Driven by the need to reduce the number of practicing physicians, the impact of international medical graduates (IMGs) is being examined more closely than ever. The AMA, along with 5 other groups, recently proposed elimination of the J-1 waiver, which allows IMGs to practice in an underserved area of the United States instead of returning to their home countries.1 The Council on Graduate Medical Education proposed extending the J-1 visa return-home period from 2 to 5 years,2 while eliminating Medicare funding for training IMGs. Congress, however, reauthorized the existing J-1 waiver in an add-on to the 1996 budget.
Motivating proposals to reduce the number of IMGs is the dramatic increase in their number during the past 8 years. From 1988 to 1996, the number of IMGs in residency programs increased from 71000 to 77000.2 The increase in IMGs is believed to be exacerbating physician oversupply. However, supporters
Whyte J, Beall D. Providing Medical Care With Reduced Numbers of Residents. JAMA. 1997;278(9):698n. doi:10.1001/jama.1997.03550090020011