Foreign-Trained and Domestically-Trained Physicians Offer Essentially the Same Care, Survey Says

August 3, 2010

Roughly a quarter of all physicians currently practicing medicine in the United States completed their medical studies in some other country. A recent survey of the quality of care shows that patients receive essentially the same care no matter where their doctors trained, but a deeper look at data suggests that doctors who were not U.S. citizens at the time they started medical school have slightly better results.

The Foundation for Advancement of International Medical Education and Research, based in Philadelphia, had a team, including the Foundation’s president and CEO John Norcini, examine records for 244, 253 hospitalizations of patients with either acute heart attacks or congestive heart failure at 184 different Pennsylvania hospitals. These patients were seen between January 1, 2003, and December 31, 2006, by a total of 6,1113 cardiologists, family physicians, and internists. 75.5% (4,616) were trained in American medical schools while the other 1,497 trained at 391 different schools in 79 countries. Of the foreign-educated physicians, 374 of them were U.S. citizens studying abroad, while the other 1,123 (75%) were not U.S. citizens when they began medical school.

According to the patient files, the percentage of in-hospital deaths due to congestive heart failure was 3.1% for internationally trained doctors, and 3.4 percent for those who studied here in the States. Among the foreign trained physicians, the percentage of deaths was 3% for those who were not U.S. citizens during medical school, and 3.5% for those who were. For heart attack patients, the in-hospital death rate was 12.7% for internationally trained doctors and 13.1% for those who trained domestically, and the split in foreign-trained doctors was 12.2% for non-U.S. citizens and 14.4% for citizens.

In noting the statistics for U.S. citizens trained at foreign medical schools, the study concluded that it “suggests the importance of further research to clarify whether their performance is a result of their medical education experiences or their ability.”

In a press release, Norcini said, “Despite a rigorous U.S. certification process for international graduates, the quality of care provided by doctors educated abroad has been an ongoing concern. It is reassuring to know that patients of these doctors receive the same quality of care that they would receive from a physician trained in the United States.” He also said, “These findings bring attention to foreign-trained doctors and the valuable role they have played in responding to the nation’s physician shortage.”