Abstract
BackgroundForeign medical graduates (FMGs) have continued to render effective health care services to underserved communities in many high- and middle-income countries. In rural and disadvantaged areas of South Africa, FMGs have alleviated the critical shortage of doctors. FMGs experience challenges to adjust to new working environments as they have studied and obtained their medical qualifications in a country that differs from the one where they eventually choose to practise.ObjectivesThis scoping review synthesises literature about the experiences of FMGs upon entering a host country and the factors that facilitate their adjustment to the new context.MethodsThe systematic review was performed to analyse articles from an initial scoping of published literature on the experiences and adjustment of FMGs between 2000 and 2016. Searches were conducted through MEDLINE and PUBMED on keywords that included “foreign medical graduates”, “experiences” “adjustment”, “adaptation” and “assimilation”. The database searches yielded 268 articles and a further 3 were identified through other sources. The number of articles was reduced to 20 after the removal of duplicates and the application of the exclusion criteria. A qualitative thematic analysis was performed.ResultsThe searches revealed an overall lack of studies on the experiences and adjustment of FMGs from the African continent. FMGs faced professional barriers, lacked country-specific knowledge and experienced stress when practising in a new location. They attributed their successful adjustment to innate personal characteristics including a persistent attitude and the use of various coping strategies. Other facilitating factors included early orientation and professional and personal support.ConclusionThe review highlighted the need for research from developing and middle-income countries and for an increased awareness of the challenges and enablers to help FMGs adjust to new clinical settings.
Highlights
The effective functioning of health care systems of many high-income countries (HICs) depends on the regular intake of foreign medical graduates (FMGs)
In response to the objective that explored the scope of publications on the experiences of FMGs, the articles in this review mainly describe research studies that were conducted in various HICs
The frequency of these descriptions suggests some degree of consensus that firstly confirm that FMGs experience a degree of difficulty in new host countries and the literature provided insight into factors that could assist in the adjustment of FMGs to their new work countries
Summary
The effective functioning of health care systems of many high-income countries (HICs) depends on the regular intake of FMGs. A study conducted in 2005 reported that FMGs comprised between 23 and 28% of the medical workforce in Australia, Canada, the United Kingdom and the United States of America [1]. A study conducted in 2005 reported that FMGs comprised between 23 and 28% of the medical workforce in Australia, Canada, the United Kingdom and the United States of America [1] In these countries, FMGs are sourced to work among the most vulnerable communities who often live in rural or peripheral geographic locations. The term foreign medical graduates (FMGs) will be used. Foreign medical graduates (FMGs) have continued to render effective health care services to underserved communities in many high- and middle-income countries. FMGs experience challenges to adjust to new working environments as they have studied and obtained their medical qualifications in a country that differs from the one where they eventually choose to practise
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