacific Islander patients made more visits to IMG’s(24.9%) than to U.S. medical graduates (12.4%). IMG’s also saw a higher percentage of visits made by patients expecting to use Medicaid or State Children’s Health Insurance Program (SCHIP) as their primary payment source (17.6 %) compared with U.S. medical graduates (10.2 %). By inference, we are valuable to the economy and making an impactful difference for American healthcare.
- IMG’s improve workplace diversity. According to a study published by JAMA Internal Medicine, a diverse workforce has positive implications for patient care and “may be key in addressing health disparities”.
Are you an IMG with additional points to offer? Tell us below …