Physician Shortage in the US and International Medical Graduates

There has been a decreasing number of international medical graduates (IMGs) in the U.S. since 1980.

Universities stemmed some of the biggest medical advances in the health care industry amongst the world. The educational platform for the United States spells long term success for health care, by growing the next generation of top health care providers. In comparison Germany and Canada also are represented amongst the top 50 medical schools in the world, but lack any representation of the top 10 prestige rankings. On top of that, both other countries lack volume and opportunity to receive a valued medical education when compared to the United States.

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

The brain drain is not confined to physicians. Doctors represent only one quarter of health workers who made the move to the states in 1996, with nurses making up the majority

The United States has a significant “delivery of care” issue wherein physicians (and other HCPs) are concentrated in and around major cities and densely populated areas. This leaves rural populations with fewer physicians and more difficult access to care.

We have an aging physician population that are reaching the age of retirement. It takes three to seven years to fully train a new

Advances in medical science and technology still have force and effect on how our health care system has and will evolve over time. We have a technologically driven health care system. Our educational system shapes our health care system through its training methods and emphasis on the medical model. Depending on the discipline, training may key on treating rather than preventing disease. This generates demand for service delivery. Training of new physicians takes time and money. Because the costs for a medical education are significant, many students seek postgraduate training in a

Reports show that there is a decline in the rate that physicians move. It is suggested that the economy is preventing physicians from jobs changes or retirement. The moving rate has declined over the years: 18.2% in 2008, 15% in 2009, 12.4% in 2010, and 11.3% in 2011. According to SK&A spokesman Jack Schember, common factors such as a big caseload, a better salary, or better community are not motivators to move anymore. Although there is a clear declining trend there is not enough to measure the market supply and demand for physicians.

The debate continues as to whether or not America is really experiencing a healthcare workforce shortage. This debate continues to rage as commercial areas experience an overflow of healthcare professionals with the option to offer per diem employment to job seekers in these areas. However, rural areas continue to suffer from a lack of professional healthcare workers; specifically, those who specialize in specialist areas. The Alliance for Healthcare Reform (2011) has highlighted the following points as the factors which will be deemed responsible for this shortage:

The vacant positions need to be filled by new “cogs” and the physicians will do this is if they receive lots of money (Phillips, 2014). Money isn’t always what is going to draw people to work in Saskatchewan (Kaul, 2013). It could be the lifestyle, opportunities and many other aspects (Kaul, 2013). They may have come to the country to provide their family with a better life and opportunity but to the government they are just here to work.

A lot of people are bewildered why more foreign doctors are not invited to work in American workplaces. There is a severe discrimination and prejudice amongst anyone who is not an innate U.S. citizen. One of the main reasons why Americans are trying to push foreigners away is for the safety of their nation. Some Americans think that all foreigners are terrorists and are set out to destroy Americans but this is not true at all. In fact, statistics show that foreigners actually bring good to the nation. Brian Palmer, author of Slate magazine says, “During the 1990s, a series of studies showed that graduates of foreign medical colleges performed slightly worse on exams than their U.S.-trained colleagues, and program heads gave marginally better reviews to domestic physicians. By the turn of the century, however, that gap had disappeared. International graduates now score higher than U.S.-educated doctors on many exams” (Palmer). This was shocking to know that even though foreign doctors are doing better than domestic doctors, they are still mistreated.

Research Question – What are the factors that created the shortage of primary care physicians?

There are two main measures of medical underservice in the U.S., health professional shortage areas and medically underserved areas and some special need populations. Both measures require communities to apply for designation. These designations allow the government to target resources to those determined to be most in need (Colwill and Cultice, 2003).

The number of physicians in the country has been decreasing at such a great rate that the government and other stakeholders in the health care sector are trying to camouflage this by increasing the number of foreign doctors practicing in the country. The American Medical Association has been trying to promote these re-entry programs designed for physicians since the year 2009 to help curb this problem. There are many people who can see what the problem is, but it is not possible for them to do much about it. Physicians also see this problem, and they are well aware of why the shortage is arising, but they are also unable to do much to prevent the issue. There are many problems that lead to the shortage of physicians, and unless something is done, it will continue escalating ADDIN EN.CITE Lynch19721573(Lynch, 1972)1573157317Lynch, MichaelThe Physician "Shortage": The Economists' MirrorAnnals of the American Academy of Political and Social ScienceAnnals of the American Academy of Political and Social Science82-88399ArticleType: research-article / Issue Title: The Nation's Health: Some Issues / Full publication date: Jan., 1972 / Copyright © 1972 American Academy of Political and Social Science1972Sage Publications, Inc. in association with the American Academy of Political and Social Science00027162http://www.jstor.org/stable/1040122( HYPERLINK l "_ENREF_6" o "Lynch, 1972 #1573" Lynch, 1972).

Slowly, months pass by, and you find yourself “drifting goals” because you do not comprehend the language or the system. A family depends on you, so you apply "fixes that fail" and nothing seems to resolve the reality that your inability to practice “limits your success.” In fact, depression and anxiety kick in, and now you start to “escalate.” The system fails you, and you find yourself “shifting the burden.” The competition is intense. In essence, it is the “tragedy of the commons,” we fight for the same resources, yet it is never sufficient. Now, you feel trapped, and realize you cannot “grow without investment,” so just give up! Never forget, regardless, U.S. trained medical professionals have better resources from the beginning. Therefore, I salute you: “Success to the Successful!” In their countries, International Medical Graduates (IMGs) study five to eight years to become physicians. When they come to the United States, graduates often struggle with a new language and standardized tests. Numerous foreign doctors like myself, explore alternative pathways into a health care career. Even if a foreign medical graduate speaks the language and passes the test, the disadvantage exists. Foreign medical graduates have a 50% chance they cannot advance their careers compared to the 94% of Seniors in US medical schools (Bailey,