U.S. Must Enact Measures To Support The Role Of International Medical Graduates In U.S. Health Care Delivery Says American College Of Physicians

Main Category: Medical Students / Training
Also Included In: Public Health
Article Date: 16 Sep 2008 - 3:00 PDT

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In a new paper, released yesterday, the American College of Physicians (ACP) says that because of the important place that international medical graduates (IMGs) have and will continue to have in the internal medicine workforce, the U.S. needs to enact measures that would support their role. The Role of International Medical Graduates in the U.S. Physician Workforce outlines recommendations that ACP feels would support that role.

IMGs are physicians who have received their medical education outside of the U.S and come to complete their residency or fellowship in the United States. Upon completion of training, IMGs are required return to their home countries for a two-year period unless they qualify for a waiver, typically by agreeing to work in a health professions shortage area. According to ACPs paper, the United States has depended on IMGs to fill gaps in care in underserved areas since the 1970s, and will probably continue to do so for some time.

The College has long recognized the value of IMGs in the U.S. health care system, said Jeffery P. Harris, MD, FACP, president of ACP. They are crucial to our continuing to be able to provide adequate care to the populations they serve.

IMGs are an important source of primary care physicians in rural and underserved areas. In a paper released by the University of North Carolina, it was estimated that if all IMGs in primary care practice were removed that "one out of every five 'adequately served' non-metropolitan counties would become underserved and the percentage of rural counties with physician shortages would rise to 44.4%." The College strongly supports opportunities for IMGs to train in the United States and supports streamlining the process for those who would like to remain in the U.S. to practice, as long as there are opportunities here.

Because of their contributions to U.S. heath care system, ACP recognizes the importance of IMGs to the U.S. To this end the College released as part of their paper seven recommendations to improve conditions for physicians seeking to train and practice in the U.S. The College:

- opposes measures that would prevent qualified IMGs from emigrating to the U.S.;
- supports streamlining the process for IMGs to obtain J-1 and H-1B visas;
- supports a permanent expansion of J-1 visa waiver programs to help alleviate physician shortages in underserved areas;
- supports exempting physicians trained in specialties facing a shortage from the annual H-1B visa cap;
- supports classifying physicians trained in internal medicine and other specialties facing a shortage as Schedule A under the Department of Labor, indicating there is an insufficient number of U.S. workers for that occupation;
- encourage collaborations between the U.S. and less-developed countries to improve medical education and training in those countries; and,
- supports the development of a Global Health Corps to provide opportunities for U.S. physicians and providers to serve in less-developed countries.

While ACP strongly advocates for policies to support the role of IMGs in meeting the U.S. health care needs, the College also advocates for policies that would increase the number of U.S. trained physicians in primary care. The College also cautions that IMGs should not be viewed as the solution to physician workforce shortages.

As noted in our paper, with an increasingly diverse population in the U.S., the physician population must also increase in diversity in order to provide culturally competent care, concluded Dr. Harris. This is only one piece of the vital role IMGs play in providing care to our underserved populations.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 126,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

American College of Physicians