Exploring Teamwork Challenges Perceived by International Medical Graduates in Emergency Medicine Residency

Introduction: Non-US international medical graduates (IMG) represent a gradually increasing portion of emergency medicine (EM) residents in the United States. Yet there are no previous studies that explore the needs of this learner population. We conducted a qualitative study to examine nonUS IMGs' perceptions of challenges they face specifically regarding team dynamics during their first year of an EM residency. Method: Nine non-US IMGs in EM from all over the US participated in anonymous, semi-structured phone interviews lasting 45-60 minutes. We then coded and analyzed the interviews to identify axes and themes using an inductive approach informed by grounded theory. Focused coding and member checking were employed. Results: Non-US IMGs' perceptions of challenges regarding team dynamics during their first year of an EM residency coalesced into two themes: system-based challenges, such as a new power dynamic and understanding the local hospital system, and interpersonal challenges, such as establishing rapport and articulation of critical thinking. Conclusion: Non-US IMGs perceived several unique challenges regarding team dynamics during their first year of an EM residency, whether system-based or interpersonal-based. We propose solutions such as a transitional curriculum (as suggested by the participants as well) and culturalcompetence training for academic leadership.

Automated summary

We conducted a qualitative study to explore non-US international medical graduates' perceptions of challenges they face in team dynamics during their first year of an emergency medicine residency. The study identified system-based challenges such as a new power dynamic and understanding the local hospital system, as well as interpersonal challenges such as establishing rapport and articulation of critical thinking.