Recertifying as a doctor in Canada: international medical graduates and the journey from entry to adaptation

Abstract

OBJECTIVE Globalisation and severe doctor shortages in many countries have resulted in increased numbers of international medical graduates (IMGs) in medical training programmes in major recipient countries such as Canada. Much of the literature on IMGs is written from the perspective of the doctor workforce. Less is known about the recertification training experiences of IMGs in recipient countries. This study aims to describe the recertification training experiences of IMGs in Canada in order to help medical training programmes understand how to facilitate the integration of IMGs into recipient medical communities.METHODS A phenomenological (qualitative) research approach was undertaken for this study. International medical graduates undergoing recertification training in order to practise in Canada were individually interviewed about their experiences. Data collection and analysis followed the procedures of interpretive phenomenology. RESULTS Twelve IMGs participated. Analysis of the interviews revealed 4 themes that typified IMG recertification training experiences: training entry barriers; and a 3-phase process of loss, disorientation and adaptation. International medical graduates must complete this 3-phase process in order to feel fully integrated into their professional environments.CONCLUSIONS This study provided a description of IMGsÕ training experiences during certification for practice in Canada and revealed that these experiences were characterised by a 3-phase process of adjustment. Using this framework, a series of recommendations were proposed for medical training programmes to help IMGs with this process.

International Medical Graduates (IMGs) in the UK—a Systematic Review of Their Acculturation and Adaptation

“…A study undertaken in Canada by Wong and Lohfeld (2008) came up with four possible reasons for challenges in training faced by the IMGs; they argued that training entry barriers exist at all levels in the process of application and the most frustrating part was that the authorities would not describe the methods of selecting somebody. The second theme in the study was the loss of personal identity, belonging, financial autonomy and the ability to fulfill a familial role.…”

“…The third theme was of confusion over the roles and responsibilities and on how to behave around peers and staff supervisors. Adaptation was the fourth theme and the IMGs would describe it as 'blending with Canadian peers', 'staying out of trouble' and 'staying focused on long term goals' (Wong and Lohfeld 2008).…”

“…In the UK, IMGs enjoy a successful profession making up to 30 % of the medical workforce (Sandhu 2005); another report suggests that IMGs constitute 48 % of the total workforce (The Information Centre for Health and Social Care 2008). Research has been done to look into the competencies, qualifications, demographic profile, distribution of workforce in various specialties and training experience of IMGs (Boulet et al 2006;Crutcher et al 2002;Wong and Lohfeld 2008). A more comprehensive approach is needed to include all pertinent issues related to IMGs and the challenges they encounter.…”

Indian Versus Canadian Health Care Systems And Policy: A Review Based On Barr's Model Of Health Care Governance

“…While the two-tier health system in India has been criticized for the lack of accessibility of the same services to those living in poverty, the publicly funded one-tier system of health care in Canada has experienced inefficiencies pertaining to waiting times, shortage of doctors, and inconsistencies pertaining to overall health care delivery coverage [22][23][24]. In particular, the Canadian public health system faces challenges in providing timely access to services such as specialist consults, family doctor visits, and surgery [25].…”

Realization of entry-to-practice milestones by Canadians who studied medicine abroad and other international medical graduates: a retrospective cohort study

“…Obtaining a residency position is the greatest obstacle to full licensure because there are more applicants than positions available to international medical graduates. [3][4][5][6][7][8][9][10][11] The term "international medical graduate" includes Canadian citizens or permanent residents who studied medicine abroad. than other international medical graduates in obtaining a residency position in Canada.…”