WASHINGTON -- The percentage of international medical graduates (IMGs) practicing in rural underserved areas of the United States is the same as that of U.S. medical graduates (USMGs) and IMGs are no more likely than USMGs to locate to rural underserved areas. These are the results of the study, "International Medical Graduates and the Rural Underserved Primary Care Workforce," to be published in this month's Health Affairs. IMGs are physicians who have graduated from medical schools outside the United States.

Both the medical profession and the federal government are interested in developing and revising policies and programs that discourage an oversupply of physicians and encourage increased training of those specialists in short supply.

Kenneth S. Fink, M.D., lead author of the article, notes "The goal of workforce policy should not necessarily be to increase the absolute number of primary care resident physicians, but rather to increase the percentage that locate in rural underserved areas."

"Given the belief by many groups that physicians are oversupplied but maldistributed, the focus of future policies should be directed at increasing the percentage of primary care physicians who locate in rural underserved areas, with attention given to the appropriate primary care specialty distribution," conclude the authors.

The authors conclude that there is not an overreliance in rural areas on international medical graduates to fulfill primary care needs. USMGs and IMGs are going into these areas at the same rate. However, USMGs are slightly more likely to become family physicians and IMGs are more likely to become pediatricians and internists.

"It is concerning to me to see that the majority of internists and pediatricians going to rural areas are IMGs. Does it indicate that rural practice is simply undesirable for USMGs in these specialties, or does it indicate something more concerning--that rural areas cannot support internal medicine and pediatric practices?" asks co-author Robert Phillips, Jr., M.D., assistant director of the Robert Graham Center: Policy Studies in Family Practice and Primary Care, located in Washington, D.C. "Given what we now know about the reliance of rural areas on USMG family physicians, I am even more concerned about the significant decline in USMGs choosing careers in family medicine."

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The Robert Graham Center conducts research and analysis that brings a family practice perspective to health policy deliberations in Washington. Founded in 1999, the Center is an independent research unit working under the personnel and financial policies of the American Academy of Family Physicians.

The information and opinions contained in research from the Robert Graham Center do not necessarily reflect the views or policy of the AAFP.