COVID Takes Heavy Toll on International Med School Grads

Graduates of international medical schools practicing in the U.S. were more likely to die of COVID-19 than their numbers in the physician workforce would suggest, according to a study that relied partly on data collected by MedPage Today.

Among 132 physicians believed to have died from COVID-19 during the pandemic, 59 were international medical graduates (IMGs), reported Abraham Verghese, MD, of Stanford University in California, and colleagues — a far greater proportion than the estimated 25% of all U.S. physicians that IMGs constitute.

The disproportion was especially glaring for physicians working in primary care, according to the study appearing in JAMA Network Open. The physician death toll included 79 whose specialty was listed as primary care, of whom 38 were IMGs.

Moreover, those numbers illustrate the heavy toll that COVID-19 took on primary care physicians overall. That total of 79 represented 60% of all the reported physician deaths, whereas only 37% of all U.S. physicians are in primary care, Verghese and colleagues noted.

And in this respect, IMGs were again in the crosshairs: those in primary care represent 10% of all U.S. physicians, which would predict that 13 of the physician COVID-19 deaths would involve IMGs, instead of the 38 who actually died (risk ratio 2.90, 95% CI 2.13-3.65).

“The larger number of deaths among IMGs highlights their important contribution to patient care,” Verghese and colleagues observed.

Although it’s tempting to conclude from these figures that IMGs were cannon fodder in the pandemic, the researchers cautioned that the study doesn’t prove that. Nearly 40% of all physician deaths from COVID-19 were in New York and New Jersey, the group noted, which are also the states with the highest proportions of IMGs in their physician workforce (37% and 38%, respectively).

Another caveat was that the underlying data came from news organizations, led by MedPage Today, which counted 101 physician deaths from April 8 to Nov. 4, 2020. The other sources included The Guardian, with an ultimate tally of 33 physician deaths, and Medscape, which identified 84. After eliminating redundancies among these projects, Verghese and colleagues counted 132 unique physician deaths. Medical school information for these individuals was obtained from the DocInfo website.