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International medical graduates (IMGs) play a vital role in the US health care system. These graduates represent 26% of physicians in practice and 24% of residents in specialty programs. All IMGs go through US medical licensing examination and credentialing verification to receive certification from the Educational Commission for Foreign Medical Graduates to become eligible to enter the US graduate medical education process. Compared with US graduates, IMGs tend to practice in primary care specialties and in underserved and rural areas. The information below summarizes available data regarding IMGs in training and in practice to convey the role IMGs play in the US health care system.

The US physician workforce includes allopathic physicians, osteopathic physicians, and international medical graduates (IMGs), who are grouped based on their medical education. International medical graduates are physicians who received their medical school education outside the United States or Canada. They comprise both US citizens (US IMGs) and citizens of foreign countries (non-US IMGs) who have trained abroad, and they are important segments of the physician population.
 

The number of physicians trained in US medical schools has been lagging behind demand for physicians over the past several decades, and a shortage of 125,000 physicians is predicted by 2025. The demand for physicians has resulted in many US health care institutions turning to international medical graduates (IMGs) to supplement their physician workforce. Today, 1 in 4 physicians practicing in the United States is trained at a foreign medical school; consequently, IMGs play a crucial role in our health care system. Until major steps are taken to expand the existing US medical education and training infrastructure, the United States’ need for overseas medical schools to train physicians is likely to continue. The purpose of this information is to summarize available data regarding IMGs in training and in practice. These data highlight the gap that IMGs fill in the US health care system.

Currently, international medical schools are not required to follow a standardized system of accreditation, though they may already follow local or international guidelines as part of their operation. This setup is likely to change, as the ECFMG has announced that by 2024, students who are seeking ECFMG certification should graduate from a properly accredited medical school. Such an accreditation process should include criteria similar to those used by the Liaison Committee on Medical Education in the United States or criteria accepted by the World Federation for Medical Education.
 

Today’s results show 17 consecutive years of growth in the number of first-year residency positions offered through the Match. In the 2019 Match, 32,194 first-year positions were offered, an increase of 1,962 (6.5%) compared to 2018 and a cumulative increase of more than 11,500 positions since 2002. As noted by the NRMP, this year’s increase in positions is due, in part, to the increased number of osteopathic programs that joined the Match as a result of the ongoing transition to a single accreditation system for U.S. graduate medical education (GME) programs.  

These graduates come from 1089 medical schools located in 143 countries or territories. English is one of the languages of instruction in approximately 59% of these medical schools. Of this group, 30.8% were US IMGs. According to the ECFMG annual report, 13.3% of certified IMGs are from medical schools in India, 9.3% from Grenada, 8.5% from Dominica, 5.9% from Pakistan, and 3.8% from St Maarten. The top 5 countries of citizenship of these graduates were the United States, India, Canada, Pakistan, and Nigeria. The majority of US IMGs receive medical education in Caribbean medical schools. Of the 2963 US IMGs who received certificates, the most common medical schools were in Dominica (674), Grenada (634), St Maarten (294), Antigua and Barbuda (283), and Saint Kitts and Nevis (132). More than half of US IMGs attended 1 of 4 institutions: Ross University in Dominica (5060 [17.8%]), St. George’s University in Grenada (4719 [16.6%]), Universidad Autonoma de Guadalajara in Mexico (2375 [8.3%]), and the American University of the Caribbean School of Medicine in Netherlands Antilles (2271 [8.0%]).

International medical graduates currently represent a quarter of the physician workforce and physicians in training. They have long been an integral part of the US health care system, contributing substantially to primary care disciplines and providing care in underserved populations. As the US health care system continues to evolve, leaders must recognize the important role that IMGs fill.

MMG intends to lead the way in establishing a world-class medical education company built specifically to serve the IMG market. Our core purpose is grounded in the unyielding belief that success is about how many lives you will improve. Since 2009, MMG has methodically developed its various experiential learning and guidance programs including USMLE training and review in print, online and live workshops, expanding it’s clinical training vision (HUBs) plus housing and other integrated offerings to provide international medical students and graduates with direct access to the highest-rated hands-on US clinical experiences and other academic-related services designed to prepare and assist IMGs in becoming practicing physicians in the US medical system.