International Medical Graduates (IMGs) in the UK—a Systematic Review of Their Acculturation and Adaptation

Abstract

International medical graduates (IMGs) constitute about 23–28 % of the medical workforce providing support and contribution to the UK, Canada, USA and Australia. This review will inform the need for trainers, deaneries and colleges to plan and develop strategies to enhance the potential of IMGs. The authors aim to review and inform the relevant authorities about the barriers faced by IMGs in training and career progression in the UK health service. Two hundred forty-eight studies were reviewed at step 1; 54 were excluded on the basis of selection criteria, and further 115 studies were excluded which did not focus on issues discussed in the selection criteria; and after reviewing 79 studies, a further 20 were excluded for methodological qualities, and finally, 59 were included. The results have been discussed under various themes which emerged as significant issues related to IMGs. Seeking better life and higher education and training are the main reasons for migration. The training process of IMGs in their own countries impacts on the transition process results in struggling career progression. The most crucial impediment in the path of career progression is the process of passing examinations which IMGs face during their career struggle. The psychological aspects of migration and legal and ethical issues are found to be significant for IMGs. They also struggle with the adaptations needed with reference to learning and teaching styles resulting in the change of multiple specialties. IMGs contributed significantly to not only filling the space of under-recruitment but also serving comprehensively in a variety of specialties. There has been a consistent decline in preferring some specialties as career option among UK medical graduates and medical students. IMGs migrate to foreign countries in pursuit of better medical education, desire for better income, general security and improved prospects for the family, but in doing so, they are confronted with psychosocial problems, cultural differences, hurdles in career progression and passing exams.