In an earlier blog, I reposted the report of a speech by a senior physician regarding how he selected a specialist for his own treatment. I added information in subsequent posts about issues to consider in selecting a doctor as that information became available. It’s time to add to that knowledge again.
For some US residents, there is a stigma attached to a doctor who receives medical training outside the US. Because offshore schools aren’t accredited by US institutions and typically cost much less to attend, there is a feeling that the training provided is not as good as that provided by US medical schools.
To test that theory, a team at Harvard conducted a statistical analysis of patient treatment and outcomes, comparing results between US-trained doctors and those trained outside the US and practice in the US.
The report on this research notes that
To practice in the US, international medical school graduates must pass two exams on medical knowledge and one assessment of clinical skills, and complete accredited residency training here. However, medical schools outside the US are not accredited by any domestic agency. In response to concerns about quality of care from internationally trained physicians, the Educational Commission for Foreign Medical Graduates will require accreditation of medical schools outside the US by 2023. [Lewis]
The study looked at hospital admissions under the care of a general internist between 2011 and 2014. Data from 44,227 general internists were included in the research, of which 44% had graduated from medical schools in one of the following countries: China, Egypt, India, Mexico, Nigeria, Pakistan, the Philippines, and Syria. Graduates of schools in the Caribbean were excluded from the research, on the grounds that most of those are US citizens and the fact that they studied outside the US would not be obvious to a patient.
The only two statistically significant differences between US-educated and foreign-educated doctors were
- The cost of care was slightly higher on average for those with offshore training ($47), and
- There was a lower rate of death among patients of offshore-trained physicians.
(Hmm. Which is more important to you, $47 or dying?)
The general conclusion from this research is that there is no difference in quality of care between physicians practicing in the US and who attended medical school in the US or in the listed countries.
- Ricki Lewis, PhD, “US Patient Mortality Lower With Non-US-Trained Physicians”. Medscape. Feb 02, 2017. http://www.medscape.com/viewarticle/875356?src=wnl_mdplsnews_170203_mscpedit_wir&uac=153634BV&impID=1284033&faf=1
- Yusuke Tsugawa, et. al. “Quality of care delivered by general internists in US hospitals who graduated from foreign versus US medical schools: observational study”. BMJ 2017;356:j273. http://www.bmj.com/content/356/bmj.j273