continued with the progress in medicine in the 20th century there were more patients and hospitals needing more physicians than the medical schools produced. The need was filled in by Americans going to overseas medical schools and foreign physicians migrating for training and practice. In America there was a need so training programs were opened , first by academic centers then by large hospitals to fulfil the need. Each specialty devised its own requirements for the years in training.
In the 1950's there was some question of the educational background of some foreign physicians and a hue and cry was created about their competence. But the demand for medicine could not be fulfilled without them. So an examination was created by the Educational Council of Foreign Medical Graduates (ECFMG) which they had to pass before coming to the U.S. A few years later another objection was created in that the U.S. was siphoning off elite professionals from poor countries where they were needed (Brain Drain). So a law was made that all physicians from such countries had to go back after the completion of their training and stay there for at least two years before they could seek to come to the U.S. Like most laws and rules, it was a kneejerk reaction to a perceived problem without properly studying it. These physicians, trained in the cutting edge Medicine did not have the tools in their country to practice that kind of medicine most of the time. Despite all this, a large number of U.S. trained physicians came back and were granted entry due to the great demand for physicians. They mostly filled slots where U.S. physicians did not or did not want to go- rural areas with small hospitals, state hospitals, V. A. and Indian services, and in specialties like general practice, pediatrics, pathology and psychiatry. These 'foreign' U.S. trained physicians acquired a new label- 'F.M.G.' Foreinn Medical Graduates.
They were shunned from academic institutions and larger medical centers. And (covertly0 institutions prided themselves in boasting of having few, if any F.M G.s on staff. F. M. G. became an unofficial stigma. Add to that the rules of some states where citizenship was required for the license to practice medicine in addition to passing state medical exam. Despite all this the F.M.G.'s thrived due to the support of their patients. Canada had gone one step further- A F. M. G. went through the training in his or her field in Canada, passed the specialty board's examination but was denied taking the practice license to many on the excuse that they did not 'recognize' their medical school !. It was like telling a space scientist that he was not one for his high school diploma was not good enough!
