探索国际医学毕业生在美国和加拿大接受微创手术培训所面临的挑战：一项横断面分析。
Exploring the Challenges for International Medical Graduates Pursuing Minimally Invasive Surgery Training in the United States and Canada: A Cross-Sectional Analysis.
机构信息
Department of Surgery, Montefiore Medical Center, Bronx, NY.
Center for Abdominal Core Health. Division of General Surgery, NYU Langone Health, New York, NY.
出版信息
JSLS. 2022 Jan-Mar;26(1). doi: 10.4293/JSLS.2021.00084.
BACKGROUND
International Medical Graduates (IMGs) are an important component of the US healthcare workforce. Prior studies have investigated bias against IMGs during the general surgery residency application in the United States. Minimally invasive surgery (MIS) is a growing field; The MIS fellowship match was established in 2004 and is a competitive process with a match rate of 47%. Opportunities for applicants who are non-US citizens are limited by a series of factors that are not related to their professional qualifications.
OBJECTIVES
The aim of the study was to explore the challenges faced by IMG in the MIS fellowship match.
METHODS
This is a cross-sectional study analyzing the minimally invasive surgery application requirements of all the programs listed in the Fellowship Council. Individual program requirements were collected into a database and a descriptive analysis was performed comparing programs who accept IMGs versus those that do not. Further statistical analysis was performed to explore those differences and associated factors.
RESULTS
There were 148 MIS fellowship programs and 187 positions offered during the 2021 match year in the US. Ninety-seven programs (65.5%) were found to accept graduates of foreign medical schools if they were US-citizens, whereas only 49 programs (33.1%) were found to accept IMG and sponsor a visa for their training. University affiliated programs (88.9% vs 75.0%, p = 0.04), programs with a general surgery residency (94.4% vs 75.0%, p = 0.003), and older programs (63.0% vs 45.5%, p = 0.04) were more likely to accept IMGs requiring visa sponsorship.
CONCLUSIONS
There is a significant bias against IMGs in the MIS fellowship match, with a reduced number of positions available based on factors not related to their professional performance or qualifications. Well established programs, university, and residency affiliated programs are more likely to consider these physicians for training.
背景
国际医学毕业生（IMG）是美国医疗保健劳动力的重要组成部分。先前的研究已经调查了在美国普通外科住院医师申请过程中对 IMG 的偏见。微创手术（MIS）是一个不断发展的领域；MIS 奖学金匹配于 2004 年建立，是一个竞争激烈的过程，匹配率为 47%。非美国公民的申请人机会有限，这与一系列与他们的专业资格无关的因素有关。
目的
本研究旨在探讨 IMG 在 MIS 奖学金匹配中面临的挑战。
方法
这是一项横断面研究，分析了 Fellowship Council 列出的所有计划的微创外科申请要求。将各个计划的要求收集到一个数据库中，并进行描述性分析，比较接受和不接受 IMG 的计划。进一步进行统计分析以探索这些差异和相关因素。
结果
在美国 2021 年的匹配年，有 148 个 MIS 奖学金计划和 187 个职位。发现 97 个计划（65.5%）如果 IMG 是美国公民，则接受外国医学院毕业生，而只有 49 个计划（33.1%）接受 IMG 并为其培训赞助签证。大学附属计划（88.9%比 75.0%，p=0.04）、有普通外科住院医师计划（94.4%比 75.0%，p=0.003）和较老的计划（63.0%比 45.5%，p=0.04）更有可能接受需要签证赞助的 IMG。
结论
在 MIS 奖学金匹配中存在对 IMG 的明显偏见，由于与他们的专业表现或资格无关的因素，可用的职位数量减少。历史悠久的计划、大学和住院医师附属计划更有可能考虑这些医生进行培训。
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