1226 



TABLE 33.— ESTIMATED SAVINGS TO THE UNITED STATES IN EDUCATIONAL COSTS OF IMMIGRANT FMG'S FROM 



LDC'S. FISCAL YEAR 1972 



Area 



Total number ' 



Total estimated 

 savings > 



Equivalent 



number of 



medical schools ' 



FMG population, December 1970 



All countries. 



AHLDCs* 



West Europe: Greece 



Latin America' 



Asia: 



Near and Middle East 



Far East 



China 



India ,. 



Korea 



Pakistan.. 



Philippines 



Other 



Africa 



Egypt : 



Other 



Ail other areas 



63, 391 



7,143 



6,462 



76 



523 



5,558 



$5,261,453,000 



592, 869, 000 



536, 364, 000 



6, 3C8, 334 



43, 409, 000 



461,314,000 



179.0 



20.0 



18.2 



.2 



1.5 



15.7 



46 



3, 818, OCO 



.1 



• The source for the total number of FMGs entering the United States is the National Science Foundation's "Highlights 

 of Aug. 20, 1973" (NSF 73-311), p. 2. The figure for the total FMG population comes from the AMA's "FMG Study for 

 1970.'^ 



» Total savings is arrived at by using the estimated figure of $83,000 per person for educational costs of a physician. 

 Cited in Henderson, "Emigration of Highly Sl<illed Manpower from the Developing Countries," 1970, p. 132. Mr. Henderson 

 cites this figure for surgeons who are, as he says, "the most expensive." However, the figure of $83,000 per person is not 

 excessively high as Mr. Henderson suggests. According to a recent report by the AAMC, the annual cost per medical student 

 in the undergraduate medical educational program leading to the M.D. degree is estimated to range from a low of $16,300 

 to a high of $26,400. Over 4 years this would amount to $65,200 and $105,600 respectively. The average total annual cost 

 from 12 selected schools amounts to $21,350 per student, or a 4-year total of $85,400. The estimate, figured in 1972 dollars, 

 was based upon a study of the 12 medical schools. The components used in computing costs were, instruction, research, 

 clinical activity, other administrative, scholarly, and professional activities. The report indicated that even this figure 

 represents only a part of the total cost of preparing a physician for independent practice. (Association of American Medical 

 Colleges. Report of the Committee on the Financing of Medical Education, "Undergraduate Medical Education: Elements- 

 Objectives— Costs." (AAMC, 1973), pp. 1-2.) 



* The equivalent number of medical schools category has been arrived at by dividing 354, the average number of students 

 per American medical school, into the total number of entering FMGs. This figure was computed in accordance with data 

 in the 1971-72 catalog of the Association of American Medical Colleges, which indicates that there were 109 medical 

 schools in the United States and Puerto Rico listed as accepting applications for classes (p. 67) and that the total enrollment 

 of American citizens for 1969-70 was 37,690 (p. 63). 



< LDCs are understood to mean the following areas and countries listed in table 1 of NSF "Highlights": Greece, North 

 and Central America (excluding Canada), South America, Asia, Africa, and "All other areas." 



» Latin America is understood to mean those areas and countries listed in table 1 of NSF "Highlights" as North and 

 Central America (excluding Canada) and South America. 



UNFAtORABLE ASPECTS OF FMG INFLOW: THREAT TO AMERICAN MEDICAL 



STANDARDS 



The United States has gained much from the inflow of FMGs, but 

 at the risk of impairing the high standards of American health care, 

 medical observers assert. These high standards evolved over genera- 

 tions that relied heavily on the quality of medical education provided 

 through institutions accredited and approved by the AMA and the 

 Association of American Medical Colleges (AAMC). High quality 

 medical education has been the initial and established criterion of 

 competence.^®^ Passing the licensure examination given by the state of 

 intended practice upon obtaining an M.D. degree represents a 



s*' Margulies and Bloch, op. clt., pp. 44-45. This section draws heavily on Chapter III 

 of this volume, entitled "Professional Qualities of Foreign Medical Graduates." In com- 

 menting on the high quality of American medical schools, Margulies and Bloch state : 

 "Decades have passed since physicians could he licensed after only an apprenticeship 

 training, and for over twenty years there have been no 'Class B' medical schools. All institu- 

 tions must meet the high minimum standards set by the medical profession through its 

 voluntary system." (p. 45) 



