Foreign Medical Graduates and Maryland Medicaid

Abstract

To determine whether foreign medical graduates provide a disproportionate share of medical care to the poor, Medicaid vendors in Maryland were compared with all licensed physicians in the State. Foreign medical graduates constitute 22 per cent of all physicians in Maryland but 36 per cent of the Medicaid vendors. In addition, of all the vendors for fiscal 1974, 94 per cent who were licensed in 1972 or 1973 were foreign medical graduates. This disproportional representation in the Medicaid program is concentrated in the specialties of general surgery, internal medicine and general practice. Thirty-two per cent of all foreign medical graduates in Maryland are board-certified physicians, but only 22 per cent of those who are Medicaid vendors are board certified. For United States medical graduates, 48 per cent of all physicians are board certified, but this figure increases to 52 per cent for the Medicaid vendors. Finally, representation of foreign medical graduates among Medicaid vendors tends to be highest in areas with the highest physician-to-population ratios and with the highest percentages of total Medicaid payments.