Inasmuch as 1 in 4 doctors in the United States were born abroad, a study published yesterday could not be more timely—or politically charged. It comes as President Trump’s 90-day ban on people from seven Muslim countries entering the U.S. takes effect. The study in BMJ (formerly the British Medical Journal) says that patients treated by doctors educated outside the U.S. are a bit less likely to die within 30 days than those patients treated by U.S. educated doctors, according to STAT.
BMJ says that the timing was coincidental; researchers began the project a year ago and the study publication date had been locked in before Trump’s announcement. The patients’ average age was 80 with the most common causes of death being congestive heart failure, sepsis, COPD, and pneumonia. Data came from 1.2 million hospital admissions of Medicare patients 65 and over. The information was collected between 2011 and 2014, and focused on 44,227 internists.
STAT reports that, “The researchers excluded from their analysis physicians who graduated from U.S. colleges but attended medical schools in the Caribbean or Central America, which usually happens because they were not accepted by U.S. medical schools. Those graduates ‘are known to be less qualified and would have biased our analysis,’” said study coauthor Dr. Yusuke Tsugawa, who graduated from a medical school in Japan.
The researchers put the significance of the findings in the study’s discussion section. “The difference in patient mortality between the international and U.S. graduates, an adjusted odds ratio of 0.95, is at most a modest clinical significance,” researchers wrote. “Based on the risk difference of 0.4 percentage points, for every 250 patients treated by U.S. medical graduates, one patient’s life would be saved if the quality of care were equivalent between the international graduates and U.S. graduates.”