What Do We Know and Not Know about the Professional Integration of International Medical Graduates (IMGs) in Canada?

Abstract

Background:The literature on international medical graduates (IMGs) in Canada is growing, but there is a lack of systematic analysis of the literature.Objectives:To examine (1) the major themes in academic and grey literature pertaining to professional integration of IMGs in Canada; and (2) the gaps in our knowledge on integration of IMGs.Methods:This paper is based on the scoping review of academic and grey literature published during 2001–2013 about IMGs in Canada.Results:The literature on IMGs focuses on (1) pre-immigration activities; (2) early-arrival activities; (3) credential recognition/professional recertification; (4) bridging and residency training; (5) workplace integration; and (6) alternative paths to integration. The gaps in the literature include pre-immigration and early-arrival activities, and alternative paths for integration for those IMGs who do not pursue medical license.Conclusion:Pre-immigration and early-arrival activities and alternative career paths for IMGs should be addressed in academic and policy research.

‘Did I pass the licensing exam?’ aspects influencing migrant physicians’ results: a mixed methods study

“…In many cases, this is the same licensing exam used for peers educated within the country. [1][2][3][4][5] However, the pass rate of MPs is usually lower. This delays their licensing, which has negative effects on both MPs and on the new country in need of physicians.…”

“…Studies from Australia, Canada, the UK, the USA and Sweden have shown a considerably lower success rate on exams for MPs than for nationally trained physicians. [1][2][3][4][5][6] These exams include those mandated before receiving a medical licence and those required for specialist/postgraduate training. 1-3 7 8 In Sweden, over 30% of MPs with a medical degree from outside the European Union/European Economic Area (EU/EEA) fail to pass the licensing examination on the first attempt, while the corresponding figure for nationally trained physicians is approximately 3%.…”

“…Potential reasons for such lower pass rates can include lacking financial resources and/ or the time needed to study, 2 not being able to prepare or to the information given before taking the test. 5 Lower pass rates can further be due to language difficulties 3 -specifically, Strengths and limitations of this study ► This study links exam data from all licensing exams taken in Sweden by physicians educated outside the European Union (EU) for the last 7 years with data on complementary programme (CPP) participation enabling for the first time a comparison between CPP participants and non-participants.…”

“…Open access some MPs require more time to sufficiently understand exam questions when they are written in an unfamiliar language. 4 Other language-related reasons for lower pass rates include insufficient communication skills 2 or misinterpretation of feedback. 5 Differences in educational traditions, 3 8 in training practices 2 4 and in examination format 2 5 are also suggested influential factors.…”

Retention of international medical graduates participating in the Iowa Conrad 30 program

“…Limited studies conducted in the United States have begun to assess the integration of IMGs into US medical practices (Laird, L.D., Abu-Ras, W., and Senzai, F., 2013;. A larger body of research on IMGs practicing outside of the United States have assessed, and programs have attempted to address, integration of IMG physicians in Canada, Australia, and Sweden among others (Neiterman, E., Bourgeault, I.L., and Covell, C.L., 2017;McGrath, P., Henderson, D., Phillips, E., 2009;Neiterman, E., Salmonsson, L., and Bourgeault, I., 2015). In general, these studies focus on both the initial "fit" of the physician and the experience during the first few years of practice, recognizing integration can be difficult and needs to be explicitly addressed in order to promote retention.…”