Foreign Medical Study

There are five pathways for foreign graduates to follow in securing AMA-approved internship and residency appointments: (1) transferring with advanced standing to a U.S. medical school and repeating one or more years (the policies of U.S. medical schools regarding transfer and advanced standing are given in the profiles for the individual schools in Chapter 6); (2) certification by ECFMG on the basis of satisfying the ECFMG educational requirements as well as passing the ECFMG examination; (3) obtaining a full and unrestricted license to practice medicine, issued by a state or other U.S. jurisdiction authorized to license physicians; (4) successfully passing the complete licensure examination in any state or licensing jurisdiction where a full and unrestricted license is issued upon satisfactory completion of internship or residency without further examination; and (5) an approach that is especially popular among one segment of foreign medical students, and is for obvious reasons known as the Fifth Pathway, which is discussed in the next section.

Among the drawbacks of attending a foreign medical school is the difficulty in securing a residency appointment at a U.S. hospital upon graduation. A substantial number of Americans, after investing much effort, time, and money, are unable to secure a residency in this country due to a variety of reasons. First, they may have received a poor medical education at the school they elected to attend, which seriously weakens their candidacy for postgraduate training. Second, they are competing against other foreign graduates for the very limited number of places not filled by graduates of U.S. schools. Finally, the total number of residency openings is diminishing in response to the perceived over-supply of physicians that is anticipated. Consequently, the awareness of this potential problem in the educational program of foreign medical students should stimulate careful consideration of this career pathway.