Why are there so many international PCPs?

[Dr Meow]

Before I begin, I want to apologize first. This topic isn't meant to offend anyone or degrade anyone's hardwork or experience.

I am curious and inexperienced. I have blue cross blue shield insurance, and I never thought about it until now as I get more and more involved in medical school (and the rigors of attending a US medical school) I am noticing stuff I haven't noticed before as I search for physicians to heal some of my chronic health problems before I start med school in 6 months. I was searching my in-network list of physicians on the website, and the usual, you get pages upon pages of physicians sorted by those closest to farthest from your location.

The biggest thing I've noticed is that nearly all of the primary care physicians for the first 3 pages, after which the distance is too far for me to get to by bike (which is currently my only method of transportation) (which is a list of 10 per page so 30 physicians total). Of the 30 physicians, only 3 of which were trained in the US. The remaining was trained internationally in mostly india, Hispanic countries, and china.

I want to understand:
1. Why are PCP's in Maryland (maybe someone can confirm if that's true elsewhere) 90% International.
2. Where are all the US train physicians if they aren't in primary care (Please correct me if I am making a wrong underlying assumption)
3. I understand that immigration is very difficult. I have friends I'm trying to help stay here. How do so many international physicians make it to the US?

Again, I apologize for my inexperience.

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[Gambino.]

1) They aren't 90% international, your sample size is just way too low; out of ~44k matched physicians this year, only ~6.9k were international (with a similar ratio of of US to IMG matching into primary care). Family medicine and internal medicine are also the least competitive residencies to obtain and since international grads have a tougher time landing a residency in general, they tend to gravitate towards less competitive specialties.

2) Point #1 also addresses this. Every PCP you see is US trained. They are all board certified in FM/IM by completing a 3 year US residency. They may have done schooling abroad but have had to pass multiple licensing exams and complete a whole residency stateside. Blue cross/shield is also a rather subpar insurance with many physicians not even accepting them so it is likely the international grads are the ones willing to see you.

3) The international ones you see are the most competitive applicant for that residency position that allowed them to move here; it is a very difficult process and many do not make it. With you being current M1 student, I would've thought you'd be more familiar with all the match rate data that gets put out showing both percentages and raw figures. They are interesting reads and recommend you check them out in your free time.