1222 



trationr*^° FMGs are also strongly represented in the field of psychia- 

 try. The AMA/FMG study lists 1,934 FMGs as having received an 

 American Specialty Board certification in Psychiatry and Nenrol- 

 ogy.=5i According to Dr. E, Fuller Torrey and Dr. Kobert L. Taylor, 

 officials of the National Institute of Mental Health, an estimated 34 

 percent or 1,370 out of 4,040 psychiatric residencies in 1970 were filled 

 by FMGs. They also estimated that 3,100 foreign-trained, unlicensed 

 M.D.s form the bulk of psychiatric staff at state mental hospitals, pris- 

 ons, and institutions for the mentally retarded.^^^ 



At least quantitatively in terms of reducing the medical manpower 

 deficit, it appears that the United States has gained much from the 

 work of the FMGs. Margulies and Bloch give the following assess- 

 ment of their general contribution to American health care: "This 

 country has received from other countries many outstanding teachers 

 and research scientists who have contributed notably to our society 

 and its institutions. Other FMGs have been of great service to the 

 communities in which they practice medicine." ^^^ 



Savings to United States fi^oni FMGs. — In terms of cash savings, 

 FMG« have made a considerable contribution to the United States. 

 Attempts have been made at a rough evaluation of savings in educa- 

 tional costs. Such costs to the LDCs, noted above, give some insight 

 into this matter. 



Generalizing on the role of the FMG in the American health system, 

 Stevens and Vermeulen state categorically that whatever the justifica- 

 tion for their use, "the cold fact" remains that 63,391 of the 334,028 

 physicians in the United States in 1970 received their primary medi- 

 cal education outside the United States. "This education," they write, 

 "represents a huge gain to this country in terms of value received for 

 medical education." ^^* Those authors do not attempt to calculate over- 

 all cash savings to the American people, but specifically with regard to 

 hospital functions, they estimate that FMGs "are contributing work 

 worth at least $125 million a year to patients in American hos- 

 pitals." =^^ 



Assuming that the educational cost of a M.D. in the United States 

 is at an estimated figure of $83,000 per person, the total F^MG popula- 

 tion as of December 1970 of 63,391 represents a theoretical savings, if 

 the equivalent number had been produced from native stock, of 

 roughly $5,261,453,000. (See Table 32.) The estimated figure of $83,- 

 000 is not excessively high, as Henderson implies. According to an 

 October 1973 report of AAMC, the average annual cost of under- 

 graduate medical education is $21,350 per student, or a 4-vear total 

 of $85,400."^ 



660 Ibid., p. 14. 



651 AMA. FMO Study, 1971, p. 11. 



652 Stuart Auerbach, "Allen Psychiatrists lilt as 'Cheap Labor' In U.S.," The Washington 

 Post, May 2, 1972. p. Al. 



663 Margulies and Bloch, op. clt., p. vl. 



66* Stevens and Vermeulen, op. dt, p. 19. 



655 Ibid., p. 9. 



5M Henderson. Emigration of Highly Skilled Manpower from the Developing Countries, 

 1970, p. 132. Mr. Henderson writes : "Costs of educating professionals in the United States 

 are, of course, very much higher [than the $20,000 figure given by the House Government 

 Operations Committee on the investment cost in education per professional in the LDCs], 

 mounting, in the case of surgeons (the most expensive), up to $83,000 per person." Sources 

 examined on brain drain generally do not explain the criteria for arriving at such base 

 figures. It cannot be determined whether estimated costs include total cost of education 

 from primary and secondary schools through college and medical school and whether they 

 include also costs beyond strictly tuition and living expenses to the student. 



The figure of $83,000 per person is not, however, too high as Mr. Henderson suggests. 

 According to a recent report by the AAMC, the annual cost per medical student in the 



