Doctor - patient Communication Issues for International Medical Graduates: Research Findings From Australia

Abstract

There is a significant need for IMGs to be educated in cultural issues including doctor-patient communication practices in Australia.

Dealing with foreign cultural paradigms: A systematic review on intercultural challenges of international medical graduates

“…‘Many of the IMGs came from countries where the doctors’ status was high and neither patients nor their family questioned the doctors’ authority.’ [35]. …”

Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians

“…In the busy OPD of this hospital in Sri Lanka, where typically more than 1000 patients are seen daily and individual patient visits tend to last less than 5 min, there is likely little time for clinicians to engage in rational decision-making. Although physicians had not described medication names or medication indications, possibly due to time pressure, most patients were satisfied with their visit and none expressed a desire to immediately seek care elsewhere [22]. However, physicians reported feeling overwhelmed by patient volume, especially since many patients were seeking care for minor complaints and had made multiple visits for the same illness.…”

Enhancing international medical graduates’ communication: the contribution of applied linguistics

“…28,29 Moreover, research to date on the language and communication difficulties of IMGs has largely drawn on interview or focus group data rather than on data from interactions involving patients. 5,30 This paper reports on a pilot study designed to address this gap by providing an analysis of the communication challenges faced by IMGs in interactions with real patients using insights from both medical and linguistics experts.…”

“…Despite the potential of these concepts to make feedback on communication issues more specific, and thus salient and constructive for IMGs, little collaborative interdisciplinary research has incorporated insights from both a medical and an applied linguistics perspective . Moreover, research to date on the language and communication difficulties of IMGs has largely drawn on interview or focus group data rather than on data from interactions involving patients . This paper reports on a pilot study designed to address this gap by providing an analysis of the communication challenges faced by IMGs in interactions with real patients using insights from both medical and linguistics experts.…”

“…[3][4][5] Patientcentred care is reflected in local medical education, 6,7 but IMGs may be unfamiliar with not only the Australian medical system and approaches to care within it, but also with the communicative demands of working with such approaches in English. 5,8,9 Moreover, in addition to more readily identifiable difficulties with English grammar, vocabulary, pronunciation or comprehension, IMGs may also have difficulty in identifying and correctly using what have been termed the more 'subtle features' 9 of communication, or those pragmatic features associated with interpersonal communication. As these vary considerably across languages and cultures, 10 they pose particular challenges to doctors who have trained in another language and can impact negatively on their ability to meet the expectations of colleagues and patients, particularly in situations that demand a nuanced approach to verbal and non-verbal interpersonal communication, such as in the establishment of rapport, and the projection of willingness to listen or the display of empathy through words and actions.…”