Title of Dissertation:
HEALING AT THE MARGINS: A CULTURAL/HISTORICAL PERSPECTIVE ON INTERNATIONAL MEDICAL GRADUATES IN THE US HEALTHCARE SYSTEM
Summary of Dissertation:
Foreign, or international, medical graduates make up about 25 percent of current American medical trainees and 20 percent of physicians actively practicing medicine in the United States. In some specialties, particularly in primary care, the percentage of residents who received their medical education abroad nears fifty. Furthermore, international medical graduates or IMGs, known as foreign medical graduates or FMGs before the mid-nineteen-nineties, are far from a novel presence within the American medical center, often credited with disproportionately caring for indigent, urban, institutionalized, and rural Americans. The presence of these physicians, however, has also long been controversial, engendering suspicion from organized medicine and concerns from policy analysts about physician surpluses in the United States and a “brain drain” of needed medical talent from much poorer nations. The past, current, and future role of IMGs is a window into American medicine from its margins. Through a historical and narrative exploration this project re-evaluates the role of medical migrants in the academic medical center and American medical practice since World War Two, arguing that the presence of these physicians has had a material impact on the nature and development of the US healthcare system, masking many of its safety-net shortfalls. Through qualitative analysis, I also delve more deeply into the relationship of migration and professional identity that has evolved within American medicine and global medicine throughout the twentieth century. The United States has not simply functioned as a passive recipient of immigrant clinicians from across the world but has also been a progenitor of powerful ideologies and policies that have had complex and often unintended effects on clinician migration
- Jason Glenn, Ph.D., (CHAIR), Associate Professor, PMCH; Member, Institute for the Medical Humanities, UTMB
- Jerome Crowder, Ph.D., Assistant Professor, PMCH; Associate Director and Member, Institute for the Medical Humanities, UTMB
- Anne Hudson Jones, Professor, PMCH; Harris L. Kempner Chair in the Humanities in Medicine; Member, Institute for the Medical Humanities; Director, Medical Humanities Graduate Program, UTMB
- Hanan Hussein, M.D., Assistant Professor, Family Medicine, UTMB
- Orkideh Behrouzan, M.D., Ph. D., Assistant Professor, Department of Social Science, Health and Medicine, King’s College, London, UK
Rimma is in the MD-PhD Combined Program. She began her PhD work in medical humanities in the summer 2008 term, went back to medical school, then rejoined the IMH in the spring of 2011 as a full-time graduate student. Rimma came to the Institute for the Medical Humanities from UCLA, where she majored in history and minored in anthropology. As an undergraduate she interned with the division of medicine and science at the Smithsonian Institution's Museum of American History. Some of her previous research interests have included the impact of the War on Cancer on the National Institutes of Health and the biomedical community at large, as well as the medical needs of adults with cerebral palsy. As an MD-PHD student, Rimma always strove to integrate her medical education as much as possible into her studies at the institute. While in her course work Rimma’s goal was to pursue her primary interest in the history of medicine, as well as her interest in the interdisciplinary issues currently facing the medical and scientific communities.
In July 2016, she will begin her residency in internal medicine at the University of North Carolina in Chapel Hill.