1667 



The LDCs of Asia, Africa, and Latin America are heavily repre- 

 sented in the AM A statistics on FMGs for 1970. Africa is credited with 

 1,126 (2 percent), Latin America with 9,929 (17.4 percent), and Asia 

 with 21,002 (36.7 percent). Altogether the LDCs account for an FMG 

 population of 32,157 of the total of 57,217, or 56.1 percent, as com- 

 pared with Europe's 24,756, or 43.3 percent.^" High on the list are the 

 following LDCs: Philippines, with 7,352 FMGs in the United States; 

 India, with 3,957; South Korea, 2,095; Mexico, 1,831; Iran, 1,631 ; and 

 Thailand, 1,098. 



Tho growing prominence of FMGs in American medicine is further 

 illustrated by the fact that, as of 1971-72, one of every six M.D.s 

 practicing in the United States was an FMG (or one of every five, if 

 FMGs from Canada are included); more foreign physicians were ad- 

 mitted to the United States in 1971 (10,540) than were graduated from 

 American medical schools (8,974); there was one FMG to every two 

 graduates of American medical schools serving on hospital staffs "in 

 approved graduate educational positions" ; ^'*^ about one-half of the 

 candidates for State licensing examinations were FMGs (in some 

 States, as many as three-quarters). Of almost 20,000 FMGs in gradu- 

 ate educational positions in American hospitals and universities in 

 1970-71, about 3,000 were interns, 13,000 we^e residents, and 3,000 

 were serving in other traditional training positions. 



The existence of this situation has led to criticism of the United 

 States. "Such criticism, much of which comes from within the country, 

 illustrates both the magnitude and seriousness of the problem for 

 domestic medical manpower concerns ^^^ and more important, for the 

 purposes of this study, for its foreign policy implications." ^*^ For 

 example, in an article on "The Migratory Flow of Doctors to and 

 from the United States" in Medical Care for January-February 1971, 

 Dr. Irene Butter of the University of Michigan School of Public 

 Health wrote: "A permanent loss of doctors from the poorest to the 

 richest nations is the most disturbing aspect of the medical brain 

 drain." As reported by the Department of State in Proceedings of 

 Workshop on the International Migration of Talent and Skills, October 

 1966, Dr. G. Halsey Hunt, Executive Director of the Educational 

 Council for FMGs, stated : "It is a depressing and humbling experience 

 for an American doctor to visit a medical school in one of the unindus- 

 trialized countries of Asia, to have his host open the conversation with 

 a bland statement, 'You people in the United States and your hospitals 

 couldn't get along without our doctors' — and to realize . . . this is a 

 fact. ... It ill becomes us to depend indefinitely on other countries 

 for the production of medical manpower to provide services to Ameri- 

 can patients." ^" 



THE FOREIGN MEDICAL GRADUATES AS A U.S. DOMESTIC PROBLEM 



But setting aside questions of equity or the long-term foreign policy 

 interests of the United States, the influx of FMGs poses a domestic 

 problem. It does so by threatening U.S. medical standards and limiting 

 the opportunities for aspiring Americans to study medicine. The 



2" Oceani a accounted for 404 (0.7 percent). 



2" VVhelan, Brain Drain, vol. II, p. 1125. 



2" Concerns over domesti c impact focus mainly on the question of medical standards and on the apparent 

 effect of a substantial annual influx of FMGs in holding back expansion of U.S. medical schools. (Further 

 discussion of these aspects follows.) 



2<T Whelan, Brain Drain, vol. II, p. 1119. 



2" Ibid., p. 1120. 



