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The CEO of Intealth, Eric Holmboe, MD, joins us to discuss the Match rate for IMGs and how to improve it, how international medical graduates can help residency programs fill critical care gaps and deliver culturally competent care, and more. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Eric Holmboe, MD, CEO, Intealth
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. It's IMG Recognition Week, and today we're talking about the unique value that international medical graduates bring to residency programs. Our guest today is Dr. Eric Holmboe, the CEO of Intealth in Philadelphia. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Holmboe, welcome.
Dr. Holmboe: Thank you. I'm really pleased to be here. Thanks for having me.
Unger: Well, I thought before we jump in, we talk a little bit about background on Intealth, because some people might not be familiar with that name. Tell us a little bit about the background there.
Dr. Holmboe: Sure. So Intealth is kind of the organization umbrella for two really important units. The first is the Education Commission for Foreign Medical Graduates, and the other is the Foundation for the Advancement of International Medical Education and Research. ECFMG is the organization that performs assessment verification that enable international medical graduates to enter the U.S. graduate medical education system. In other words, we assess the readiness for international medical graduates to enter residency training.
FAIMER is the unit that is our giving back based on the benefits we get from IMGs coming into this country. As you probably know, 25% of all practicing physicians and trainees are IMGs, and so FAIMER provides educational resources and training, and interacts with various entities around the world to really advance health professions education.
Unger: Well, that's a huge number, and I guess maybe this question answers itself, but what drew you to this work? I know you joined Intealth in January. You're about coming up on the end of your first full year. I'm curious, how it's been going?
Dr. Holmboe: Really, the primary attractant, if you will, for me, was its mission. I've had the good fortune to work globally over the last several decades, and I think the roles that both ECFMG and FAIMER play are very important, and having the opportunity to help contribute and improve the service we provide was really a wonderful opportunity. I'm very grateful for that.
Unger: Dr. Holmboe, right now we are in the middle of residency interview season, as I'm sure you know.
Dr. Holmboe: Yes, we are.
Unger: Every year many IMGs apply for residency programs, but matching with one can be a challenge. What percentage of IMGs typically match, and is that lower or higher than the national average?
Dr. Holmboe: So the actual percentage of folks who match into U.S. residency programs, it's been quite stable at around 60% to 61%. However, the numbers who've been matching is actually continue to go up, so that in 2024, over 9,000 IMGs successful matched into U.S. training programs, the highest number we've seen.
Unger: When you look at the match rate among IMGs and you compare that to national averages for non IMGs, what accounts for that disparity and how do we close that gap?
Dr. Holmboe: Well, I think you have to recognize that first, 99% of U.S. graduates, both MDs and DOs, will match into a training program, and that actually makes sense, right? They're going to school here in the country and so they're matching into training programs here. And so what's left, however, are a fair number of residency slots that cannot be filled by U.S. grads. In fact, that number is approaching almost 10,000, if you consider residencies and fellowships.
And so IMGs are very important for not only filling that gap, but bringing in their own skills, abilities and expertise that we contribute to the U.S. health care system and to our GME training programs.
Unger: Well, in addition to filling the care gaps that you've just talked about, IMGs can also play a role in helping their organizations provide culturally competent care. Tell us a little bit about what that looks like.
Dr. Holmboe: Well, I think there's several aspects of that are really important. I'll just highlight a few. So in the United States, about 14% of the folks living here are immigrants. And so when you think about their health care needs, having access to folks who've had a similar experience can be very powerful. Second, IMGs are more likely not only to train in underserved areas, but after completing their training to actually practice in those underserved areas. And so they are filling really important roles in helping us address some of the disparities in these communities within our own health care system.
Unger: So you've got these care gaps that you've talked about, the need for culturally competent care. And so there's a lot of impetus to make sure that we can integrate IMGs into our health care system. Such a critical role to play in health care right now. How do we address—what are those challenges that we talked about to make it easier for IMGs to practice here?
Dr. Holmboe: Yeah. So I think there's a couple things. One is, I would just encourage any residency or fellowship program to consider an international medical graduate for their program. I think that's one step we can all take, and to consider how they might be a good fit within their program, but also to look at their abilities, based on where they've trained and what they're bringing in to their local context.
The second is that we know that transition, particularly if you're a foreign national, international medical graduate coming in, can be somewhat challenging. There's a lot of things that have to do in order to matriculate, such as they need to get a visa and then they've got to relocate, maybe move family. So I think helping them through that transition is another area that we're certainly paying attention to, and I also know the AMA is paying attention to, and we appreciate the efforts in that space, so I think that can be helpful.
A third is that once they're here, making sure that they have resources to help them with that acculturation, and that's something that we've been trying to do at Intealth, for example, by supporting grants around improving wellness within the programs that work with IMGs, and this past year, we made available to all those on a J-1 visa, they now have access to an app called Headspace to help them with their wellness activities. So those are just a few things. But I think really attending to that assimilation and acculturation that needs to occur when they're coming over and helping them make that transition, I think would be a really important thing all programs can do.
Unger: Dr. Holmboe, thank you so much for joining us today and for everything you do at Intealth to support IMGs.
Dr. Holmboe: And thank you so much for having me and all the work that you do to support IMGs as well.
Unger: Well, on those lines, the AMA does provide a wealth of resources to help anyone on the road to residency, and that includes FREIDA, our residency and fellowship database. To support our work, become an AMA member at ama-assn.org/join. That wraps up today's episode and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.
Dr. Holmboe: Thank you.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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