About 22 percent of the medical doctors licensed in Oklahoma received their professional training outside of the United States.
Whether this is good news or bad depends on where the doctors were born, at least according to a study released by a foundation that advocates for foreign-trained medical professionals.
The study, released by the Foundation for Advancement of International Medical Education and Research in late 2010, found that foreign-trained doctors are just as capable as their U.S.-trained counterparts.
But the study also draws attention to U.S.-born citizens who leave the country to earn medical degrees abroad, suggesting that such doctors may provide inferior care to their patients.
In Oklahoma, there are 2,199 licensed medical doctors who received their medical training outside of the country, or 21.8 percent of all licensees.
Nationally, that figure is closer to 25 percent, the foundation's study shows.
Lyle Kelsey, executive director of the Oklahoma Board of Medical Licensure and Supervision, said the number of foreign-trained medical doctors has never been an issue in Oklahoma.
Kelsey agreed with the study's assertion that medical doctors trained outside of the U.S. are just as capable as their counterparts who graduated from American universities. He also said that doctors have to pass a rigorous, three-phase exam before being granted a medical license in Oklahoma.
“When we looked through the complaints and disciplinary actions over the years ... it seems like the same kind of percentage ... as far as the number of U.S.-trained doctors versus foreign ones,” Kelsey said.
Indeed, the board's records show that doctors trained abroad have disproportionately fewer complaints filed against them than doctors trained in the U.S.
In 2010 and 2011, the licensure board took disciplinary action against 48 medical doctors, for a variety of reasons. Eight of those doctors — or 16.7 percent — were educated outside of the country.
Kelsey also believes the number of doctors trained outside the U.S. will increase due to an ongoing doctor shortage, both in Oklahoma and nationwide.
“It's probably more of a doctor maldistribution. We have more doctors in Tulsa and Oklahoma City because of the training available, the fact that they're metropolitan areas and the fact that they're more attractive to families because of the activities available,” he said. “But we do have a per capita doctor shortage, based on the national averages.”
That “maldistribution” is evident by looking at where doctors live and work.
Oklahoma County has a medical doctor for every 264 residents, the highest concentration of doctors among the state's 77 counties, according to licensure board data. Tulsa County has a doctor for every 359 residents, the second- highest concentration.
In smaller counties, that ratio looks significantly different.
Hughes County has only one doctor for its 14,154 residents, which gives the rural county the second- lowest concentration of medical doctors. Four counties in Oklahoma have no licensed medical doctors.
“There is a need for any new doctors, especially in rural areas, plus we've got a large number of doctors who are reaching retirement age,” Kelsey said. “Because of this, I think, you're going to see an increase in foreign-trained doctors ... that will continue and grow for some time.”
While the study released in 2010 found that doctors trained outside of the U.S. provide patient care that is on par with their U.S.-educated counterparts, it also revealed some details about Americans who attend medical school abroad.
The study, which provides an analysis of 244,153 heart failure and heart attack cases in Pennsylvania, found that patients of American doctors who went to medical school abroad had higher death rates and experienced longer hospital stays compared with other groups.
Doctors born and educated outside of the U.S. had the lowest death rates, while American doctors who earned medical degrees at domestic universities were in the middle, according to the study.
Of the 2,199 foreign-trained doctors licensed in Oklahoma, 967 were born in the U.S. but left the country to earn their medical degrees.
Kelsey said he couldn't comment about the study's findings regarding U.S.-born doctors who received their medical training abroad. He said the licensure board has not studied the issue and that such an inquiry hasn't been requested by board members.
“I guess the only issue that has come up is how many are from offshore medical schools ... Caribbean schools as opposed to countries we're more familiar with, like India,” Kelsey said. “The issue that comes up there is what quality they are. Some of them have been around for a long time now and have become more readily accepted.
“Some of the new ones that crop up, sometimes, the board will not approve licenses from them because we just don't know enough about the medical school.”
Kelsey said he thinks U.S.-born students often seek medical degrees outside the U.S. because they couldn't get into domestic programs.
“Medical school is hard to get into, here in the United States,” he said. “Usually, there's not a huge concern about that unless they just don't do well on their exams.”