Global Care: The Impact International Medical Graduates Make on Michigan’s Physician Workforce


Medicine is a global science, but it is only in relatively recent history – since World War II – that the United States has been part of the field’s cutting edge. International medical graduates provide one bridge between innovations abroad and the needs of Michigan’s patients.

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Broadly speaking, international medical graduates can be grouped into five categories based on their residency status: US born, J-1 visas, H-1B visas, green cards, and US citizens.

Many US-born citizens are educated in medical schools abroad. According to the American Medical Association, most of these students were educated in India or Dominica.

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Physicians with J-1 visas are graduates of international medical schools in the United States for internship, residency, or fellowship training. Unless they receive a waiver or green card, these physicians must return to their home country for two years before working in the United States.

H-1B visas are a type of non-immigration visa that allows employers to employ physicians and other individuals with specialized occupations. Employers may also sponsor a physician to become a naturalized citizen.

This month (October) marks the beginning of the application window for international medical graduates (IMGs), who are enrolled in residency or fellowship programs, to apply for the Conrad 30 program, under which 30 physicians with a J-1 visa, or educational exchange visa, may waive the requirement that they must return to their home country for two years prior to working full-time in the U.S.

In order to qualify for the program, the Conrad 30 physicians must agree to work full-time for three years in an underserved community, with priority going to physicians working in primary care specialties including: internal medicine, obstetrics and gynecology, family medicine, psychiatry, and pediatrics.

Michigan has more than 550 physicians with J-1 visas providing care in underserved communities. About half (45%) of J-1 physicians nationally specialize in internal medicine, 11% specialize in pediatrics, 8% in family medicine, 7% in general surgery, and 5% in psychiatry.

After completing their J-1 requirements, many of these physicians will stay in Michigan. In fact, Michigan has the 9th largest number of full-time physicians with international backgrounds. Over 10,000 international physicians bring their talent to Michigan to live and work in our communities.

This is especially important since a significant number of US medical school seniors prefer specializations beyond primary care. In 2000, 57% of graduating medical school students went into family medicine; in 2011, less than half – 47% – of graduating medical school seniors entered family medicine.

Internationally-educated physicians come to the US from a variety of countries, but the five biggest (in order) are India, Canada, Pakistan, Lebanon, and the Philippines.

From providing care to bringing new cultural experiences to Michigan schools, everyone in the state benefits from these physicians and their families.

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