4.6 Article

International Medical Graduate Resident Wellness: Examining Qualitative Data From J-1 Visa Physician Recipients

Journal

ACADEMIC MEDICINE
Volume 97, Issue 3, Pages 420-425

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ACM.0000000000004406

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This study identified the wellness barriers and challenges faced by international medical graduates (IMGs) as they transitioned to residency programs in the United States. The findings showed that IMGs encountered challenges related to cultural differences, healthcare system, distance from family and friends, bureaucratic barriers, and language/communication and finances. Additionally, the study highlighted the importance of friendships/relationships, exercise, family, socialization, and healthy eating for the wellness of IMGs.
Purpose International medical graduates (IMGs), approximately 25% of the U.S. physician workforce, have unique needs as they enter residency programs. This study identified wellness barriers and challenges that IMGs encounter as they transition to the United States. Method The authors analyzed results from 3 open-ended questions in a 21-item survey. This survey was administered in December 2019 to 11,504 IMG resident physicians sponsored by the Educational Commission for Foreign Medical Graduates' J-1 visa program. These questions asked respondents to describe challenges to their wellness, how they maintain wellness, and resources that would have aided their transition. Data were analyzed using a mixed-methods approach, including both qualitative descriptions and category frequencies. Results Of the surveys administered, 7,817 responses (68% response rate) were received. Respondents identified challenges navigating cultural differences (1,314, 17%), health care system (1,108, 14%), distance from family and friends (890, 11%), bureaucratic barriers (724, 9%), and language/communication and finances (575, 7%; 565, 7%, respectively). They also specified that friendships/relationships (2,800, 36%) followed by exercise (2,318, 30%), family (1,822, 23%), socialization (1,001, 13%), and healthy eating (775, 10%) were factors important to their wellness. Respondents requested more information about socialization (741, 9%), bureaucratic support (456, 6%), IMG support networks (427, 5%), financial support (404, 5%), and greater online resources (240, 3%). Conclusions IMGs have needs and concerns specific to their demographic group. Participants' responses suggested that they wanted additional support in the workplace and their personal lives. Answers also indicated that IMGs experienced a unique set of stressors such as fluctuating immigration laws that U.S. medical graduates do not face. Finally, this study supports a body of research that connects social and physical wellness. By identifying and describing these challenges, the authors seek to inform the development of specific programs and resources to improve IMG resident wellness.

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