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International Medical Graduate Resident Physicians in Psychiatry: Decreasing Numbers, Geographic Variation, Community Correlations, and Implications

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Abstract

Objectives

The number of International Medical Graduate (IMG) physicians matching into categorical psychiatry decreased steadily over the past decade. The authors sought to understand if this trend was occurring in other specialties, if US IMG physicians and non-US IMG physicians were equally affected, and if certain regions of the USA were more affected by this decrease than others. Finally, the authors compared the proportion of foreign-born individuals within a US census region to the proportion of non-US IMG physicians within that region.

Methods

The authors analyzed data from the National Resident Matching Program from the years 2014–2020. Statewide data was aggregated into nine geographic regions, as per the US Census Bureau. The number of foreign-born individuals within each US census region was calculated from the 2018 American Community Survey data.

Results

In comparison to eight other specialties, psychiatry saw the greatest decrease (46.3%) in IMG physicians matching into PGY-1 positions. Both US IMG physicians and non-US IMG physicians were equally affected. The percentage of IMG physicians decreased in each of the nine US census regions. In six out of nine geographic regions, non-US IMG physicians were under-represented when comparing their proportion to the number of foreign-born people that lived within that region.

Conclusions

Decreasing numbers of IMG physicians in psychiatry training may have long-term implications for cultural competency, serving underserved populations, and fellowship recruitment. We advocate for program directors to recognize IMG physicians as an important source of diversity and to recruit residents that reflect the communities they serve.

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Acknowledgements

Selected portions of the data from this manuscript were presented at the 2020 American Association of Directors of Psychiatric Residency Training Annual Meeting.

Author information

Authors and Affiliations

  1. Yale School of Medicine, New Haven, CT, USA

    Sanya Virani

  2. BronxCare Health System, Bronx, NY, USA

    Souparno Mitra

  3. Emory University School of Medicine, Atlanta, GA, USA

    M. Alejandra Grullón & Robert O. Cotes

  4. American University of Integrative Sciences, School of Medicine, Bridgetown, Barbados

    Ayesha Khan

  5. Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA

    Jessica Kovach

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  1. Sanya Virani
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  2. Souparno Mitra
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  3. M. Alejandra Grullón
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  4. Ayesha Khan
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  5. Jessica Kovach
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  6. Robert O. Cotes
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Corresponding author

Correspondence to Sanya Virani.

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Disclosures

Outside of this work, Dr. Cotes has received research funding from Otsuka, Lundbeck, Alkermes, and Roche. He is a consultant to the American Psychiatric Association and Saladax Biomedical. The remaining authors have nothing to disclose.

Additional information

Selected portions of the data from this manuscript were presented at the 2020 American Association of Directors of Psychiatric Residency Training Annual Meeting.

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Virani, S., Mitra, S., Grullón, M.A. et al. International Medical Graduate Resident Physicians in Psychiatry: Decreasing Numbers, Geographic Variation, Community Correlations, and Implications. Acad Psychiatry 45, 7–12 (2021). https://doi.org/10.1007/s40596-020-01380-0

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  • DOI: https://doi.org/10.1007/s40596-020-01380-0

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