We propose a practical explanation for the preferential response to U.S. graduates on the basis of our recent experience with international medical graduate applications. By the end of 1997, we had received 710 applications for six residency positions; 685 were submitted by international medical graduates. We are keenly interested in identifying qualified applicants, regardless of their demographics, as are the other training directors we know. We have been successful in recruiting a diverse residency group that includes both U.S. and foreign graduates. The problem for us, and perhaps for other programs, is the amount of time and money expended in the search for those residents. In 1997, our faculty spent more than 70 hours thoroughly reviewing every application; for every application that results in an interview, 24 are declined because of inadequate qualifications.