Riley J D, Hannis M, Rice K G
Section of General Medicine, East Carolina University School of Medicine, Greenville, North Carolina, USA.
Acad Med. 1996 Apr;71(4):381-6. doi: 10.1097/00001888-199604000-00017.
To examine whether the proportions of international medical graduates (IMGs) enrolled in certain residency programs would affect students' selection of those programs during the match, and to determine the importance of this factor relative to other established program-selection factors.
A sample of 702 fourth-year students at 18 geographically diverse U.S. medical schools during March and April of 1994 were mailed a confidential survey asking them to rank and rate hypothetical programs and to rate the importance of selected characteristics in their rankings of programs during the match. The students were asked to rank five hypothetical programs described by nine characteristics. One-third of the students received additional information about the programs' reputations; another third, information about the percentages of IMGs in the programs. The control group received no information about these two characteristics. Comparisons of the mean rankings and ratings of the five programs between the control and intervention groups were made using the Mann-Wilcoxon rank-comparison statistical test.
The response rate was 44%, with 291 survey forms returned completed (45 were returned due to no forwarding address). When the rankings and ratings of the control and intervention groups were compared, the programs with higher numbers of IMGs worsened significantly in rank and rating (p < .001 for both), whereas the programs with better reputations improved in rank (p < .001) and rating (p < .005).
The results suggest that the proportion of IMGs in a residency program is a significant factor in program selection and is as important as previously established factors such as program reputation. Students, however, do not acknowledge the importance of this factor. Program directors and governing bodies may want to consider these findings when evaluating the impact and distribution of IMGs in U.S. training programs.
研究参加某些住院医师培训项目的国际医学毕业生（IMG）比例是否会影响学生在配对过程中对这些项目的选择，并确定该因素相对于其他既定的项目选择因素的重要性。
1994年3月和4月，对美国18所地理位置分散的医学院的702名四年级学生进行抽样，邮寄一份保密调查问卷，要求他们对假设的项目进行排名和评分，并对配对过程中项目排名中选定特征的重要性进行评分。要求学生对由九个特征描述的五个假设项目进行排名。三分之一的学生收到了有关项目声誉的额外信息；另外三分之一收到了有关项目中IMG百分比的信息。对照组未收到有关这两个特征的信息。使用曼-惠特尼秩和检验对对照组和干预组之间五个项目的平均排名和评分进行比较。
回复率为44%，共返回291份完整的调查问卷（45份因无有效转寄地址而返回）。当比较对照组和干预组的排名和评分时，IMG数量较多的项目在排名和评分上显著变差（两者p均<0.001），而声誉较好的项目在排名上有所提高（p<0.001），在评分上也有所提高（p<0.005）。
结果表明，住院医师培训项目中IMG的比例是项目选择中的一个重要因素，与项目声誉等先前确定的因素同样重要。然而，学生们并未认识到这一因素的重要性。项目主任和管理机构在评估IMG在美国培训项目中的影响和分布时，可能需要考虑这些发现。
