Somewhere around 25 percent of doctors practicing in this country have been trained at medical schools outside the United States (a good percentage are from India, the Philippines, Mexico, Pakistan and the Dominican Republic).

Some of these foreign-trained doctors grew up in foreign countries. Others are American citizens who were not able to find a spot in a U.S. medical school and decided to go abroad for medical training.

Collectively, these foreign-trained doctors are far more likely to practice in less desirable specialties like internal medicine, psychiatry and family medicine, and they are far more likely to practice in physician-short areas like the inner city or rural America.

They are more likely to care for poor patients, charge less money for a visit and work longer hours than American-trained physicians. There are studies suggesting that the quality of care these foreign-trained doctors provide is at least as good as that provided by the average American doctor.

Bottom line is that without these foreign-trained doctors, we as a nation would be in big trouble providing our citizens with health care.

Yet, too often foreign-trained doctors are ostracized and treated as second class citizens both by American-trained doctors and by patients. Foreign-trained doctors may speak with an accent, and some may be difficult to understand.

It is not uncommon to hear a patient tell the hospital clerk that they only want to see an "American doctor" and sometimes the language they use is even uglier when they make this request. I understand that people have prejudices, they have fears, and when they go to the doctor they are sick but these assumptions can be counterproductive.

A foreign accent does not mean poor medical training. Some of the very best doctors I've worked with have been trained outside of North America. Admittedly, medical schools outside the U.S. vary considerably, and there are some absolutely rotten schools. But there are many foreign schools that provide the same excellent level of training that is provided by American schools. Unfortunately, our American medical schools also train some poor doctors. After all, someone has to graduate at the bottom of the class, right?

In many areas, such as in the ability to do a comprehensive physical examination or to understanding the underlying science behind medicine, foreign-trained students surpass American students. However, there is one common area where foreign medical schools fall short and that is in the area of preparing doctors for the culture, communication and ethics required to practice in the United States.

As patients, Americans expect their doctors to listen to them and explain their condition so that they as consumers can participate in making medical decisions. Americans expect doctors to be honest with them and tell them the truth even when the news is bad news. In many countries, such approaches to medical care are not routine and are not taught. But foreign-trained doctors are smart men and women, and they learn Americanisms quickly.

Continue reading here:

Inside Medicine: Pros and cons of foreign-trained doctors