Identifying Recent Trends in the Prevalence of International Medical Graduates Entering the Surgical Workforce in the United States.

OBJECTIVE

The objectives of this study were to 1.) determine recent trends in the prevalence of international medical graduates (IMGs) in the US surgical workforce, and 2.) understand differences in match rates between IMGs, allopathic, and osteopathic graduates.

DESIGN

Data from the American Medical Association (2008-2022) and National Resident Match Program (2018-2023) were analyzed for eight surgical subspecialties including vascular surgery, thoracic surgery, general surgery, plastic surgery, orthopedic surgery, neurosurgery, otolaryngology, obstetrics and gynecology.

SETTING

Accreditation Council for Graduate Medical Education (ACGME)-accredited surgical residency training programs.

PARTICIPANTS

Surgical residents (2018-2023) and active surgeons (2008-2022) in the United States.

RESULTS

Over the study period, the prevalence of IMGs in the US surgical workforce decreased for all surgical specialties except vascular surgery. Among surgical residents, allopathic graduates constituted the majority (82%) followed by osteopathic graduates (12%) and IMGs (6%). The annual prevalence of IMGs was highest in thoracic (10%) and general surgery (10%), and lowest in orthopedic surgery (1%). Allopathic graduates had the highest match rates followed by osteopathic graduates and then IMGs (p < 0.001) across all surgical specialties. Match rates for IMGs were lowest in thoracic surgery and vascular surgery (4%) and highest in obstetrics and gynecology (12%). Most surgical residency program directors reported never or seldomly interviewing (range, 73%-100%) or ranking (range, 77%-100%) IMGs.

CONCLUSIONS

The prevalence of IMGs in the US surgical workforce is decreasing. IMGs have lower match rates than US allopathic and osteopathic graduates and most surgical residency programs report rarely interviewing or ranking IMGs. Strategies that support IMGs enter surgical residency training may help promote diversity and inclusion in the US surgical workforce.