Do foreign med school grads provide the same quality of care as those trained in the U.S.? A study published today in Health Affairs suggests there’s no functional difference, at least by one set of measures. Researchers analyzed records covering 244,153 people hospitalized for heart failure or heart attack in Pennsylvania and found no difference in death rates or length of hospital stay between those treated by foreign- and U.S.-trained docs. There was a distinction, however, between U.S.-born physicians who went abroad for training and foreign-born students who trained outside the U.S. — patients treated by the former fared significantly worse than the latter. Whether the U.S.-born students’ poorer patient outcomes were a result of med school quality or the doctors’ inherent aptitude isn’t clear, says John Norcini, head of the Foundation for Advancement of International Medical Education and Research and first author of the study, via email. While some previous research has suggested that foreign-medical school graduates don’t perform as well on standardized tests and other indicators, there’s been little published work addressing differences in actual patient care, Norcini tells us. More than a quarter of U.S. residency slots — the training doctors complete after medical school and before practicing independently — are filled by graduates of international medical schools, according to the Accreditation Council for Graduate Medical Education. That percentage that has remained relatively flat since 2005. Some medical schools have been expanding their numbers in anticipation of a doctor shortage, but the number of residency slots is capped, creating a bottleneck. “Since residency training is a requirement for a license, this medical school expansion will not lead to more doctors and so it will not address the shortage,” Norcini says. “Moreover, it will likely mean that fewer international medical graduates will be able to train and practice in the US.” Source
