Studying Medicine Abroad Research Articles

The motives, academic performance, and career prospects of Gazan medical students abroad: a cross-sectional study

BackgroundIn Gaza, 2 million people have been affected by more than 13 years of strict land, air, and sea blockades and three wars, during which over 4000 people have been killed and many more have been injured. Additional severe effects have been seen on lives, aspirations, and prospects. Given the conditions, medical students have many competing reasons for and against studying medicine abroad. We investigated motives, academic situations, and future plans of the upcoming generation of doctors in Gaza, occupied Palestinian territory. MethodsWe did a questionnaire-based cross-sectional study involving Palestinian medical students originally from Gaza who were studying at the largest five medical schools in Egypt (Cairo, Ain Shams, Alexandria, Mansoura, and Zagazig Universities). We used a self-designed questionnaire developed from previous similar studies and created on Google Forms (Google, Menlo Park, CA, USA). A pilot study of 37 participants was done to test the comprehensibility of questions and the time needed to complete the questionnaire. After being updated, the questionnaire was distributed in August and September, 2018, to individuals who provided verbal informed decision to participate. Analysis of the results was performed with SPSS version 22. FindingsOf 453 questionnaires given to students, 340 (75%) were returned completed. The mean age of respondents was 21·7 (SD 1·8) years; 225 (66%) were men and 115 (34%) were women. Excellence was achieved in secondary school examinations (result ≥90%) by 315 (93%) of students, but only 26 (8%) of students achieved excellence in their first year of medical school (examination results ≥85%). 317 students (93%) reported that they chose their medical schools independently without pressure from their families. Among the 115 women, 70 (61%) went to a third party to persuade their parents to allow them to study abroad. Of ten motives to study medicine given in the questionnaire, “to relieve pains” and “childhood dream” were the most frequently selected among the 340 respondents, chosen by 228 (67%) and 208 (61%), respectively. 104 (31%) reported they were seeking freedom more than to study medicine. 214 (63%) of students had at least one relative who had been physically injured in or killed during of one of the wars in Gaza. Most students (n=278 [82%]) were delayed from starting at their medical school due to border closures and 189 (56%) had been unable to attend for at least one semester. Since starting at medical school, 269 (79%) of 340 respondents had visited Gaza only once or not at all. 55 (16%) intended never return to Gaza and 209 (62%) reported that they wanted to specialise and work abroad for a period and then return to Gaza. Of the remainder, 64 (19%) wanted to specialise abroad then return to work in Gaza, and 12 (3%) wanted to specialise and work in Gaza. InterpretationThe motives, academic performance, and career prospects of Gazan medical students studying in Egypt are influenced in many ways by the situation in Gaza, some of which could worsen the already bad condition of medical care in Gaza. Awareness and supportive programmes for Gazan medical students should be encouraged to improve the quality of health care providers in Gaza. FundingNone.

The Strength of Motivation of Medical Students in Romania in the Context of Migration Opportunities

In this study we aim to study in what way the Strength of motivation of the Romanian medical students has been influenced by harsh economic conditions that led to a massive migration. We conducted a cross-sectional study on a sample size of N=1516. We applied The Strength of Motivation for Medical School-Revised (SMMS) questionnaire and a questionnaire that examines the opinion of the students about migration. The mean value of motivation was 48 (maximum score is 75), 85% of the students have the intention to migrate. The determining factor of studying medicine abroad that correlates significantly with the Strength of motivation is represented by the better work conditions. Students studying in the South of the country want to practice primary in France, students in the North West and in the Center choose to practice medicine in Germany, and students from the East would like to go to Great Britain. The students with a high Strength of motivation are driven by the desire of the students to practice medicine abroad. Higher salaries don’t represent the principal factor for leaving the country. The percent of 85% of the students aiming to practice medicine abroad, represent a concerning result for all of us because it took the form of brain drain.

“Home and Away” A look at Gulf Medical Students’ Influencing Factors, Challenges and Attitudes for Studying Medicine Abroad

Introduction: Higher education is no longer provided solely in the confines of national borders. Now days, the general trend is that students are no more reluctant to cross boundaries and travel to different places for achieving better education. Aim: To explore gulf medical students influencing factors, challenges, and perceptions to study abroad. 
 Methods: Cross sectional prospective study was conducted with self-administered survey which consisted of six sections. The survey was distributed by email to gulf medical students studying in four countries (United Kingdom, Ireland, Kingdom of Bahrain, and Jordan). Data were tubulated on Excel and analysed with SPSS V.22.
 Results: Total responses received that met inclusion criteria were 94 with mean age of 20.89 (68.08% females). 51% of participants were from Kuwait, and 57% of participants were studying in European universities. Broadening personal experience was the main influencing factor to study abroad, and word of mouth from parents and students studying abroad were the main individual influences. Financial issues were the main challenges for studying abroad. Surgical specialities were the desired specialities for future career accounting for 44.7%.
 Conclusion: Understanding the underlying reasons behind a student’s decision to study abroad plays an important part on structuring scholarship and allocating resources. The high rate of students regretting studying abroad and at the same time the high rate of recommendation for other to study abroad indicate that personal satisfaction is a key factor, however, studying abroad does not suit everyone.

Canadians studying medicine abroad and their journey to secure postgraduate training in Canada or the United States.

BackgroundFrom national and international workforce perspectives, Canadians studying medicine abroad (CSAs) are a growing provider group. Some were born in Canada whereas others immigrated as children. They study medicine in various countries, often attempting both American and Canadian medical licensure pathways.MethodsUsing data from the Educational Commission for Foreign Medical Graduates (ECFMG) and the Medical Council of Canada (MCC), we looked at CSAs who attempted to secure residency positions in both Canada and the United States. We detailed the CSAs’ countries of birth and medical education. We tracked these individuals through their postgraduate education programs to enumerate their success rate and categorize the geographic locations of their training.ResultsThe majority of CSAs study medicine in one of 10 countries. The remainder are disbursed across 88 other countries. Most CSAs were born in Canada (62%). Approximately 1/3 of CSA from the 2004-2016 cohort had no record of entering a residency program in Canada or the United States (U.S.). Recently graduated CSAs were most likely to secure residency training in Ontario and New York.ConclusionMany CSAs attempt to secure residency training in both Canada and the U.S. Quantifying success rates may be helpful for Canadians thinking about studying medicine abroad. Understanding the educational pathways of CSAs will be useful for physician labour workforce planning.

Natives as international medical graduates: A nationwide analysis in Taiwan

International medical graduates (IMGs) play an important role in many Western countries because of globalization and physician shortages. While the IMGs investigated in most studies were immigrants, few studies have considered the situation in which people native to a given country have studied medicine abroad and then returned to practice in their home country. To illustrate that situation, our study aimed to investigate practicing IMGs in Taiwan by comparing practicing physicians' nationalities to the countries in which the medical schools the IMGs graduated from are located. Data were obtained from the annual official statistics released by the Taiwan Medical Association from 1998 to 2017. The number of practicing IMGs in Taiwan increased from 834 (3.1% of 26,991 physicians) in 1998 to 1,733 (3.7% of 46,452) in 2017. Their medical schools were distributed across 37 countries, with graduates of schools in the Philippines (n=550), Poland (n=420), and Myanmar (n=364) accounting for 77.0% of all practicing IMGs in 2017. However, only 29, 0, and 253 physicians were themselves Filipinos, Polish, and Myanmarese, respectively. Most of the practicing IMGs in Taiwan are native Taiwanese. The real impact of IMGs in health policy-making and the existing quota system of admissions to medical schools thus deserve further investigations.

\u201cWe have been forced to move away from home\u201d: print news coverage of Canadians studying abroad at Caribbean offshore medical schools

BackgroundCanadian international medical graduates are Canadian-citizens who have graduated from a medical school outside of Canada or the United States. A growing number of Canadians enroll in medical school abroad, including at Caribbean offshore medical schools. Often, Canadians studying medicine abroad attempt to return to Canada for postgraduate residency training and ultimately to practice.MethodsThe authors conducted a qualitative media analysis to discern the dominant themes and ideologies that frame discussion of offshore medical schools, and the Canadian medical students they graduate, in the Canadian print news. We carried out structured searches on Canadian Newsstand Database for print media related to offshore medical schools.ResultsCanadian news articles used two frames to characterize offshore medical schools and the Canadian international medical graduates they train: (1) increased opportunity for medical education for Canadians; and (2) frustration returning to Canada to practice despite domestic physician shortages.ConclusionFrames deployed by the Canadian print media to discuss Caribbean offshore medical schools and Canadians studying abroad define two problems: (1) highly qualified Canadians are unable to access medical school in Canada; and (2) some Canadian international medical graduates are unable to return to Canada to practice medicine. Caribbean offshore medical schools are identified as a solution to the first problem while playing a central role in creating the second problem. These frames do not acknowledge that medical school admissions are a primary means to control the make-up of the Canadian physician workforce and they do not address the nature of Canadian physician shortages.

Retention Patterns of Canadians Who Studied Medicine Abroad and Other International Medical Graduates.

Objectives:Are Canadians who study abroad (CSAs) more likely to stay in Canada than other international medical graduates (IMGs)? We looked at retention patterns of CSAs and immigrant IMGs who completed post-graduate medical education (PGME) training in Canada to describe the proportion and predictors of those working in Canada and in rural communities in Canada in 2015.Methods:We linked the National IMG Database to Scott's Medical Database to track the work locations of CSAs and immigrant IMGs in 2015.Results:Of the 1,214 IMGs who entered PGME training in Canada between 2005 and 2011, most were working in Canada in 2015 (88.0%). Relatively few IMGs worked in rural communities (9.1%). There were no differences in work location patterns of CSAs and immigrant IMGs.Conclusion:Contrary to what CSA advocates suggest, CSAs have the same retention patterns as immigrant IMGs. PGME admission policies should treat all IMGs in the same manner, regardless of their citizenship or residency before medical school.

Realization of entry-to-practice milestones by Canadians who studied medicine abroad and other international medical graduates: a retrospective cohort study.

International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006. We examined 3 entry-to-practice milestones; obtaining a postgraduate position, passing the Medical Council of Canada Qualifying Examination Part II and obtaining a specialty designation. Of the 6925 eligible graduates in cohort 1, 2144 (31.0%) had obtained a postgraduate position. Of the 1214 eligible graduates in cohort 2, 1126 (92.8%) had passed the Qualifying Examination Part II, and 889 (73.2%) had obtained a specialty designation. In multivariate analyses, Canadian graduates of Western or Caribbean medical schools (odds ratio [OR] 4.69, 95% confidence interval [CI] 3.82-5.71) and Canadian graduates of other medical schools (OR 1.49, 95% CI 1.31-1.70) were more likely to obtain a postgraduate position than non-Canadian graduates of other (not Western or Caribbean) medical schools. There was no difference among the groups in passing the Qualifying Examination Part II or obtaining a specialty designation. Canadians who studied abroad were more likely than other international medical graduates to obtain a postgraduate position; there were no differences among the groups in realizing milestones once in a postgraduate program. These findings support policies that do not distinguish postgraduate applicants by citizenship or permanent residency status before medical school.

Two Wings and a Prayer: Should Canada Make It Easier for Canadian Doctors Trained Abroad to Enter Practice Here?

About 3,600 Canadians are currently studying medicine abroad (CSMAs). Most hope to return to practise in Canada. But the road back is not easy. These graduates must complete postgraduate residency training in Canada and alas, there are less openings than there are aspirants. One might have thought, amid the endless rhetoric of "physician shortages," that an obvious solution would be to increase the number of residency positions. But provincial governments are well aware, even if the media are not, that Canada is in the early stages of a dramatic expansion in physician supply fuelled by increased domestic training capacity. Last time the physician supply outpaced population growth, as it is doing today, governments choked off the entry of international graduates. It could happen again.

Comment to: The Canadian International Medical Graduate Bottleneck: A New Problem for New Doctors

Re: The Canadian International Medical Graduate Bottleneck: A New Problem for New Doctors.1 As a Canadian studying medicine abroad (CSA), I see first-hand the ever-growing number of students like myself facing an uphill battle to return home. There were an estimated 650 CSAs in Ireland in 2010,2 and since then we have seen class sizes (and number of CSAs) grow further. The process of returning to Canada to complete our residency training varies by province, and there exists an irony in the process that is no more evident than in British Columbia (BC). Only 24 of 279 residency positions in BC were dedicated to international medical graduates (IMGs) in the 2012 match,3 but virtually no BC residents in their final year of medical school abroad were able to apply for these first iteration positions. This is due to a restrictive BC assessment program for IMGs, that is simply timed too late in the year, such that most CSAs are ineligible to apply to the match in their final year of medical school; the current IMG system is better suited for landed immigrants who hold foreign medical degrees. The Dean of Medicine at the University of British Columbia (UBC), Dr. Gavin Stuart, stated in an interview, “clinical skills are probably one of the big areas of difference of Canadian graduates from those that are graduating from Ireland or Australia… those individuals may have comparable knowledge base, [but] have not had the clinical exposure.”4 Meanwhile, BC is actively recruiting physicians from the very countries where the CSAs are studying.5 Health Match BC has been making recurrent trips to Ireland and the UK, to recruit only foreign doctors but not Canadians finishing their medical degree abroad. Unless there are significant changes to better allow CSAs to return home upon graduation, more and more students will find themselves unable to serve Canada.

The Canadian International Medical Graduate Bottleneck: A New Problem for New Doctors

Background: A growing population of Canadian students are travelling outside of Canada for medical training. The purpose of this study is to assess the opportunity for Canadians studying medicine abroad (CSAs) to secure post-graduate medical residency positions as International medical graduates (IMGs) in Canada.Methods: Current statistics on IMG applicants into the Canadian Residency Matching Service (CaRMS) will be compared to the number of CSAs applying to return to Canada.Results: In 2010, 75% (1232) of IMG applicants were unmatched following application to CaRMS, despite a doubling in positions reserved for IMGs from 2003. An estimated 3750 CSAs are currently attending over 55 medical schools globally; a six-fold increase since first reports in 2006. Between 2012 and 2014, it is estimated that 72.8% of CSAs will graduate, with 90.4% hoping to return to Canada for post-graduate residency training. Discussion: The increasing population of CSAs poses a significant risk for future IMGs attempting to secure postgraduate training positions in Canada. From this perspective, we have coined the term ‘Canadian IMG Bottleneck’ – which describes the funnelling effect that has been created by the growing number of CSAs and the limited number of IMG residency positions available in Canada.

Estimated 1500 Canadians studying medicine abroad

The number of Canadians studying medicine outside Canada is almost 4 times higher than previously estimated, a new survey indicates. The first of its type, the survey was completed for Health Canada last October by Canadian Resident Matching Service (CARMS) Executive Director Sandra Banner. After

United States citizens studying medicine abroad. Their backgrounds and test performance.

To acquire information about the characteristics of U.S. citizens who had recently studied medicine abroad, the Educational Commission for Foreign Medical Graduates (ECFMG) and the Association of American Medical Colleges merged independently collected data on a study group of 10,460 U.S. citizens who attended 359 medical schools in 75 foreign countries and who took their first ECFMG examination between 1978 and 1982. The study group was markedly heterogeneous: 21 percent were not U.S. citizens at birth, 32 percent did not have English as a native language, and 12 percent had two or more years of undergraduate college education in Puerto Rico. Sixty-seven percent resided in New York, New Jersey, California, Florida, or Puerto Rico, and 74 percent studied medicine in Mexico or the Caribbean. Forty-six percent passed the ECFMG examination on their first attempt, and 22 percent passed a subsequent examination. Only 45 percent had applied to a U.S. medical school, and 65 percent had taken the Medical College Admission Test. The means of the college grade-point averages, known for 39 percent of the study group, and of the scores on the admission test, known for 65 percent, were lower than those of both accepted and unaccepted applicants to U.S. medical schools in the 1976 and 1978 entering classes. The finding that 55 percent of the study group did not apply to a U.S. medical school does not support the widely held belief that most, if not all, U.S. citizens who attend foreign medical schools do so only after several unsuccessful attempts to gain admission to a U.S. school.

Where have all the students gone? An epidemiologic study of US nationals applying for certification by the Educational Commission for Foreign Medical Graduates, 1969 through 1982.

Larger and larger numbers of US nationals are studying medicine abroad and they now comprise the foremost national group of foreign medical graduates (FMGs) seeking to enter the US health care system. The Educational Commission for Foreign Medical Graduates (ECFMG) is currently conducting a comprehensive study of 205,542 graduates of foreign medical schools who, during a 14-year study period, 1969 through 1982, have sought its certification, an established prerequisite for FMGs applying for training in an accredited hospital residency program and/or licensure within the United States. This report summarizes preliminary data on the 17,642 US citizens included in the study who attended 431 different medical schools in 79 foreign countries. Particular attention is given to their performance on the combined medical knowledge-English language competence examinations requisite to the awarding of ECFMG certification.

Perceptions of Physicians as Expressed by Americans Studying Medicine Abroad

The perceptions that fifty-one Americans studying medicine abroad had of six types of medical practitioners were assessed. Surgeons were viewed as being aggressive and adventurous and internists were perceived as being analytical, knowledgeable and probing. These findings are similar to those previously reported for Americans studying medicine in U.S. medical schools.

Performance of U.S. citizen-foreign medical graduates on certifying examinations in internal medicine

Increasing numbers of U.S. citizens are studying medicine abroad and returning for graduate medical education and practice. The numbers and performance of U.S. citizen and all other graduates of foreign medical schools on the certifying examination of the American Board of Internal Medicine were compared with those of graduates of U.S. medical schools for 1975–1980. Numbers of first-taker U.S. citizen foreign medical school graduates increased whereas numbers of all other foreign medical school graduates decreased during this period. In 1980, U.S. citizens represented 19 percent of all first-taker foreign medical school graduates. During the study period, annual examinations were passed by 79 to 82 percent of U.S. medical school graduates, 15 to 38 percent of U.S. citizen foreign medical school graduates, and 27 to 45 percent of all other foreign medical school graduates taking an examination for the first time. On each examination, U.S. citizen foreign medical school graduates did not do as well as all other foreign medical school graduates. Members of all groups met the same postdoctoral training requirements.

On Policymaking in Medicine

WHEN Abraham Flexner made his study of medical education and presented his findings and recommendations to the public in 1910,¹he did not foresee the complex issues that presently exist in medical education. Currently there are approximately 268 national specialty organizations, 23 specialty certifying boards, 125 medical schools, 55 state and territorial medical societies, and 412 county medical societies. Some of the issues debated by and activities of these organizations include the accreditation of medical schools, residency training programs, and continuing medical education; certification and recertification; foreign medical graduates and US citizens studying medicine abroad; and government regulation of hospitals, drugs, and health care delivery—the list could go on and on. All of the organizations listed have an impact on the lives of more than 350,000 physicians in this country and on their involvement with their patients. The membership of the governing and policymaking bodies inthese organizations largely consists

On policymaking in medicine

WHEN Abraham Flexner made his study of medical education and presented his findings and recommendations to the public in 1910,¹he did not foresee the complex issues that presently exist in medical education. Currently there are approximately 268 national specialty organizations, 23 specialty certifying boards, 125 medical schools, 55 state and territorial medical societies, and 412 county medical societies. Some of the issues debated by and activities of these organizations include the accreditation of medical schools, residency training programs, and continuing medical education; certification and recertification; foreign medical graduates and US citizens studying medicine abroad; and government regulation of hospitals, drugs, and health care delivery—the list could go on and on. All of the organizations listed have an impact on the lives of more than 350,000 physicians in this country and on their involvement with their patients. The membership of the governing and policymaking bodies inthese organizations largely consists

Foreign Medical Graduates

To the Editor.— I think it is an act of omission to disregard again the pool of American-born FMGs who can partially satisfy the demand for house staff members in postgraduate training programs. Assuming that the education received at foreign medical schools is equivalent for the native of that country and the foreign student (ie, the American studying there), once in postgraduate programs in the United States, the familiarity with our American culture plus fluency in English and occasionally a second language in which he or she studied medicine abroad puts the American-born FMG at an advantage in taking histories and performing physical examinations, two skills Weinstein cited as deficient in foreign-born FMGs. As stated in Future Recommendations No. 1, it seems that educational support for FMGs can be updated with special emphasis on programs for American-born FMGs, such as the Fifth Pathway. It is time to support our own

American Foreign Medical Graduates

The performance during graduate medical education of Americans who have studied medicine abroad and who have taken a year of intense and closely supervised clinical clerkships (fifth pathway program) was assessed. Only 14% of such house officers were given inadequate or below-average ratings in overall clinical performance by residency program directors. Ninety percent or more received average, good, very good, or excellent evaluations in their ability to take medical histories and perform physical examinations, in their response to instruction, in behavior and interpersonal relationships, and in appearance and emotional stability. Seventy percent were said to be as good as or better than house staff in general. Carefully selected and properly motivated Americans who have studied medicine in a foreign country can become good physicians following a well-organized, comprehensive, closely supervised year of clinical clerkship education. (<i>JAMA</i>241:714-716, 1979)