Training on the internal medicine teaching wards

TRAINING ON THE WARDS: AN INTERNATIONAL FACE OF CANADIAN (NORTH AMERICAN) MEDICINE

Letter to the editor

I read with interest the article by Flegel and Palepu (1), which discusses the issue of postgraduate medical training in Canada. The authors have identified several problems with postgraduate medical education (training) in Canada (all applicable to the USA as well) and should be congratulated on this. I fully agree with the Flegel and Palepu that there have been significant changes within the resident population over the past decade in Canada (as well as across the border in the United States of America). However, is it is my opinion (as a foreign/international medical school graduate), that the authors should have at least mentioned the increased presence (participation) of the international medical graduates (IMGs) in Canadian (North American) medicine while discussing the changes within the resident population. For example the percentage of IMGs in the US health care work force has been steadily increasing over the last two decades. Today, IMGs fill approximately one-third of Pediatric and Internal Medicine residency positions, and one-fifth of Family Medicine residency positions. Most IMGs come from non-English speaking countries, and are consequently confronted by a series of transcultural challenges that include not only language, but also sex-role differences, lifestyles, and culture. Currently, one in five physicians practicing medicine in the United States received their initial medical training in another country.

Reference: 1.Flegel KM, Palepu A. Training on the internal medicine teaching wards [editorial]. CMAJ 2003; 168(8): 997-8

AUTHORS: Krzysztof M. Kuczkowski, M.D.,

Assistant Clinical Professor of Anesthesiology

And Reproductive Medicine

Director of Obstetric Anesthesia

INSTITUTION: Departments of Anesthesiology

And Reproductive Medicine University of California San Diego San Diego, California, USA