International Medical Graduate Physician Training in American Psychiatry: Where We Are and Where We Are Going

Abstract

International medical graduate physicians contribute greatly to psychiatry at every level in the United States and Canada. Distinguished members of this community of physicians are well represented among the leading educators, researchers, and administrators in major medical centers. Historically, international graduate psychiatrists have disproportionately provided clinical care for disadvantaged patients in public settings such as state hospitals, community mental health centers, federal health care institutions, jails, and prisons. They have also been over-represented in geographic areas where graduates of medical schools in the United States and Canada are less likely to be found or to practice. In general, the intellectual strengths and overall quality of international resident physicians in the United States and Canada are high, even if and when their prior formal psychiatric education and clinical experiences may be less complete than those of medical graduates from the United States and Canada. As a rule, residents born and schooled in other countries represent a pre-screened elite of physicians from other countries. According to this logic, these physicians have had the drive and the stamina to uproot themselves and make the necessary efforts to migrate, study in what may not be their native tongue, take additional sets of examinations to qualify for appointment, and go through numerous additional educational steps and bureaucratic hoops before landing a residency position. Do regional differences occur with regard to the cultural origins of physicians? The sky is the limit with respect to diversity in New York City, where nearly 200 different languages are spoken. Programs in this and other urban areas reflect their incredibly rich heterogeneity. Given these diversities, what particular issues are pertinent for international resident physicians and for the faculty who train them? We need to separately consider the educational needs of the international physicians themselves and the educational needs of their faculty members and supervisors. (PsycInfo Database Record (c) 2022 APA, all rights reserved)