Study: Foreign training doesn’t affect care

A Health Affairs study evaluating the relative quality of care provided by international medical graduates practicing in the United States has attracted attention from all quarters and reignited the discussion about medical licensing in this country.

First, a few background statistics pulled from Pauline Chen’s commentary in The New York Times.

  • About 25 percent of all practicing physicians in the U.S. graduated from international schools (Canada is not considered international in this context)
  • 20 percent of those are Americans who studied medicine abroad, usually in the Caribbean
  • 30 percent of the nation’s primary care doctors graduate from international med schools

Chen, again:

… it turns out that contrary to certain individuals’ worst fears, accent or nationality did not affect patient outcomes. Rather, the main factor was being board-certified: completing a full residency at an accredited training program, passing written and, depending on the specialty, oral examinations, and having proof of experience with a defined set of clinical problems and technical procedures.

There was, however, one key difference, and it came in primary care. Patients of foreign-born primary care doctors fared better than patients of American primary care doctors. “The foreign international medical graduates are some of the smartest kids from around the world,” said John J. Norcini, lead author of the study . “When they come over, they tend to fill in where the U.S. medical school graduates don’t necessarily go.”

If you’re looking for further background on the international component of America’s physician workforce, I recommend the AMA’s 2010 profile of international medical graduates. As you can see below, 20 countries taught more than 70 percent of the international medical graduates in the United States.


Remember, free access to Health Affairs is one of many perks enjoyed by AHCJ members.

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