International Medical Graduates in Academic Cardiothoracic Surgery

To assess the research productivity, career advancement, grant funding, and scholarly impact of international medical graduates (IMGs) in academic cardiothoracic (CT) surgery.

Physician shortages undermine patient care and risk exacerbating inequities, especially in CT surgery, which may lose a quarter of its workforce by 2050-the most substantial reduction in surgery. IMGs could help alleviate these shortages, but there is limited data about their academic experiences.

All CT surgeons (n = 1065) at accredited U.S. CT surgery training centers in 2020 were included. IMGs were defined as surgeons who completed medical school outside the United States and Canada, per the Association of American Medical Colleges. Educational and professional backgrounds were recorded from publicly available sources.

Of academic CT surgeons, 24.0% were IMGs. These surgeons started as attendings in later years (2012 vs 2005, P < 0.001) than non-IMGs. In unadjusted analyses, IMGs had lower publication counts and H-index, as well as lower likelihood of R01 funding and full professor attainment. Matching by attending start year, propensity score analysis created 2 groups of 254 surgeons: both IMGs and non-IMGs had similar publication counts (45.0 vs 45.0, P = 0.98), H-index (10.5 vs 11.0, P = 0.61), R01 funding rates (4.3% vs 5.1%, P = 0.83), and full professor attainment (24.8% vs 20.5%, P = 0.45).

IMGs represent a more junior cohort of surgeons but contribute significantly to the CT surgery workforce, with comparable academic success. Policy efforts to streamline IMGs' path toward U.S. practice could help alleviate surgical shortages while enhancing diversity and strengthening academia.