Geographic Trends of International Medical Graduate Residents and Faculty in U.S. Plastic Surgery Training Programs
Ronald K. Akiki, MD1, Brooke Barrow, BA1, Nikhil Sobti, MD1, Scott Schmidt, MD1
Brown University, Providence, RI.
Background: 13.6% of academic plastic surgeons in the US are IMGs. The objective of this study was to evaluate US plastic surgery training programs and identify the countries in which IMGs obtained their medical degrees and the states in which they matched. In addition, we sought to establish a correlation between IMG faculty and IMG residents in US plastic surgery programs.
Methods: Program websites were reviewed for current residents and faculty. The primary outcome of interest was the country in which IMG plastic surgery residents had obtained their medical degrees. Secondary outcomes of interest included program state location, PGY year of each IMG resident, and number of IMG faculty (including program director and chair) per program.
Results: 101 independent and integrated plastic surgery programs were screened for IMG faculty and residents. A total of 39 different states were represented which included 1262 current residents of which 92 (7.3%) were IMGs. IMG residents received their medical degrees from 46 different countries. The most common countries were England (n=6, 6.5%) for IMG residents and Canada (24.5%) for IMG faculty. The most common region represented for residents was South America (n=44, 47.8%). The highest proportions of IMGs per total state plastic surgery residents were found in West Virginia (33.3%) and Minnesota (25%). This high percentage was also represented within the faculty where13.5% and 15.6% of Program Directors and Program Chairs were IMGs, respectively. There was a statistically significant difference between the proportion of IMG residents in programs that had an IMG program director versus programs with no IMG program director (p=0.016). No such statistically significant difference was found between the proportion of IMG residents in given programs with IMG chairs (p=0.55). There were significantly more IMG faculty in programs with IMG chairs (p=0.001). The number of IMG faculty was positively correlated to the number of IMG residents in a given program (p=0.0001, r=0.39).
Conclusion: IMG residents constitute a small but appreciable portion of current plastic surgery residents in the US; the majority have earned their degrees from the South America region. IMG faculty have a strong representation in academic plastic surgery, as evidenced by the number of IMG Program Directors and Chairs. Programs with IMG Chairs had a greater number of IMG faculty. IMG plastic surgery residents are more likely to be recruited to programs that have an IMG program director and a higher number of IMG faculty.
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