title: Comparison of surgical residency applicants from U.S. medical schools with U.S.-born and foreign-born international medical school graduates.
abstract: OBJECTIVE
  Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  East Carolina University, a tertiary care teaching hospital.
  
  
  METHODS
  Demographic data, United States Medical Licensing Examination (USMLE) scores, attempts needed to achieve a passing score, number of scholarly works, attainment of an advanced degree, and employment history since medical school graduation were obtained from all Electronic Residency Application Service applications to a general surgery residency for the 2007 match.
  
  
  RESULTS
  In all, 572 applicants were evaluated. Comparing U.S. graduates with U.S.-born IMGs and foreign-born IMGs. IMGs are older (mean, 28.9 vs 29.9 vs 33.0 years, respectively), more frequently male (70% vs 80% vs 86%, respectively), and hold more advanced degrees (11% vs 13% vs 19%, respectively). Mean time between graduation and application to residency was 0.3 years for U.S. graduates, 1.5 years for U.S.-born IMGs, and 7.7 years for foreign-born IMGs. Although mean USMLE Step 1 scores were similar (206 vs 200 vs 202, respectively), IMGs more frequently required multiple attempts to achieve a passing score (9% vs 20% vs 24%, respectively). Mean USMLE Step 2 scores were lower (213 vs 201 vs 203, respectively), and IMGs again required more attempts to achieve a passing score (11% vs 22% vs 19%, respectively). U.S. graduates produced an average of 1.7 scholarly works compared with 0.9 scholarly works for U.S.-born IMGS and 3.9 scholarly works for foreign-born IMGs. U.S.-born graduates held a mean of 0.3 jobs since graduation with most positions being preliminary surgery residents. U.S.-born IMGs held an average of 2.2 jobs most frequently in research or U.S. preliminary surgery, and foreign-born IMGs held an average of 5.1 jobs; most frequently, positions included international surgery or research.
  
  
  CONCLUSIONS
  IMGs are older, frequently male, hold more advanced degrees, and produce more scholarly works but require multiple attempts to pass the USMLE. IMGs also hold more jobs after graduation with most positions being in research or surgery.
authors.affiliation: Division of Surgical Education, Department of Surgery, Brody School of Medicine East Carolina University, Greenville, North Carolina 27858, USA. pschenar@pcmh.com
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Schenarts
authors.forename: Katie M
authors.initials: KM
authors.lastname: Love
authors.forename: Steven C
authors.initials: SC
authors.lastname: Agle
authors.forename: Carl E
authors.initials: CE
authors.lastname: Haisch
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004521:Educational Measurement; D005260:Female; D005550:Foreign Medical Graduates / Q000706:statistics & numerical data*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012189:Retrospective Studies; D014481:United States