A new study evaluated the effects of citizenship status on physician specialty choice and practice location among U.S. citizen and non-citizen international medical graduates (IMGs), which account for a quarter of all active physicians in the U.S. Citizenship status has significant effects on IMGs' choices of specialties and practice locations. Though non-citizen IMGs were historically found to be more likely to specialize in primary care and work in rural areas and shortage areas, the proportion has declined over the past decade. Strategies to recruit physicians to specialize in primary care, and especially to practice in underserved areas, should be tailored to the unique characteristics of IMGs.