Objective

Although foreign medical graduates (FMGs) have been essential to the US physician workforce, the increasing competitiveness has made it progressively challenging for FMGs to match in US neurosurgery programs. We describe geographic origins and characteristics associated with successful match into US neurosurgery training programs.

Methods

Retrospective review of AANS membership data (2007–2017). Scopus was used to collect bibliometrics.

Results

From 2009 neurosurgical residents, 165 (8.2%) were FMGs. Most were male (n = 148; 89.6%) with a median age of 34.0 years. Top six feeder countries (TFC) included India (13.9%; n = 23), Lebanon and Pakistan (9.1%; n = 15), Caribbean Region (7.2%; n = 12), Mexico (6.67%; n = 11), and Greece (3.6%; n = 6). Compared to FMGs from non-top feeder countries (NTFC), TFC FMGs had higher H-indices (2 vs 4, p = 0.049), greater number of publications (2 vs 5, p = 0.04), were more likely to have an MBBS/MBBCh (n = 38 vs n = 17, p = 0.03), and had twice as many candidates from major feeder medical schools that successfully matched into a US neurosurgery program (n = 43 vs NTFC = 20, p < 0.001). NTFC FMGs were almost 3-times more likely to match at an affiliated neurosurgery program (8 vs TFC = 3, p = 0.03), while TFC FMGs were 1.5-times more likely to match at an NIH Top-40 program (33 vs NTFC = 21, p = 0.03).

Conclusions

TFC graduates have higher bibliometrics, frequently come from major feeder schools, and have greater match success at a broader selection of programs and NIH top-40 programs. Future studies characterizing FMG country and medical school origins may enable foreign students to geographically target institutions of interest and could allow US programs to better evaluate foreign training environments.

中文翻译：

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2007-2017年美国神经外科培训项目外国医学毕业生地理分布

客观的

尽管外国医学毕业生 (FMG) 对美国医师队伍至关重要，但日益增长的竞争力使得 FMG 在美国神经外科项目中的匹配变得越来越具有挑战性。我们描述了与成功匹配美国神经外科培训计划相关的地理起源和特征。

方法

对 AANS 成员数据的回顾性审查（2007-2017 年）。Scopus 用于收集文献计量学。

结果

从 2009 年的神经外科住院医师中，有 165 名 (8.2%) 是 FMG。大多数是男性（n = 148；89.6%），中位年龄为 34.0 岁。前六个支线国家 (TFC) 包括印度 (13.9%; n = 23)、黎巴嫩和巴基斯坦 (9.1%; n = 15)、加勒比地区 (7.2%; n = 12)、墨西哥 (6.67%; n = 11) , 和希腊 (3.6%; n = 6)。与来自非顶级支线国家 (NTFC) 的 FMG 相比，TFC FMG 的 H 指数更高（2 比 4，p = 0.049），出版物数量更多（2 比 5，p = 0.04），更有可能获得MBBS/MBBCh（n = 38 vs n = 17，p = 0.03），并且成功匹配美国神经外科计划的主要支线医学院的候选人数量是其两倍（n = 43 vs NTFC = 20，p < 0.001）。NTFC FMG 在附属神经外科项目中匹配的可能性几乎是其 3 倍（8 vs TFC = 3，p = 0.03），而 TFC FMG 为 1。

结论

TFC 毕业生具有更高的文献计量能力，经常来自主要的附属学校，并且在更广泛的项目选择和 NIH 前 40 名项目中具有更大的匹配成功率。未来对 FMG 国家和医学院起源的研究可能使外国学生能够在地理上定位感兴趣的机构，并使美国项目能够更好地评估外国培训环境。