LHS+ Individuals in Graduate Medical Education

According to the Accreditation Council on Graduate Medical Education (ACGME), in the 2018–2019 year, LHS+ individuals consist of 5.3% of residents and fellows (Data Resource Book Academic Year 2018–2019. PDF. Accreditation Council for Graduate Medical Education; 2018 ( https://www.acgme.org/Portals/0/PFAssets/PublicationsBooks/2018-2019_ACGME_DATABOOK_DOCUMENT.pdf ). More concerning are specialty areas where the percentage of LHS+ individuals is critically low, such as radiology, orthopedic surgery, and otolaryngology. Some tout Latin American graduates as a potential solution, but the data is scarce. The Educational Commission for Foreign Medical Graduates does not release regular reporting on the racial and ethnic composition of internationally trained physicians aspiring to enter residencies and fellowships. Beyond recognizing USMLE and clerkship grades as biased, institutional leaders should consider the question “How ought GME Program Directors best assess the LHS+ medical student?” The answer is to do so the same way we should evaluate all candidates—holistically.