title: A longitudinal study of the characteristics and performances of medical students and graduates from the Arab countries.
abstract: BACKGROUND
  While international physician migration has been studied extensively, more focused and regional explorations are not commonplace. In many Arab countries, medical education is conducted in English and students/graduates seek postgraduate opportunities in other countries such as the United States (US). Eligibility for residency training in the US requires certification by the Educational Commission for Foreign Medical Graduates (ECFMG). This study investigates ECFMG application trends, examination performance, and US physician practice data to quantify the abilities and examine the career pathways of Arab-trained physicians.
  
  
  METHODS
  Medical students and graduates from 15 Arab countries where English is the language of medical school instruction were studied. The performances (1(st) attempt pass rates) of individuals on the United States Medical Licensing Examination Step 1, Step 2CK (clinical knowledge), and and a combination of Step 2CS (clinical skills) and ECFMG CSA (clinical skills assessment) were tallied and contrasted by country. Based on physician practice data, the contribution of Arab-trained physicians to the US healthcare workforce was explored. Descriptive statistics (means, frequencies) were used to summarize the collected data.
  
  
  RESULTS
  Between 1998 and 2012, there has been an increase in the number of Arab trained students/graduates seeking ECFMG certification. Examination performance varied considerably across countries, suggesting differences in the quality of medical education programs in the Eastern Mediterranean Region. Based on current US practice data, physicians from some Arab countries who seek postgraduate opportunities in the US are less likely to stay in the US following specialty training.
  
  
  CONCLUSIONS
  Countries, or regions, with concerns about physician migration, physican performance, or the pedagogical quality of their training programs should conduct longitudinal research studies to help inform medical education policies.
authors.affiliation: Department of Medical Education, College of Medicine, University of Illinois at Chicago, 808 South Wood Street (MC 591), Chicago, IL, 60612-7309, USA. tekian@uic.edu.
authors.forename: Ara
authors.initials: A
authors.lastname: Tekian
authors.affiliation: Foundation for Advancement of International Medical Education and Research, 3624 Market Street, Philadelphia, PA, 19104, USA. jboulet@faimer.org.
authors.forename: John
authors.initials: J
authors.lastname: Boulet
mesh_terms: D002983:Clinical Competence; D005260:Female; D005550:Foreign Medical Graduates / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008007:Licensure, Medical / Q000592:standards / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008877:Middle East / Q000208:ethnology; D010820:Physicians / Q000706:statistics & numerical data*; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States