Nakhostin-Ansari Amin, Tackett Sean
School of Medicine, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran.
Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
J Gen Intern Med. 2025 Feb;40(2):347-353. doi: 10.1007/s11606-024-09151-5. Epub 2024 Oct 30.
The United States has more foreign-born (FB) individuals than any other country and a large international medical graduate (IMG) workforce. Yet little is known about the trends of FB IMGs matching into primary care specialties residency programs or the alignment between FB individuals and FB IMGs.
This study examined the recent trends in FB IMGs entry into primary care specialty residency programs and their distribution in relation to the US FB population.
In this retrospective study, we used archives of National Resident Matching Program (NRMP) data on the main residency match from 2010 to 2022.
We extracted match data and program directors' policies for internal medicine, pediatrics, family medicine, and internal medicine/pediatrics. We also extracted data on the total population and FB individuals from the US Census Bureau for each US state from 2010 to 2022.
From 2010 to 2022, 17.2% of primary care specialty positions were filled by FB IMGs, with 22.1% for internal medicine, 11.3% for pediatrics, 10.7% for family medicine, and 3.2% for internal medicine/pediatrics. The percentage of primary care specialty positions filled by FB IMGs was significantly higher than the percentage of FB people in the US overall and 7 of 9 US regions (p < 0.001) (excepting Pacific and Mountain). The percentage of family medicine, pediatrics, and internal medicine/pediatrics positions filled by FB IMGs was significantly lower than the proportion of FB people (p < 0.001). Internal medicine had a higher proportion of positions filled by FB IMGs compared to the proportion of FB individuals in the general population (p < 0.001).
Distribution of FB IMGs varies in primary care specialties compared to FB people in the US. Given the importance of aligning medical education with patients' needs, programs could take into account population demographics while assessing and admitting the applicants.
美国的外国出生（FB）人口比其他任何国家都多，且拥有庞大的国际医学毕业生（IMG）劳动力队伍。然而，关于FB IMG匹配到初级保健专科住院医师项目的趋势，以及FB人群与FB IMG之间的匹配情况，我们知之甚少。
本研究调查了FB IMG进入初级保健专科住院医师项目的近期趋势及其与美国FB人口的分布关系。
在这项回顾性研究中，我们使用了2010年至2022年全国住院医师匹配项目（NRMP）主要住院医师匹配数据档案。
我们提取了内科、儿科、家庭医学和内科/儿科的匹配数据以及项目主任的政策。我们还从美国人口普查局提取了2010年至2022年每个美国州的总人口和FB人群数据。
2010年至2022年期间，17.2%的初级保健专科职位由FB IMG填补，其中内科为22.1%，儿科为11.3%，家庭医学为10.7%，内科/儿科为3.2%。FB IMG填补的初级保健专科职位百分比显著高于美国整体FB人群的百分比，以及9个美国地区中的7个地区（p < 0.001）（太平洋地区和山区除外）。FB IMG填补的家庭医学、儿科和内科/儿科职位百分比显著低于FB人群的比例（p < 0.001）。与普通人群中FB个体的比例相比，内科中由FB IMG填补的职位比例更高（p < 0.001）。
与美国的FB人群相比，FB IMG在初级保健专科中的分布有所不同。鉴于使医学教育与患者需求相匹配的重要性，项目在评估和录取申请人时可考虑人口统计学因素。
