To the Editor.
—The otherwise informative article on licensure of international medical graduates (IMGs) concluded that conversation with US medical graduates regarding licensing boards "might lead IMGs to believe that they are not treated much differently after all."1 However, the article misses the main point of contention. The licensing boards have introduced protectionist policies using the excuse of necessity for protecting the public from suboptimally trained IMGs. The discrimination is extended not only to those who are truly suboptimally trained but also to those who have better training than the average US medical graduate. For instance, board-certified ophthalmologists from Great Britain or South Africa had, by the time of their board-equivalent examinations, undergone more rigorous (and longer) training than their US counterparts. Regardless whether one considers the respective ophthalmology residencies equivalent, in no way can any licensing board justify the discrimination that follows the arrival of such an ophthalmologist in