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Background <p>Performance of International Medical Graduates (IMGs) compared to US Medical Graduates (USMGs) remains a key area of interest. This meta-analysis compared performance of IMGs and USMGs regarding surgical&#xa0;residency matching, research productivity, and postoperative outcomes.</p> Methods <p>Systematic literature search of PubMed and Scopus was conducted up to December 2024. Data from eligible studies were synthesized to assess differences between IMGs and USMGs in matching, research, and postoperative outcomes. Random-effect meta-analyses were conducted, and risk of bias was assessed using the Newcastle–Ottawa Scale.</p> Results <p>A total of&#xa0;22 studies, published from 2002 to 2024, were included. Neurosurgery (n = 8, 36.4%) was the most assessed subspecialty, followed by General Surgery (n = 6, 27.3%), Orthopedic, and Plastic Surgery (n = 3 each, 13.6%). Residency matching was assessed in 17 studies, while academic productivity was assessed in five, and surgical outcomes in three. IMGs had significantly lower pooled rates of matching into Residency programs (5.4%, 95%CI 3–7.7%; p &lt; 0.001) and Fellowship programs (0.518, 95%CI 0.19–0.83; p = 0.001)&#xa0;but had a significantly higher mean number of publications (WMD 10.9, 95%CI 2.45–19.3; p = 0.011) and H-index (WMD 2.41, 95%CI 1.46–3.36; p &lt; 0.001). IMG faculty had slightly higher odds of postoperative mortality (OR 1.076, 95%CI 1.01–1.14; p = 0.023) but no significant difference in 30-day complications (OR 1.033, 95%CI 0.92–1.16; p = 0.576).</p> Conclusions <p>IMGs were less likely to match into surgical residencies but outperformed USMGs in research output. Postoperative outcomes appear broadly comparable, although limited observational data suggested a small mortality signal that should be interpreted cautiously given high heterogeneity and potential residual confounding. Further nuanced investigation is warranted.</p>

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Comparing international and US medical graduates in surgical subspecialties: meta-analysis of residency matching, research output, and postoperative outcomes

  • 期刊论文

  • 发表日期：

    2026年8月4日

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  • Nir Horesh,
  • Sameh Hany Emile,
  • Zoe Garoufalia,
  • Ilana Grosman Setton,
  • Emanuele Lo Menzo,
  • Steven D. Wexner,
  • Raul J. Rosenthal

摘要

Background

Performance of International Medical Graduates (IMGs) compared to US Medical Graduates (USMGs) remains a key area of interest. This meta-analysis compared performance of IMGs and USMGs regarding surgical residency matching, research productivity, and postoperative outcomes.

Methods

Systematic literature search of PubMed and Scopus was conducted up to December 2024. Data from eligible studies were synthesized to assess differences between IMGs and USMGs in matching, research, and postoperative outcomes. Random-effect meta-analyses were conducted, and risk of bias was assessed using the Newcastle–Ottawa Scale.

Results

A total of 22 studies, published from 2002 to 2024, were included. Neurosurgery (n = 8, 36.4%) was the most assessed subspecialty, followed by General Surgery (n = 6, 27.3%), Orthopedic, and Plastic Surgery (n = 3 each, 13.6%). Residency matching was assessed in 17 studies, while academic productivity was assessed in five, and surgical outcomes in three. IMGs had significantly lower pooled rates of matching into Residency programs (5.4%, 95%CI 3–7.7%; p < 0.001) and Fellowship programs (0.518, 95%CI 0.19–0.83; p = 0.001) but had a significantly higher mean number of publications (WMD 10.9, 95%CI 2.45–19.3; p = 0.011) and H-index (WMD 2.41, 95%CI 1.46–3.36; p < 0.001). IMG faculty had slightly higher odds of postoperative mortality (OR 1.076, 95%CI 1.01–1.14; p = 0.023) but no significant difference in 30-day complications (OR 1.033, 95%CI 0.92–1.16; p = 0.576).

Conclusions

IMGs were less likely to match into surgical residencies but outperformed USMGs in research output. Postoperative outcomes appear broadly comparable, although limited observational data suggested a small mortality signal that should be interpreted cautiously given high heterogeneity and potential residual confounding. Further nuanced investigation is warranted.