This article reviews the literature on the quality of care provided by foreign-trained physicians (international medical graduates or IMGs) compared with that of U.S. medical graduates (USMGs). As concerns are raised about IMGs in the U.S. physician workforce, there are suggestions that IMGs do not deliver care equal in quality to that of USMGs. The review of process and outcome studies finds little support for this claim. However, lower IMG levels of performance on structural measures of quality like credentialing examinations exist and may indicate quality differences. Because no consistent evidence exists that there is a connection between IMG test scores and process or outcome measures of quality of care, whether test scores matter in clinical practice and its outcome is uncertain. Until research shows the contrary, one should be cautious in accepting IMG-USMG quality arguments to support policy to reduce the size of the IMG component of the physician workforce.
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