Challenges Faced by International Medical Students in the United States
Bibliographic record
Abstract
To the Editor: The United States has always been a desirable destination for international students seeking higher education, including medical degrees. However, for non-U.S. citizens or permanent residents, the path to becoming a physician in the United States is challenging. With only 43 out of 157 U.S. allopathic medical schools considering non-Canadian international candidates,1 the competition for admission is fierce. The Association of American Medical Colleges reported that in the 2021–2022 application cycle to U.S. allopathic medical schools, only 1959 (3.7%) of the 55,188 total applicants were non-U.S. citizens or permanent residents. Of these 1959 applicants, only 314 were accepted, resulting in an acceptance rate of just 16.0% compared to 41.2% for all applicants.2 Even once accepted, international medical students continue to face challenges upon matriculation. One of the biggest challenges for international medical students is limited access to financial aid and scholarships. In the United States, the average cost of tuition and fees for students at private medical schools and out-of-state students at public medical schools was over $60,000 in the 2022–2023 academic year.3 This cost can be even more daunting for international students with limited financial aid and scholarship options. Although some medical schools offer financial assistance to international students, these opportunities are limited. The majority of international students need to secure private loans, which can be difficult if they lack a cosigner with U.S. citizenship. While in medical school, international students often face a lack of mentorship and support for their unique needs.4 Many struggle to find mentors and role models, making it challenging for them to adapt to a new culture, language, and education system. This process can be further challenged after completing medical school, as international medical graduates must apply for a J-1 or H-1B visa. This limits the number of residency programs they can apply to as only a limited number can sponsor their visa application.5 Obtaining a visa for residency can be a complicated, time-consuming process with no guarantee of approval. Despite these challenges, international medical students remain motivated and determined to succeed. They bring diverse perspectives and cultural experiences to the U.S. health care system, allowing them to connect with patients from diverse backgrounds and provide effective and compassionate care. With the right support, international medical students can develop successful careers as physicians in the United States. It is essential to recognize their valuable contributions amid the challenges they face. By doing so, we can foster a more welcoming and inclusive health care system and improve the health and well-being of patients. Chiamaka L. Okorie Fourth-year medical student, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; email: [email protected]; ORCID: https://orcid.org/0000-0003-2233-4557
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.016 | 0.015 |
| Insufficient payload (model declined to judge) | 0.017 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".