September 3, 1997

Providing Medical Care With Reduced Numbers of Residents

Author Affiliations

Palo Alto Veterans Affairs/ Stanford University School of Medicine Palo Alto, Calif; Johns Hopkins University School of Medicine Baltimore, Md

JAMA. 1997;278(9):698n. doi:10.1001/jama.1997.03550090020011

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