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The March 6 issue reports on the new Clinical Skills Assessment. Reportedly this examination would allow international medical graduates (IMG's) to "show competency in core clinical skills and spoken English" and ensures "that individuals entering graduate medical education are adequately prepared," according to Sidney Weissman, M.D.
As stated by APA President-elect Rodrigo Muņoz, M.D., this certainly creates another barrier for IMG's to pursue graduate medical training in the United States, given the added expense of the examination and the travel and lodging expenses associated with it. Thus, data should be presented supporting the contention that IMG's have deficits in those areas that need to be remedied, and if so, whether the CSA is an appropriate solution for this before implementing it. Otherwise, it will be hard to dispel the notion that this may yet be another instance of barriers aimed solely at IMG's. Indeed it may be worthwhile to remind readers that potential discrimination against IMG's has been described even while selecting prospective caxndidates for psychiatric residencies (American Journal of Psychiatry, November 1997).
I remember quite clearly how difficult it was for my family to secure the funds for my interviewing trip to the United States, especially given the already steep fees paid for the ECFMG examination and prior book expenses preparing for it. I had to stay in youth hostels and travel by Greyhound bus to my interviews. I would not have been able to afford yet another trip for the sole purpose of taking another exam, so I can only empathize with the IMG's who may never have the opportunity of pursuing training in the United States due to this new hurdle in their path.
Eduardo Dunayevich, M.D.
Reading, Ohio