ARE INTERNATIONAL MEDICAL GRADUATES A FACTOR IN RESIDENCY PROGRAM SELECTION - A SURVEY OF 4TH-YEAR MEDICAL-STUDENTS

Purpose. To examine whether the proportions of international medical g raduates (IMGs) enrolled in certain residency programs would affect st udents' selection of those programs during the match, and to determine the importance of this factor relative to other established program-s election factors. Method. A sample of 702 fourth-year students at 18 g eographically diverse U.S. medical schools during March and April of 1 994 were mailed a confidential survey asking them to rank and rate hyp othetical programs and to rate the importances of selected characteris tics in their rankings of programs during the match. The students were asked to rank five hypothetical programs described by nine characteri stics. One-third of the students received additional information about the programs' reputations; another third, information about the perce ntages of IMGs in the programs. The control group received no informat ion about these two characteristics. Comparisons of the mean rankings and ratings of the five programs between the control and intervention groups were made using the Mann-Wilcoxon rank-comparison statistical t est. Results. The response rate was 44%, with 291 survey forms returne d completed (45 were returned due to no forwarding address). When the rankings and ratings of the control and intervention groups were compa red, the programs with higher numbers of IMGs worsened significantly i n rank and rating (p<.001 for both), whereas the programs with better reputations improved in rank (p<.001) and rating (p<.005). Conclusion. The results suggest that the proportion of IMGs in a residency progra m is a significant factor in program selection and is as important as previously established factors such as program reputation. Students, h owever, do not acknowledge the importance of this factor. Program dire ctors and governing bodies may want to consider these findings when ev aluating the impact and distribution of IMGs in U.S. training programs .