1235 



said, "trying to assess the mental problems of a drug-using American 

 adolescent who is undergoing an existential crisis." 



According to the doctors, an estimated 34 percent (1,370 out of 

 4,040) of all psychiatric residencies in 1970 were filled by FMGs, 

 mostly from the LDCs— Philippines (149), India (136), Korea (107), 

 Cuba (95), Argentina (55), Columbia (46), Iran (39), Mexico (25), 

 Egypt (19) and Pakistan (19). "This list," they indicated, "corre- 

 sponds with the frequently cited estimate that 85 percent of our im- 

 ported medical manpower comes from underdeveloped countries." It 

 was also pointed out that of the 186 residency programs that were 

 active during 1970 for psychiatrists, 28 were completely filled by 

 FMGs. In fact, there were more psychiatric residents in American hos- 

 pitals who were graduates from the medical schools of the University 

 of Havana (77) or from the University of Santo Tomas in Manila 

 (74) than were graduates of any American or Canadian medical 

 school (5). 



The doctors also revealed that many of the 3,100 unlicensed FMGs 

 at mental hospitals, prison psychiatric wards, and institutions for the 

 mentally retarded were unable to pass their State Boards. But they 

 were able to practice medicine under special permits allowing them 

 to work only in State institutions. Pressures are now being brought to 

 bear to create more loopholes for the unlicensed FMG. According to 

 Dr. Torrey and Dr. Taylor, all but seven States have loopholes in their 

 licensing laws that permit such temporary licensing. In New York 

 and Ohio, 40 percent of the M.D.s in State mental hospitals are un- 

 licensed; in West Virginia more than 90 percent are unlicensed; in 

 Maryland, 77 percent of psychiatric residents in State mental hos- 

 pitals are FMGs ; in Virginia's Central State Hospital, all the psychi- 

 atric residents are FMGs. 



Dr. Torrey and Dr. Taylor examined the question of competence. 

 They noted that the majority of foreign medical schools offered "little 

 or no psychiatric teaching to medical students." Upon graduating and 

 arriving in the United States for a psychiatric residency, these doctors 

 have "less knowledge of psychiatry than most American trainees at the 

 same level." 



After pointing out the difficulties of "catching up" owing to work 

 pressure, Dr. Torrey and Dr. Taylor examined the other criterion of 

 competence, the ECFMG examination. "Looking specifically at the 

 pass rate for the eight foreign medical schools that contributed the 

 greatest number of residents to American psychiatry in 1970," they 

 said, "only two attained the worldwide average of 40 percent or 

 higher." The two medical schools contributing the most psychiatric 

 residents, the University of Havana and the University of Sai;ito 

 Tomas, had pass rates of only 20 and 13 percent respectively. 



The same poor showing was made in the State Board licensure 

 examinations. The graduates of these two schools, they said, "scored 

 below the average pass'^ate of 63 percent for all foreign medical grad- 

 uates," which in turn is considerably below the 91 percent for USMGs. 

 Four FMGs, they reported, actually failed State Board examinations 

 for the 13th time during 1970. "Between failures," the doctors pointed 



