International medical graduates (IMGs) make up roughly one quarter of the U.S. physician supply and residency training positions. Commentary related to IMGs tends to project a continuing rise in supply over time. This study wanted to challenge these perceptions by disaggregating IMGs by immigration and citizenship status to carefully examine their numerical levels and choices in training specialty and location during a 10-year period. The results demonstrate a shrinking IMG population overall for the state of New York, with noncitizen IMGs shrinking the most markedly. This may bear heavily on New York's physician supply and distribution, particularly for underserved locales. The authors find evidence consistent with some degree of substitution in favor of native-born and naturalized IMGs versus noncitizen IMGs.
Akl, E.A., Mustafa, R., Bdair, F., & Schunemann, H.J. (2007). The United States Physician Workforce and International Medical Graduates: Trends and Characteristics . Journal of General Internal Medicine, 22, 264-268.
2.
Armstrong, D.P., & Forte, G.J. (2006). Annual New York physician workforce profile, 2006 edition. Rensselaer, NY: Center for Health Workforce Studies, School of Public Health, SUNY Albany.
3.
Aronson, R.D. (2000). National interest waiver eligibility for international medical graduates. Journal of the American Medical Association , 283, 1747.
4.
Baer, L.D., Ricketts, T.C., Konrad, T.R., & Mick, S.S. (1998). Do international medical graduates reduce rural physician shortages? Medical Care, 36, 1534-1544.
5.
Boulet, J.R., Swanson, D.B., Cooper, R.A., Norcini, J.J., & McKinley, D.W. (2006). A comparison of the characteristics and examination performances of U.S. and non-U.S. citizen international medical graduates who sought Educational Commission for Foreign Medical Graduates certification: 1995-2004. Academic Medicine, 81, S116-S119.
6.
Calman, N.S., Hauser, D., Forte, G., & Continelli, T. (2006). New York State physicians: Characteristics and distribution in health professional shortage areas. Journal of Urban Health, 84, 307-309.
7.
Ester, K.A. (2004). CRS Report for Congress. Immigration: Foreign physicians and the J-1 visa waiver program. Retrieved April 25, 2008, from http://www.immigration-lawyer-us.com/images/j-current-state.pdf
8.
Hagopian, A. (2007). Recruiting primary care physicians from abroad: Is poaching from low-income countries morally defensible? Annals of Family Medicine, 5, 483-485.
9.
Hallock, J.A., & Kostis, J.B. (2006). Celebrating 50 years of experience: An ECFMG perspective . Academic Medicine, 81, S7-S16.
10.
Hallock, J.A., Seeling, S.S., & Norcini, J.J. (2003). The international medical graduate pipeline. Health Affairs, 22, 94-96.
11.
Hart, L.G., Skillman, S.M., Fordyce, M., Thompson, M., Hagopian, A., & Konrad, T.R. (2007). International medical graduate physicians in the United States: Change since 1981. Health Affairs, 26, 1159-1169.
12.
Hussey, P.S. (2007). International migration patterns of physicians to the United States: A cross-sectional panel analysis. Health Policy, 84, 298-307.
13.
Iglehart, J.K. (2008). Medicare, graduate medical education, and new policy directions. New England Journal of Medicine, 359, 643-650.
14.
Johnson, K., Hagopian, A., Veninga, C., & Hart, G.L. (2006). The changing geography of Americans graduating from foreign medical schools. Academic Medicine, 81, 179-184.
15.
Leon, L.R., Jr., Ojeda, H., Mills, J.I., Sr., Leon, C.R., Psalms, S.B., & Villar, H.V. (2008). The journey of a foreign-trained physician to a United States residency: Controversies surrounding the impact of this migration to the United States. Journal of the American College of Surgeons , 206, 171-176.
16.
Mick, S.S., Lee, S.-Y.D., & Wodchis, W. (2000). Variations in geographical distribution of international medical graduates and U.S. medical graduates: "Safety nets" or "surplus exacerbation ? Social Science & Medicine, 50, 185-202.
17.
Mills, E.J. (2008). Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime? Lancet, 371, 685-688.
18.
Norcini, J.J., McKinley, D.W., Boulet, J.R., & Anderson, M.B. (2006). Educational Commission for Foreign Medical Graduates certification and Specialty Board certification among graduates of the Caribbean medical schools. Academic Medicine, 81(Suppl.), 112-115.
19.
Phillips, R.L., Fryer, G.E., Chen, F.M., Morgan, S.E., Green, L.A., Valente, E., et al. (2004). The Balanced Budget Act of 1997 and the financial health of teaching hospitals. Annals of Family Medicine , 2, 71-78.
20.
Salsberg, E., & Grover, A. (2006). Physicians workforce shortages: Implications and issues for academic health centers and policymakers. Academic Medicine, 81, 782-787.
21.
Salsberg, E., & Nolan, J. (2000). The post-training plans of international medical graduates and US medical graduates in New York State. Journal of the American Medical Association, 283, 1749-1750.
22.
Salsberg, E., Rockey, P.H., Rivers, K.L., Brotherton, S.E., & Jackson, G.R. (2008). US residency training before and after the 1997 Balanced Budget Act. Journal of the American Medical Association , 300, 1174-1180.
23.
Starfield, B., & Fryer, G.E., Jr. (2007). The primary care workforce: Ethical and policy implications. Annals of Family Medicine , 5, 486-491.
24.
Syed, N.A., Khimani, F., Andrades, M., Ali, S.K., & Paul, R. (2008). Reasons for migration among medical students from Karachi. Medical Education, 42, 61-68.
25.
Whelan, G.P., Gary, N.E., Kostis, J., Boulet, J.R., & Hallock, J.A. (2002). The changing pool of international medical graduates seeking certification training in US medical education programs. Journal of the American Medical Association, 288, 1079-1084.
