Contribution of International Medical Graduates (IMGs) to U.S. Physician Workforce Diversity

The purpose of this study was to determine the contribution of IMGs to the diversity of our physician workforce. Currently, underrepresented minorities (URMs) represent 28% of the population yet less than 10% of the physician workforce. Past efforts to increase enrollment of URMs in our medical schools have by hindered by legal challenges. Overlooked is the fact the 25% of our physicians as well as those enrolled in our Graduate Medical Education (GME) residency training programs are IMGs Although concordance between provider and patient is not a necessity, studies demonstrate that a workforce that mirrors the racial / ethnic make up of the general population will be more capable of meeting the needs of a diverse population. Data sources: Review of racial/ethnic background of both US Medical graduates (USMGs) and IMGs enrolled in GME residency training programs from 1999 through 2005 AMA Masterfile data. Findings: For the past 6 years US GME training programs have averaged 98,761 physicians in training/ year of which 72,660 (73.6%) were USMGs and 26,101 (26.4%) were IMGs. Approximately 25% of this total complete training each year, enter the workforce and are replaced by almost 25,000 new trainees. The known racial/ethnic background of USMGs and IMGs enrolled in GME programs for the period 1999-2005 is as follows.

Racial group % US Population # / % USMGs # / %IMGs

Blacks 13% 4,214 /5.8% 1,253/4.8% Whites 68% 46,357 /63.8 9,970/38.2 Hispanics 14% 3,633 /5.0 2,279/8.5 Asian/PI 4% 11,976 /16.4 11,571/44.7

IMGs contribute significant diversity to the US physician workforce. The greatest impact is a large increase in the number of Asian/PI physicians in our workforce. POLICY IMPLICATIONS: The importance of URM physicians in the direct provision of care to our nation's underserved populations has been documented. A review of current data from the past 6 years of IMGs entering our workforce suggests a potential new pool to augment our URM workforce. "Medical Migration is a controversial subject, viewed as a “brain drain” in Africa. The issue is different in some Latin America countries which have ample physicians Moreover, the US is home to more than 17 million immigrants from Latin America. Further studies are needed.