1230 



The inequality in performance on examinations between FMGrs and 

 TJSMGs has also remained fairly consistent, to the marked disadvan- 

 tage of the FMG. In the case of the ECFMG examination for Feb- 

 ruary 1969, the annual report of the ECFMG compared the 

 actual performance of FMGs on that examination with what would be 

 expected of USMGs on the basis of th« latters' performanc-e on the 

 same questions in National Board exam.ihations. The theoretical score 

 for American medical graduates dramatizes the inequality in profes- 

 sional competence. In the grade range between 74 to 90 or higher, the 

 actual distribution averaged 48.0 percent for the FMGs, and the ex- 

 pected distribution averaged 99.1 percent for the USMGs. In other 

 words, 99.1 percent of USMGs would have passed an examination 

 which only 48.0 percent of FMGs had passed. The actual distribution 

 for 78 and below, that is, failures, averaged 62 percent for the FMGs, 

 and the expected distribution for USMGs was 0.9 percent. If the pass- 

 ing grade were advanced to 80, only 12 8 percent of the FMGs would 

 have qualified, while 79.6 percent of the TTSMGs would have passed. In 

 other words, the majority (25.7 percent) of FMGs passing were 

 marginal. ^^^ 



Parenthetically, it might be noled that the majority of ECFMG 

 certificates are now being granted to FMGs from the LDCs. The 

 largest sijtigle group of certificates awarded in 1970 was to graduates 

 of schools in India (791), with the Philippines second (366). Both 

 together accounted for more than one-fifth of the ECFMG certificates 

 awarded in 1970. Other LDCs with relatively large numbers included 

 Korea with 229 and Egypt with 228."8 Further increases can be 

 expected in view of the proportional increase in FMGs from the LDCs 

 in the fiscal years 1971 and 1972. 



Many FMGs. take the ECFMG examination several times before 

 passing. In generalizing on the ECFMG examination, Dr. Dublin 

 noted that slightly over 66 percent of the FMGs taking the examina- 

 tion ultimately obtain qualifying certificates but on any single exami- 

 nation only 35 to 40 percent receive a passing grade. Thus, many candi- 

 dates repeat the test several times. Currently, he said, 45 percent of 

 the candidates have taken the examination and failedon one or more 

 previous occasions.*^^ 



"Not is the FMG record on other examinations better. Dr. Dublin says 

 frankly, "FMG's have difficulty passing licensure examinations." Over 

 a period of 35 years, the average failure rate, he states, has been 39.4 

 percent. Variations in success occurred depending on the State. A few 

 years ago some States did not accept FMG credentials for licensure, 

 but, according to Dr. Dublin, this is no longer the case.^^° 



Stevens and Vermeulen also state frankly that FMG "performance 

 on specialty board examinations from pediatrics to surgery suggests a 

 much poorer record by foreign than American graduates." ^^^ 



Other sources indicate poor FMG performance on other examina- 

 tions. Margulies and Bloch noted that since 1935 the FMG failure rates 



B" Ibid., p. 131. 



s'sibid.. p. 33. 



6^ Dublin, on. clt., p. 873. 



^ Ibid., p. 874. 



•*" Stevens and Vermealen. op. cit, p. 44. 



