Report Patients cared by international graduates had lower mortality than patients cared by US graduates

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This is a study with a sample size of 1,215,490 admissions of patients, aged 65 years or older admitted to hospital with a medical condition in 2011-14, treated by 44,227 general internists.

Medicare patients admitted to the hospital and treated by internists who graduated from medical schools outside the United States had lower 30-day mortality than matched patients cared for by graduates of US schools, according to results of a study published online today in the British Medical Journal (BMJ).

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.

Studies comparing the quality of care provided by internationally trained physicians with that by domestically trained physicians are few and small in scope. Yet, physicians trained outside the US may be perceived by some as not as competent as physicians who attended medical school in the US.

To compare the two, Yusuke Tsugawa, MD, MPH, PhD, from the TH Chan School of Public Health at Harvard, and colleagues conducted a large observational study of hospitalized Medicare beneficiaries to assess whether outcomes differ depending upon whether or not their general internists were trained domestically or abroad. The study excluded graduates from Central America and the Caribbean to minimize inclusion of US citizens trained outside the country. The countries that contributed the most internists to US hospitals were China, Egypt, India, Mexico, Nigeria, Pakistan, the Philippines, and Syria.

Read more here. (Medscape)
Study Link (BMJ)
 
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