Geographic Distribution of International Medical Graduate Residents in U.S. Neurosurgery Training Programs

Background: Neurosurgery residency in the United States is highly sought after by many international medical graduates (IMGs), and the geographic distribution of IMG candidates who have successfully matched has not been quantitatively explored to date. The aim of this study was to highlight the countries in which successfully matched IMG residents obtained their medical degrees and the states of their respective residency destinations. Methods: All available resident lists of approved neurosurgical residency programs within the United States with at least 7 years of history were reviewed for IMGs in the most currently updated rosters. Demographic and geographic characteristics were summarized. Results: A total of 1393 current neurosurgical residents in U.S. residency programs were identified from 99 programs across 39 states. Of 1393 residents, 87 were IMGs (6%). The IMG contingent originated from 39 countries, the most common of which was Lebanon (n = 14/87 [16%]). The Middle East was the most represented geographic region (n = 23/87 [26%]). The states with the highest number of IMGs were Kentucky, New York, and Texas (all n = 7/87 [8%]). Conclusions: IMGs constitute a small but appreciable portion of current neurosurgical residents in U.S. training programs. Particular countries have contributed more IMGs to neurosurgical programs than others, and particular states have higher counts and proportions of IMG residents than others. These outcomes are not geographically homogeneous, and the mechanisms by which IMG applicants successfully match to U.S. neurosurgery programs require more biographic granularity to elucidate.