Cultural transition of international medical graduate residents into family practice in Canada

Abstract

ObjectivesTo identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice.MethodsThis was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. ResultsParticipants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada’s health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. ConclusionsResidency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.

A systematic review of supervisory relationships in general practitioner training

“…Power imbalance was considered a potential threat to supervisors and trainees being able to reaching agreement, with the assessment and monitoring role of the supervisor suggested to exaggerate this imbalance . Non‐hierarchical relationships were advocated to minimise this and can be fostered through trainee feedback to supervisors, and through supervisors recognising and respecting their trainees .…”

“…This suggests that power imbalance, and its influence on agreement, may diminish with time. Between supervisors and international medical graduates (IMGs), differing expectations were suggested regarding roles, hierarchy and gender . Generally, supervisors were reported to respond to the trainee's needs, even in instances when this conflicted with their preferred supervision style .…”

“…35,45,64 Explicit recognition of these multiple and changing roles in both parties was recommended at the outset of the supervision process. 35,53 Power imbalance was considered a potential threat to supervisors and trainees being able to reaching agreement, 49,64,[71][72][73] with the assessment and monitoring role of the supervisor suggested to exaggerate this imbalance. 42,49,72 Non-hierarchical relationships were advocated to minimise this 38,44,72 and can be fostered through trainee feedback to supervisors, 40,73 and through supervisors recognising and respecting their trainees.…”

“…Between supervisors and international medical graduates (IMGs), differing expectations were suggested regarding roles, hierarchy and gender. 71 Generally, supervisors were reported to respond to the trainee's needs, even in instances when this conflicted with their preferred supervision style. 44,53 Finding common ground for roles within the relationship, and teaching content, were suggested as key elements of supervisory interactions.…”

Educational needs of healthcare professionals and members of the general public in Alberta Canada, 2 years after the implementation of medical assistance in dying

“…Participants born in Canada were also more often correct about MAID as compared to those born elsewhere. This is not the first study that has found immigrants have greater healthcare educational needs than naturalised citizens (Triscott, Szafran, Waugh, Torti, & Barton, ). A higher level of MAID knowledge was also evident among participants who had a university degree, which again is not surprising as higher education has often been revealed as a key influence for health and healthcare knowledge.…”