The increase in international medical graduates in family practice residency programs.
OBJECTIVE
The number of filled positions in family practice residency programs decreased by 18.6% from 1997-2001. This study sought to determine the degree of reliance on international medical graduates (IMGs) to fill family practice residency positions and the relative proportion of US citizen IMGs.


METHODS
We analyzed the 1992-2001 National Resident Matching Program results, the 2000 American Medical Association Masterfile, and the 1992-2001 American Academy of Family Physicians Annual Survey of Family Practice Residency Programs.


RESULTS
The percentage of IMGs matching in family practice remained stable between the years of 1992-1996 (10.0%-11.8%) but since 1997 has increased to a high of 21.4% in 2001. This rise in IMGs corresponds with a drop in the total percentage of family practice residency positions filled in the Match from 90.5% in 1996 to 76.3% in 2001. Despite the drop in Match numbers, the percentage of first-year family practice positions filled in July has remained in the range of 95.5%-97.8% since 1996. IMGs account for an increasing percentage of post-Match fills from 16.7% in 1996 to 47.9% in 2001. In 1999, a majority of family practice programs (279 [55.6%]), had at least one IMG. Of these, 48 programs (9.6%) had at least 50% of residents who were IMGs, and eight programs (1.6%) were entirely composed of IMGs. In five states (Connecticut, Illinois, Michigan, New Jersey, and New York), more than 25% of family practice residents were IMGs.


CONCLUSIONS
Family practice is becoming increasingly reliant on IMGs to fill residency positions.
Koehn
Nerissa N
NN
Robert Graham Center for Policy Studies in Family Practice and Primary Care, Washington, DC, USA. nerissa_koehn@post.harvard.edu
Fryer
George E
GE
Phillips
Robert L
RL
Miller
John B
JB
Green
Larry A
LA
D002322:Career Mobility; D002983:Clinical Competence; D004521:Educational Measurement; D005194:Family Practice / Q000193:education*; D005550:Foreign Medical Graduates / Q000600:supply & distribution*; D006291:Health Policy; D006302:Health Services Research; D006280:Health Workforce / Q000639:trends*; D006801:Humans; D007396:Internship and Residency / Q000639:trends; D010558:Personnel Loyalty; D014481:United States