The internal medicine workforce, international medical graduates, and medical school departments of medicine

ABSTRACT Background Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990–2015, the slope was estimated using simple linear regression. Results IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. Conclusions IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

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Performance of U.S. and International Medical Graduates on the 1995 Internal Medicine In-Training Examination

Annals of Internal Medicine ◽

10.7326/0003-4819-125-2-199607150-00033 ◽

1996 ◽

Vol 125 (2) ◽

pp. 158 ◽

Cited By ~ 4

Author(s):

Herbert S. Waxman

Keyword(s):

Internal Medicine ◽

International Medical ◽

International Medical Graduates ◽

Medical Graduates

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Similarities and Differences Between International Medical Graduates and U.S. Medical Graduates at Six Maryland Community-Based Internal Medicine Residency Training Programs

Academic Medicine ◽

10.1097/acm.0b013e318197321b ◽

2009 ◽

Vol 84 (3) ◽

pp. 385-390 ◽

Cited By ~ 19

Author(s):

Aysegul Gozu ◽

David E. Kern ◽

Scott M. Wright

Keyword(s):

Internal Medicine ◽

Residency Training ◽

Training Programs ◽

International Medical ◽

Internal Medicine Residency ◽

International Medical Graduates ◽

Community Based ◽

Medical Graduates ◽

Internal Medicine Residency Training ◽

Similarities And Differences

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Comparison between Mexican and International Medical Graduates’ scores in the ENARM Competing for Clinical Specialities in Mexico during 2012-2019: Data Visualization, Trends and Forecasting Analyses

International Journal of Statistics in Medical Research ◽

10.6000/1929-6029.2021.10.05 ◽

2021 ◽

Vol 10 ◽

pp. 46-62

Author(s):

Alexela-Nerey Mendoza-Aguilar ◽

◽

Aime Cedillo-Pozo ◽

Ernesto Roldan-Valadez

Keyword(s):

Internal Medicine ◽

High Performance ◽

Performance Test ◽

Medical Genetics ◽

International Medical ◽

International Medical Graduates ◽

Cross Sectional ◽

Medical Graduates ◽

Significant Difference ◽

Global Mean

Objectives: Because there is heterogeneity in the ENARM scores obtained between Mexicans and International medical graduates (IMG) in the eight clinical specialities with direct-entry (Anesthesiology, and Emergency Medicine. Geriatrics, Internal Medicine, Medical Genetics, Pediatrics, Pneumology, Psychiatry), we aimed to evaluate those scores. We hypothesized that Mexican test-takers achieve higher scores than IMG with significant growth trends in their exam scores. Methods: This study was cross-sectional, used historical data from the annual public report of the ENARM for eight years (2012 to 2019). We compare the minimum (MinSco) and maximum (MaxSco) scores of each speciality using ANOVA. Mexican versus IMG scores were evaluated with an independent student t-test, trends with Spearman’s correlation coefficient, and a 5-years forecasting trend. Results: There was a significant difference among the MinSco for five surgical specialities; F (7, 115) = 26.611, p = < .001; the global mean of MinSco was 69.133; specialities above this mean were Internal Medicine, Anesthesiology, Pediatrics, and Pneumology. The global mean for MaxSco was 79.422; five specialities were above: Internal Medicine, Pneumology, Geriatrics, Psychiatry, and Medical Genetics. We did not find a significant difference in the MinSco between Mexicans and IMG, but a significant difference was found in the MaxSco between both groups. Conclusions: ENARM represents a market of high-performance test-takers across the clinical specialities. Mexicans and IMG achieved similar entrance scores, but Mexicans showed a higher MaxSco over IMG in all clinical specialities.

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Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

Journal of Graduate Medical Education ◽

10.4300/jgme-d-10-00105.1 ◽

2010 ◽

Vol 2 (4) ◽

pp. 616-623 ◽

Cited By ~ 3

Author(s):

Lauren M. Byrne ◽

Kathleen D. Holt ◽

Thomas Richter ◽

Rebecca S. Miller ◽

Thomas J. Nasca

Keyword(s):

Medical Education ◽

Medical School ◽

Graduate Medical Education ◽

Clinical Education ◽

The United States ◽

International Medical ◽

International Medical Graduates ◽

Graduate Medical ◽

Medical Graduates ◽

Longitudinal Tracking

Abstract Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.

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