‘Thrown in at the Deep End’: The Experience of Graduates of Transnational Western Medical Education Transitioning into Middle Eastern Clinical Practice

Abstract

Background: Newly qualified doctors educated in their home country usually go on to work in their first hospital job in same country. These graduates are familiar with the socio-cultural context of clinical setting they work in. But, with many Western universities providing cross-border education to host countries in the Middle East and South East Asia in subjects such as medicine. The experiences of those graduating from transnational medical education and working in local hospitals are absent.The aim of the study was to explore the early transitional experiences of newly qualified doctors moving from a European branch campus to practice at hospitals affiliated to the medical school situated in a Middle-Eastern country.Methods: A qualitative study using an interpretive phenomenological approach through interviews to explore experiences of graduates of transnational medical education working in Middle Eastern hospitals. Results: The main findings can be summarised under the three themes generated: the essentials of practice, routine of practice and realities of practice. The results evidenced the transition as a challenging period for new doctors finding dissonance between the skills taught while in transnational education and the workplace. There were three particular areas of discord for the graduates in clinical practice: working in medical teams with a different arrangement to the one prepared for; adapting to a more patient-centred language and coping with differences in ethical norms, values and practices in the hospital.Conclusions: The graduates found transitioning from university to full-time clinical practice difficult and were disappointed by their experience not matching their expectations of work. These findings are valuable for transnational medical educators seeking to improve the experience of graduates who are moving from the clear ideals, norms and values of transnational medical education into the complexity of full-time clinical practice.

Early career experiences of international medical program graduates: An international, longitudinal, mixed-methods study

“…For example, the experienced lack of clinical skills and sudden high responsibility are commonly reported [26,27]. Furthermore, our findings on challenges specific for cross-border transitions align with research on International Medical Graduates, for example, regarding familiarization with health systems, administration, hierarchies and language [9,10,28]. However, where previous studies focused on remediation and interventions at the postgraduate level in the destination countries [29][30][31], our study adds the undergraduate perspective, where guidance, networking and entrance exam preparation could all facilitate cross-border transitions.…”

Medical education without borders

“…For example, the experienced lack of clinical skills and sudden high responsibility are commonly reported (Cameron et al, 2014;Yardley et al, 2018). Furthermore, our findings on challenges specific for cross-border transitions align with research on International Medical Graduates, for example, regarding familiarization with health systems, administration, hierarchies and language Rashid-Doubell et al, 2019;. However, where previous studies focused on remediation and interventions at the postgraduate level in the destination countries (Kehoe et al, 2016;, our study adds the undergraduate perspective, where guidance, networking and entrance exam preparation could all facilitate cross-border transitions.…”