The Effect of Importing Physicians — Return to a Pre-Flexnerian Standard

Abstract

Increasing concern about the control of the quality of medical care raises the question of the dilution of the physical manpower pool with foreign medical graduates, who constituted 46 per cent of new licentiates in medicine in the United States in 1972. The use of the Educational Council for Foreign Medical Graduates examination as a minimal level of educational quality for graduates entering the United States from medical schools in developing countries and the increasing number of such graduates entering the United States each year from those countries have produced a dual standard. Medical schools in the United States established controls over the input and process of medical education after the Flexner Report in 1910. Such controls do not exist in many foreign medical schools. Recommendations are made for control of a minimal educational level for physicians entering the United States health-care system and implications of these recommendations are discussed. (N Engl J Med 290:1453–1458, 1974)