Quality of care by IMGs: Is it up to par?

Over a quarter of all physicians or about 180,000 working in the U.S are international medical graduates. U.S citizens born here and graduate from a foreign medical school represent 12.5% of all IMG’s. The quality of care rendered by IMG’s has always been a sensitive issue with claims and counter claims. The issue is being discussed because of the anticipated shortage of physicians. 
Norcini et al just reported their findings comparing the care rendered by non-U.S.-citizen international graduates, U.S.-citizen international graduates, and U.S. medical school. graduates by reviewing inpatient death rates and lengths-of-stay for patients with congestive heart failure or acute myocardial infarction—or heart attack in 184 Pennsylvania hospitals from January 1, 2003, to December 31, 2006. Physician specialties included FP (33%), IM (48%) and Cardiology (19%). Non-U.S.-citizen international graduates had significantly lower mortality. No difference in mortality were found when comparing all international medical graduates with U.S. graduates meaning that the difference between non-U.S.-citizen and U.S.-citizen international graduates was the difference and was striking. The patients cared for by U.S.-citizen international graduates and non-U.S.-citizen international graduates had significantly longer stays than patients of U.S. graduates. The authors speculated that “variability in the quality of the medical schools that U.S.-citizen international graduates attend, but to some degree, it may also reflect their ability” implying that U.S citizen IMG’s may not be receiving the same quality education or that possibly the pool was not as strong.