Whitcomb M E, Miller R S
Division of Medical Education, Association of American Medical Colleges, Washington, DC, USA.
JAMA. 1996 Sep 4;276(9):700-3.
To provide insight into the dynamics that determine the pattern of participation of international medical graduates (IMGs) in graduate medical education (GME).
Data on IMG-dependent programs (ie., those having at least 50% of first-year positions filled by IMGs) and non-IMG-dependent programs in 6 core specialties (internal medicine, family practice, obstetrics and gynecology, surgery, pediatrics, and psychiatry) were matched with application data from the 1989 and 1995 National Resident Matching Program (NRMP).
Participation of IMG-dependent and non-IMG-dependent programs in the 1995 NRMP and the pattern of US medical graduate (USMG) and IMG applications to these programs in 1989 and 1995.
Of the 1634 programs in the 6 specialties, 93.5% participated in the 1995 NRMP. The 1165 non-IMG-dependent programs were significantly more likely to participate in the NRMP and were slightly more likely to fill their offered positions than were the 469 IMG-dependent programs. Specifically, IMGs constituted 76% of applicants to IMG-dependent programs and only 14% of applicants to non-IMG-dependent programs. Changes in NRMP data between 1989 and 1995 indicated that the number of IMG applications to IMG-dependent programs increased 88.7%, as did the number of applicants ranked.
Persistent differences exist in the mix of USMGs and IMGs applying through the NRMP to IMG-dependent and non-IMG-dependent programs. Over time, programs that enroll large numbers of IMGs are likely to experience an increase in the number and proportion of applications from IMGs and a decrease in the number and proportion of applications from USMGs. If policies are adopted to limit IMG access to GME, IMG-dependent programs may be unable to recruit USMGs unless the total number of GME programs or the quality of existing programs fundamentally changes.
深入了解决定国际医学毕业生（IMGs）参与毕业后医学教育（GME）模式的动态因素。
将6个核心专业（内科、家庭医学、妇产科、外科、儿科和精神病学）中依赖IMG的项目（即第一年职位至少50%由IMG填补的项目）和不依赖IMG的项目的数据，与1989年和1995年全国住院医师匹配计划（NRMP）的申请数据进行匹配。
1995年NRMP中依赖IMG和不依赖IMG的项目的参与情况，以及1989年和1995年美国医学毕业生（USMGs）和IMG向这些项目的申请模式。
6个专业的1634个项目中，93.5%参与了1995年的NRMP。1165个不依赖IMG的项目比469个依赖IMG的项目更有可能参与NRMP，并且填补所提供职位的可能性略高。具体而言，IMG占依赖IMG项目申请人的76%，仅占不依赖IMG项目申请人的14%。1989年至1995年NRMP数据的变化表明，向依赖IMG项目申请的IMG数量增加了88.7%，排名的申请人数量也增加了88.7%。
通过NRMP申请依赖IMG和不依赖IMG项目的USMGs和IMGs组合存在持续差异。随着时间的推移，招收大量IMG的项目可能会经历IMG申请数量和比例的增加以及USMG申请数量和比例的减少。如果采取政策限制IMG进入GME，依赖IMG的项目可能无法招募到USMGs，除非GME项目的总数或现有项目的质量发生根本性变化。
