"International medical graduate" is used by Dr. Levey [1] as an attempt to decrease the negative stigmata associated with the term "foreign medical graduate." However, Dr. Levey's recommendation of evaluation and training solely for international medical graduates suggests a negative attitude.

Program directors must maintain the highest standards for internal medicine residents, and it would be more appropriate to re-evaluate the internal medicine postgraduate entrance process for all prospective residents. My experience as a foreign medical graduate in an internal medicine residency program, together with other studies [2], leads me to conclude that Dr. Levey's "pre"-postgraduate training evaluation would help to maintain the desired standards if it were applied to all entering residents.

As for how many international medical graduates should be trained, Dr. Potts' article [3] on recruitment of minority physicians into careers in internal medicine is instructive. Graduating physicians tend not to practice in underdeveloped areas. By increasing the percentage of minority representation in medical school, a greater percentage of physicians might return to provide service in minority communities. Hence, the entrance of international medical graduates into internal medicine residencies should perhaps reflect their ethnic representation in the population.

Finally, the funding of international medical graduates during postgraduate training is not an issue. A resident provides service and receives education and compensation. A qualified international medical graduate should receive the same benefits as an equally qualified U.S. graduate. Approximately 80% of the international medical graduate trainees remain in the United States, continuing to dedicate themselves to the care of the American people.