International medical graduates (IMGs) are vital to U.S. surgical care, but face significant barriers in training and integration.

• IMGs represent a substantial part of the physician workforce yet are underrepresented in many surgical specialties.
• Persistent challenges include licensing issues, financial burdens, and biases within training environments.

Support through mentorship and policy reform is critical for better integration of IMGs into surgical practice.

• Addressing immigration hurdles and expanding residency opportunities can enhance access to quality surgical care.