Acculturation Needs of Pediatric International Medical Graduates: A Qualitative Study

Abstract

The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.

Internationally educated nurses’ and medical graduates’ experiences of getting a license and practicing in Sweden – a qualitative interview study

“…Furthermore, both IENs and IMGs described how they had to learn about the Swedish healthcare system. The challenge of adapting to a another healthcare system has been widely documented [ 8 , 18 , 24 ]. For IMGs this could involve, among other things, following national treatment recommendations for various diseases, knowing the sick-leave rules and writing various certificates.…”

“…Apart from adjusting to a new healthcare system, IENs and IMGs also have to learn about the culture in the host country [ 22 – 24 ]. When building their lives in the new country, some IENs and IMGs describe the differences between countries as culture shock [ 10 , 25 – 27 ].…”

Performance of International Medical Graduates in Pediatric Residency: A Study of Peer and Faculty Perceptions

“…The literature suggests that this is a major concern when programs consider recruiting IMGs, 8,12 and multiple studies recommend initial cultural and linguistic orientation. 6,13,14 In addition, IMGs' own perceived underperformance in public health knowledge may suggest the need for more extensive linguistic and cultural orientation, as well as socioeconomic and health systems orientation, which may enhance IMGs' confidence. 7 Our experience suggests that IMGs have extremely heterogeneous cultural backgrounds, meaning that such orientation initiatives must be carefully tailored.…”

The Acculturation Toolkit: An Orientation for Pediatric International Medical Graduates Transitioning to the United States Medical System

“…Upon arrival, they must adjust to a new culture in the US, to the practice of medicine in the US, and, even more specifically, to the culture of pediatrics. 13 The resulting response is the Acculturation Toolkit, a four-module acculturation curriculum that serves to address the unique needs of most IMG trainees matched to pediatric programs across the country.…”

“…The literature highlights the need for a deliberate acculturation curriculum for IMGs in their transition to the US medical system. 13 The needs that IMG trainees have include lack of familiarity with the US medical system, adjusting to a new culture, and mastering the nuances of communication with specific patient populations. 14 - 17 Prior to coming to the US, IMG residents have been socialized to the culture of their home country.…”