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August 3, 1994

Improving Health Care for the Poor

Author Affiliations

Clinica de Salud del Valle de Salinas Salinas, Calif

JAMA. 1994;272(5):352. doi:10.1001/jama.1994.03520050029013

To the Editor.  —I read the article by Dr Ginzberg1 with great interest and largely with agreement. Trained in rural health care and working with migrant farm workers in a California community clinic as I do, the degree of abandonment of indigent care by the medical profession at large has seemed remarkable.However, I take strong exception to his passing and demeaning reference to international medical graduates (IMGs). As a US-born and University of Toronto— and University of California—San Francisco—trained physician myself, I am stunned by his lack of awareness.Rather than being of "indifferent professional competence" and "with language problems that impede effective communication," IMGs constitute a highly skilled group. Thanks to an effective maintenance of local monopolies, the medical profession has long denied IMGs their fair due. Only the best of the foreign graduates make it through the testing and interview processes. They provide care in regions

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