COMPARISON OF IMG-DEPENDENT AND NON-IMG-DEPENDENT RESIDENCIES IN THE NATIONAL RESIDENT MATCHING PROGRAM

Objective.-to provide insight into the dynamics that determine the pat tern of participation of international medical graduates (IMGs) in gra duate medical education (GME), Design.-Data on IMG-dependent programs (ie, those having at least 50% of first-year positions filled by IMGs) and non-IMG-dependent programs in 6 core specialties (internal medici ne, family practice, obstetrics and gynecology, surgery, pediatrics, a nd psychiatry) were matched with application data from the 1989 and 19 95 National Resident Matching Program (NRMP), Main Outcome Measures.-P articipation of IMG-dependent and non-IMG-dependent programs in the 19 95 NRMP and the pattern of US medical graduate (USMG) and IMG applicat ions to these programs in 1989 and 1995. Results.-Of the 1634 programs in the 6 specialties, 93.5% participated in the 1995 NRMP, The 1165 n on-IMG-dependent programs were significantly more likely to participat e in the NRMP and were slightly more likely to fill their offered posi tions than were the 469 IMG-dependent programs. Specifically, IMGs con stituted 76% of applicants to IMG-dependent programs and only 14% of a pplicants to non-IMG-dependent programs. Changes in NRMP data between 1989 and 1995 indicated that the number of IMG applications to IMG-dep endent programs increased 88.7%, as did the number of applicants ranke d. Conclusions.-Persistent differences exist in the mix of USMGs and I MGs applying through the NRMP to IMG-dependent and non-IMG-dependent p rograms. Over time, programs that enroll large numbers of IMGs are lik ely to experience an increase in the number and proportion of applicat ions from IMGs and a decrease in the number and proportion of applicat ions from USMGs, If policies are adopted to limit IMG access to GME, I MG-dependent programs may be unable to recruit USMGs unless the total number of GME programs or the quality of existing programs fundamental ly changes.