A proposed framework for analyzing the potential replacement of international medical graduates.

There has been sentiment against international medical graduates (IMGs) that could lead to a reduction in their future supply within the US. In this study, an analytical framework is proposed to illustrate the many issues that need to be considered in replacing IMGs in rural, needy areas. To learn about possible approaches to IMG replacement, interviews with 15 recruiters and planners at the local, regional and state levels in four states with strong IMG concentrations were conducted. Through analysis of participants' comments, this study shows that every posited solution to replacing IMGs has serious flaws.