Facilitating international medical graduates' acculturation: From theory to practice

Abstract

ContextInternational medical graduates (IMGs) are forming an ever‐increasing proportion of the medical workforce. Much of the discourse around IMGs is about their performance at work and interventions to improve it. This discourse, however, is rarely situated in the wider context of the experiences of IMGs as migrants despite the wider context of migration and acculturation being likely to have a significant impact on IMGs' well‐being and, ultimately, performance at work.ObjectivesThe objectives of this article were to (1) raise awareness of the inextricable broader context within which IMGs are situated as migrants; (2) outline the impact this context might have on IMGs' performance; (3) discuss literature from the social sciences related to acculturation that could better inform the way we view IMG transition and performance; (4) highlight how acculturation theory can help inform the design, implementation and evaluation of interventions to facilitate the transition of IMGs into the host country and the workplace; (5) list some interventions that can provide support; and (6) suggest theory driven lines of enquiry to study acculturation in IMGs and the impact related issues might have on performance.MethodsThis is a cross‐cutting edge review drawing on selected theory and literature from the social sciences to explore its relevance to IMGs.ConclusionThe broader context of migration and acculturation should not be ignored when discussing IMG performance in the workplace or when instigating interventions to improve it. There is an urgent need to further evaluate the impact this broader context has on IMGs' well‐being and performance.

It takes two to tango: The ‘inter’ in intercultural competence

“…Migrants, such as migrant IMGs (of whom refugee IMGs are a subset), develop intercultural competence by two means: The first is by exposure to mass media of the dominant host country culture, and the second is by interacting with natives of the dominant host country culture. 5,9 This is in line with the findings of Smith et al, 1 who had 'connecting' as one of the three pillars vital for integration. In this context, it is the bridging connections that facilitate the development of intercultural competence, which-in a virtuous cycle-improve the ability of migrants to form further bridging connections.…”

“…This argument takes us back to the centrality of bridging connections that are formed in this third space. The extent to which migrants can successfully build bridging connections therefore also depends on host receptivity 5,9 and requires commitment from members of both cultures as well as time and capital resources.…”

“…3,4 Developing intercultural competence, therefore, depends on the personal attitudes of individuals, which allow them to develop the knowledge and skills, which when internalised lead to a new way of thinking and behaving, the collective of which is intercultural competence. 3,5 As migrants arrive in the host country, they enter a 'third' space or zone of 'in-betweenness' 6 where differences in the migrant's own heritage culture and that of the dominant host culture are observed.…”

“…By doing this, migrants develop an intercultural identity which is vital for developing a sense of belonging to the host country. 5,7 For migrants, intercultural competence is a pre-requisite for both 'integration' or 'assimilation', and without it, migrants can become 'separated' or 'marginalised'. 5,8 Migrants develop an intercultural identity which is vital for developing a sense of belonging to the host country.…”