More than 22 million Medicare patients received care from doctors born outside the United States in 2024, according to an American Board of Internal Medicine study published in JAMA. The research found that foreign-born international medical graduates comprise nearly half of the internal medicine workforce at 47.2% and play a central role in providing essential care to patients in underserved communities.
Analysis of Medicare claims showed that patients treated by foreign-born physicians were more likely to come from underserved populations than those treated by U.S.-born doctors. Among their patients, 9.5% were Black compared with 7% for U.S.-born physicians, and 6.6% were Latino compared with 3.9%. Nearly 21% of patients seen by foreign-born doctors were eligible for both Medicare and Medicaid, versus 11.7% for U.S.-born physicians, and 19.8% lived in high-poverty ZIP codes compared with 15.9%.
Foreign-born physicians represent at least 27% of doctors in every internal medicine subspecialty examined and more than half of those practicing geriatrics, sleep medicine and nephrology, the study found. The research analyzed data from 249,679 physicians initially certified in internal medicine between 1990 and 2025.
"These findings highlight the important role of non-U.S.–born physicians in our nation's health care system, particularly for patients who have more difficulties accessing care," said Giacomo Meille, lead author and senior health services researcher at ABIM. "As the nation's population ages, demand for care continues to grow, especially for physicians certified in subspecialties such as geriatrics, which relies extensively on physicians born outside the United States."
The study comes amid continued physician shortages and a shifting immigration policy landscape. Doctors born in countries affected by recent U.S. travel restrictions accounted for 6% of internal medicine physicians. The National Resident Matching Program reported in March that the match rate for non-U.S.–citizen international medical graduates in U.S. residency programs reached a five-year low.
