President Barack Obama’s recent health care reforms aim to increase overall access to health care while reducing the associated cost. Unfortunately, the United States already suffers from a shortage of primary care physicians, and the demand for more will grow sharply in the coming years as the government implements the reforms. The Association of American Medical Colleges expects a shortage of more than 91,000 doctors by 2020, a figure that has more than doubled from previous estimates due to expanded coverage. Part of the problem lies in the fact that graduates from American medical schools generally choose to pursue specialties, which earn more money than general practitioner positions. Many even feel forced to do this, anxious about the student loans that await them in the future.
Many people have suggested turning to foreign medical graduates in order to minimize the shortage of family doctors. Unfortunately, restrictive licensing rules and limited slots in American residency programs keep many foreign medical graduates from practicing in the United States. Those who wish to practice in American facilities must complete at least three years of residency here, but many applicants get turned away. In the European Union, partnerships exist between countries to import medical professionals to areas most in need. While the United States has a similar arrangement with Canada, graduates of institutions in other nations often face great difficulties in finding a residency program. Before these medical graduates can apply for the residency, they must travel to the United States and pass an exam. Many, especially those from the Middle East and South Asia, have trouble securing a travel visa in order to take the exam. If accepted into a program, students must then obtain another visa. The J-1 visa for education, however, requires that applicants leave the United States after training, defeating the purpose of completing a residency here.
The federal government’s Medicare program subsidizes hospital training programs, effectively giving Congress the power to control the number of available residency positions. Many foreign medical graduates are unable to gain entrance to residency programs due to a 1997 cap on Medicare-supported positions. Congress declared it would pay for only 98,000 residency slots. Since that time, the number of available residency slots has not grown at the same rate as the American population. Most of that expansion, furthermore, represents opportunities in advanced fields, not family medicine. Foreign medical graduates now fill about one in four residency positions, but that figure will decrease as more Americans choose to attend medical school. Many have proposed that Congress fund more residency slots, but that will detract from the funding that goes to health care subsidies. As the need for general practitioners increases, however, the United States will need to reach beyond its borders for new physicians.
AmeriClerkships matches pre-qualified foreign medical graduates with attending physicians and other medical professionals, allowing them to gain pre-residency clinical experience in a variety of specialties. This experience gives clinical trainees a serious competitive advantage when looking for a residency; in addition, several programs actually require foreign medical graduates to complete such training. After finishing clinical training through AmeriClerkships, international medical graduates receive an evaluation of their performance from their supervisor, who uses the same criteria applied to residents.