AP NEWS

Solution to Texas’ doctor shortage lies abroad

March 6, 2019

More than 30 Texas counties lack a single primary care doctor. Nearly 6 million Texans live in areas with a shortage of primary care providers.

It’s no wonder the state has the fourth worst doctor-patient ratio in the nation. And things could get even worse. According to a recent report from the Department of State Health Services, Texas’ shortfall of primary care physicians will increase 67 percent by 2030.

Simply put, the Lone Star State needs more doctors. It can find them at international medical schools. Many of these international medical graduates, or IMGs, are U.S. citizens who went abroad for medical school and are eager to return home to practice.

Primary care doctors are crucial to managing the state’s immense public health challenges. One in 3 Texans is obese. One in 10 has Type 2 diabetes. One in 5 suffers from multiple chronic diseases.

Yet Texas medical schools aren’t producing enough primary care doctors to meet the state’s needs. Forty percent of the state’s medical students leave after graduation. Many of the remaining 60 percent pursue careers as specialists.

International medical graduates, by contrast, seek careers in primary care more often than their U.S.-educated peers. Nearly 70 percent of IMGs chose residencies in primary care last year, compared to just 37 percent of U.S. medical school graduates.

IMGs are also more likely to practice in minority and underserved communities. Nationwide, in regions where at least three-quarters of the population is nonwhite, nearly 4 in 10 doctors were educated overseas. That propensity to serve in minority communities is important for Texas, given that more than half the state’s population identifies as either African-American, Hispanic or Latino.

In areas where 10 percent of residents are below the federal poverty line, one-quarter of doctors are international medical school graduates. That’s significant for cities such as Lubbock and Houston, where 1 in 5 people lives in poverty.

There’s even evidence that international medical graduates deliver superior patient care. One study from the medical journal BMJ found that patients who received care from IMGs had lower mortality rates than those treated by U.S. graduates.

Many IMGs are already practicing stateside, and their ranks are growing. Last year, international medical graduates matched into U.S. residencies at the highest rate in 25 years. Between 2010 and 2016, the number of practicing U.S. physicians who graduated from medical schools in the Caribbean increased by 13,000.

Texas’ numerous teaching hospitals are home to many of these international grads. More than 30 alumni of St. George’s University in Grenada — the school I lead — started residency programs in Texas last year, everywhere from Corpus Christi and San Antonio to Fort Worth and Amarillo. Between 2014 and 2018, the number of our graduates entering residencies in Texas more than doubled.

The Lone Star State’s doctor shortfall will widen unless state leaders take action. Their first call should be to international medical graduates — to let them know that they are welcome in Texas.

Dr. G. Richard Olds is president of St. George’s University (www.sgu.edu).