Nasir L S
Department of Family Practice, University of Nebraska Medical Center, Omaha.
Fam Med. 1994 Nov-Dec;26(10):625-9.
The purpose of the study was to test the hypothesis that discrimination exists against international medical graduates (IMGs) applying to US family practice residency programs.
Two sets of letters were sent to 146 family practice residency programs randomly selected from the Directory of Graduate Medical Education Programs. The letters requested information and an application. All letters were identical except that the author of the first set was described as "a foreign medical graduate." The author of the second set was described as "a fourth-year medical student at the University of Nebraska Medical Center." Replies were monitored for 6 weeks after the second mailing. Response rates to each "candidate" were measured. In addition, responses were evaluated for the presence of a brochure describing the residency program, an application, cover letter, invitation for interview, eligibility criteria, and other material.
A total of 113 programs (79%) responded. Of these, 102 responded to the fourth-year medical student and 57 responded to the IMG. Of the 46 programs replying to both candidates, only 20 provided identical mailings. Nine of the 46 programs required IMGs to meet standards that exceeded requirements set by the Educational Commission for Foreign Medical Graduates for residency training in the United States.
A pattern of dissimilarity exists in the way family practice residency programs respond to requests for application materials, and the differences appear to depend on whether the candidate is a US medical graduate or an IMG. These results raise questions about the fairness of current methods of resident selection.
本研究旨在验证针对申请美国家庭医学住院医师培训项目的国际医学毕业生（IMGs）存在歧视这一假设。
从研究生医学教育项目名录中随机选取146个家庭医学住院医师培训项目，分别发送两组信件。信件索要信息及申请表。所有信件内容完全相同，只是第一组信件的作者被描述为“外国医学毕业生”，第二组信件的作者被描述为“内布拉斯加大学医学中心四年级医学生”。第二次邮寄后持续6周监测回复情况。统计每个“候选人”的回复率。此外，评估回复中是否包含描述住院医师培训项目的手册、申请表、求职信、面试邀请、资格标准及其他材料。
共有113个项目（79%）回复。其中，102个项目回复了四年级医学生，57个项目回复了国际医学毕业生。在回复两位候选人的46个项目中，只有20个提供了相同的邮寄材料。46个项目中有9个要求国际医学毕业生达到超出外国医学毕业生教育委员会为美国住院医师培训所设定要求的标准。
家庭医学住院医师培训项目对申请材料请求的回复方式存在差异模式，且差异似乎取决于候选人是美国医学毕业生还是国际医学毕业生。这些结果引发了对当前住院医师选拔方法公平性的质疑。
