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Acad Med. 2006 Oct;81(10 Suppl):S116-9.

A comparison of the characteristics and examination performances of U.S. and non-U.S. citizen international medical graduates who sought Educational Commission for Foreign Medical Graduates certification: 1995-2004.

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Research and Data Resources Foundation for Advancement of International Medical Education and Research (FAIMER), 3624 Market Street, Philadelphia, Pennsylvania 19104, USA.



International medical graduates (IMGs) make up a substantial part of the U.S. physician workforce. Unfortunately, little is known about the demographic and performance characteristics of these doctors, especially over time.


Educational Commission for Foreign Medical Graduates (ECFMG) applicants from 1995-2004 were studied. The characteristics and examination performances of U.S. citizen and non-U.S. citizen IMGs were contrasted.


ECFMG applications from U.S. citizen IMGs have been increasing. Compared to non-U.S. citizen IMGs, these individuals perform less well on some of the certification examinations, especially in the last 5 years, but are more likely to eventually achieve certification. Based on those medical students/graduates who took the examinations, the performance of U.S. citizen IMGs varied considerably from one medical school to another.


The composition of the pool of ECFMG-certified IMGs available for graduate medical education has changed over the past 10 years. Shifts in the characteristics and abilities of IMGs are likely to have some future impact on health care delivery in the United States.

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