Qualification programmes for immigrant health professionals: A systematic review

Abstract

BackgroundImmigrant health professionals are a particularly vulnerable group in a host country’s labour market, as they face several barriers when re-entering their occupations. International studies indicate that early interventions can increase the employability of immigrants. Qualification programmes are one of these early interventions that can support the re-integration of these health professionals into the labour market. The purpose of this review is to identify international qualification programmes for immigrant health professionals, analyse their content and evaluate their effectiveness.MethodsSix international databases (PubMed, Web of Science, CINAHL, PsychInfo, EBSCO and ProQuest Social Sciences) were systematically searched. The search terms were identified using the PICOS-framework. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were screened independently by two authors and discussed. Studies included in the final synthesis were assessed with the Mixed Methods Appraisal Tool (MMAT) and Kirkpatrick’s Training Evaluation Model.ResultsOut of 10,371 findings, 31 articles were included in the final synthesis. The majority of them were addressed to international health care professionals and doctors. Two of them were addressed to refugee doctors. Three types of programme elements were identified: teaching, clinical practise and social support. The programmes’ length ranged from 2 days to up to 2.5 years. Despite recommendations in its favour, pre- and post-programme support was scarce. Results also indicate a lack of transparency and quality in terms of evaluation. Effectiveness was mostly observed in the area of language improvement and an increase in self-confidence.ConclusionThis review points out the lack of systematically evaluated qualification programmes for immigrant health professionals. Programme providers should focus on implementing programmes for all health professionals as well as for underrepresented groups, such as refugees. In order to generate best practises it is necessary to evaluate these programmes. This requires the development of appropriate instruments when working with immigrant population in the context of educational programmes.

Challenges for International Medical Graduates in the US Graduate Medical Education and Health Care System Environment: A Narrative Review

“…Given the relevance of IMGs and the barriers they tend to face before and after residency admission, many attempts have been made to develop instruments that make them aware of the US HCS and GME environment and support their transition [31,[49][50][51][52][53][54][55][56][57][58][59][60][61][62]. The importance and efficacy of qualification programs have been stressed [63], and recommendations for implementing interventions for IMGs have been developed [64]. US clinical experience before applying to residency programs embodies the ideal opportunity to enhance curriculum competitiveness, acquire strong letters of recommendation, and get closer to the national HCS, which can ease the transition to post-graduate training [65].…”

Process- and outcome evaluation of an orientation programme for refugee health professionals

“…In order to assess the second level of Kirkpatrick's training evaluation model (learning), participants completed a self-developed post-questionnaire at the end of the project. The questionnaire was based on three identified outcome-levels from a previous review on qualification programmes for immigrant health professionals [18] and was developed with additional experts in migration research. These outcome-levels refer to (1) improvement of language skills such as learning new vocabulary or improving ones communication skills in clinical work, (2) improvement of personal and professional skills, such as being more confident, gaining knowledge about the health care system or being less afraid to speak German, (3) the improvement of formal resources/career prospects such as getting in contact with other health professionals, being encouraged to work, improving their CVs and finding internship or job placements.…”

“…There seems to be a challenge in designing programmes for all health professionals and addressing relevant issues for all professions. This may also be the reason why there are so few programmes aimed at all professional groups [18]. Differentiating the curriculum and offering specialised workshops corresponding to competencies and professions as proposed by the participants may be difficult due to limited resources and unequal distribution of the professions.…”

“…Findings from a systematic review on programmes for international medical graduates pose the assumption that programmes need to focus on increasing self-efficacy whilst reducing work-related stress and anxiety [ 16 ]. However, most of the programmes have in common that they lack methodological quality and transparency in terms of evaluation methods [ 15 – 18 ]. Thus, it remains unclear how effective programmes are in this context.…”

Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda

“…In addition, given that migration status is tied to additional disadvantages for migrant workers ( Baron et al., 2014 , Lewchuk et al., 2018 , Ahonen and Benavides, 2016 ), the PE conditions experienced by non-migrant HCWs, can be further exacerbated for migrant HCWs. For instance, given that licenced health professionals must have their credentials accepted by the host country before being allowed to practice their profession, the process can be long and filled with barriers and, during this time, they have little choice but accept any work that allows them to survive ( Covell et al., 2016 , Khan-Gökkaya et al., 2019 ).…”