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J Gen Intern Med2026;41(9):2551-2559.July 1, 2026Journal Article

End-of-Life Care Processes and Outcomes for Older Adults Treated by International Medical Graduates vs. US Medical Graduates.

Gillian S Kaneshiro1, David B Reuben2, David S Zingmond3, Anne M Walling3,4, Anupam B Jena5,6, Neil S Wenger3, Cheryl L Damberg7, Haiyong Xu3, Nate Gross8, Hiroshi Gotanda9, Yusuke Tsugawa10,11
1Columbia University Mailman School of Public Health, New York, NY, USA.
2Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
3Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
4VA Greater Los Angeles Health System, Los Angeles, CA, USA.
5Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
6Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
7RAND, Santa Monica, CA, USA.
8Doximity, San Francisco, CA, USA.
9Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
10Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. ytsugawa@mednet.ucla.edu.
11Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, 90024, USA. ytsugawa@mednet.ucla.edu.
PubMed PMC DOI PDF

Abstract

IMPORTANCE: International medical graduates (IMGs-physicians who graduated from a medical school outside the US) hold a significant role in the US healthcare system. Research suggests that clinicians' attitudes towards end-of-life (EOL) care may vary across countries. OBJECTIVE: To compare EOL care processes and outcomes for older adults treated by IMGs vs. US medical graduates (USMGs). DESIGN:…

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