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International Medical Graduates (IMGs)
Publications
Alphabetical list. You can also view by publication date.
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2005 Physician Supply and Distribution in Rural Areas of the United States (Full Report)
Author(s): Meredith A. Fordyce, Frederick M. Chen, Mark P. Doescher, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Physicians,
Workforce
Date: 11 / 2007
This study describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates) with particular emphasis on generalists in rural areas. Results indicate variability in the rural-urban distribution of physicians, with generalist physicians playing prominent roles in rural areas.
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2005 Physician Supply and Distribution in Rural Areas of the United States (Project Summary)
Author(s): Meredith A. Fordyce, Frederick M. Chen, Mark P. Doescher, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Physicians,
Workforce
Date: 11 / 2007
This study describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates) with particular emphasis on generalists in rural areas. Results indicate variability in the rural-urban distribution of physicians, with generalist physicians playing prominent roles in rural areas.
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Changing Geography of Americans Graduating from Foreign Medical Schools
Author(s): Karin E. Johnson, Amy Hagopian, Catherine Veninga, Meredith A. Fordyce, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Working Paper No. 96
Date: 03 / 2005
While only 4 percent of U.S. physicians known to have been born in the United States attended medical school in foreign countries, these physicians represent at least 11 percent of the physicians known as international medical graduates (IMGs). Americans continue to pursue medical education abroad. The majority of United States-born IMGs (USIMGs) trained in just a dozen countries and at just two-dozen medical schools. Several foreign medical schools have contributed more graduates to the current practice pool than U.S. medical schools. Currently practicing older USIMGs were most likely to have attended medical school in Europe and Mexico, while more recent USIMGs are most likely to have attended medical school in Mexico and the Caribbean. U.S.-born students comprise a large percentage of the total IMGs from those countries. Offshore medical schools continue to train large numbers of Americans, but in smaller numbers than in the 1980s. Schools in European countries are less prominent and relatively new schools in Caribbean countries have become more popular.
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Changing Geography of Americans Graduating from Foreign Medical Schools
Author(s): Karin Johnson, Amy Hagopian, Catherine Veninga, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Workforce
Citation: Academic Medicine, 81(2), 179-184
Date: 02 / 2006
Reports the results of a study of U.S.-born international medical graduates, analyzing changes in their numbers and countries of training from the 1960s and before until the early 2000s.
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Do International Medical Graduates "Fill the Gap" in Rural Primary Care in the United States?
Author(s): Matthew J. Thompson, Amy Hagopian, Meredith A. Fordyce, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Working Paper No. 106
Date: 2006
Compares the practice locations of international medical graduates (IMGs) and U.S. medical graduates (USMGs) in primary care specialties. Report available upon request by contacting rhrc@fammed.washington.edu.
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Effects of the 1997 Balanced Budget Act on Family Practice Residency Training Programs
Author(s): Ronald Schneeweiss, Roger A. Rosenblatt, Susan Dovey, L. Gary Hart, Frederick M. Chen, Susan Casey, George E. Fryer Jr
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Physicians,
Workforce
Citation: Fam Med 2003;35(2):93-9
Date: 2003
Background and Objectives: This study assessed the impact of the Balanced Budget Act (BBA) of 1997 on family practice residency training programs in the United States.
Methods: We surveyed 453 active family practice residency programs, asking about program closures and new program starts (including rural training tracks), changes in the number of residents and faculty, and curriculum changes. Programs were classified according to their urban or rural location, university or community hospital setting, and rural and/or urban underserved mission emphasis.
Results: A total of 435 (96%) of the programs responded. Overall, the impact of the BBA was relatively small. In 1998 and 1999, nationwide, there were 11 program closures, a net decrease of only 82 residents, and a net increase of 52 faculty across program settings and mission emphasis. The rate of family practice residency program closures increased from an average of 3.0 per year between 1988–1997 to 4.8 per year in the 4 years following passage of the BBA.
Conclusions: The 1997 BBA did not have an immediate significant negative impact on family practice residency programs. However, there is a worrisome increase in the rate of family practice residency closures since 1997. A mechanism needs to be established to monitor all primary care program closures to give an early warning should this trend continue.
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Flight of Physicians From West Africa: Views of African Physicians and Implications for Policy
Author(s): Amy Hagopian, Anthony Ofosub, Adesegun Fatusic, Richard Biritwumd, Ama Essele, L. Gary Hart, Carolyn Watts
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Physicians
Citation: Social Science and Medicine, 61, 1750-1760
Date: 2005
West African-trained physicians have been migrating from the sub-continent to rich countries, primarily the US and the UK, since medical education began in Nigeria and Ghana in the 1960s. In 2003, we visited six medical schools in West Africa to investigate the magnitude, causes and consequences of the migration. We conducted interviews and focus groups with faculty, administrators (deans and provosts), students and post-graduate residents in six medical schools in Ghana and Nigeria. In addition to the migration push and pull factors documented in previous literature, we learned that there is now a well-developed culture of medical migration. This culture is firmly rooted, and does not simply fail to discourage medical migration but actually encourages it. Medical school faculty are role models for the benefits of migration (and subsequent return), and they are proud of their students who successfully emigrate.
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Health Departments' Use of International Medical Graduates in Physician Shortage Areas
Author(s): Amy Hagopian, Matthew J. Thompson, Emily Kaltenbach, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
J-1 Visa Waiver,
Workforce
Citation: Health Affairs, 22(5), 241-249
Date: 2003
Describes results of a survey of program administrators of the Conrad State 20 Program, which places international medical graduates (IMGs) on J-1 visas in health professional shortage areas (HPSAs). Problems reported include unfair working conditions and compensation for physicians. Federal
immigration agencies were reported to be unresponsive and difficult. Employers seem to be more satisfied than physicians with the program.
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How International Medical Graduates Enter U.S. Graduate Medical Education or Employment
Author(s): Karin E. Johnson, Emily Kaltenbach, Kenneth Hoogstra, Matthew J. Thompson, Amy Hagopian, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
J-1 Visa Waiver,
Workforce
Report Number: Working Paper No. 76
Date: 2003
Provides an overview of the steps that must occur for an international medical graduate (IMG) to come to the United States to practice medicine. Describes how long and by what means IMGs holding temporary visas can remain in the United States, with detailed coverage of the State 30/Conrad J-1 visa waiver program.
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If Fewer International Medical Graduates are Allowed in the U.S., Who Might Replace Them in Rural Underserved Areas?
Author(s): Leonard D. Baer, Thomas R. Konrad, Rebecca T. Slifkin
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Findings Brief
Date: 05 / 2001
Describes a study to identify rural communities that would be most affected by a decrease in availability of international medical graduates (IMGs) and perceptions of recruiters on who might replace IMGs in these areas. Includes maps. A full report is also available.
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If Fewer International Medical Graduates Were Allowed in the U.S., Who Might Replace Them in Rural Areas?
Author(s): Leonard D. Baer, Thomas R. Konrad, Rebecca T. Slifkin
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Working Paper No. 71
Date: 02 / 2001
Identifies rural communities that would be most affected should restrictions on IMG entry into the United States be tightened, and reports on the perceptions of physician recruiters and health planners about who might replace IMGs currently working in such areas. Findings indicate that given the difficulty of expanding ongoing recruitment and retention efforts, many underserved rural areas would likely remain underserved in the event of a cutback in IMGs, and many rural areas that are currently adequately served could face serious problems as well. A single national solution to replace IMGs would be difficult. Recruiters and planners within states and local areas will need to expand creative and innovative approaches, and even then, many rural communities might have to make do with less.
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International Medical Graduate (IMG) Physicians in the U.S.: Changes Since 1981
Author(s): L. Gary Hart, Susan M. Skillman, A. Hagopian, M. Fordyce, M. Thompson, R. Konrad
Topic:
International Medical Graduates (IMGs)
Citation: In National Health Workforce Assessment of the Past and Agenda for the Future: Proceedings of an International Symposium. Paris: Centre de Sociologie et de Demographie Medicales
Date: 2006
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International Medical Graduate Physicians in the U.S.: Changes Since 1981
Author(s): L. Gary Hart, Susan M. Skillman, Amy Hagopian, Meredith A. Fordyce, Matthew J. Thompson, Thomas R. Konrad
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Working Paper No. 102
Date: 03 / 2005
The U.S. relies on international medical graduates (IMGs) to provide a significant portion of the country's health care, including generalist care and service to underserved populations. Understanding the trends in IMG migration and practice is important for determining how best to train an adequate supply of physicians with appropriate skills for the U.S. Key findings show that since 1981, India, the Philippines, Mexico and the Republic of Korea have remained leading countries in which IMGs in the U.S. attended medical school, and most IMGs are located in 10 U.S. states. Relatively fewer IMGs are now working in hospitals than 20 years ago. Currently IMGs are only a little more likely to be generalists than U.S. medical school graduates (USMGs).IMGs have remained less likely than USMGs to practice in rural areas, but among rural physicians, a greater proportion of IMGs practice in Health Professional Shortage Areas than of USMGs.
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International Medical Graduates in the United States: A Review of the Literature 1995 to 2003
Author(s): Amy Hagopian, Matthew J. Thompson, Karin E. Johnson, Denise M. Lishner
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Workforce
Report Number: Working Paper No. 83
Date: 10 / 2003
Synthesizes the literature addressing International Medical Graduates (IMGs) from 1995 to 2003, with sections addressing the overall U.S. supply of physicians, IMG demographics and characteristics, the IMG pipeline, Graduate medical education, the role of IMGs in the U.S. health care safety net, IMG quality, and legal issues.
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Migration of Physicians From Sub-Saharan Africa to the United States of America: Measures of the African Brain Drain
Author(s): Amy Hagopian, Matthew J Thompson, Meredith Fordyce, Karin E Johnson, L Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
International Medical Graduates (IMGs),
Physicians
Citation: Human Resources for Health, 2(1):17
Date: 2004
The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.
Methods: We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA.
Results: More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools.
Conclusions: Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
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Role of International Medical Graduates in America's Small Rural Critical Access Hospitals
Author(s): Amy Hagopian, Matthew J. Thompson, Emily Kaltenbach, L. Gary Hart
Research center:
WWAMI Rural Health Research Center
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
International Medical Graduates (IMGs),
Workforce
Citation: Journal of Rural Health, 20(1), 52-58
Date: 2004
Descriptive report presenting the roles and characteristics of foreign-born international medical graduates (IMGs) in Critical Access Hospital (CAH) facilities and the opinions of the CEOs about these practitioners.
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