International medical graduates (IMGs) in the US refer to physicians who received medical training outside of the United States. Typically, these physicians hold an MD degree, though some hold a MBBS degree. IMG physicians may be US citizens who have attended an offshore medical school (usually in the Caribbean) or citizens of other countries who have immigrated to the US. Of US citizens who attend offshore medical schools, more than half receive training at 4 institutions: Ross University (17.8%), St. George’s University (16.6%), Universidad Autonoma de Guadalajara in Mexico (8.3%), and the American University of the Caribbean School of Medicine (8.0%).