Academic Psychiatry

, Volume 36, Issue 4, pp 277–281 | Cite as

Preparing International Medical Graduates for Psychiatry Residency: A Multi-Site Needs Assessment

  • Sanjeev Sockalingam
  • Raed Hawa
  • Mazin Al-Battran
  • Susan E. Abbey
  • Ari Zaretsky
Original Article



Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.


Using a 15-item online questionnaire, authors conducted a needs-assessment of IMG residents in five Canadian psychiatry residency programs. The survey examined IMGs’ perceived difficulties with the transition into psychiatry residency, educational needs, and demographic data. Data were analyzed with descriptive statistics and Mann-Whitney tests.


IMGs identified the following difficulties with their transition into residency: understanding the healthcare system, medical documentation, and evidence-based medicine/mental health. Language barriers and social isolation were significant factors affecting the transition into residency for residents who did not speak English as their first language. Residents who lived in Canada 12 months or less had greater perceived difficulties in psychotherapy knowledge and adapting to the Canadian healthcare system; 88% of IMGs reported having little- or- no IMG-specific preparation for psychiatry residency from their psychiatry program; however, 69% reported that they would use IMG resources if offered; 63% felt that faculty in their program should undergo training to assist with IMG transition.


Several perceived challenges, needs, and gaps in training were reported by IMGs in Canadian psychiatry residency programs. The results of this survey will be used to inform future curriculum development to facilitate IMG transition into psychiatry postgraduate training programs. We thank the survey working group, and, especially, Drs. N. Roberts, M. Hasnain, H. Haensel, T. Callanan and K. Skakum, J. Parent, and the postgraduate office administrative staff for each program for their assistance with survey dissemination. We also thank the Canadian Psychiatric Association Membership Affairs Committee and Members-in-Training Committee for their input in this project. We appreciate the time and effort of the participating international medical graduates from the five psychiatry residency programs.


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  1. 1.
    National Resident Match Program: Results and Data: 2009 Main Residency Match (Table 12); available at; accessed November 1, 2009
  2. 2.
    CAPER: Annual Census 2008–09; available at; accessed October 27, 2009
  3. 3.
    The Association of Faculties of Medicine of Canada; available at:; accessed on November 1, 2009
  4. 4.
    Bates J, Andrew R: Untangling the roots of some IMGs’ poor academic performance. Acad Med 2001; 76:43–46PubMedCrossRefGoogle Scholar
  5. 5.
    Kramer MN: The educational needs of international medical graduates in psychiatric residencies. Acad Psychiatry 2005; 29:322–324PubMedCrossRefGoogle Scholar
  6. 6.
    Majumdar B, Keystone JS, Cuttress LA: Cultural sensitivity training among foreign medical graduates. Med Educ 1999; 33:177–184PubMedCrossRefGoogle Scholar
  7. 7.
    Whelan GP: Commentary: Coming to America: the integration of international medical graduates into the American medical culture. Acad Med 2006; 81:176–178PubMedCrossRefGoogle Scholar
  8. 8.
    Hall P, Keely E, Dojeiji S, et al: Communication skills, cultural challenges, and individual support: challenges of international medical graduates in a Canadian healthcare environment. Med Teach 2004; 26:120–125PubMedCrossRefGoogle Scholar
  9. 9.
    Pilotto LS, Duncan GF, Anderson-Wurf J: Issues for clinicians training international medical graduates: a systematic review. Med J Aust 2007; 187:225–228PubMedGoogle Scholar
  10. 10.
    Wong A, Lohfeld L: Recertifying as a doctor in Canada: international medical graduates and the journey from entry to adaptation. Med Educ 2008; 42:53–60PubMedCrossRefGoogle Scholar
  11. 11.
    Zulla R, Baerlocher MO, Verma S: International medical graduates (IMGs) needs-assessment study: comparison between current IMG trainees and program directors. BMC Med Educ 2008; 8:42PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Rosner F, Dantzker DR, Walerstein S, et al: Intensive one-week orientation for foreign medical graduates entering an internal medicine residency program. J Gen Intern Med 1993; 8:264–265PubMedCrossRefGoogle Scholar
  13. 13.
    Whyche S: Course Helps IMGs Adapt to Psychiatric Practice in U.S. Psychiatr News 2009;44(4):4Google Scholar
  14. 14.
    Rao NR, Kramer M, Saunders R, et al: An annotated bibliography of professional literature on international medical graduates. Acad Psychiatry 2007; 31:68–83PubMedCrossRefGoogle Scholar
  15. 15.
    Myers GE: Addressing the effects of culture on the boundary-keeping practices of psychiatry residents educated outside of the United States. Acad Psychiatry 2004; 28:47–55PubMedCrossRefGoogle Scholar
  16. 16.
    Coombs AA, King RK: Workplace discrimination: experiences of practicing physicians. J Natl Med Assoc 2005; 97: 467–477PubMedGoogle Scholar

Copyright information

© Academic Psychiatry 2012

Authors and Affiliations

  • Sanjeev Sockalingam
    • 1
  • Raed Hawa
    • 1
  • Mazin Al-Battran
    • 1
  • Susan E. Abbey
    • 1
  • Ari Zaretsky
    • 2
  1. 1.Dept. of PsychiatryUniversity Health Network & University of TorontoTorontoCanada
  2. 2.Dept. of PsychiatryUniversity of TorontoCanada

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