Work Experiences and Satisfaction of International Medical School Graduates

Abstract

We compared demographics and work, financial, and satisfaction experiences of early-career and midcareer pediatricians categorized by their childhood and medical school locations. METHODS: Data from the Pediatrician Life and Career Experience Study were used to examine the characteristics and experiences of 3 groups, which were categorized as (1) international childhood and medical school graduate (international-IMG), (2) United States childhood and international medical school graduate (US-IMG), and (3) United States or international childhood and United States medical school graduate (USMG). With multivariable logistic regression, we examined the experiences of the groups, controlling for participant characteristics. RESULTS: Data from 1467 of 1804 participants were analyzed; 13% were categorized as international-IMGs, 6% were categorized as US-IMGs, and 81% were categorized as USMGs. International-IMGs and US-IMGs were less likely than USMGs to report their race and ethnicity as white and non-Hispanic (26%, 32%, and 71%, respectively; P < .05) and more likely to report caring for patients with public insurance (adjusted odds ratio [aOR] 1.80 [95% confidence interval (CI) 1.27-2.56] and aOR 2.12 [95% CI 1.31-3.42], respectively). International-IMGs were less likely than USMGs to agree that physician colleagues value their work (aOR 0.35; 95% CI 0.21-0.56). Overall, 8 in 10 reported that their work was personally rewarding; international-IMGs were less likely than USMGs to report such satisfaction (P < .05). CONCLUSIONS: Among a national sample of pediatricians, international-IMGs and US-IMGs play important roles in workforce diversity. They also report unique challenges. Most are satisfied with their work, but international-IMGs are the least satisfied.

The Pediatric Workforce: Recent Data Trends, Questions, and Challenges for the Future

“…IMGs fill an important gap in the rural workforce and add significant diversity to our discipline. [51][52][53][54] One large residency program has noted their success with recruiting IMGs, a goal that they have now achieved for almost 20 years. 55 Recently, Chakraborty and colleagues have discussed the important role of IMGs in our workforce and called for programs to address known challenges in preparing non-US born IMGs for residency training.…”

Normalized “medical inferiority bias” and cultural racism against international medical graduate physicians in academic medicine

“…International medical graduate physicians report lower career satisfaction in jobs and perceive a lack of support from colleagues. 38 , 39 International medical graduate physicians are generally reconciled with this disadvantaged professional existence and see it as the “cost of being immigrant”. 38 This may lead IMGs, expecting diminishment and non-advancement, to choose to concentrate their efforts to job-aspects with greater likelihood of success, e.g.…”

The Effect of Electronic Health Record Burden on Pediatricians' Work–Life Balance and Career Satisfaction

“…For the work-life balance and satisfaction measures that varied significantly by EHR burden, we used multivariable logistic regression to examine the independent effect of burden controlling for pediatrician self-reported level of input on EHR implementation and staffing, age cohort (between 2009 and 2011 or 2002 and 2004 residency graduate), sex, race and ethnicity, medical school location, married or partnered, children, career specialty (generalist, subspecialist, or hospitalist), practice ownership, and part-time hours. Characteristics included in the models were based on prior work 17,18 and a priori hypotheses that they would be related to work-life balance and satisfaction.…”