We would like to thank Dr Antonio Boba for his interesting letter in response to our recent communication.1 However, we simply do not agree with the content of this letter.
First, how did Dr Boba arrive at the conclusion that "50%" of IMGs cannot communicate in English? We would very much like to see where he got those numbers. We know of so many of our IMG colleagues who can speak, write, and communicate not only in English but also in other languages, which, by the way, are spoken in abundance in the United States. Most IMGs are bilingual and some are even trilingual. These IMGs do a wonderful job of communicating in more than 1 language compared with their American counterparts and are an asset to the surgical programs. A lot of patients coming through the doors of surgical departments in major US cities are of foreign origin and not all speak English. If it were not for these IMGs, a very important source of revenue would be lost by these surgical departments. One can say with great confidence that many of surgical departments should consider themselves privileged to be associated with IMGs and not the other way around. It is, therefore, the American medical graduates (AMGs) who are at a disadvantage in this situation. Maybe Dr Boba would like to address this question and perhaps offer us a solution as well. Should those AMGs who cannot communicate in languages other than English (which without a doubt will be >50%) be penalized for their language inadequacies, be placed in language schools, or even be excluded from residency slots in the major US hospitals?