Brotherton SE, Tang SF.

AHSR FHSR Annu Meet Abstr Book. 1996; 13: 159-60.

Division of Health Policy Research, American Academy of Pediatrics, Elk Grove Village, IL 60007-1098, USA.

RESEARCH OBJECTIVES: Several proposals suggest limiting international medical school graduates (IMGs) into U.S. residency training slots to slow the growth of physicians. We compare practice and demographic characteristics of IMG general pediatricians to USMG general pediatricians to get a glimpse of what the "IMG-less" pediatric workforce would look like. STUDY POPULATION: In 1994 a practice characteristics survey was sent to a random sample of 1,800 pediatricians, with 1,137 responding. We limited our analyses to general pediatricians (51.5% of respondents), excluding residents and pediatricians who were currently in or had completed subspecialty training. Of these general pediatricians, 17.3% were IMGs. STUDY DESIGN: We used bivariate and multivariate statistics to compare characteristics of IMGs to USMGs, examining sex, age, race, ethnicity, practice location, time in direct patient care (DPC), number of patients per week, and other practice variables. PRINCIPAL FINDINGS: The two largest practice differences between the two groups are 1) more IMGs are in solo practice compared to USMGs (29.1% vs. 10.1%), and 2) 30% fewer IMGs than USMGs are board certified in general pediatrics. Substantial demographic differences exist; IMGs are less likely to be white and female, and more likely to be Hispanic. Discriminant analysis demonstrated which variables independently distinguish the two groups, revealing that IMG general pediatricians were more likely to not be board certified, to be non-white, Hispanic, male, and to practice in a solo practice, and not in a group. The discriminant function explained 27% of the differences between the two groups, and correctly classified 85% of the total, performing more accurately for the larger USMG group. CONCLUSION: There are several significant practice and demographic differences between IMG and USMG general pediatricians, which may affect practice styles and patients' access to pediatric care. RELEVANCE TO HEALTH CARE POLICY AND DELIVERY: Our survey did not cover patient characteristics; however, research has found IMG pediatricians, non-board certified pediatricians, and pediatricians in solo practice are more likely to fully participate in the Medicaid program, and that minority group physicians are more likely than non-minority physicians to treat minority patients. Insofar as primary care IMGs may serve divergent patient populations compared to primary care USMGs, their reduction in numbers may create a weakness in the ability of the pediatric workforce to provide for all children.

Publication Types:

• Meeting Abstracts

Keywords:

• Child
• Data Collection
• Female
• Humans
• Internship and Residency
• Male
• Medicaid
• Pediatrics
• Physicians
• Primary Health Care
• Schools, Medical
• United States
• economics
• manpower
• hsrmtgs

Other ID:

• HTX/97604457

UI: 102222359

From Meeting Abstracts