Where Have All American Specialists Gone?

When I recently visited my cardiologist at a major medical academic institution, he commented to me, “All the candidates we’re getting are foreign-medical school graduates, Not Americans,”

When I asked why, he said in words to this effect,”Because our patients are mostly MediCare. The ObamaCare administration is arbitrarily slashing cardiology fees to save money, and cardiologists are being forced to accept hospital employment. Ambitious American medical school graduates don’t like that scenario.”

I suspect this sort of thing is going on among many fellowship programs in many specialties. And I suspect it is why many foreign medical school graduates are flocking to America to live the American dream – to become a highly respected and highly paid specialist.

This phenomena, foreign –trained physicians as American medical specialists, is not new. But heretofore , it is has been obscured by the focus on primary care shortages.

Yet, truth be known, foreign-educated and American-trained specialist are already prevalent in American.

Among specialists, these percentages of foreign-born specialists are filling the vacuum created by the number of American medial graduates becoming specialists.

Anesthesiologists, 31%

Cardiologists, 31%

Internal medicines, 32%

Nephrologists, 40%

Psychiatrists, 31%

There is nothing intrinsically wrong with this. It simply illustrates that the demand for specialists exceeds the supply of graduates from U.S. medical schools and that fellowship offered by U.S. hospitals and academic centers are not attractive to these graduates. And specialty shortages may grow worse. Shortages are now estimated to be 33,100 this year, 46,109 by 2015, and 64,000 by 2025 (Thomas Hemphill, Gerald Knesak, “The Physician Specialty Shortage, Real Clear Policy, March 12, 2015).