International Medical Graduates Produce Significant Research Contributions During Hematology/Oncology Fellowship

Although international medical graduates comprise a significant portion of practicing oncologists in the United States (US), their research contributions as hematology/oncology fellows have been poorly understood historically, and structural barriers persist in terms of matching into suitable fellowships and residencies, according to Arya Mariam Roy, MD, MBBS.

During the 2025 ASCO Annual Meeting, Roy presented findings from a retrospective study, which examined the research productivity of international medical graduates during hematology/oncology fellowship.¹ Findings from the study demonstrated that international medical graduates produced higher research productivity vs American medical graduates during fellowship in terms of the median numbers of abstracts, Google scholar articles, total manuscripts, first author manuscripts, high-impact journal articles, original articles, and review articles (all P < .001).

“International medical graduates make vital contributions to academic medicine,” Roy, an assistant professor in the Division of Oncology at The Ohio State University College of Medicine in Columbus, said in an interview with Oncology Fellows. “There is a need to address potential structural barriers, which prevent them [from practicing] at US academic institutions. [This study] is a stepping stone, and we are doing more research in this area.”

In the interview, Roy discussed the rationale for the study, the key findings, and how the study results can be used to break down the barriers that international medical graduates often face.

Oncology Fellows: What prompted the initiation of this study?

Roy: [Approximately] 25% of all practicing physicians in the US are international medical graduates.² International medical graduates also account for [approximately] one-third of all practicing oncologists in the US.³ However, [although] we are represented in the oncology workforce, we see that it’s hard for international medical graduates to match into good residency and fellowship programs in the US. Even if they have good credentials, exam scores, and a CV with good publications, it’s hard to get matched into good fellowship programs or residency programs.

That’s where the importance of this project [lies] because we are trying to [determine] the academic productivity of international medical graduate hematology/oncology fellows and compare that with the academic productivity of American medical graduates. The main idea behind this project is that if we identify that international medical graduate hematology/oncology fellows are more productive in terms of their academic [publications] compared with American medical graduates, we can use this as a metric for recruiting more international medical graduate fellows into fellowship.

What were the key design characteristics of your study?

In this study, we utilized publicly available websites of ACGME-accredited institutional fellowship programs in the US. We identified the hematology/oncology fellowship programs in the US through the fellowship match website. Then we went into the institutional hematology/oncology fellowship program websites and identified all the hematology/oncology fellows who were receiving training from US institutions during 2021 to 2024. We categorized them into international medical graduates vs American medical graduates.

Using the names of the fellows, we looked into their PubMed and Google Scholar profiles. We [assessed] their academic productivity by the number of manuscripts, Google Scholar articles, first-authors papers, review articles, and high-impact publications.

What were the key findings of the retrospective study, and how can they inform future strategies to address the barriers for international medical graduates?

We identified a total of 1858 hematology/oncology fellows, and 30% were international medical graduates. Forty-two percent were females, and a 10.90% had additional degrees, such as master’s degree or PhDs. We observed that American medical graduates were more likely to have advanced degrees compared with international medical graduates, at [a rate of] 12% vs 8.3%, [respectively].

Although American Medical graduates had more advanced degrees, we observed that international medical graduates exhibited significantly higher research productivity compared with American medical graduates. In all the categories in terms of research productivity, international medical graduates did better than American medical graduates. That was a significant finding from our project. We also observed that international medical graduates [produced] more manuscripts on average than American medical graduates, even after adjusting for their gender or advanced degrees.

What are the next steps for this research?

This is important research because it helped us to prove our hypothesis that international medical graduates are working harder before getting into fellowship and during fellowship. This [research] will help us to recruit more international medical graduates into good academic and fellowship programs in the US; program directors can use this as a metric to recruit more international medical graduates.

Since their productivity is higher, it also increases the quality of the hematology/oncology fellowship programs in the US. At this time, there are so many structural barriers that international medical graduates are facing to practice at US academic medical institutions. If [institutions] recruit more international medical graduates into academic hematology/oncology fellowship programs, there is a likelihood that they will stay in these programs and continue their research productivity, which will be useful for the institution and our patients.

References

1. Roy AM, McPherson T, Wannaphut C, et al. Research productivity of international medical graduate (IMG) hematology and oncology fellows in the United States (US). J Clin Oncol. 2025;43(suppl 16):9003. doi:10.1200/JCO.2025.43.16_suppl.9003
2. FSMB physician census identifies 1,082,187 licensed Physicians in U.S. News release. The Federation of State Medical Boards. August 15, 2025. Accessed October 22, 2025. https://www.fsmb.org/advocacy/news-releases/fsmb-physician-census-identifies-1082187-licensed-physicians-in-u.s/#:~:text=Key%20findings%20of%20the%202024,highlighting%20potential%20future%20workforce%20attrition.
3. Dizman N, Bakouny Z, Haykal T, et al. Guide to understanding and supporting international medical graduates in hematology/oncology by the ASCO International Medical Graduates Community of Practice. JCO Oncology Practice. 2024;21(3):292-299. doi:10.1200/OP-24-00565