Foreign medical graduates and U.S. physician supply: old issues and new questions.

Recent increases in the number of foreign medical graduates (FMGs) in U.S. hospital-training positions raise new questions about the future role of FMGs in U.S. medicine. Despite an historical surplus of physicians, forces such as greater demand for resident house officers, stabilization in undergraduate medical education enrollment, increase in demand for medical services, growth in both the number of women in medicine and physician employment in group practices, and continuing imbalances in the distribution of physicians favor FMG migration to the United States. Health system reform must be sensitive to the historical, current, and future role FMGs play in medical care delivery, especially in regard to service in underserved areas, specialties, and employment settings.