An international medical graduate (IMG), earlier known as a foreign medical graduate (FMG), is a physician who has graduated from a medical school outside of the country where he or she intends to practice. The term non-local medical graduate may be similarly used in countries with distinct licensing regions within them. Generally, the medical school of graduation is one listed in the World Directory of Medical Schools (WDOM) as accredited by the Foundation for Advancement of International Medical Education and Research or the World Health Organization.
Medical schools around the world vary in education standards, curricula, and evaluation methods. Many countries have their own certification program, equivalent to the ECFMG in the United States. The purpose of ECFMG Certification is to assess the readiness of international medical graduates to enter clinical specialty training programs as resident physicians and fellowship programs in the United States.
License requirements by country
The requirements to obtain a license to practice varies by country and often by state, province, or territory.
Australia
IMGs (or Overseas Trained Doctors) who wish to be licensed in Australia must apply to the Australian Medical Council (AMC) to arrange an appropriate assessment pathway. The standard pathway involves an IMG sitting a series of assessments, including an AMC MCQ Exam and an AMC clinical exam. The AMC MCQ Exam consists of 150 MCQs organized through computer adaptive scoring.
For AMC clinical exam, a candidate is required to pass 12 out of 16 cases: including one compulsory case in both gynecology and pediatrics.
IMGs who have passed the necessary exams and obtained AMC certification can then apply to Australian specialty training positions.
Australia is in the process of establishing a national registration process for all the doctors under theMedical Board of Australia.
In 2010 the Minister for Health and Ageing (Australia) launched an Inquiry process into registration and accreditation processes for international medical graduates which reported in 2012.
Canada
In Canada, international medical graduates include all graduates from outside Canada. For IMGs to be eligible for full licensure in every Canadian province and territory, they must hold: A medical degree from a school listed in the World Directory of Medical Schools with a Canada Sponsor Note ; OR A Doctor of Osteopathic Medicine degree from a U.S. school accredited by the AACOM; OR
The candidate must also: Be a Licentiate of the Medical Council of Canada (LMCC), which requires passing the MCCQE Part I and Part II Complete postgraduate training program in allopathic medicine and been evaluated by a recognized authority. For entering a residency program, the candidate must first pass the National Assessment Collaboration Examination Be certified by the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, or the Collège des médecins du Québec.
However, some provinces may have alternate paths to licensure, e.g. British Columbia. Alberta province, with six other provinces across Canada, has a program called Practice Ready Assessment (PRA) which enables eligible IMGs to start practice under supervision and leading to their independence where they need to fulfill certain requirements.
IMGs in Canada have a harder time getting into residency programs compared to Canadian graduates—only ten percent of IMG applicants get a position.
Several organizations have put pressure on the government such as the Association For Access to Health Care Services, Alberta International Medical Graduates Association, and Association of International Physicians and Surgeons of Ontario. However, other organizations deny there is a physician shortage that requires Canada to import more physicians.
United States
In the United States, an international medical graduate (IMG) is a graduate from a medical school located outside the United States and Canada. Graduates of Canadian M.D. programs are not considered IMGs in the United States. IMGs may be either United States citizens or non-citizens who were educated in a school outside U.S. or Canada.