International supply to the US physician workforce: Historical trends and characteristics

摘要: Introduction Recent analyses predict an impending physician shortage in the US. Policy makers are considering tapping from the pool of international medical graduates (IMGs) to address this crisis. The objective of this study is to describe the historical trends of the number of IMGs in the US and to compare their characteristics to those of US Medical Graduates (USMGs). Methods We derived the historical trends from the 1978-2004 historical files of the American Medical Association Physicians' Professional Data (AMA-PPD). We then compared the characteristics of a random sample of 1000 USMGs and 1000 IMGs using the 2004 AMA-PPD. Compared characteristics included: board certification, practice specialty, practice type, practice location, and primary employer. Results Over the last quarter century, the number of IMGs in the US grew by 4873 per year reaching a total of 215, 576 in 2004, about 2.4 times its size in 1978. Their proportion increased yearly by 0.12 reaching a 2004 level of 25.57%. The two subgroups of residents IMGs and practicing physicians IMGs experienced similar increases. In 2004, compared with USMGs, IMGs were older, less likely to be board certified, less likely to work in group practice or in a medical school, more likely to have Internal Medicine as practice specialty and more likely to be residents. Conclusion The US physician workforce increasingly consists of IMGs whose characteristics differ from those of USMGs. US policy makers should consider the sustainability of this trend, its effects on source countries and its implications for the US physician workforce.