Foreign medical graduates (FMGs) sometimes struggle to get into residency programs, and U.S.-trained graduates are often chosen over these equal but foreign individuals. The reasons for choosing U.S.-trained medical graduates vary, but there is one very good reason to include more FMGs into U.S. medical residencies and the healthcare field, and that is that they bring more cultural competence to healthcare.
In the United States, there is a dominate culture that is Christian and Caucasian. While this culture greatly influences our government and healthcare systems, America has always been a “melting pot” consisting of natives and immigrants with religious freedom and a multitude of skin colors. In fact, the dominant culture in the U.S. came from migrant populations, but their conquering history created a long-lasting power struggle between different races.
In modern medicine, lawmakers and medical educators strive to make the healthcare culture more diverse and inclusive. People realize that there are disparities in healthcare outcomes caused by a lack of cultural competence, and they work diligently to equalize the results. No person should receive better care based on their race or religion, nor should they be forced to take part in care that goes against their personal values. This is where foreign medical graduates are able to bring more cultural competence to healthcare.
If it doesn’t make sense how simply being from a different country could bring cultural confidence, consider the United States law enforcement or government system. In these systems, the minority races they serve feel underrepresented and therefore feel as though they have no voice. As these societal systems become more diverse, you see a decrease in disparities and more comfort with the impositions that result from these systems. It is not that a police officer should not have white skin. It is simply that having a diverse force implies that there is no bias. It is not that government should include every race, but making sure it includes multiple races without discrimination is essential to show equality among all races.
In U.S. medicine, there are surprising cultural healthcare disparities. According to one study, over 10 percent of African American, Asian Americans, and Latinos feel they would receive better care if they were a different race. That’s compared to 1% of Caucasians. This does not take into account actual results, but the simple feeling of disparity is enough to affect health outcomes. If disparities are real or imagined, they have a negative impact.
One of the most obvious places in medicine where shortfalls occur because of lack of cultural competence is in language. There are so many different languages that it is nearly impossible to include each in the primary care setting. Including more FMGs in the healthcare system provides more opportunity for bilingualism (or multilingualism), and patients who do not speak English are willing to travel or participate in remote care in order to speak their native tongue. The inability to reach people who share cultures and languages is a shortfall that is difficult to overcome without more diversity. Not only that, but the more people are exposed to different languages, the more they are able to communicate authentically despite language barriers. It is a sort of immersion therapy where people become more aware of non-verbal communication in order to improve environments. It also helps to remove biases associated with not knowing English, which has no impact on intelligence or worth.
Another advantage of including more FMGs in the healthcare provider mix is that they have awareness of other cultures. It is difficult to understand some cultures even when cultural competence is included in medical training. The values of one culture may directly contradict the values inherent in U.S. medicine. In these situations, physicians may feel they are violating their own moral code in order to satisfy a patient’s cultural needs. Having other physicians who are familiar with different cultural attitudes and goals for healthcare results in better outcomes. Patient-centered care is not possible without cultural competence.
One last reason more FMGs brings more cultural competence is that it reinforces the ideas already presented in cultural competence training many doctors receive today. It is easy to say you understand cultural competence and are ready to practice it every day in the healthcare setting. It is much more difficult to put those words into action. Having more FMGs in the healthcare field gives all medical providers the ability to practice cultural competence among their colleagues. This makes cultural competence with patients more natural and maybe even instantaneous.
The world is diverse, but the U.S. healthcare system is lacking somewhat in its diversity. This impacts healthcare outcomes whether it is because of bias and discrimination or perceived bias and discrimination. Having more FMGs in the healthcare field will improve healthcare outcomes and make patients feel like they are equal to all others in the eyes of their providers.