Journal of General Internal Medicine

, Volume 25, Issue 9, pp 947–953

Professional Experiences of International Medical Graduates Practicing Primary Care in the United States

Authors

    • Robert Wood Johnson Foundation Clinical ScholarsYale University School of Medicine
  • Marcella Nunez-Smith
    • Robert Wood Johnson Foundation Clinical ScholarsYale University School of Medicine
    • Section of General Internal MedicineYale University School of Medicine
  • Susannah May Bernheim
    • Robert Wood Johnson Foundation Clinical ScholarsYale University School of Medicine
    • Department of Internal MedicineYale University School of Medicine
    • Center for Outcomes Research and EvaluationYale-New Haven Hospital
  • David Berg
    • Robert Wood Johnson Foundation Clinical ScholarsYale University School of Medicine
    • Department of PsychiatryYale University School of Medicine
  • Aysegul Gozu
    • Department of Internal Medicine, Franklin Square HospitalJohns Hopkins University School of Medicine
  • Leslie Ann Curry
    • Robert Wood Johnson Foundation Clinical ScholarsYale University School of Medicine
    • Division of Health Policy and AdministrationYale University School of Public Health
Original Research

DOI: 10.1007/s11606-010-1401-2

Cite this article as:
Chen, P.G., Nunez-Smith, M., Bernheim, S.M. et al. J GEN INTERN MED (2010) 25: 947. doi:10.1007/s11606-010-1401-2

Abstract

Background

International medical graduates (IMGs) comprise approximately 25% of the US physician workforce, with significant representation in primary care and care of vulnerable populations. Despite the central role of IMGs in the US healthcare system, understanding of their professional experiences is limited.

Objective

To characterize the professional experiences of non-US born IMGs from limited-resource nations practicing primary care in the US.

Design

Qualitative study based on in-depth in-person interviews.

Participants

Purposeful sample of IMGs (n = 25) diverse in country of origin, length of practice in the US, specialty (internal medicine, family medicine and pediatrics), age and gender. Participants were currently practicing primary care physicians in New York, New Jersey or Connecticut.

Approach

A standardized interview guide was used to explore professional experiences of IMGs.

Key Results

Four recurrent and unifying themes characterize these experiences: 1) IMGs experience both overt and subtle forms of workplace bias and discrimination; 2) IMGs recognize professional limitations as part of “the deal”; 3) IMGs describe challenges in the transition to the culture and practice of medicine in the US; 4) IMGs bring unique skills and advantages to the workplace.

Conclusions

Our data reveal that IMGs face workplace challenges throughout their careers. Despite diversity in professional background and demographic characteristics, IMGs in our study reported common experiences in the transition to and practice of medicine in the US. Findings suggest that both workforce and workplace interventions are needed to enable IMG physicians to sustain their essential and growing role in the US healthcare system. Finally, commonalities with experiences of other minority groups within the US healthcare system suggest that optimizing IMGs’ experiences may also improve the experiences of an increasingly diverse healthcare workforce.

KEY WORDS

primary carequalitative researchworkforceinternational medical graduates

Copyright information

© Society of General Internal Medicine 2010