A qualitative study of the international medical graduate and the orientation process.

INTRODUCTION: International medical graduates (IMGs) play an important role in physician resource planning in many countries and are heavily relied on to fill vacancies in underserved communities. New IMGs may experience difficulty with understanding how medicine is organized in new countries. Effective orientation processes can assist new IMGs in making successful transitions to medical practice in their new countries, reducing professional isolation and enhancing the integration of IMGs and their families within their new communities. The purpose of this qualitative study was to explore perceptions of, and experiences with, orientation processes for new IMGs.

METHODS: A stratified sample of IMGs and senior administrators of medical services from each of the regional health authorities in Newfoundland and Labrador was invited to participate in semistructured telephone interviews.

RESULTS: Thirteen general practitioners/family physicians, 6 specialists and 4 administrators were interviewed. New IMGs need to learn about the health care system and the peculiarities of the specific practice context in which they will be working. Orientation needs to include opportunities for reflecting on one's own cultural biases and for learning about the cultural background and beliefs of a new patient population. Mentoring and effective integration within the community also emerged as important components of effective orientation processes.

DISCUSSION: Our findings suggest that orientation processes for new IMGs must be attentive to both professional and personal needs, comprehensive, multifaceted and sustained. Orientation that is responsive to the various needs of new IMGs and their families may contribute to enhanced retention.

CONCLUSION: Effective orientation processes are an important means of reducing professional isolation and supporting new IMGs in the transition to medical practice in their new communities.