Where Do International Medical Graduates Fit in the US Healthcare Picture?

Leigh Page

Disclosures

February 03, 2016

In This Article

The Struggle to Get Promoted

IMGs have a conflicting sense of self-worth in America, says Peggy G. Chen, MD, a researcher at the RAND Corporation who has studied the IMG experience extensively. "As a doctor, you're in a high-prestige position, but as an IMG, you may be viewed as an outsider by some of your patients and some of your colleagues," says Dr Chen, whose own parents were highly educated immigrants.

According to a 2012 study[22] that Dr Chen led, IMGs report lower satisfaction with their careers. Whereas 82.3% of US graduates reported career satisfaction, 75.7% of IMGs did so. The study was unable to identify why this is, but some light was shed on this in an earlier anecdotal study[23] led by Dr Chen, in which several IMGs were interviewed. In that study, a family physician from Southeast Asia working at a large organization said that few IMGs reach the top, and their work is "not validated" by the organization.

Someone who has had these kinds of experiences is Bhushan Pandya, MD, chairman-elect of the AMA's IMG Section and a gastroenterologist in Danville, Virginia. When he arrived in Danville in 1985, he was one of the first IMGs in the area, and his application for privileges at the local hospital was "delayed and delayed," he recalls. Only with the help of a lawyer was he finally able to get on staff. He then joined the same hospital credentials committee that had balked at granting him privileges and eventually became its chair. As the new evaluator of applications for privileges, "I made sure that everyone was treated equally," he says.

Dr Pandya's easygoing manner and willingness to promote change from the inside no doubt helped make him popular with colleagues. He became the first IMG president of the medical staff, and currently he's president-elect of the Medical Society of Virginia. Again, he's the first IMG to hold the position. "It's to the credit of the establishment that they elected me," he says.

Like Dr Ahmad, Dr Pandya is a steadfast advocate of assimilation. When he arrived in Danville, he was told, "Everyone here has roots in Danville," he recalls. "I may not have roots here," he replied, "but my grandchildren will."

Dr Pandya believes there's less discrimination against IMGs within medicine than when Dr Ahmad formed the IMG Section two decades ago. Last year, when leaders of the section met with the AMA president, "nobody was talking about discrimination," he says. The subjects were the usual ones for other physicians: electronic medical records, the move to the 10th edition of the International Classification of Diseases, and the new payment methodologies.

"Many of us have been able to establish ourselves in mainstream medicine," Dr Pandya says. "After all, we represent 25% of the physician workforce."

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