A recent study reveals a concerning trend among foreign-trained doctors immigrating to the United States, indicating significant barriers to entering comparable medical roles despite their qualifications and experience. The study, conducted jointly by the Federal Reserve Bank of Minneapolis and the nonprofit Upwardly Global, examined the experiences of 300 physicians who migrated to the US between 2004 and 2022.
While a majority of these international medical graduates (IMGs), around 85%, managed to secure employment, only a third of them were able to transition into medical residency or practicing as physicians. This disparity underscores the formidable challenges faced by IMGs, who often find themselves compelled to navigate arduous educational and licensing processes anew upon reaching the US.
Despite possessing medical degrees and substantial clinical backgrounds from their home countries, IMGs encounter a daunting set of prerequisites in the US, including passing the rigorous United States Medical Licensing Examination (USMLE), accumulating clinical hours, and securing coveted residency positions. Failing to surmount these hurdles, many IMGs are forced to settle for healthcare roles for which they are overqualified and underpaid, exacerbating their professional frustrations and financial strains.
The study unveils some disheartening statistics regarding the alternative career paths pursued by IMGs who are unable to progress in traditional medical roles. Notably, 23% of IMGs found themselves working as medical assistants, while others gravitated towards roles such as clinical research, medical interpretation, and case management, indicative of their diverse skill sets and adaptability.
Maxim Nikolaevskiy, an obstetrician/gynecologist from Russia who relocated to the US in 2018, empathizes with fellow IMGs who opt for career diversions. Sharing his own experience, Nikolaevskiy reveals how the exigencies of resettlement compelled his wife, also a trained physician, to enroll in a respiratory therapy program, while he himself embarked on a career as a research coordinator. He emphasizes the formidable challenges faced by IMGs in securing residency positions tailored to their unique trajectories, often encountering skepticism and administrative hurdles from residency programs unfamiliar with their backgrounds.
“Multiple residency programs refuse IMGs’ applications, saying they graduated too long ago, without understanding they worked as a physician before,” Nikolaevskiy elucidates, shedding light on the systemic barriers impeding the professional advancement of immigrant doctors in the US.
In response to these challenges, both federal and state-level initiatives have been proposed to alleviate practice barriers for IMGs and address physician shortages, particularly in underserved areas. The Conrad State 30 and Physician Access Reauthorization Act, backed by the American Medical Association, seeks to overhaul the J-1 visa waiver program, enabling more immigrant physicians to practice in medically underserved regions rather than being compelled to return to their home countries.
Furthermore, several states, including Alabama and Washington, have implemented legislative reforms aimed at expediting the licensure process for foreign-trained doctors. These measures include provisions allowing IMGs to bypass residency requirements and obtain temporary medical licenses upon meeting specific criteria, such as completing postgraduate training abroad or fulfilling physician duties outside the US.
In addition to legislative efforts, community-based initiatives have emerged to provide support and guidance to IMGs navigating the complexities of the US healthcare system. Dr. Daniel Weber, for instance, established the International Healthcare Professionals Program in Lancaster, Pennsylvania, with the aim of offering essential assistance to immigrant doctors.
“It is daunting to master a new language and pass medical licensing and English proficiency exams while working full time to support themselves and their families,” Dr. Weber acknowledges, underscoring the multifaceted challenges confronting IMGs in their pursuit of professional integration.
Despite the formidable obstacles, some IMGs have managed to make significant strides towards resuming their medical careers in the US. Maxim Nikolaevskiy, for instance, recently completed the Bridge to Residency for Immigrant International Doctor Graduates (BRIIDGE) program at the University of Minnesota Medical School, which has paved the way for him to pursue family medicine residency and potentially secure a position in the current cycle.
Reflecting on his journey, Nikolaevskiy expresses gratitude for the opportunities afforded by the BRIIDGE program, which has enabled him to acquire invaluable clinical experience and reignite his aspirations of practicing medicine in the US.
“If not for the BRIIDGE program, I would still be [doing] medical monitoring in clinical trials or pharmacovigilance jobs. I’m grateful for the clinical experience and the people and institutions ready to give me a second chance,” Nikolaevskiy reflects, embodying the resilience and determination of IMGs striving to overcome formidable barriers in pursuit of their professional dreams.