CORRESPONDENCE: LETTER TO THE EDITOR
Role of International Medical Graduates in the American College of Cardiology
Habib A. Dakik, MD*
* Associate Professor of Medicine, American University of Beirut, P.O. Box 11-0236/A38, Beirut, Lebanon (Email: hd01{at}aub.edu.lb).
I read with much interest the recent commentary by Dr. W. Douglas Weaver (1), President of the American College of Cardiology (ACC), in which he addressed the challenges that international medical graduates (IMGs) face when they enter fellowship programs or clinical practice in the U.S. and proposed ideas to get them more involved and integrated in the functions of the ACC. Because I am an IMG myself, it was rewarding to see that the ACC at its highest leadership level is genuinely interested in the welfare of IMGs, who certainly go through difficult times to get into a cardiology fellowship program in the U.S. in the first place.
Although most IMGs who complete their cardiovascular training end up staying in the U.S. in private practice or academic positions, a substantial portion do actually go to their countries (mainly developing countries) to start their careers there. Those also tend to disconnect from the ACC and, other than attending the annual ACC or American Heart Association scientific sessions, they are not so much involved in the functions of the college. Many of those IMGs have received rigorous research training in the U.S. in addition to their clinical training, and unfortunately their research productivity significantly decreases once they leave the U.S. (2). Limited funding, the absence of senior supporting mentors, and the lack of dedicated time all combine to significantly curtail the research potential of IMGs returning to their developing countries. How can the ACC support and enhance the academic careers of IMGs in their home countries?
First, encourage them to continue their research and to publish it. There is a feeling, which may be difficult to prove, that there is a certain bias in U.S. and European journals against research performed in developing countries. Most of the research conducted in these countries is clinical rather than basic and although it might not be directly relevant to the U.S. health care system, it remains relevant to "global cardiovascular health." The ACC could help IMGs by having its journals more "open" to their research or perhaps having a journal dedicated to cardiovascular health in developing countries just like it has journals dedicated to imaging or interventions.
Second, help them create a network with leading pharmaceutical companies conducting clinical trials. Most of those companies view developing countries primarily as markets for their products, and although some of them are beginning to conduct clinical trials in these countries, their attempts have not been always successful because of the lack of supporting infrastructure and improper selection of sites and investigators. Proper networking among the ACC, pharmaceutical companies, and investigators with solid research background can ensure the success of the clinical trials conducted and at the same time enhance the academic careers of the investigators involved.
A third way the ACC could support IMGs and at the same time achieve its mission to improve global cardiovascular health is by conducting some of its educational programs and workshops in developing countries and getting IMGs in these countries intimately involved in these programs.
The interest of the ACC leadership in IMGs is an important positive step forward. The IMGs remaining in the U.S. and those returning to their home countries possess tremendous clinical and research potentials that should be used effectively to improve the global cardiovascular health and fulfill the mission of the ACC.
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1. Weaver WD. President's page: expanding our diversity to expand our reach J Am Coll Cardiol 2008;52:1885-1886.[Free Full Text]2. Dakik HA, Kaidbey H, Sabra R. Research productivity of the medical faculty at the American University of Beirut Postgrad Med J 2006;82:462-464.[Abstract/Free Full Text]
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