International medical graduates’ experiences before and after migration: a meta-ethnography of qualitative studies

Al-Haddad, M., Jamieson, S. and Germeni, E. (2022) International medical graduates’ experiences before and after migration: a meta-ethnography of qualitative studies. Medical Education, 56(5), pp. 504-515. (doi: 10.1111/medu.14708) (PMID:34859484)

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Introduction: International Medical Graduates (IMGs) represent a large portion of practicing doctors in many countries. Many experience difficulties, including higher rates of complaints against them and lower exam pass rates. The UK’s General Medical Council (GMC) recently set targets to ‘eliminate disproportionate complaints’ and ‘eradicate disadvantage and discrimination in medical education’. Our timely meta-ethnography aimed to synthesise existing qualitative literature on the wider personal and professional experiences of IMGs, to identify factors affecting IMGs’ professional practice (either directly or indirectly). Methods: In September 2019 we systematically searched Medline, Embase, Cochrane, PsycINFO, ERIC and EdResearch for peer-reviewed qualitative and mixed-methods articles that described experiences of IMGs. We extracted participant quotes and authors’ themes from included articles and used the technique of meta-ethnography to synthesise the data and develop new overarching concepts. Results: Of the 1613 articles identified, 57 met our inclusion criteria. In total, the articles corresponded to 46 studies that described the experiences of 1142 IMGs practicing in all 6 continents in a range of settings, including primary and secondary care. We developed 5 key concepts: Migration dimensions (issues considered by IMGs when migrating), a challenging start (the stressful early period), degree of dissonance (between the IMG and host country in relation to the 4 main barriers of language, culture, medical education and belonging), levelling the playing field (interventions to reduce the impact of the barriers) and survive then thrive (adjustments IMGs made). A conceptual model that brings these constructs together in a line of argument is presented. Conclusions: This meta-ethnography, based on a large amount of diverse qualitative studies, is the first to provide a comprehensive picture of the experiences and challenges that IMGs face before and after migration. Our results should be used to guide the development of interventions aiming to support IMGs and meet the GMC targets.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Al-Haddad, Mo and Germeni, Dr Evi and Jamieson, Professor Susan
Authors: Al-Haddad, M., Jamieson, S., and Germeni, E.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Medical Education
ISSN (Online):1365-2923
Published Online:02 December 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Medical Education 56(5): 504-515
Publisher Policy:Reproduced under a Creative Commons Licence

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