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

Abstract

Introduction Increasingly medical students pursue medical education abroad. Graduates from International Medical Programs (IMPs) practice globally, yet how to prepare students for an unknown international environment is complex. Following IMP graduates throughout their early careers, this study offers insights into gaps in current undergraduate education. Methods In this international, longitudinal, mixed-methods study, 188 graduates from seven IMPs completed baseline surveys on career choice and job preparedness. Forty-two participants completed follow-up until three years after graduation. Nine graduates participated in semi-structured interviews on individual experiences and the evolution of their perspectives. The multiphase, sequential design allowed data collected at baseline to inform further data collection instruments. Results Two typical student profiles emerged. The first depicts a student who, despite the challenges of studying abroad, pursues a medical degree ‘anyhow’, with a common aim of practicing in their home country. The other deliberately selects an IMP while envisaging an international career. Two years after graduation, the majority (> 70%) of our participants were practicing in a country other than their country of training. They reported challenges around licensing, the job application process and health system familiarization. Participants’ experiences point towards potential curriculum adaptations to facilitate cross-border transitions, including career guidance, networking and entrance exam preparation. Discussion IMP graduates lack support in practical aspects of career orientation and international exposure. Most IMPs essentially prepare their graduates for a career elsewhere. Gaps and challenges that IMP graduates experience in this cross-border career transition entail a responsibility for preparation and guidance that is currently lacking in IMP curricula.

A national analysis of the medical schools of training for merit award-winning laboratory medical doctors working in Britain

“…It serves to identify university medical schools contributing to the outcome of excellence in the medical education [19] of doctors who have subsequently become award-winning clinicians. Naturally, the information we provide will be of importance to current and future graduates from International Medical Programs [20] as well as local prospective medical students.…”

Medical education without borders

“…Another common critical frame is that IMPs are "an opportunity for students who will otherwise "miss out" on medical education due to the compe[ti]tiveness of American and Canadian medical schools" (Morgan et al, 2017). In a previous project, we found that IMPs are indeed a popular choice for those who cannot or choose not to study medicine in their home country (Brouwer et al, 2022). Yet, these students not only benefit; many face significant intercultural challenges or even rather hostile rhetoric from other doctors and the public (Ho et al, 2015) upon graduation and returning to their home country.…”

“…Moreover, IMPs have been found to offer an opportunity for students who cannot or choose not to study medicine in their home country . Notably, with more than 70% of their graduates practicing abroad, IMPs essentially prepare their students for a career elsewhere (Brouwer et al, 2022). Scholars have critiqued this perceived commercial model and the applicability of IMP curricula to other health care systems .…”

“…For the study presented here, we first performed a secondary analysis of interview transcripts from our previous work, which consisted of 17 semi-structured interviews with staff and recent graduates from the two IMPs, conducted between 2018 and 2020 Brouwer et al, 2022). Our analysis focused on identifying the discourses that participants draw upon to rationalize the purpose of, and practices associated with IMPs.…”