International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Int Orthop. 2024 Nov;48(11):2775-2784. doi: 10.1007/s00264-024-06283-5. Epub 2024 Sep 2.
International Medical Graduates (IMGs) face challenges in securing orthopaedic surgery residencies in the U.S. This study examines residency matching trends and geographic distribution for U.S. and non-U.S. citizen IMGs.
The National Resident Matching Program (NRMP) data from 2008 to 2022 were analyzed for USMLE scores, publication counts, and match rates, using linear regression. The proportion of non-US IMGs in orthopaedic surgery residency was compared with the foreign-born population of each region based on the 2021 American Community Survey.
The overall IMG fill rate decreased significantly from 2.04% in 2008 to 1.26% in 2022 (P = 0.002). The number of publications for matched US IMGs was at least three times that of matched MD seniors and about two times that of unmatched US IMGs. Matched non-US IMGs had approximately five and three times the number of publications as matched MD seniors and unmatched non-US IMGs, respectively. Mississippi had the highest IMG-to-all-filled-position ratio (6.7%) and New York matched the most IMGs (36 residents). Although the foreign-born population comprises approximately 13.72% of the US population, non-US IMGs accounted for less than 1% of total matched residents. When compared to the foreign-born population, non-US IMGs were underrepresented in the US. This underrepresentation was observed in all nine geographic divisions, particularly in the West South Central and Pacific regions.
While IMGs constitute a low percentage of matched MDs in orthopaedic surgery, they show three to five times more publications than MD seniors. IMGs should recognize the importance of higher publication numbers in the matching process as well as states with higher IMG matching rates.
国际医学毕业生（IMG）在美国获得骨科住院医师职位面临挑战。本研究检查了美国和非美国公民 IMG 的住院医师匹配趋势和地理分布。
分析了 2008 年至 2022 年全国住院医师匹配项目（NRMP）的数据，包括美国医师执照考试（USMLE）成绩、出版物数量和匹配率，并使用线性回归进行分析。根据 2021 年美国社区调查，将骨科住院医师中非美国 IMG 的比例与每个地区的外国出生人口进行比较。
总体而言，IMG 的填充率从 2008 年的 2.04%显著下降到 2022 年的 1.26%（P=0.002）。与匹配的 MD 高年级学生相比，匹配的美国 IMG 的出版物数量至少高出三倍，与未匹配的美国 IMG 相比，大约高出两倍。匹配的非美国 IMG 的出版物数量分别是匹配的 MD 高年级学生和未匹配的非美国 IMG 的大约五倍和三倍。密西西比州的 IMG 与所有已填补职位的比例最高（6.7%），纽约州匹配的 IMG 人数最多（36 名住院医师）。尽管外国出生人口约占美国人口的 13.72%，但非美国 IMG 不到总匹配住院医师的 1%。与外国出生人口相比，非美国 IMG 在全美九个地理区域都存在代表性不足的情况，尤其是在中西部和太平洋地区。
尽管 IMG 在骨科住院医师中所占比例较低，但他们的出版物数量比 MD 高年级学生高出三到五倍。IMG 应该认识到在匹配过程中更高的出版物数量以及具有更高 IMG 匹配率的州的重要性。
