Achieving equity for International Medical Graduates: a systematic review
IntroductionForeign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countr...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1601492/full |
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| author | Sangeeta G. Saxena Elizabeth Tisdell Elana Farace Thomas Godfrey Betsy Aumiller Esther Dell Omrana P. Razzak Bernadette N. Kumar Kristin K. Sznajder |
| author_facet | Sangeeta G. Saxena Elizabeth Tisdell Elana Farace Thomas Godfrey Betsy Aumiller Esther Dell Omrana P. Razzak Bernadette N. Kumar Kristin K. Sznajder |
| author_sort | Sangeeta G. Saxena |
| collection | DOAJ |
| description | IntroductionForeign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.MethodsFollowing the PRISMA statement, we searched PubMed, Embase, PsycINFO, CINAHL, Web of Science for all peer-reviewed articles using keywords “international medical graduate”, “overseas trained doctor”, “overseas trained physician”, “foreign trained doctor”, “foreign trained physician” (group A); and “discrimination” and “microaggressions” (group B) published between January 1st, 2000 to October 24th, 2021.ResultsThe 46 studies included in this review fall into three groups – acculturation interventions for FIMGs, FIMG’s perceptions of what they found useful, and trainers’ perspectives on ‘what works’. This review also includes interventions that pivoted to the online mode during the Covid-19 pandemic, making the findings relevant, as this is likely to the norm in the future. Acculturation requires training on clinical protocols, host country and health system culture and norms and communication, language and self-awareness skills.DiscussionMuch work remains to be done. Interventions need to be tailored to suit the unique needs of FIMGs from 150+ countries, trainings require a foundation of theoretical frameworks, additional professional, personal and social support to be provided, life course related changing needs demand attention and the preparedness of host country health systems to accept FIMGs require enhancement. |
| format | Article |
| id | doaj-art-602206b3c5dc4df4a8d1b41aa98db996 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-602206b3c5dc4df4a8d1b41aa98db9962025-08-20T03:55:54ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16014921601492Achieving equity for International Medical Graduates: a systematic reviewSangeeta G. Saxena0Elizabeth Tisdell1Elana Farace2Thomas Godfrey3Betsy Aumiller4Esther Dell5Omrana P. Razzak6Bernadette N. Kumar7Kristin K. Sznajder8Department of Public Health, Coastal Carolina University, Conway, SC, United StatesPenn State Harrisburg, Middletown, PA, United StatesPenn State Milton S. Hershey Medical Center, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Hershey, PA, United StatesCity College of New York (CUNY), New York, NY, United StatesNorwegian Institute of Public Health (NIPH), Oslo, NorwayPenn State Milton S. Hershey Medical Center, Hershey, PA, United StatesIntroductionForeign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.MethodsFollowing the PRISMA statement, we searched PubMed, Embase, PsycINFO, CINAHL, Web of Science for all peer-reviewed articles using keywords “international medical graduate”, “overseas trained doctor”, “overseas trained physician”, “foreign trained doctor”, “foreign trained physician” (group A); and “discrimination” and “microaggressions” (group B) published between January 1st, 2000 to October 24th, 2021.ResultsThe 46 studies included in this review fall into three groups – acculturation interventions for FIMGs, FIMG’s perceptions of what they found useful, and trainers’ perspectives on ‘what works’. This review also includes interventions that pivoted to the online mode during the Covid-19 pandemic, making the findings relevant, as this is likely to the norm in the future. Acculturation requires training on clinical protocols, host country and health system culture and norms and communication, language and self-awareness skills.DiscussionMuch work remains to be done. Interventions need to be tailored to suit the unique needs of FIMGs from 150+ countries, trainings require a foundation of theoretical frameworks, additional professional, personal and social support to be provided, life course related changing needs demand attention and the preparedness of host country health systems to accept FIMGs require enhancement.https://www.frontiersin.org/articles/10.3389/fmed.2025.1601492/fullIMGsacculturationtraininghigh income countriesequity |
| spellingShingle | Sangeeta G. Saxena Elizabeth Tisdell Elana Farace Thomas Godfrey Betsy Aumiller Esther Dell Omrana P. Razzak Bernadette N. Kumar Kristin K. Sznajder Achieving equity for International Medical Graduates: a systematic review Frontiers in Medicine IMGs acculturation training high income countries equity |
| title | Achieving equity for International Medical Graduates: a systematic review |
| title_full | Achieving equity for International Medical Graduates: a systematic review |
| title_fullStr | Achieving equity for International Medical Graduates: a systematic review |
| title_full_unstemmed | Achieving equity for International Medical Graduates: a systematic review |
| title_short | Achieving equity for International Medical Graduates: a systematic review |
| title_sort | achieving equity for international medical graduates a systematic review |
| topic | IMGs acculturation training high income countries equity |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1601492/full |
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