Stanley Medical Research Institute, Chevy Chase, Maryland, United States of America.
PLoS One. 2012;7(3):e33076. doi: 10.1371/journal.pone.0033076. Epub 2012 Mar 21.
Since the 1960 s, the number of international medical graduates (IMGs) in the United States has increased significantly. Given concerns regarding the effects of this loss to their countries of origin, the authors undertook a study of IMGs from lower income countries currently practicing in the United States.
The AMA Physician Masterfile was accessed to identify all 265,851 IMGs in active practice in the United States. These were divided by state of practice and country of origin. World Bank income classification was used to identify lower income countries.
128,729 IMGs were identified from 53 lower income countries, constituting 15 percent of the US active physician workforce. As a percentage of the workforce, West Virginia (29%), New Jersey (27%), and Michigan (26%) had the most IMGs from lower income countries, and Montana, Idaho, and Alaska (all less than 2%), the least. The countries with the greatest loss of physicians to the United States per 100,000 population were the Philippines, Syria, Jordan, and Haiti.
The reliance of US medicine on physicians from lower income countries is beneficial to the United States both clinically and economically. However, it results in a loss of the lower income country's investment in the IMG's education. We discuss possible mechanisms to compensate the lower income countries for the medical education costs of their physicians who immigrate to the US.
自 20 世纪 60 年代以来，美国的国际医学毕业生（IMG）人数显著增加。鉴于对这些人离开原籍国所带来影响的担忧，作者对目前在美国执业的来自低收入国家的 IMG 进行了研究。
访问 AMA 医师主文件，以确定在美国从事活跃实践的 265851 名 IMG。根据执业地点和原籍国对这些 IMG 进行了划分。使用世界银行收入分类来识别低收入国家。
从 53 个低收入国家确定了 128729 名 IMG，占美国现役医师队伍的 15%。就劳动力的百分比而言，西弗吉尼亚州（29%）、新泽西州（27%）和密歇根州（26%）拥有最多来自低收入国家的 IMG，而蒙大拿州、爱达荷州和阿拉斯加（均低于 2%）则拥有最少。每 10 万人口中有最多医师流失到美国的国家是菲律宾、叙利亚、约旦和海地。
美国医学对来自低收入国家的医师的依赖对美国在临床和经济方面都有益处。然而，这导致了低收入国家对 IMG 教育投资的损失。我们讨论了可能的机制，以补偿移民到美国的低收入国家的医生的医学教育费用。
