ORIGINAL RESEARCH
Kento Sonoda, MD, AAHIVS; Jetty Anuradha, MPH; Shikha Chandarana, PhD, MS; Tomoko Sairenji, MD, MS; Sarah Kureshi, MD, MPH
Corresponding Author: Kento Sonoda, MD, AAHIVS; Department of Family and Community Medicine, Saint Louis University.
Email: kento.sonoda@health.slu.edu
DOI: 10.3122/jabfm.2026.260003R1
Keywords: Family Medicine, Foreign Medical Graduates, Primary Health Care, Workforce Diversity
Dates: Submitted: 01-02-2026; Accepted: 04-13-2026
Status: In Press.
INTRODUCTION: International medical graduates (IMGs) currently comprise approximately one-third of certifying family physicians in the United States. This study aims to describe the demographic profiles of IMGs in Family Medicine and the characteristics of the residency programs that train them.
METHODS: We utilized data mainly from the American Board of Family Medicine (ABFM) Initial Certification Questionnaire (ICQ) 2017-2022 linked with the American Medical Association (AMA) Masterfile 2024 and the AMA FREIDA data. We categorized family physicians based on their country of birth and the location of their medical school: 1. US-born graduates of US medical schools (USMG), 2. US-born graduates of non-US medical schools (US-IMG), and 3. non-US-born graduates of non-US medical schools (non-US IMG). The final study sample was 14,152.
RESULTS: In our study sample, 70.2% were USMGs, 14.4% were US-IMGs, and 15.4% were non-US IMGs. While 28% of the USMG FPs were trained in rural residency programs, 21% US-IMGs and 20% non-US IMGs were trained in rural training programs (p<0.001). More than half of non-US IMGs (54.1%) were originally from four countries: Canada, India, Pakistan, and United Kingdom. An additional 23.4% were born in other countries, each representing between 1.1% and 2.6% of the total. The remaining 22.5% were from countries that individually account for less than 1% of the total.
DISCUSSION: IMGs play a critical role in diversifying the US primary care workforce through their unique cultural, linguistic, and clinical perspectives. Further targeted recruitment support and recruitment strategy for IMGs need to be explored.