Foreign doctors in the United States (those who graduated from medical schools outside of the U.S.) are formally referred to as International Medical Graduates (“IMGs”). From the time of the U.S. Civil War until World War II, Americans would go abroad for advanced medical education (particularly to France and Germany) and brought back with them new knowledge and skills that improved medicine in the U.S. IMGs have been part of medicine in the U.S. since the late 1940s. IMGs come from 1,078 medical schools located in 135 countries and they speak 130 different languages. Almost three-quarters of IMGs do not return to their native countries after completing their training. The United States is the most welcoming country to IMGs among all of the advanced nations.
There were 12,325 internship positions in the United States in 1958 but only 6,861 graduates of American medical schools. The number of IMGs increased from 2,072 in 1950 to 9,457 by 1959. European and Latin American physicians made up the majority of IMGs in the 1950s and 1960s but the majority of IMGs were from Asia beginning in the 1970s. Data from the last 25 years show that the top five countries with medical school applicants achieving certification were India, Pakistan, Philippines, Grenada, and Dominica.
From the 1940s until 1981, the number of allopathic and osteopathic medical schools in the U.S. rose from 93 to 140 and the number of graduates increased from 7,000 to 16,950. With the recent introduction of “Obamacare” that impacts 37 million more Americans and 15 million more Medicare recipients due to the aging of baby-boomers, the demand for physicians in the U.S. has increased, similar to the expanding demand for physicians that occurred after Medicare was introduced in 1965.
In 2009, the top five states where IMGs worked were New York (35,900), California (27,271), Florida (21,225), Texas (14,642), and Illinois (13,938). Statistics for IMGs for 2011 show that the top five countries of origin for IMGs were India (2,023), Canada (902), Pakistan (511), Lebanon (392), and the Philippines (324). The top five U.S. states for IMGs for 2011 were New York (1,227), Michigan (552), Texas (474), Massachusetts (444), and Illinois (440). The top five medical specialties for IMGs for 2011 were internal medicine (3,603), pediatrics (861), family medicine (622), general surgery (566), and psychiatry (412).
Between 1975 and 2010, the number of IMGs grew by 214.7% (non-IMGs grew by 133.6% during the same period of time). Presently, there are 254,396 (25.8%) IMG physicians out of a total of 985,375 physicians in the United States. 75.5% of IMGs are in patient care (55.1% are office-based and 20.4% are hospital-based), 19.9% of IMGs are in research, 16.7% are in medical teaching, and 12% are in administration. About 30% of IMGs hold full-time salaried positions. 22.3% of IMGs are over age 65; 19% are from 55 to 64; 21.2% are from 45 to 54; 22.8% are from 35 to 44; and, 14.7% are under age 35.
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