The Journey of a Foreign-Trained Physician to a United States Residency: Controversies Surrounding the Impact of This Migration to the United States

TY - JOUR

T1 - The Journey of a Foreign-Trained Physician to a United States Residency

T2 - Controversies Surrounding the Impact of This Migration to the United States

AU - Leon, Luis R.

AU - Ojeda, Herminio

AU - Mills, Joseph I.

AU - Leon, Christine R.

AU - Psalms, Shemuel B.

AU - Villar, Hugo V.

N1 - Funding Information: IMG training, like almost all GME, is funded by the federal Medicare program. Some think that taxpayer dollars should not be used to train doctors who are not US citizens, who have not signed a contract to practice in the United States, and could finish their residencies and return to their home countries, after having their residency training fully funded by US taxpayers. Congressional proposals have aimed to reform Medicare reimbursement practices for direct and indirect costs incurred by hospitals for their residency training programs. These proposals attempted to restrict IMG training by denying Medicare payment to hospitals for services provided by IMGs. 8 Funding Information: It is important to differentiate permanent from temporary migration status when performing this analysis. The latter can benefit donor countries through an upgrading of skills and technological and financial benefits, if the fully trained physician returns to his country of origin to practice, and the United States, in theory, loses one physician whose education was supported by US dollars. Statistics show that 70% to 75% of all IMGs in GME eventually enter practice in the United States after completion of training. 2 Permanent migration represents a net transfer of human capital from the donor to the recipient country. In permanent migration, the prospects of individual IMGs are generally improved. But the donor countries “waste” resources spent to educate a physician and the value of the health care services that IMGs would have rendered to their country had they returned. It has been shown that the majority of IMGs who participate in GME in the United States ultimately relocate and enter into permanent practice in this country. 2 Taxpayer dollars dedicated to train IMGs are spent mostly on physicians who ultimately work in the United States during their most productive years and offer their services to ill patients in the United States and will pay taxes in high brackets. Hospitals in the United States receive money to train IMGs and USMGs, who they use as cheap sources of labor. They replace with their work what nurse practitioners or physician assistants would do for higher salaries, partially compensating taxpayer dollars spent in their training. Because both the American Medical Association and the Accreditation Council for Graduate Medical Education adopted a limit of an 80-hour workweek for resident physicians, an increase in the use of physician assistants as substitutes for resident physicians in hospital settings have been noted, 19 a necessity that has increased hospital costs.

PY - 2008/1

Y1 - 2008/1

UR - http://www.scopus.com/inward/record.url?scp=37249065676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37249065676&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2007.06.311

DO - 10.1016/j.jamcollsurg.2007.06.311

M3 - Article

C2 - 18155584

AN - SCOPUS:37249065676

SN - 1072-7515

VL - 206

SP - 171

EP - 176

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

IS - 1

ER -