International Medical Graduate Representation in the US Physician Workforce

International medical graduates (IMGs), both US- and foreign-born, make up a significant minority of the US physician workforce. In-depth analyses examining the path IMGs take to become US physicians as well as the role they play in contributing to the US physician workforce and addressing gaps in healthcare are limited. In this chapter, we characterize the representation trends for IMGs across training specialties over the past several decades including their areas of highest representation (i.e., Internal Medicine, Pathology, and Neurology), as well as their declining representation over the most recent decade. Potential explanations for the declining representation, such as geopolitical, economic, cultural, and visa challenges, are explored. This discussion includes an overview of the roadmap that IMGs take to become licensed and board-certified US physicians and the hurdles they face to achieve that end. Lastly, potential interventions and solutions to mitigate some of these barriers and facilitate the training of IMGs are reviewed.