title: International Medical Graduates in Radiation Oncology: Historical Trends and Comparison With Other Medical Specialties.
abstract: This is the first National Resident Matching Program analysis evaluating historical patterns of international medical graduates (IMGs) in radiation oncology (RO) and providing comparison with American (MD) medical graduates (AMGs), osteopathic students (DOs), unfilled positions, and other specialties.
  
  
  
  National Resident Matching Program data for IMGs were available from 2003 to 2015, with limited data for other specialty matches. The following RO-specific figures were obtained per year: total positions available; total matched positions; number of unfilled positions; and number of IMG, AMG, and DO matches. In addition, the number of IMG matches and total matched positions were obtained for 19 other specialties. Fisher exact tests and χ(2) tests were considered significant at α <.05.
  
  
  
  From 2010 to 2015, 0.8% of RO matches were IMGs, a decline from 2.4% in 2003 to 2009 (P=.006). Proportions of DO matches during these intervals increased by 40% (from 1.0% to 1.4%), significantly lower than IMGs for 2003 to 2009 (P=.03) but not 2010 to 2015 (P=.26). From 2003 to 2015, the percentage of IMG matches, at 1.5%, was significantly lower than the percentage of unfilled seats, at 3.5% (P<.001). In comparison with other specialties (2003-2015), RO had the fewest IMG matches (1.5%), followed by otolaryngology (1.9%) and orthopedics (2.2%); specialties with the highest IMG proportions were internal medicine (37.1%), family medicine (35.7%), and neurology (31.1%).
  
  
  
  Presently, IMGs represent <1% of RO matches, the lowest among major specialties. There are several speculative factors associated with this low proportion. There are significantly more unfilled positions than those filled by IMGs; programs at risk of not matching could weigh the advantages and disadvantages of interviewing IMGs.
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: vivek333@gmail.com.
authors.forename: Vivek
authors.initials: V
authors.lastname: Verma
authors.affiliation: Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Chirag
authors.initials: C
authors.lastname: Shah
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Tim
authors.initials: T
authors.lastname: Lautenschlaeger
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Chi
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Weining
authors.initials: W
authors.lastname: Zhen
authors.affiliation: Department of Radiation Oncology, Miami Cancer Institute, Coral Gables, Florida.
authors.forename: Minesh P
authors.initials: MP
authors.lastname: Mehta
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Zietman
mesh_terms: D004501:Education, Medical; D005550:Foreign Medical Graduates / Q000639:trends*; D006801:Humans; D008511:Medicine / Q000639:trends*; D018787:Radiation Oncology / Q000193:education* / Q000639:trends; D013997:Time Factors