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Where Do International Medical Graduates Matriculate for Internal Medicine Training? A National Longitudinal Study
Shalini T Reddy1,2, Michael Kisielewski3, Lisa L Willett4
1Internal Medicine Residency, Cook County Health and Hospitals System, 1950 W. Polk St. 6302, Chicago, IL, 60612, USA. shalini.reddy@cookcountyhhs.org.
Journal of General Internal Medicine
|February 12, 2021
Summary
International medical graduates (IMGs) fill a significant portion of internal medicine residency positions, with community programs recruiting them at higher rates than university programs. This trend highlights disparities in IMG recruitment within US residency training.
Area of Science:
- Medical Education
- Residency Training
- Graduate Medical Education
Background:
- International medical graduates (IMGs) constitute a substantial portion of applicants matching into US internal medicine (IM) residencies.
- Understanding trends and program perceptions regarding IMG recruitment is crucial for addressing workforce needs and potential disparities.
Purpose of the Study:
- To analyze 12-year trends in the distribution of IMGs across internal medicine training programs.
- To explore differences in program directors' perceptions and recruitment practices concerning IMGs.
Main Methods:
- Utilized data from the Association of Program Directors in Internal Medicine Annual Surveys from 2007-2019.
- Included a 2017 survey with 16 additional questions on program perceptions of IMG recruitment.
Main Results:
- Community programs consistently recruited higher percentages of IMGs for PGY1 positions (55-70%) compared to university programs (22-30%) over 12 years.
- In 2017, community programs allocated significantly more interview and ranking positions to IMGs (45%) than university programs (15%).
- Departmental pressure, institutional priority, and reputational concerns were cited as key factors influencing IMG recruitment, with university programs reporting higher influence.
Conclusions:
- Significant and longstanding disparities exist in the recruitment of IMGs between US community-based and university residency programs.
- These differences are evident early in the recruitment process, including interview and ranking stages.
- Further research is needed to investigate the pressures, preferences, and potential biases influencing IMG recruitment.
