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Slow Elimination of International Medical Graduates

November 21, 2011

According to the American Medical Association, IMGs make up one fourth of the physician workforce in the United States and more than one quarter of resident physicians. In addition, IMGs are more likely than graduates of US medical schools to serve in medically underserved areas and in primary and critical care.

I see on forums people lamenting that the reason that they are not getting interviews for residency is that there are now more AMGs because more medical schools have opened in the recent past.

This may have a small effect this year but has some truth for tomorrows applicants. Over 85 percent of existing medical schools have either already expanded their first-year enrollment or plan to expand within the next five years

The following figure shows what will likely happen. By 2019, the number of AMGs will equal or be somewhat higher than the residency slots that are available in the US. It is interesting that the amount of the proposed increase of AMGs is similar to the numbers of IMG PGY1 residents. The following projections are from the AAMC.


Medical school enrollment has already increased by 13.2 percent as of the 2010-11 academic year. The AAMC estimates that almost 800 first-year students will attend these new schools in the academic year 2012-13, based on future enrollment figures. Enrollment is projected to increase by 27.6 percent by 2015. Existing medical schools have increased the numbers of students and new US schools are opening. The trends seen already are not in IMGs favor. Between the 2005 and 2009 matches, the percentage of IMGs who submitted rank lists and matched dropped from 54.7% to 47.8% for US-IMGs and from 55.6% to 41.6% for non-US IMGs. Once these new US students graduate it will get progressively more difficult to attain a residency slot as an IMG. I see it as unlikely that the US government will expand funding of US residency programs to increase the size of residency programs.
All this adds up to the slow elimination of the IMGs as residents by 2019.

The views expressed in this post are those of Kenneth Christopher, MD and do not necessarily reflect the views of Dr. Christopher’s employer Partners HealthCare.

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