1119 



As in the past, the LDCs of Asia accounted for the highest percent- 

 age of nonimmigrant scientists and engineers (78 percent) and of phy- 

 sicians and surgeons (88 percent) who opted for immigrant status. 

 That student exchange is a source of leakage is shown by the fact that 

 about 62 percent of the Asian scientists and engineers who adjusted 

 their status had formerly been students. Seventy-four percent of the 

 change-of-status doctors and surgeons had been exchange visitors, an- 

 other source of drain.^^^ 



iTrmdgration of M.D.8 to the United States : A Special Case 



The entry of foreign medical graduates (FMGs) is a special case in 

 the immigration of foreign professionals to the United States. (The 

 term "FMG" generally, but not always, refers to foreign medical grad- 

 uates in all countries except Canada and Puerto Rico, whose stand- 

 ards of medical training are equivalent to those in the United States.) 

 An extensive literature both in the public and private domain exists 

 in which all facets of this problem have been surveyed and analyzed in 

 the most minute detail. Reference has already been made to the 

 Margulies-Bloch study of FMGs. Their work has recently been up- 

 dated and expanded in a study prepared by Rosemary Stevens and 

 Joan Vermeulen of Yale University's Medical School. This study was 

 sponsored by the U.S. Department of Health, Education, and Welfare, 

 printed in June 1972 and released to the public a year later."* In ad- 

 dition, the American Medical Association (AMA) publishes peri- 

 odically a special report on FMGs in the United States ; the most re- 

 cent was published in 1971.^®* 



CRITICAL VIEWS ON MEDICAL BRAIN DRAIN 



The literature conveys the impression that the United States is vul- 

 nerable to criticism as to medical brain drain. Such criticism, much of 

 which comes from within the country, illustrates both the magnitude 

 and seriousness of the problem for domestic medical manpower con- 

 cerns and more important, for the purposes of this study, for its 

 foreign policy implications. The following are examples : 



1. Gregory Henderson, Harvard University : 



The medical situation is worse. Dr. Ward Darley in the Journal of the National 

 Medical Association has observed : 'In the years from 1950 to 1960 almost 10,000, 

 approximately 12 percent of the country's licentiates in medicine, were trained in 

 foreign medical schools.' He also states : 'In 1960, 1,400 foreign-trained physicans 

 were added, or 18 percent of the total number of licentiates for that year.' 



"Though all these entered under visitor exchange visas and were thus con- 

 strained to leave the United States for at least 2 years after a maximum period of 

 5 years of study, the Bureau of Immigration and Naturalization between 1958 

 and 1963 gave 3,636 waivers permitting them to remain in the United States. 

 Dr. H. Van Zile Hyde, former Chief of the Division of International Health of 

 the U.S. Public Health Service, observes that under the education and exchange 

 program, other countries in effect maintain the equivalent of three medical 

 schools to satisfy U.S. domestic medical care demands. In 1961, the United States 



i« Ibid., p. 4. ^ 



1"* Rosemary Stevens and Joan Vermeulen, Foreign Trained PhyBiciana and American 

 Medicine, U.S. Department of Health, Education, and Welfare, Bureau of Health Man- 

 power Education, Division of Manpower Intelligence, June 1972, 184 pp. (DEW Publica- 

 tion No. NIH 73-325.) 



1* J. N. Haug and B. C. Martin, Foreign Medical Graduates in the United States, 1970. 

 (Chicago; American Medical Association, 1971), 319 pp. (Special Statistical Series; Center 

 for Health Services Research and Development) (Hereafter cited as, AMA, FMO Study.) 



