An ERAS-Based Survey Evaluating Demographics, United States Medical Licensing Examination Performance, and Research Experience Between American Medical Graduates and United States Citizen International Medical Graduates: Is the Bar Higher on the Continent?

• Published in: Journal of surgical education Vol. 69; no. 2; pp. 143 - 148
• Main Authors: Go, Pauline H., MD, Klaassen, Zachary, MD, Chamberlain, Ronald S., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2012
• Subjects: Adult; American Medical Association; Automatic Data Processing; Cross-Sectional Studies; Databases, Factual; Demography; Educational Measurement - standards; Female; Foreign Medical Graduates - statistics & numerical data; General Surgery - education; Hospitals, University; Humans; international medical graduate; Internship and Residency - statistics & numerical data; Interpersonal and Communication Skills; Job Application; Licensure, Medical - standards; Licensure, Medical - trends; Male; Medical Knowledge; Professionalism; Research - statistics & numerical data; residency match; Surgery; Surveys and Questionnaires; United States; United States medical licensing examination (USMLE) step 1 research; United States; international medical graduate; United States medical licensing examination (USMLE) step 1 research; residency match; Professionalism; Interpersonal and Communication Skills; Medical Knowledge
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2011.07.013

Objective To provide an assessment and comparison of the demographics, medical school academic performance, United States Medical Licensing Examination (USMLE) performance, and research experience between American Medical Graduate (AMG) and United States International Medical Graduate (USIMG) candidates who applied for and successfully matched into categorical general surgery residency programs. Design Data were obtained through the Electronic Residency Application Service (ERAS) and a post-match survey distributed to all applicants. Setting The study was conducted at a community-based, university-affiliated hospital. Participants All United States citizen graduates of allopathic American medical schools or international medical schools, who were applying for a general surgery residency position at our institution. Results A total of 854 candidates applied, including 143 AMGs and 223 USIMGs. Seventy-two AMGs (50.3%) and 41 USIMGs (18.4%) were invited to interview (p < 0.0001). Mean USMLE step 1 scores were higher among USIMG applicants overall (USIMG: 212.1 ± 14.9 vs AMG: 206.9 ± 15.5; p < 0.0005) and among those invited to interview (USIMG: 227.8 ± 16.2 vs AMG: 215.5 ± 16.2; p < 0.0001). Seventy percent of AMGs matched into a categorical surgery residency compared with 31.6% of USIMGs (p < 0.001). Compared with AMGs, USIMGs applied to more programs (USIMG: 90.3 ± 42.8 vs AMG: 52.1 ± 26.4; p < 0.002), were offered fewer interviews (USIMG: 9.0 ± 6.9 vs AMG: 20.9 ± 13.7; p < 0.0001), and subsequently ranked fewer programs (USIMG: 7.5 ± 4.5 vs AMG: 12.5 ± 6.1; p < 0.0008). Conclusions USIMGs require higher USMLE scores than their AMG counterparts to be considered for categorical general surgery residency positions. However, excellence on the USMLE neither ensures an invitation to interview nor categorical match success. A well-rounded application in conjunction with a practical application strategy is critical for USIMGs to achieve success in attaining a general surgery residency position.