Osta Amanda D, Barnes Michelle M, Pessagno Regina, Schwartz Alan, Hirshfield Laura E
a Department of Pediatrics , University of Illinois-Chicago , Chicago , Illinois , USA.
b Department of Internal Medicine , University of Illinois-Chicago , Chicago , Illinois , USA.
Teach Learn Med. 2017 Apr-Jun;29(2):143-152. doi: 10.1080/10401334.2016.1251321. Epub 2016 Dec 29.
Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children.
In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries. The focus group transcripts were analyzed using open and focused coding methodology.
The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.
现象:国际医学毕业生(IMGs)在东道国卫生系统中发挥着关键作用,但面临独特挑战,这使得为IMGs提供有效、量身定制的支持至关重要。先前描述IMGs文化适应需求的文献主要集中在沟通内容和风格上。我们进行了一项定性研究,以探索可能特定于照顾儿童的IMG住院医师的文化适应情况。
在2011年11月至2012年4月进行的一项研究中,我们与来自12个国家的26名儿科IMG住院医师进行了4次90分钟的半结构化焦点小组讨论。使用开放式和聚焦式编码方法对焦点小组记录进行了分析。
焦点小组讨论及后续分析表明,儿科IMG住院医师对其本国文化的社会化影响他们向美国执业的过渡;他们不仅必须适应与自己国家不同的美国文化,还必须适应美国的医学文化。我们确定了以下新的文化适应主题:理解教育系统和家庭结构、健康的社会决定因素、与非裔美国父母的沟通、避孕、医生交接班、医生在预防中的作用、青少年健康以及医生在儿童权益倡导中的作用。我们进一步强调了儿科IMG住院医师面临的文化适应挑战,并为创建针对儿科IMG住院医师的有意文化适应课程提供了简要建议。见解:住院医师培训是医生个人和职业发展中的一个独特时期,对IMGs来说可能特别具有挑战性。在已确定的文化适应需求与目前为照顾儿童的IMG住院医师提供的课程之间存在显著差距。