ARLINGTON, VA. — International medical graduates have become an integral part of providing medical care in federally designated physician shortage areas.
“Compared to U.S.-trained physicians, IMGs provide more primary care and more [overall] medical care to populations living in primary care shortage areas” as well as to minorities, immigrants, patients in poor areas, and Medicaid recipients, said Esther Hing of the National Center for Health Statistics, in Hyattsville, Md.
Ms. Hing and her colleague Susan Lin, Dr.P.H., studied 2005–2006 data from the National Ambulatory Medical Care Survey, which included information from 2,390 office-based physicians. Ms. Hing presented the survey results at the 2008 Physician Workforce Research Conference.
The survey showed that IMGs make up 25% of office-based physicians. They also tend to be a little older than U.S.-trained doctors, with an average age of 52 years, compared with 50 years for U.S.-trained physicians. The racial and ethnic differences were more pronounced: 71% of U.S. medical graduates were non-Hispanic white, compared with 26% of IMGs. Asian/Pacific Islanders made up 32% of IMGs, compared with 5% of U.S. medical graduates. Hispanic and Latino physicians accounted for 7% of IMGs, compared with 2% of U.S. graduates.
More of the IMGs than U.S. medical graduates were working as primary care physicians—57% vs. 46%—a statistically significant difference, Ms. Hing noted.
IMGs also practiced more often in primary care shortage areas than did U.S.-trained physicians—87% vs. 79%. And IMGs were more likely to accept new patients and to accept Medicaid—nearly one-third of IMGs surveyed derived 20% or more of their incomes from Medicaid, compared with less than one-fourth of U.S.-trained physicians.
“The U.S. health care system continues to rely on IMGs to address shortages in primary care,” Ms. Hing said at the conference, which was sponsored by the Association of American Medical Colleges and Harvard Medical School. “The U.S. health care system faces challenges if the future supply and use of IMGs is constrained by recent changes in visa policy that reduce the number of incoming [medical graduates].”
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