IMGs and "physician surplus"

[kent14]

Being a 1st year US medical student, I have read several articles about how physicians face an uncertain employment future due to growing oversupply of physicians in this country. This oversupply of physicians does not only adversely effect physician employment opportunities, it also is thought to be bad for the US health care system in general. Studies have shown that in regions with a glut of physicians, the number of procedures done rises in direct proportion to the oversupply of physicians. This suggests that some of these procedures may have been 'unnecessary' procedures, and this raises the cost of healthcare for everybody. I would argue that the solution to the oversupply of physicians is not to drastically decrease the number residency spots open to International Medical Graduates (IMGs). Although there is a surplus of physicians in the US, it is a geographic surplus, meaning that while certain regions have too many physicians, other regions, such as rural or poor urban areas, remain underserved and are in desperate need of more physicians. IMGs have historically been the most willing of all physicians to work in these underserved areas that have been all but ignored by the US graduates. By decreasing the number of residency positions open to IMGs, the maldistribution of physicians in this country will only be exaggerated while a glut of physicians will still remain in those regions that US graduates find most desirable to practice in. Increasing the number of US medical school spots would only magnify the problem of a physician surplus and make the maldistribution of physicians worse. IMGs are an easy target for the physician surplus problems but they are not the solution. The geographic distribution of the physicians in this country must be adressed before decreasing the number of residency spots. Finding ways to make these underserved areas more attractive to US graduates, through either federal aid loan forgiveness programs or by creating medical school admission programs that require students to practice in underserved areas might be part of the solution. I think that US legislators are rightfully hesitant to do anything about a 'surplus' of physicians in training or decreasing the number of IMGs when they have communities in their own district that are serious need of more physicians. Before we start turning away more qualified IMGs, I think that we need to first address the geographic maldistribution of physicians in this country.

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[baylor21]

I agree for the most part with your statement, but a minor detail needs clarification.

I agree with you completely that IMGs initially are much more willing to work in rural/underserved areas.

However, the vast majority of IMGs stay in rural areas only long enough to get a foothold in the U.S., and then move to the big cities like all the other doctors.

I cant necessarily blame them. Since most rural areas tend to be poorer and white (with the exception of the Deep South) it must be hard living somewhere where there is no-one else of their own nationality.

If you look at rural statistics, I think you will find that while there are many more short term IMGs working in rural areas, in the long run the vast majority move back to urban areas. This is probably mostly due to the fact that they have a much better chance of landing a residency/fellowship position once they have a little time behind their belts practicing in the U.S.

I feel a better solution would be to increase incentives for doctors to practice in rural areas.

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"There is nothing more powerful on this Earth as a man who has nothing to lose. It does not take ten such men to change the world--one will do." Elijah Mohammed

 

[Socceroo4ever]

That's an interesting idea, increasing incentives for working in rural, underserved areas. Just to put all that into perspective, what kind of incentives do you all think would be good to offer, and if you realize we might be offered these same incentives later in our careers, which ones would you accept?

I think I'd vote for more paid vacation/travel (to allow rural physicians to be near their big-city colleagues more often); reduced living costs in return for lower wages (although I'm not certain about the statistics: is it cheaper to live rural or urban?); and especially incentives to assist in educating your children to offset lower wages.

 

[Billie]

Hello,

Speaking as a native West Virginian from a rural area, it usually is cheaper to live in a rural area. Land and housing costs are "usually" cheaper, though I am currently having a friendly debate with a pal from FL, and he says it is cheaper in FL. I used to live in Boston, and it is DEFINITELY cheaper than there or really most all of New England. I think my friend is referring to taxes as this state (WV) does seem to enjoy its taxes!

One of the hospitals I shadow and do rotations at pays its doctors well above the national avg to get physicians to come to the rural area. It has worked well. Yet recently, the hosp. is in the midst of being bought out by a bigger health care corp and the worry among the staff is that salary will drop to more "normal" levels. In efforts to cut costs, the corp. may force physicians out. We shall see...

Just my two cents

Billie, MS-III