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February 19, 1982

Foreign Medical Graduates and Physician Assistants

JAMA. 1982;247(7):977. doi:10.1001/jama.1982.03320320017009

To the Editor.—  Louis J. Goodman, PhD, and Lorna E. Wunderman, MPH, report a decline in the flow of foreign medical graduates (FMGs) into US graduate medical education programs (1981;246:854). The authors attribute this decline to certain provisions of the 1976 Health Professions Educational Assistance Act (PL 94-484) and point out that, despite offsetting increases in US medical graduates and US citizen FMGs, residency positions in certain urban hospitals will go unfilled. They recommend waiver of sections of PL 94-484 as a means of providing these facilities with a continuing supply of health manpower in the form of FMGs.This analysis fails to take into consideration that many of these hospitals have already discovered an alternative solution to resident shortages brought about by FMG restrictions. Physician assistants (PAs) are commonly replacing FMG house staff in many institutions. Over the past several years a number of hospitals that were previously dependent