The US physician workforce includes allopathic physicians, osteopathic physicians, and international medical graduates (IMGs), who are physicians who received their medical school education outside the US or Canada. These physicians comprise both US citizens (US IMGs) and citizens from other countries (non-US IMGs) who have trained abroad. The US health care system has depended on IMGs to fill residency positions since the 1970s. Today, 1 in 4 physicians practicing in the US is an IMG.1 One estimate from 2001 suggested that if IMGs in primary care practice were removed, 1 of every 5 “adequately served” nonmetropolitan counties may become underserved and the percentage of rural counties with physician shortages could increase to 44.4%.2 This trend continues with the J-1 exchange waiver called the Conrad 30 Waiver, which enables IMGs to continue practicing in the US only if they commit to practice in a federally designated Health Professional Shortage Area, Medically Underserved Area, or Medically Underserved Population for at least 3 years.3 With a projected shortage of an estimated 125 000 physicians by 2025, IMGs will remain an important source of primary care physicians in rural and underserved areas.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Desai A, Hegde A, Das D. Change in Reporting of USMLE Step 1 Scores and Potential Implications for International Medical Graduates. JAMA. 2020;323(20):2015–2016. doi:10.1001/jama.2020.2956
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: