In the September 3 issue Joshua Thornhill M.D., wrote about the apathy of early career psychiatrists (ECPs) toward APA. I want to share my own observations on this issue.

I have been trying very hard to get my fellow ECPs to become APA members. Many of these are international medical graduates (IMGs). According to some estimates, nearly 40 percent of ECPs are IMGs. One reason I often hear from IMG ECPs is that they feel that they are unwanted outsiders. Most complain that during residency they have heard many faculty members openly lament the lack of American medical graduates (AMGs) in their programs and muse fondly about the days when the program used to be AMG dominated. They also hear faculty openly discussing the prospect of sending "scouts" to Puerto Rico to attract AMGs into the program. Many report that when they have tried to discuss issues regarding discrimination against IMGs and practice patterns and other issues in journal clubs or other forums, they have been strongly discouraged. Those who served as chief residents have heard worse things in education committee meetings.

These experiences have left IMGs very demoralized. I have tried to explain to them that APA is nondiscriminatory and actually goes out of its way to welcome IMGs, and I have shown them articles in support of my claims. But unfortunately most are unable to overcome the resentment of what they consider to be "the establishment."

If American psychiatry is to prosper and if APA is to maintain its credibility as an organization representing a significant majority of psychiatrists in the United States, it is imperative that residency programs drastically change the way they treat their IMG residents.

Sanjay S. Chandragiri, M.D.

Throop, Pa.