Communication skills, cultural challenges and individual support: challenges of international medical graduates in a Canadian healthcare environment

Abstract

Physicians require good communication skills to develop effective patient-physician relationships. Externally funded international medical graduates (IMGs) move directly from their home countries to complete residency training at the University of Ottawa, Canada. They must learn quickly how to work with patients, families and colleagues. A detailed needs assessment was designed to assess IMGs' communication skill needs through focus groups, interviews and surveys with IMGs, program directors, allied healthcare professionals and experts in communication skills. There was a high degree of consensus amongst all participants concerning specific educational needs for communication skills and training issues related to the healthcare system for externally funded IMGs. Specific recommendations include (1) English-language skills; (2) how to get things done in the hospital/healthcare system; (3) opportunities to practise specific skills, e.g. negotiating treatment, (4) adequate support system for IMGs; (5) faculty and staff education on the cultural challenges faced by IMGs.

Characteristics and rates of disciplinary findings amongst anesthesiologists by professional colleges in Canada

“…12 Focus groups composed of IMGs, program directors, and allied healthcare professionals advocated improvement in communication and English language skills amongst the top recommendations for IMGs working in Canada. 13 Communication alone has been identified as the single most important factor in determining whether a patient pursues a complaint or claim against a physician. [14][15][16] Low scores in the Medical Council of Canada clinical skills examination have been associated with future complaints against a physician.…”

English for the Workplace: Doing Patient-Centred Care in Medical Communication

“…In addition to the more obvious language difficulties with vocabulary, grammar, pronunciation, and an understanding of accents and colloquialisms, they can also struggle with the less salient but vitally important interpersonal features of language use, such as how to build rapport and show empathy (Hall et al, 2004;McDonnell & Usherwood, 2008;Pilotto, Duncan, & Anderson-Wurf, 2007). Moreover, many may not be familiar with the demands of the patientcentred models of care expected in developed medical environments in Canada and Australia, but less common in developing countries where medical facilities are very stretched (Dahm, 2011b;Khalil & Bhopal, 2009).…”

“…

(Kachru, 1992), including countries such as India, Pakistan and Sri Lanka, where a different variety of English is spoken (AMC, 2009(AMC, , 2011(AMC, , 2012a(AMC, , 2012b.In addition to the challenges of working in an unfamiliar medical system, these doctors can also face considerable difficulties in daily communications with patients, families, and colleagues (Hall, Keely, Dojeiji, Byszewski, & Marks, 2004;McDonnell & Usherwood, 2008;Tipton, 2005). In addition to the more obvious language difficulties with vocabulary, grammar, pronunciation, and an understanding of accents and colloquialisms, they can also struggle with the less salient but vitally important interpersonal features of language use, such as how to build rapport and show empathy (Hall et al, 2004;McDonnell & Usherwood, 2008;Pilotto, Duncan, & Anderson-Wurf, 2007).

…”

A Model for a Novel Communication Training Program Focused on Accent Modification for International Medical Professionals

“…The pronunciation and intonation patterns of these non-native speakers of English often interfere with their ability to make themselves completely understood (Hall, Keely, Dojeiji, Byszewski, & Marks, 2004;Mahajan & Stark, 2007). Furthermore, IMGs often lack an understanding of regional dialects, colloquialisms and cultural nuances of communication (Fiscella & Frankel, 2000;Kramer, 2006).…”