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International medical graduates (IMG) account for one-quarter of the practicing U.S. physician population. And during the past 20 years, their ranks have steadily grown at a rate faster than that of U.S.-trained physicians, according to the American Medical Association's (AMA) 2006 Physician Characteristics and Distribution in the U.S. As the number of internationally trained physicians rises, so does their influence on the physician marketplace. Some experts contend that without IMGs, it would be virtually impossible to maintain America's healthcare system, because these recruits typically practice in some of the areas hit hardest by physician shortages.