Supply, distribution and characteristics of international medical graduates in family medicine in the United States: a cross-sectional study

BackgroundTo describe the supply, distribution, and characteristics of international medical graduates (IMGs) in family medicine who provide patient care in the U.S.MethodsA cross-sectional study design, using descriptive statistics on combined data from the Educational Commission for Foreign Medical Graduates and the American Medical Association, including medical school attended, country of medical school, and citizenship when entering medical school.ResultsIn total, 118,817 physicians in family medicine were identified, with IMGs representing 23.8% (n=28,227) of the U.S. patient care workforce. Of all 9579 residents in family medicine, 36.0% (n=3452) are IMGS. In total, 35.9% of IMGs attended medical school in the Caribbean (n=10,136); 19.9% in South-Central Asia (n=5607) and 9.1% in South-Eastern Asia (n=2565). The most common countries of medical school training were Dominica, Mexico, and Sint Maarten. Of all IMGs in family medicine who attended medical school in the Caribbean, 74.5% were U.S. citizens. In total, 40.5% of all IMGs in family medicine held U.S. citizenship at entry to medical school. IMGs comprise almost 40% of the family medicine workforce in Florida, New Jersey and New York.ConclusionsIMGs play an important role in the U.S. family medicine workforce. Many IMGs are U.S. citizens who studied abroad and then returned to the U.S. for graduate training. Given the shortage of family physicians, and the large number of IMGs in graduate training programs, IMGs will continue to play a role in the U.S. physician workforce for some time to come. Many factors, including the supply of residency training positions, could eventually restrict the number of IMGs entering the U.S., including those contributing to family practice.