International Medical Graduates Research Articles

Linguistic Differences by Gender in Letters of Recommendation for Maternal-Fetal Medicine Fellowship Applicants.

As in many realms of academia and medicine, in obstetrics and gynecology, women experience gender bias in residency evaluations and academic promotions. More specifically, women in Maternal-Fetal Medicine (MFM) are underrepresented within departmental leadership positions. As a means of identifying spaces where bias may exist, multiple investigators have previously reported on gender bias in letters of recommendation (LORs) for residency and subspecialty training programs. We aimed to determine if linguistic differences exist in LORs for self-identified male and female applicants to MFM fellowship at an academic institution. This was a retrospective single-site cohort study from 2019 to 2021. Data collected included applicant's age, self-reported race/ethnicity and gender, geographic region of residency, step 1 and 2 scores, scholarly and volunteer activities, and number of LORs. The Linguistic Inquiry and Word Count (LIWC) software, a validated text analysis program, was used to characterize LOR linguistic content. Multivariable analysis was used to compare letter characteristics to applicant demographics. A total of 212 applications were reviewed, including 808 LORs. Women comprised 76.9% of applicants, and men 23.1%. Most applicants identified as non-Hispanic White (52.8%). Men were more likely to be international medical graduates (20 vs. 6%, p ≤ 0.01), and women reported more volunteer activities (7.1 ± 5.1 vs. 5.5 ± 4.3, p = 0.04). There were no differences in step scores, number of research projects, or number of LORs. Multivariable analysis controlling for applicant race, step 1 score, and gender of letter writer revealed that letters written for males contained significantly more references to the word category cognitive processes (7.4 ± 0.2 vs. 7.1 ± 0.1, p = 0.046), specifically in reference to the subcategories of certainty and differentiation. We identified linguistic differences in LORs written for MFM applicants, suggesting potential bias in the style of writing for male and female physicians applying to this field. · Gender bias exists in the evaluation and promotion of women in medicine.. · We sought to determine whether it also exists in letters of recommendation for MFM fellowship.. · Previous studies have examined gender bias in letters of recommendation for other specialties.. · Linguistic bias was detected in letters of recommendation for MFM fellowship from 2019 through 2021.. · We found evidence of linguistic differences based on gender of applicant and letter writers..

Accreditation of the Iraqi Medical Colleges: Urgent call for action

The National Council for Accreditation of Medical Colleges (NCAMC) has made some progress towards accrediting Iraqi medical schools. However, to date, NCAMC is not internationally recognized by the World Federation for Medical Education (WFME) which fulfils the requirements of the ECFMG’s Recognized Accreditation Policy (due for initial implementation from 2024). The policy requires that a medical school must achieve a recognized accreditation status by a recognized accrediting agency that in itself is recognized and reviewed by an external quality assurance organization. When the policy is fully implemented, only medical schools accredited in line with the Recognized Accreditation Policy will satisfy the requirements of the ECFMG. Medical graduates intending to pursue work, training, registration, research, volunteering or other opportunities are required to apply for verification of their primary medical qualification (PMQ). Certification and verification of PMQ for international medical graduates (IMGs) in the United States, Australia, Canada, Ireland, New Zealand, and the United Kingdom and an increasing number of countries globally is done via the ECFMG’s online system known as Electronic Portfolio of International Credentials (EPIC). Therefore, the future of Iraqi medical schools’ education standards is at stake as they do not meet the international standards risking the future of new graduates. The Ministry of Higher Education, universities, medical colleges and the Iraqi Medical Association (IMA) need to collaborate with the NCAMC to get it recognized by the WFME in order to safeguard Iraqi medical education and the future of new doctors from 2024.

Burnout in International Medical Graduate Trainees in the United Kingdom Compared to Domestic Medical Graduate Trainees. Analysis of Data from the GMC's National Training Survey in 2019 and 2021.

International Medical Graduates (IMGs) have lower educational attainment and a higher rate of complaints against them compared to Domestic Medical Graduates (DMG). The aim of this study was to investigate the potential role of burnout on these adverse outcomes experienced by IMGs. Every year, the General Medical Council (GMC) conducts the National Training Survey of all doctors in the United Kingdom which includes optional questions on work-related burnout from the Copenhagen Burnout Inventory (CBI). Work-related burnout data for doctors in training, linked to country of Primary Medical Qualification were obtained from the GMC for the years 2019 and 2021. Burnout scores of IMGs and DMGs were compared using Chi2. The total number of eligible participants in 2019 and 2021 was 56,397 and 61,313 respectively. The response rates for all doctors in training to the CBI were 35,739 (63.4%) in 2019, and 28,310 (46.2%) in 2021. IMGs were at a lower risk of burnout compared to DMGs, 2,343 (42.9%) vs 15,497 (51.2%), Odds Ratio (OR) 0.72 (CI 0.68-0.76, P < 0.001) in 2019; and 2,774 (50.2%) vs 13,000 (57.1%), OR 0.76 (CI 0.71-0.80, P < 0.001) in 2021. IMGs, as a group, appear to be at a lower risk of work-related burnout compared to DMGs. Burnout is unlikely to be contributing to lower educational attainment and higher rates of complaints experienced by IMGs compared to DMGs.

A rapid review of challenges faced by early-career international medical graduates in general practice and opportunities for supporting them.

British General Practice is facing a workforce crisis against a backdrop of an ageing population experiencing increasingly complex health challenges. The National Health Service must increase the supply of General Practitioners (GPs), including International Medical Graduate (IMG) GPs, by increasing recruitment and retention. IMG GPs face distinct challenges during training and their early careers. Understanding these challenges as well as the help and support offered to early-career IMG GPs is crucial to building and sustaining the general practice workforce. To understand the challenges facing early-career IMG GPs and the help and support they can access. Rapid review. Six databases and four websites were searched. Titles and abstracts were screened according to inclusion and exclusion criteria, followed by the full study where applicable. The included studies were analysed using a thematic synthesis approach to identify the challenges faced by early-career IMG GPs, as well as the help and support available. The database search yielded 234 studies, with 38 additional studies identified via handsearching of websites. Twenty-one studies were included. Seven challenges were identified, as well as a range of help and support available. Early-career IMG GPs face a range of psychological, social, and practical challenges which may not be adequately addressed by the help and support currently offered by the NHS. Further research is required to understand the extent to which early-career IMG GPs access the help and support offered, and if it adequately addresses the unique challenges they face.

A narrative review of refugee & asylum seekers’ transitions into & experiences of working in the United Kingdom National Health Service

BackgroundThe United Kingdom (UK) has a significant and rising population of refugees and asylum seekers, including many who have previously worked as healthcare professionals. Evidence shows they have struggled to join and successfully work in the UK National Health Service (NHS) despite initiatives designed to improve their inclusion. This paper presents a narrative review based on research surrounding this population to describe the barriers that have impeded their integration and possible ways to overcome them.MethodsWe conducted a literature review to obtain peer-reviewed primary research from key databases (PubMed, Web of Science, Medline, EMBASE). The collected sources were individually reviewed against predetermined questions to construct a cohesive narrative.Results46 studies were retrieved, of which 13 satisfied the inclusion criteria. The vast majority of literature focussed on doctors with minimal research on other healthcare workers. Study review identified numerous barriers impeding the integration of refugee and asylum seeker healthcare professionals (RASHPs) into the workforce that are unique from other international medical graduates seeking employment in the UK. These include experiences of trauma, additional legal hurdles and restrictions on their right to work, significant gaps in work experience, and financial difficulties. Several work experience and/or training programs have been created to help RASHPs obtain substantive employment, the most successful of which have involved a multifaceted approach and an income for participants.ConclusionsContinual work towards improving the integration of RASHPs into the UK NHS is mutually beneficial. Existing research is significantly limited in quantity, but it provides a direction for future programs and support systems.

5 Habits of Highly Successful Scientists: THE EDITORIAL

Earl Nightingale, one of the most well known personaldevelopment speakers and authors of the last century,defined success as "The Progressive Realization of aworthy idea." This means that the moment you startmoving towards something worthwhile, you are alreadysuccessful.&#x0D; Therefore, success is not a destination; it is a journeyyou embark upon while working towards a goal. As longas you strive to achieve something, you are a success;otherwise, you are considered a failure.Ever since I developed an interest in the subject ofsuccess and became a lifelong learner, I decided toembark on my own marvelous journey towards successand bring others along with me.Consequently, I constantly educate my students onsuccess through my social media videos. This article isyet another attempt to guide the students and readersof this journal who aspire to become exceptional andoutstanding scientists in the future, providing them withprinciples of success that will help them achieve theirgoal of becoming successful scientists.Numerous books have been written on the subject ofsuccess. Different authors have explained varioussecrets and natural or divine laws that govern successin this universe. I, too, firmly believe in the laws ofsuccess. We all know that success comes from hardwork, discipline, dedication, and determination –qualities that top scientists already possess. However,in this editorial, I have chosen what I believe to be thetop five habits or traits of successful individuals, inaddition to hard work, discipline, dedication, anddetermination. I consider all of these success habits tobe natural or divine laws of success, and any scientistwho adheres to them is bound to achieve success.JIMGSJournal for International Medical Graduates. 2022.Journal for International Medical GraduatesVolume 1 (01) June 7th, 2023.Editorialadvances in their field. They make a point of notmissing any significant seminars, conferences, orwebinars. This commitment to lifelong learning persiststhroughout their lives

Collaboration Key to Psychiatry’s Future and a Mentally Healthy Nation, Levin Says

Back to table of contents Next article Annual MeetingFull AccessCollaboration Key to Psychiatry’s Future and a Mentally Healthy Nation, Levin SaysMark MoranMark MoranSearch for more papers by this authorPublished Online:8 Jun 2023https://doi.org/10.1176/appi.pn.2023.07.7.15AbstractLevin introduced a major APA Foundation campaign titled “Mental Health Care Works,” dedicated to encouraging Americans to seek treatment for mental and substance use disorders when they need it.“Collaboration, innovation, and leadership are key components of progress for psychiatry and for the future of mental health care in America,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., citing the theme of this year’s APA Annual Meeting, at the Annual Meeting’s Opening Session.“It seems like just yesterday that we were here in San Francisco celebrating the 175th anniversary of our Association back in 2019, where we celebrated our past,” Levin recalled. “The events of the past few years have underscored the importance of innovation, collaboration, and of claiming our future as experts in the connection between mind, body, and brain.”“Integrated health systems that emphasize the total health of a patient are the way forward.,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A.Levin said this year’s presidential theme is a timely one. “In order to chart the best course for our future, we must collaborate with other medical specialties and outside groups; pursue and embrace innovative treatments, technologies, and solutions to persistent problems; and motivate our members and psychiatrists everywhere in the world to take a leadership role in affecting positive change in our profession,” he said.Collaboration is especially important, he said, noting that most patients who need care for mental or substance use disorders first find care in an emergency department or primary care setting. “For years we have espoused the benefits of the collaborative care model and the potential they have for addressing the immense demand of mental health care, reducing costs, and improving outcomes for our patients,” Levin said. “Integrated health systems that emphasize the total health of a patient are the way forward.”Levin used the occasion to introduce a major APA Foundation campaign titled “Mental Health Care Works,” dedicated to encouraging Americans to seek treatment for mental and substance use disorders when they need it.“Our goal for this campaign is to reinforce the idea that the work that psychiatrists do every day is essential to the health and well-being of our nation … and that it is courageous and life-affirming to seek it out.” He added that achieving a mentally healthy nation is well worth the investment of whatever time and money are necessary.“We must emphasize that no one is immune from mental health challenges, nor is anyone beyond help,” he said. “By embracing our humanity and promoting community, we can socialize the idea that mental illness and addiction are not moral failings, but are treatable illnesses like any other physical ailment.”Levin reminded attendees of several positive trends for APA—membership numbers are trending upward, with more than 38,000 psychiatrists, and the association is more diverse in race, gender, and geography.“We are embracing and supporting this change, as it is a reflection of the ever-diversifying patient population in our country,” Levin said. He hailed especially the place of international medical graduates (IMGs) in American psychiatry. “I myself am an IMG and am heartened to see how invested our members are in ensuring that their colleagues who are IMGs feel supported and are able to integrate into our system successfully,” he said.He emphasized that principles of diversity, equity, inclusion, and belonging are inseparable from APA’s mission as a medical association.“Equality and health equity cannot truly happen unless we address the social determinants of health and mental health that cause and worsen barriers and gaps in care,” he said. “These principles are our guiding light as we work to support and facilitate diversity in our profession and improve access to high-quality mental health care for minority and underrepresented groups, including women and the LGBTQ+ community.” ■ResourcesMental Health Care Works campaign site ISSUES NewArchived

Fellowship in the United States as an exceptionally qualified applicant.

International medical graduates (IMGs) play an important role in the United States healthcare as they make up more than a quarter of the medical workforce. Some of these IMGs have significant experience abroad and are eligible to join fellowships in the United States after meeting certain requirements through the Exceptionally Qualified Candidate Pathway designed by the Accreditation Council (ACGME), While this is a great opportunity to train in the United States healthcare system, awareness remains lacking about this pathway. This is especially important given the growing shortage of physicians in the United States and unfilled positions in several fellowships where physicians are urgently needed. This article demonstrates the crisis in several fellowship programs and aims to increase awareness of this ACGME training pathway. It will also provide a deeper understanding of this fellowship path way in the United States, which may be useful to as piring fellowship candidates as well as underfilled fellowship programs. It also highlights potential opportunities and pathways leading to practice after the fellowship, current limitations in this process and provides several recommendations for success.

Oral cancer screening knowledge and practices among dental professionals at the University of Toronto

IntroductionOpportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists.MethodsA 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected.ResultsNinety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p < 0.01). Over 80% of dentists referred to a specialist when a suspected lesion was found. The greatest barrier for oral cancer screening was lack of time. Almost all dentists (98.8%) reported that their screening practices do not differ depending on the patient’s insurance status and 63.8% reported compensation would not influence their decision to perform oral examinations.ConclusionMost dentists have a good knowledge of the presentation and risk factors associated with oral cavity cancer. Most dentists perform screening with every patient, with no influence from compensation and insurance status. Dentists are therefore an excellent first contact for oral cavity cancer screening for the general public and for high-risk populations.

Understanding the Use of Program Resources During Virtual Recruitment by Psychiatry Residency Applicants.

This study aims to understand the residency resources used by psychiatry applicants who applied during the first two virtual recruitment seasons, match 2021 and 2022. Between January 27, 2022, and February 24, 2022, a non-probabilistic sample of psychiatry residents from the match 2018 through match 2022 cycles were asked to complete a survey via email and social media. Due to the continuation of virtual recruitment post-pandemic, an analysis of psychiatry residents in the match 2021 and 2022 cycles was conducted. Questions assessed the use of recruitment resources, including websites, the Fellowship and Residency Electronic and Interactive Database, virtual open houses, video tours, away rotations, and social media platforms. Descriptive statistics and chi-square analyses were used. Psychiatry residents from the match 2021 and 2022 cycles completed the survey (n = 605), with 288 US allopathic medicine doctors (47.6%), 178 (29.4%) international medical graduates, and 139 (23.0%) osteopathic medicine doctors. More than half of respondents (n = 347, 57.4%) reported that the virtual interview season increased the number of programs they intended to apply to. Most respondents (n = 594, 88.3%) reported attending one or more psychiatry virtual open houses and 84.6% (n = 512) followed psychiatry residency programs on at least one social media platform. Program websites were reported to be the most influential digital platform for both applying and ranking. Understanding the influence of recruitment resources is essential for residents and program leadership to optimize time and resources to assist applicants with their decision-making.

Medical school origins of award-winning surgeons; analysis of a complete national dataset

BackgroundBritain attracts doctors from all over the world to work in the National Health Service. Elucidating the educational backgrounds of award-winning doctors working in the country is potentially an important medical education issue and merit award audit. Using the British clinical merit award schemes as outcome measures, we identify medical school origins of award-winning doctors who have been identified as having achieved national or international prominence.MethodsThe Clinical Excellence Awards/Distinction Awards schemes select doctors in Britain who are classified as high achievers, with categories for national prominence and above. We used this outcome measure in a quantitative observational analysis of the 2019 dataset of all 901 award-winning doctors. Pearson's Chi-Square test was used where appropriate.ResultsSeven medical schools (London university medical schools, Glasgow, Edinburgh, Aberdeen, Oxford, Cambridge and Manchester) accounted for 52.7% of the surgical award-winning doctors in the 2019 round, despite the dataset representing 85 medical schools. Surgeons with the lower grade national awards came from a more diverse educational background of 43 medical schools. International medical graduates accounted for 16.1% of the award-winning surgeons and 9.8% of the award-winning non-surgeons. 87.1% of the surgical award-winners were from European medical schools, whereas 93.2% of the non-surgical award-winners were from European medical schools.ConclusionsThe majority of the award-winning surgeons originated from only seven, overrepresented, medical schools. A greater diversity of medical school origin existed for the lowest grade national merit awards. These comprised 43 medical schools and indicated greater globalization effects in this category. International medical graduates contributed substantially to these award holders; surgical award-winners were more likely to be international medical graduates (16.1%) than non-surgical award-winners (9.8%). This study not only indicates educational centres associated with the production of award-winners but also provides students with a roadmap for rational decision making when selecting medical schools.

Problems Faced by International Medical Graduates during the United States Medical Licensing Exam and Match Pathway

Most students aspire to pursue higher education andimmigrate to countries that offer opportunities to growtheir character and succeed in their fields. Theseimmigrants face a lot of issues and challenges in theirinitial years of hard work to settle in a completelydifferent culture away from home. This opinion articleaims to bring forward some of the issues thatInternational Medical Graduates (IMGs) face during thewhole United State Medical Licensing Exam (USMLE)and Match Pathway

International Medical Graduates in Radiology Residencies: Demographics, Performance, and Visa Issues

The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them. We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered. We received responses from 121 of 195 (62.1%) DR programs (121/149=81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork. Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas. Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment.

Bridging the Healthcare Gap: The Critical Importance of International Medical Graduates in the US

International Medical Graduates (IMGs) contribute toaddressing the physician shortage gap, especially inunderserved areas. They also bring cultural competenceand understanding to the healthcare system, improvepatient satisfaction and outcomes, and advance medicalknowledge through their diverse experiences andknowledge. Additionally, IMGs support the UnitedStates (US) economy through their contributions viataxes, spending, and revenue generation for healthcareinstitutions. Overall, IMGs play a vital role in enhancingthe US healthcare system and are essential in areaswhere there is a lack of physicians

To the United States and Back: Perspective from an International Medical Graduate Trainee.

To the United States and Back: Perspective from an International Medical Graduate Trainee.

Examining antibiotic prescribing and urine culture testing for urinary tract infections (UTIs) in a primary care spinal cord injury (SCI) cohort.

A retrospective cohort study. To describe antibiotic prescribing and urine culture testing patterns for urinary tract infections (UTIs) in a primary care Spinal Cord Injury (SCI) cohort. A primary care electronic medical records (EMR) database in Ontario. Using linked EMR health administrative databases to identify urine culture and antibiotic prescriptions ordered in primary care for 432 individuals with SCI from January 1, 2013 to December 31, 2015. Descriptive statistics were conducted to describe the SCI cohort, and physicians. Regression analyses were conducted to determine patient and physician factors associated with conducting a urine culture and class of antibiotic prescription. The average annual number of antibiotic prescriptions for UTI for the SCI cohort during study period was 1.9. Urine cultures were conducted for 58.1% of antibiotic prescriptions. Fluroquinolones and nitrofurantoin were the most frequently prescribed antibiotics. Male physicians and international medical graduates were more likely to prescribe fluroquinolones than nitrofurantoin for UTIs. Early-career physicians were more likely to order a urine culture when prescribing an antibiotic. No patient characteristics were associated with obtaining a urine culture or antibiotic class prescription. Nearly 60% of antibiotic prescriptions for UTIs in the SCI population were associated with a urine culture. Only physician characteristics, not patient characteristics, were associated with whether or not a urine culture was conducted, and the class of antibiotic prescribed. Future research should aim to further understand physician factors with antibiotic prescribing and urine culture testing for UTIs in the SCI population.

First Author Highlights

AnnouncementFirst Author HighlightsPublished Online:19 May 2023https://doi.org/10.1152/ajprenal.2023.324.5.AUMoreSectionsPDF (362 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations DANIELLE L. KIRKMANDepartment of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, United StatesFigure 1.Danielle KirkmanDownload figureDownload PowerPointDanielle Kirkman is an Assistant Professor in the Department of Kinesiology and Health Sciences at Virginia Commonwealth University. She received her PhD in Clinical Exercise Physiology from Bangor University in Wales before completing her postdoctoral fellowship in vascular physiology at the University of Delaware. Her research is focused on applied, integrative physiology at the nexus of cardiovascular and renal health. As an exercise physiologist by training, a large body of her work has investigated the cardiovascular and metabolic effects of exercise in patients across the spectrum of kidney diseases. In her spare time, she enjoys the outdoors [Photo: Fig. 1].https://doi.org/10.1152/ajprenal.00046.2023FERNANDO MARMOLNorthwestern University Feinberg School of Medicine, Chicago, Illinois, United StatesFigure 2.Fernando MarmolDownload figureDownload PowerPointFernando Marmol is a research scholar at Northwestern University in Chicago, IL, mentored by Dr. Daniel Batlle. He is an International Medical Graduate MD from Ecuador. His research interests focus on acid-base and electrolyte disorders as well as angiotensin-converting enzyme 2 and its potential therapeutic use. Like Dr. Batlle, he is a fan of the soccer team Barcelona FC. Away from the laboratory bench, he loves practicing basketball, soccer, and cycling. He is pursuing becoming a nephrologist [Photo: Fig. 2].https://doi.org/10.1152/ajprenal.00312.2022LINDSEY A. RAMIREZDepartment of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, United StatesFigure 3.Lindsey RamirezDownload figureDownload PowerPointLindsey Ramirez completed her PhD in Physiology at Augusta University under the mentorship of Jennifer Sullivan. In 2022, she successfully defended with distinction. In her doctoral laboratory, she studied the role of inflammation in mediating high-fat diet-induced changes in adiposity and blood pressure. Currently, she is a postdoctoral fellow in the laboratory of Elizabeth Glover at the University of Illinois in Chicago, IL. In her current role, she is investigating the neural mechanisms that mediate aversion to ethanol. She enjoys learning about true crime, collecting rocks, and various crafts such as sewing, knitting, and crocheting [Photo: Fig. 3].https://doi.org/10.1152/ajprenal.00308.2022YU TAODepartment of Physiology and Anatomy, University of North Texas Health Science Center, Texas, United StatesFigure 4.Yu TaoDownload figureDownload PowerPointYu Tao is a PhD student in the Integrative Physiology Department in the University of North Texas Health Science Center, mentored by Dr. Rong Ma. She got her MS from Wuhan University, China. Her research focused on the podocyte and mesangial cell physiology in diabetic kidney disease. She enjoys cooking, baking, and hiking in her spare time [Photo: Fig. 4].https://doi.org/10.1152/ajprenal.00297.2022This article has no references to display. Download PDF Previous Back to Top Next FiguresReferencesRelatedInformation Related ArticlesCall for Papers: Exercise and the kidneys in health and disease 27 Apr 2023American Journal of Physiology-Renal PhysiologyFecal ammonium in mice with CKD: gastrointestinal sequestration by sodium zirconium cyclosilicate 02 May 2023American Journal of Physiology-Renal PhysiologyPerinatal intermittent hypoxia increases early susceptibility to ANG II-induced hypertension in adult male but not in female Sprague–Dawley rats 27 Apr 2023American Journal of Physiology-Renal PhysiologyStore-operated Ca2+ entry inhibition ameliorates high glucose and ANG II-induced podocyte apoptosis and mitochondrial damage 27 Apr 2023American Journal of Physiology-Renal Physiology More from this issue > Volume 324Issue 5May 2023Pages i-ii Crossmark Copyright & PermissionsCopyright © 2023 the American Physiological Society.https://doi.org/10.1152/ajprenal.2023.324.5.AUPubMed37204405History Published online 19 May 2023 Published in print 1 May 2023 Metrics

The consequences of cultural difference: the international medical graduate journey in New Zealand.

To identify how differences in cultural and professional values between New Zealand born and trained doctors and International Medical Graduates (IMGs) affect the practice and retention of IMGs in New Zealand. A mixed-method approach was used. An anonymous 42-item online questionnaire was used to compare participants' cultural and professional values. Participants were 373 New Zealand doctors, 198 IMG, and 25 doctors born and raised elsewhere but who qualified in New Zealand, a group not identified prospectively. The qualitative component used interviews with 14 IMGs to identify cultural challenges faced and with nine New Zealand doctors to identify the challenges they faced working alongside IMGs. Qualitative data were transcribed and analysed thematically. There were differences in power distance, with the medically qualified in New Zealand doctors having the highest power distance, followed by the IMGs, suggesting a preference for a hierarchical environment at odds with the New Zealand culture. Interviews found cultural differences in communication styles and hierarchy contributed to professional challenges. The cultural transition was difficult for IMGs as they received minimal support. One-third of IMGs acknowledged their behaviours did not fit well in New Zealand. Complaints about IMGs increased when they reverted to default behaviours regarded negatively by New Zealand colleagues or patients. IMGs are open to change but face a lack of orientation and cultural education opportunities, hindering integration. Residency programs must recognise this disconnect and incorporate cross-cultural programmes in the curriculum. Such programmes would assist the adaption and retention of IMG doctors.

Trends in Demographics of Neurology House Staff in the United States (P6-2.005)

<h3>Objective:</h3> To examine the demographic characteristics of neurology residents and fellows. <h3>Background:</h3> The lack of an adequate number of neurologists is a worldwide problem. In addition to the growing demand, inadequate diversity in the neurology healthcare workforce still exists. <h3>Design/Methods:</h3> This cross-sectional study used data from the ACGME, AAMC, and the United States Census Bureau. Trends (from 2007 to 2018) in demographic characteristics were assessed using the slope and the associated p-value of a simple linear regression model, with the year as the independent variable. <h3>Results:</h3> From 2007 through 2018, the percentage of US medical school graduates in neurology residency decreased from 58% to 55% (slope = −0.25; p = 0.0004), while the percentage of international medical graduates (IMGs) decreased from 36% to 32% (slope = −0.29; p = 0.0141) and doctor of osteopathy (DO) graduates increased from 6% to 13% (slope = 0.58; p &lt; 0.0001). Although the percentage of female neurology residents increased from 39.5% in 2007 to 43.1% in 2018 (slope = 0.03; p = 0.8659), female physicians were underrepresented in vascular neurology fellowship (34% in 2018). Collectively, the percentage of underrepresented minorities in neurology residencies was low and increased only slightly over time (from 8% in 2011 to 9% in 2018; slope = 0.17; p = 0.0788). In 2018, the proportion of underrepresented minorities was smaller in neurology fellowships (5.5% neurophysiology, 12.5% epilepsy, 10.4% neuromuscular, and 12.4% vascular) compared to the population as a whole (31.3%). <h3>Conclusions:</h3> IMGs still play an important role in filling a significant portion of the neurology residencies and fellowships. DO graduates have slowly increased in neurology residencies and fellowships. Members of several racial/ethnic minority groups and women are underrepresented in neurology house staff and efforts need to be taken to increase diversity. <b>Disclosure:</b> Dr. Dhasakeerthi has nothing to disclose. Dr. Gil Tommee has nothing to disclose. Dr. Thatikala has nothing to disclose. Dr. Nalleballe has nothing to disclose. Dr. Onteddu has nothing to disclose.

Matching into residency as an old graduat

Matching into residency is challenging, but itis more difficult for many internationalmedical graduates when they have an oldyear of graduation. A few years before,most programs had the cutoff for the yearof graduation at five years or less. Butrecently, we have noticed that manyprograms have reduced it to 3 years or less.This has made it challenging for images asthey don’t always have plans to get into aresidency in the UNITED STATES from thestart; a lot of times, after a few years ofpractice, they feel like doing a residency inthe UNITED STATES, and they find themselves in a situation where their year of graduation has become a red flag forthem.