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Reports revealed that demand for medical technologists had skyrocketed. This places more
pressure on educators to make medical technology training flexible and accessible (AMT, 2006).
Valdez, A. (2010). Competencies of Career-Entry Medical Technology Graduates of Lyceum of
Batangas: Basis for Enhancement of the Internship Training Program. JPAIR Multidisciplinary
Journal, 4, 16-33. doi:
The typical career path for U.S. medical graduates includes medical licensure, completion of
categorical/advanced residency training, and achievement of board certification. Specialty-board
certification has become increasingly important for practicing physicians as a measure of quality
of care,1 and is being used by Health Maintenance Organizations, hospitals, and health insurance
companies in selecting physicians to provide care to their constituents.2 In spite of the increasing
importance of board certification, anecdotal evidence indicates a shift away from plans to
become specialty-board certified by a growing proportion of U.S. allopathic medical-school
graduates. Therefore, we sought to explore this seemingly paradoxical trend by identifying
factors that are associated with contemporary medical graduates plans to become board certified.
Andriole, D.A., et. al. (2006). Which U.S. Medical Graduates Plan to Become Specialty-Board
Certified? Analysis of the 19972004 National Association of American Medical Colleges
Graduation Questionnaire Database. Academic Medicine, 81(10 Suppl), S98-S102.
Approximately 25% of practicing physicians in the United States are graduates of medical
schools outside of the United States and Canada; they are commonly referred to as international
medical graduates (IMGs).1,2 This number is likely to rise, given both the increased demand for
physicians for the aging population and the fixed supply of physicians graduating from medical
schools in this country.3,4 The United States is not alone in its large number of IMGs; the
number of practicing IMG physicians is also rising in other countries including the United
Kingdom, Canada, Australia, and New Zealand.58 The U.S. health care system is dependent on
IMGs to fulfill the health services needs for health services of the American population.1,3,4,9 In
particular, IMGs are more likely to practice in specialties in which there have been shortages
(including primary care medicine and psychiatry)3,912 and to serve socioeconomically
disadvantaged patients.10,13,14 More specifically, IMGs disproportionately care for vulnerable
segments of the American population in the following settings: (1) rural, underserved areas,15
18 (2) not-for-profit, community health centers chartered to provide care to the indigent,19,20 (3)
clinics in impoverished, urban settings,19,20 and (4) Critical Access Hospitals.21 IMGs make up
a large constituency in the U.S. graduate medical education (GME) enterprise. For 4,500 5,000
IMGs annually,22,23 GME is the entry point into U.S. medicine from more than 120 different
countries.2,24 IMGs have trained at medical schools or health systems with varying levels of
sophistication and resources.24 Thus, each trainee arrives with unique personal, cultural, and
professional experiences and perspectives. Residency training is a demanding time for all
physicians. Some researchers believe that acculturation to a new health care system and way of
life makes this transition additionally challenging for IMGs.25,26 The goal of this study was to

identify personal, professional, and psychological similarities and differences between IMGs and
U.S. medical graduates (USMGs) who work together in the same internal medicine (IM)
residency training programs. We hypothesized that IMGs would score less favorably than
USMGs on scales measuring fatigue, stress, self-esteem, and personal growth because of the
added difficulties associated with their acculturation into both a new health care system and the
United States.
A.G., MD, MPH, D.E.K., MD, MPH, & S.M.W, MD. (2009). Similarities and Differences
Between International Medical Graduates and U.S. Medical Graduates at Six Maryland
Community-Based Internal Medicine Residency Training Programs. Academic Medicine, 84(3),
Worldwide, there has been a trend away from primary care by both allopathic and osteopathic
medical school graduates in recent years.12 This is a cause for concern, because the availability
of primary care directly and favorably affects the health status of local communities,
socioeconomic regions, and countries.3 4 We carried out the research reported below to identify
reliable predictors of students choosing primary care as their specialty of choice.
N.E., PhD, H.S.T., DO, PhD, MPH, & L.T., MS. (2009). Factors Affecting Specialty Choice
Among Osteopathic Medical Students Academic Medicine, 84(6), 718-723.
Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2016-17 Edition, Medical and Clinical Laboratory Technologists and
on the Internet at (visited July 31, 2016).