From Residency to Practice: Overcoming Employment Obstacles for Non-US Citizen Pathologists in the United States

Non-US citizen international medical graduates (IMGs) represent a significant minority of individuals filling pathology positions in the Main Residency Match and actively practicing as pathologists. Prior surveys have not allowed definitive conclusions about how the citizenship status impacts pathology job search experiences.

To improve understanding of the possible barriers to non-US citizen IMGs entering the US job market.

The College of American Pathologists Graduate Medical Education Committee developed a survey to understand the impact of US versus non-US medical graduates and citizenship status on the job search experience. Pathologists who graduated from US pathology residency and/or fellowship training programs who have been in practice for 10 years or less were targeted. Multiple distribution channels were used.

Survey responses were received from 413 individuals. Significantly fewer non-US IMGs found their first non-fellowship position in the United States and many reported greater difficulty finding a position, with a longer job search. Non-US IMGs more frequently encountered bias during their job search, most often due to visa sponsorship. Both non-US IMGs and their employers found their experiences with the immigration system to be complicated, confusing, and financially challenging.

The reported survey results suggest possible opportunities for improving how non-US citizen pathology residency graduates navigate the job market, how their potential employers approach hiring them, and how professional associations assist their non-US citizen members.