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 Nationwide, roughly 18 percent of medical professors in the U.S. are
graduates of foreign medical schools, according to an analysis
published today in the Annals of Internal Medicine.
Foreign medical graduates also lead 19 percent of clinical trials,
produce 18 percent of published biomedical research, and lead 13
percent of research grants funded by the National Institutes of
Health (NIH).
Without the contributions of physicians trained abroad, research in
the U.S. would suffer, said senior study author Dr. Anupam Jena of
Harvard Medical School and Massachusetts General Hospital in Boston.
“I would expect fewer clinical trials to be conducted, fewer
research papers to be written, and the overall pace of medical
innovation to decline,” Jena said by email. “The impact might not
occur immediately but the long-run impact on medical innovation
would be substantial.”
Foreign medical graduates make up nearly a quarter of the physician
workforce in the U.S. and disproportionately practice in underserved
areas as well as in specialties with practitioner shortages, Jena
and colleagues write.
Some states and hospitals rely heavily on physicians in the H-1B
visa program, which President Donald J. Trump recently proposed
revamping, the study authors note. Trump has also issued an
executive order barring entry for people from several predominantly
Muslim nations.
To assess the potential impact of barring foreign medical graduates
from working in the U.S., researchers examined data from Doximity, a
database of U.S. physicians.
In 2015, among 778,781 physicians practicing in the U.S., 164,111,
or 21 percent, were foreign medical graduates, the analysis found.
Foreign medical graduates led 1,526 of 12,155 NIH grants, the study
also found.
One potential drawback of having large numbers of foreign medical
graduates working in the U.S. is that they may take jobs from some
U.S. graduates, the authors acknowledge. But they also bring a
culturally and ethnically diverse workforce to both clinical
practice and medical research, which can benefit patients from a
broad range of backgrounds.
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One limitation of the analysis is the potential for Doximity to have
inaccurate information about where some physicians trained, the
authors note. Researchers also lacked data on how the proportion of
foreign medical graduates practicing in the U.S. has changed over
time, which may impact their contribution to research.
“This study provides further validation that international medical
graduates are integral to U.S. health care across a continuum of
roles, from clinicians to teachers to researchers,” said Dr. William
Pinsky, president and chief executive of the Educational Commission
for Foreign Medical Graduates.
“For patients, this study reinforces the importance of international
medical graduates, not only as their physicians who deliver quality
care, but also as the creators of new therapeutic options,” Pinsky,
who wasn’t involved in the study, said by email.
Without foreign medical graduates, the quality of care and research
may suffer, said Dr. Ahmad Masri, a cardiology fellow at the
University of Pittsburgh who wasn’t involved in the study.
That’s because currently, programs that recruit new physicians for
clinical and research jobs select the cream of the crop from around
the world, Masri said by email.
“Diversity is the key to success, and science has no boundaries,”
Masri said. “You remain the best by attracting the brightest minds.”
SOURCE: http://bit.ly/2wYH0qu Annals of Internal Medicine, online
September 25, 2017.
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