Cohen Jordan J
Association of American Medical Colleges, Washington, DC, USA.
Acad Med. 2006 Dec;81(12 Suppl):S17-21. doi: 10.1097/01.ACM.0000243339.63320.98.
At 25% of the nation's physician workforce, international medical graduates (IMGs) contribute significantly to the U.S. health care system. Beyond their sheer numbers, however, IMGs have played critically important roles, both in aggregate and as individuals. By choosing to pursue specialties less attractive to U.S. medical graduates, IMGs have filled important gaps that otherwise would have seriously compromised the effectiveness of the U.S. health care system. Moreover, individual IMGs have made notable contributions to the improvement of clinical practice, to biomedical and health services research, and to medical education. The Educational Commission for Foreign Medical Graduates (ECFMG), through its certification process, has enabled the best and the brightest medical students from other nations to train in the United States and can take justifiable pride in the undeniably positive impact IMGs have had on U.S. health care. It is imperative to note, however, that while the United States and other developing nations have benefited enormously from this "medical migration," there is considerable concern about the damaging effects on many countries in the developing world. Among the options to consider in offsetting the negative consequences of this so-called brain drain is working to improve the medical education available to aspiring physicians in "donor" countries. In facilitating such a process, the ECFMG and its partner, the Foundation for Advancement of International Medical Education and Research, have the opportunity to amplify their contributions significantly by building on their established programs of international assistance in improving medical education.
国际医学毕业生（IMGs）占美国医生劳动力的25%，对美国医疗保健系统做出了重大贡献。然而，除了他们的数量众多之外，IMGs作为一个整体以及作为个体都发挥了至关重要的作用。通过选择攻读对美国医学毕业生吸引力较小的专业，IMGs填补了重要的空白，否则这些空白将严重损害美国医疗保健系统的有效性。此外，个别IMGs在改善临床实践、生物医学和卫生服务研究以及医学教育方面也做出了显著贡献。外国医学毕业生教育委员会（ECFMG）通过其认证过程，使其他国家最优秀、最聪明的医学生能够在美国接受培训，并可以为IMGs对美国医疗保健产生的不可否认的积极影响而感到理所当然的自豪。然而，必须指出的是，虽然美国和其他发展中国家从这种“医学移民”中受益匪浅，但人们对其对许多发展中国家造成的破坏性影响也深感担忧。在考虑抵消这种所谓人才外流负面影响的选项中，努力改善“输出”国家有志成为医生者所能获得的医学教育是其中之一。在推动这一进程时，ECFMG及其合作伙伴国际医学教育与研究促进基金会有机会通过在其已有的国际援助计划基础上进一步改善医学教育，从而大幅扩大其贡献。
