Racial and Ethnic International Medical Graduates in the US

Purpose: Currently 24% of US patient care physician workforce are International Medical Graduates (IMG). However, little is known about the characteristics of IMGs with racial and ethnic minority background. This study describes the race and ethnicity status of racial and ethnic IMGs.

Data and Method: 2013 AMA physician masterfile and AAMC Minority Physician Database are used to assess the specialty distribution and race/ethnicity status of IMGs. The study cohort is limited to direct patient care physicians who graduated from residency programs between 1980 and 2010. Chi square statistics or ANOVA used where appropriate.

Results: 22.7% of the cohort are IMGs. 46% of IMGs are practicing primary care compared to 34% of non-IMG physicians (p < 0.0001). There are 10,588 IMGs identified as Asian, 1,423 as Black, 78 as Native American, 3,164 as Hispanic, and 14,732 as White. 67% of Asian IMGs and 68% of Black, American Native, and Hispanic IMGs specialize in primary care compared to 49% of White IMGs (p<0.0001). Black, American Native, and Hispanic IMGs as a group has significantly higher proportion practicing in a Primary Care Health Professional Shortage Areas (33.1%) or Medically Underserved Areas/Populations (45.8%) than any other groups.

Conclusions: IMGs with known racial ethnic minority background are more likely to practice primary care and serve in medically underserved areas. Increasing physician workforce diversity could help mitigate maldistribution both by specialty and by geography. Much work is still needed to ascertain the race and ethnicity of IMG physicians in the nation.