Unlicensed foreign medical graduates in California. Social and demographic characteristics and progress toward licensure.

Foreign-born physicians graduated from foreign medical schools who were unlicensed in California are described by nationality, age, sex, location, visa status, employment, English fluency, and specialty. Over 1,210 unlicensed foreign medical graduates (FMGs) were located in California and 736 were interviewed, approximately 40% of the estimated 3,000 FMGs residing in the state. Most of the FMGs who passed the ECFMG and FLEX were young, had specialty training, had studied for the examination, had participated in review courses, and were unemployed. GMENAC projections for the number of FMGs entering the residency pool to the year 1990 may be far too low, because many unlicensed FMGs are already in the country. Two thirds of the FMGs studied came to the United States after immigration of FMGs was restricted in 1977. Many were refugees or were from countries in political upheaval. Policy issues raised are the role of FMGs in improving care to the underserved, medical standards, humanitarian issues related to the resettlement of refugees and immigrants, and the projected oversupply of physicians.