Women in US medicine: the comparative roles of graduates of US and foreign medical schools.

The feminization of US medicine has occurred historically through two separate phenomena: the increase in the number of female graduates of US medical schools and the in-migration of female graduates of foreign medical schools. Reported here are the findings regarding gender on specialty choice, employment setting, and specialty board certification of 55,031 and 191,723 graduates of foreign medical schools and US medical schools, respectively. Graduates of foreign schools were subdivided into those who were foreign-national international medical graduates (IMGs), naturalized US citizen IMGs, and native-born US citizen IMGs at the time of entry into the US medical system. Statistically significant differences between women and men as well as among groups of medical graduates were found, with women in each medical graduate group proportionately overrepresented in primary care specialties, underrepresented in medical and surgical specialties, and underrepresented in both solo practice and group practice settings. Foreign-national IMG women were especially overrepresented in pathology, radiology, and anesthesiology, and in certain employment settings such as public hospitals and the Veterans Administration. The findings provide a basis for further study of the causes and consequences of the observed differences.