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- W. Douglas Weaver, MD, FACC, ACC President⁎
- ↵⁎Address correspondence to:
W. Douglas Weaver, MD, FACC, American College of Cardiology, 2400 N Street NW, Washington, DC 20037
One of the College's goals is to involve more members whose roots lie outside of the U.S., enriching our initiatives through their diverse educational, cultural, and clinical experiences. As the American College of Cardiology (ACC) becomes increasingly international in its scope, who is best prepared to introduce us to international societies and their members? Who best understands the health care problems and the role of physicians in other countries? Who can best help us fulfill our mission to improve global cardiovascular health?
International medical graduates (IMGs) make up about 30% of the cardiovascular workforce in the U.S. (1), with particularly high proportions being interventional cardiologists. For the past several years, approximately one-third of the new Fellows at Convocation have been IMGs.
William A. Zoghbi, MD, FACC, chair of our Working Group on IMGs, pointed out in a 2004 article in the Journal (2) that IMGs fill the large gap between the number of available cardiology residencies and the number of U.S. medical graduates. Dr. Zoghbi also underscored that this segment disproportionately serves inner-city and rural areas and that they have a heightened ability to understand cross-cultural issues among patients. As we are all aware, IMGs make many significant contributions to clinical cardiovascular medicine and both basic and clinical research in this country.
Although IMGs routinely seek and achieve Fellowship in the College, it is my sense that too many become silent members, with little involvement in either our chapters or our national initiatives and committees.
This trend must change. A failure to adequately engage IMGs is a failure to engage a large and significant portion of our membership. Although we have done several surveys of our membership in the past, I do not believe we fully understand the needs of this segment. What do we know?
We know IMGs face particular challenges due to the disparities in international medical education. Many IMGs must repeat a portion of their training upon arrival in the U.S. to achieve board certification. They must pass licensing exams and an expensive clinical skills assessment given in only a few cities nationwide. This is a complex and challenging issue that deserves attention from the major credentialing bodies.
We also know that visas, especially in the wake of September 11, 2001, have become increasingly difficult to obtain, and even more so for IMGs from the Middle East. Many of these trainees want to remain in the U.S. They go through many “hoops” to do so. This is a political agenda item—I will not make judgments here about our national security and immigration policies. I do know, however, that many IMGs find a way to stay in the U.S., that many are extremely hardworking and motivated to excel, and that at least for the foreseeable future, we have a shortage of cardiologists for our aging population.
Finally, and regrettably, we know cultural prejudice and bias remain a challenge to IMGs in the U.S. Language barriers, unfamiliar cultural customs, and more may make cardiovascular practice and professional interaction more challenging for IMGs than for those who were born and raised in the U.S.
So what can the ACC as a professional society do to help IMG members overcome these hurdles to success in cardiovascular medicine? We have ideas, including:
• Mentoring of early-career IMGs by veteran IMGs and/or seasoned ACC members
• Networking sessions at ACC events and Annual Scientific Sessions
• Encouraging increased involvement in chapters and committees
We want to hear from IMGs, especially those early in their careers who need the College's support the most. Which of these services would be most helpful to you? And what else do you need from your College? Please share your thoughts with me by e-mailing. Also, watch for more information on an inaugural reception for IMGs to be held at ACC.09 in Orlando, Florida. This will be an opportunity for IMG members and nonmembers alike to network and offer their advice to the College on how to improve the member experience for IMGs.
I urge all members to share your insight with the ACC and to become involved in the College's many initiatives and activities. As our diversity grows, so will our ability to fulfill our mission to enhance the quality of cardiovascular care worldwide.
- American College of Cardiology Foundation