August 12, 2011
According to a recent report on PRI’s The World, “the U.S. suffers from a shortage of primary care physicians, and the problem is expected to worsen. America’s baby boom generation is aging, and health care reform could put greater demands on doctors as more American gains medical insurance.”
How do we intend to address this problem? There is one solution that can address the physician shortage and it would be to allow more foreign-trained doctors to work in the United States. In fact, thousands of such doctors are already here, but face a myriad of challenges that prevent them from the profession they spent years studying and practicing before coming to the U.S.
In order to get a medical license in the U.S., a foreign-trained doctor must first take board exams followed by an English language proficiency test, and complete a residency program. This is where the process becomes difficult. Foreign-trained candidates, along with their U.S. trained counterparts, apply for hundreds of residency positions but nearly “95% of candidates accepted for residency positions are graduates of U.S. medical schools while fewer than 40% of the foreign-medical doctors are accepted for US residency.”
In order to qualify for the board exams, the foreign-trained doctors seeking a medical license in the U.S. have already satisfied the academic and medical education criteria, otherwise they would not be eligible to sit for the exams. And, if they pass the exams, they are qualified to apply for residency like their U.S.-trained counterparts. Given the shortage of medical doctors and the expected demand for more physicians, why is our system stacked against these qualified individuals? Is the residency system unfair and biased against non-U.S. trained medical doctors? Or, is this selection process intended to discourage foreign-medical doctors from abandoning their home countries in order to practice in the U.S.?
The PRI report cites Prof. Mullan of George Washington University School of Medicine who studies the global migration of doctors that “there are several reasons why US residency programs prefer US graduates. A doctor in almost every country in the world is a product of the taxpayers or the tax base of that country. Because governments spend money on medical education, countries want a return on their investment. For that reason, it is appropriate for U.S. residency programs to select US graduates over those from foreign countries…if the US made it easy for foreign doctors to work here, that would be unfair to other countries.” But this is true of foreign-educated candidates with degrees in business, humanities, science, nursing, engineering who migrate to the US for either economic or socio-political reasons.
The fact remains that we have a shortage of medical professionals and we are not addressing this need through our limited residency programs. And until which time we have more medical schools, expand existing schools and able to increase the number of American medical graduates, we would need to deal with the qualified foreign-medical graduates in the US who are eager to step in and help.
Alan A. Saidi
Sr. VP & COO, ACEI, Inc.