November 28, 2017

Fewer foreign docs seek residencies in US, early ERAS data show

Daily Briefing

    The number of international applicants for medical residency programs is down for the second year in a row, according to preliminary data from the Electronic Residency Application System, Youyou Zhou reports for Quartz.

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    Background

    According to Zhou, foreign graduates typically comprise about one-third of applicants and one-quarter of admissions to U.S. residency programs. Overall, foreign physicians account for about 26% of all licensed doctors in the United States. That share is higher in primary care and elder care, with 40% of primary care physicians and more than half of physicians caring for elderly patients coming from other counties.

    Visa requirements often mandate that foreign physicians who want to remain in the United States when their residencies are completed work in areas or fields facing shortages, Zhou reports. As such, a decline in the number of foreign physicians in the United States would likely be felt first among elderly patients and low-income residents in remote, rural areas, according to Zhou.

    Latest figures

    As of Nov. 11, 17,437 international medical graduates applied for U.S. residencies for 2018, down from 17,769 applicants for 2017 and 17,829 applicants for 2016. In comparison, 28,077 U.S. and Canadian medical graduates applied for U.S. residencies for 2018, up from 27,340 applicants for 2017 and 26,302 applicants for 2016. 

    According to Zhou, observers have said immigration policy is behind the decline. Travel restrictions stopped more than 500 applicants from Iran, Libya, Somalia, Sudan, Syria, and Yemen from obtaining visas, Zhou reports, and updates to the policy in September added to uncertainty.

    For instance, in response to the September proclamation, Association of American Medical Colleges President and CEO Darrell Kirch noted that while the move "eases restrictions on individuals from most of the previously affected countries who hold visas commonly used for medical education and training … highly qualified aspiring and practicing physicians and scientists may still face barriers to entry, including potentially inconsistent waiver decisions."

    Hospital program directors also have voiced concerns that the developments could make hospitals lose physicians. A survey in 2016 found 42% of directors consider "visa status" to be an important factor when determining whether to grant an interview.

    William Pinsky, president of Educational Commission for Foreign Medical Graduates, expressed similar concerns. "We are heading into a second resident recruitment season with a great deal of uncertainty," Pinsky said. "One challenge for programs will be to continue to select the best and the brightest, without regard to nationality, in order to continue to produce the best physicians possible" (Zhou, Quartz, 11/22).

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