Is attracting International Medical Graduate the solution to the Doctor Shortage problem of USA ?

By Dr Michael Everest

There are not enough physicians in the United States. If you live here, there is roughly a one in three chance that you are experiencing it, as close to a hundred million people live in areas that The US Health Resources and Services Administration designates as ‘Health Professionals Shortage Area’ for their primary care. It takes, on average, 26 days to schedule a physician appointment for a new patient, Merrit Hawkins found. By 2034, USA might have a shortage of up to 124,000 physicians, states a report by Association of American Medical Colleges.

It is impossible to point out a single culprit or reason why we are at this point. The problem is complex, and many factors lead to it. We have more patients than ever due to a growing population. People living longer means the population is also ageing, and that is a factor, too. The doctors we have working at the moment are also ageing, and we are bound to see more of them retire soon.

The list goes on. For some fields of medicine, such as primary care, the issue might be the need for more interest. For others, it might be that slots available at residency programs in the US that have not been growing in line with the need for more doctors. Training a doctor is a lengthy and expensive process that might turn some people off the career path.

Because the problem is so complex, many different attack vectors exist. Some organizations, even startups, are finding new ways to manage our resources more efficiently, often through the latest tech advancements. On the other hand, legislators are pushing for more residency positions in a bipartisan effort.

The Indian Help
One of the most effective and necessary ways to address a shortage in any workforce is to import it, something that countries around the world, including the US, have been doing for ages. One in five doctors working in this country is a non-US international medical graduate (IMG). Without them, the doctor shortage crisis would be even worse. If USA wants to ensure that they do not run out of doctors in the next few decades, they will definitely need all the help.

India can be the front runner in solving USA’s Doctor shortage problem as there is absolutely no dearth of talented doctors migrating to USA. Based on American American Physicians of Indian-Origin (AAPI) data, despite comprising less than 1 percent of the U.S. population, Indian Americans make up 9 percent of all doctors and physicians in the country. This means that one in seven medical practitioners in the U.S. is of Indian descent, offering healthcare services to more than 40 million Americans. A study by the New England Journal of Medicine reveals that India supplies the highest number of international medical graduates to the United States. AAPI approximates that there are roughly 80,000 active Indian American physicians, in addition to approximately 40,000 medical students, residents, and fellows of Indian heritage.

The Residency problem
IMGs—as the abbreviation goes—face many difficulties and red tape before they can practice in the US. It is not just their visa or immigration status—securing a residency can also be an issue for them. The 2023 Match data shows that 59.4% of non-US IMG applicants are matched to a residency program. The ratio was 67.6% for US IMGs or United States citizens who graduated abroad. The match rate for active applicants to year-one residency positions was 81.1%. For US medical school graduates, the percentage was 93.7% for MD seniors and 91.6 for DO seniors. The discrepancy cannot be boiled down to foreign medical schools providing substandard education because that is untrue. Even though American universities traditionally rank the highest in the field, there are plenty of places outside the US that create qualified physicians.

Experts have found that offering thorough medical residency placement services is an effective way to level the playing field. It gives a 97% success rate, placing several more hundred candidates into residencies and fellowships. The key to this success lies in developing sets of services for every step of the graduates’ journey, such as externships, 1-on-1 USMLE tutoring, and CITI research certification course as part of an educational program, besides providing ERAS application and interview preparation, and speech pathology classes to help applicants speak confidently. There has to be 100% hands-on in-patient rotations, research-to-residency, and clinical-to-residency pathways for the placement phase.

Guiding Med Grads
Every graduate is different, with a unique background, aspirations and circumstances, medical residency experts can create a package of services that address their exact needs and ensure the best possible results. To make the curricula as available and interactive as possible, the medical residency experts can rely on an innovative learning platform that leverages AI to create a more nurturing learning environment.

Being nurturing and empathetic is another important aspect of helping students from abroad succeed in the US to help resolve the doctor shortage. International students of different races often receive different treatments. But, even if they do not, the fact that they lack the domestic students’ support system means that they have a tougher starting point in the competition.

The support and mentorships that international medical graduates need and deserve must be provided with empathy and understanding. It makes all the difference when these young people start to lose hope, buckle in uncertainty, or even face medical issues of their own.
To be there for them through thick and thin, like doctors are for their patients, is a privilege. Hopefully, the legislators will understand that and create an easier pathway for people to stay here after residency. The doctor shortage must be tackled one successful residency and fellowship placement success at a time.

Dr Michael Everest is a pioneering figure in medical education and the visionary Founder and Chief Academic Officer of Residents Medical, a Los Angeles-based institution dedicated to guiding medical and graduate students toward their ideal residency or fellowship placements.

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