• August 31, 2015

Doctors Who Trained Abroad Provide Same Quality of Care as U.S. Graduates, Study Finds

Graduates of U.S. medical schools and doctors who graduated from medical schools overseas provide the same quality of care, according to a new study in Health Affairs. The study, led by John J. Norcini of the Foundation for Advancement of International Medical Education and Research, found little difference when comparing the mortality rates of patients treated by foreign-trained physicians with those who studied in the United States.

The patients treated by foreign-born doctors who graduated from medical schools abroad even had the lowest death rates. Those treated by U.S. citizens who studied at foreign medical schools, on the other hand, had the highest mortality rates, raising questions about the training provided by medical schools overseas that admit many students from the United States and the quality of students who seek admission to offshore medical schools.

About a quarter of physicians over all, including both U.S. citizens and foreign nationals, studied at foreign medical schools, and about 25 percent of physicians in the new study were trained abroad. Congress has recently taken increased notice of the training provided by foreign medical schools, passing legislation that requires schools to have at least 75 percent of their students who take a U.S. medical licensing examination pass the test, up from 60 percent under current law, for those students to remain eligible for federal student aid.

"Despite a rigorous U.S. certification process for international graduates, the quality of care provided by doctors educated abroad has been an ongoing concern," said Mr. Norcini in a written statement from Health Affairs. "It is reassuring to know that patients of these doctors receive the same quality of care that they would receive from a physician trained in the United States."


1. physicsprof - August 03, 2010 at 09:47 am

It is possible that US-bound foreign-educated doctors are simply among the best in their classes while those US-born foreign-educated and coming back to US are simply the worst, failing in the past to get admitted to domestic medical schools. Thus the difference in mortality rates.

2. 11180837 - August 03, 2010 at 12:12 pm

An omitted consideration is the Graduate Medical Education of physcians in this study. The care received by a patient may be more reflective of the post-medical school training (residency-specialty training) than the training in medical school. There is a stratification in US residency programs, and higher tier US residency programs typically do not accept foreign medical school graduates, thus, typically, relegating these foreign medical school graduates to lower tier residency programs. Therefore, "the questions that are raised" should also be about the training in lower tier residency programs.

3. davi2665 - August 03, 2010 at 04:16 pm

Mortality rates vary considerably from hospital to hospital. The difference in mortality rates for the various groups mentioned above may reflect the types of positions available to these graduates when they complete their total medical training- undergraduate and graduate. Many of the "elite" hospitals try their best to avoid hiring FMGs, especially those from offshore medical schools. However, many of the offshore medical schools have their basic sciences courses taught by one or two professors per discipline who usually are there because they actually like to teach, and often have a distinguished record of teaching. They often are senior professors who are tired of the NIH grant money factories that pass as US medical schools. The third and fourth years then are spent in clerkships in US hospitals, at which one can also find many medical students from the US medical schools. In one major hospital system in which I oversaw graduate medical education, the offshore medical students were considerably more diligent and mature than the US medical students. So what is the difference in the actual educations? Perhaps the quality of students who are accepted, and the hospitals they end up in after their entire education, which is likely the main determinant of mortality. Patient mortality is affected by FAR MORE than the physicians caring for them.

4. drmink - August 03, 2010 at 09:07 pm

I think physicsprof has deduced what they didn't want to state at HA. Our students who go to foreign schools are the worst students, the foreign-born who come here are among the best.

5. davh7278 - August 04, 2010 at 10:49 am

Interesting article.

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