Society for Canadians Studying Medicine Abroad (SOCASMA), 22879-29B Avenue, Langley, BC, V2Z 3B1, Canada.
BMC Prim Care. 2023 Jul 14;24(1):147. doi: 10.1186/s12875-023-02105-6.
In their paper "Challenges with international medical graduate selection: finding positive attributes predictive of success in family medicine residency," (BMC Prim Care 23(256):2-9, 2022) the authors report on their research into qualitative attributes that positively correspond to success in residency with the objective of assisting in the selection of International Medical Graduate (IMG) residents most likely to achieve success in family medicine residency. The authors found that positive predictors of IMG residents' success were: presence of a positive attitude, proficient communication skills, high level of clinical knowledge, and trainability. The authors conclude that selecting IMG residents who possess these attributes will result in residents developing increased aptitudes for patient care. A careful reading of the paper raises a number of concerns. MacFarlane (Can Med Educ J 12(4):132-40, 2021) points out that IMGs are already marginalized in the residency selection process. Our concern is that this paper may contribute to this marginalization through a tone of negativity or bias against IMGs and the use of biased language throughout the paper that tends to cast IMGs as being inferior and somehow less well prepared for residency than Canadian Medical Graduates (CMGs). We argue that the proposed predictors are generic and equally relevant to both CMGs and IMGs. In focusing on these predictors in IMGs specifically, the paper appears to imply, without evidence, that IMGs are inadequate in the identified areas. After reviewing the paper's references, the existing literature, and an analysis of language used, we conclude that IMGs are capable candidates for residency, and that the qualitative attributes outlined in the paper offer little utility for the selection of IMG residents relative to CMG residents.
在他们的论文“国际医学毕业生选拔面临的挑战:寻找与家庭医学住院医师培训成功相关的积极特征”(BMC 初级保健 23(256):2-9,2022 年)中,作者报告了他们对与住院医师培训成功呈正相关的定性特征的研究,目的是帮助选择最有可能在家庭医学住院医师培训中取得成功的国际医学毕业生(IMG)住院医师。作者发现,IMG 住院医师成功的积极预测因素是:积极的态度、熟练的沟通技巧、较高的临床知识水平和可培训性。作者得出结论,选择具有这些特征的 IMG 住院医师将使住院医师在患者护理方面发展出更高的能力。仔细阅读这篇论文会引起许多关注。MacFarlane(加拿大医学教育杂志 12(4):132-40,2021 年)指出,IMG 在住院医师选拔过程中已经处于边缘地位。我们担心的是,这篇论文可能会通过对 IMG 持否定或偏见的语气以及在整篇论文中使用有偏见的语言来促成这种边缘化,这些语言往往将 IMG 描述为不如加拿大医学毕业生(CMG),并且在准备住院医师培训方面有所欠缺。我们认为,这些预测因素是通用的,对 CMG 和 IMG 同样相关。该论文特别关注这些 IMG 预测因素,而没有证据表明 IMG 在确定的领域存在不足。在审查了论文的参考文献、现有文献以及语言使用的分析之后,我们得出结论,IMG 是住院医师的合格候选人,而且论文中概述的定性特征在选择 IMG 住院医师相对于 CMG 住院医师方面几乎没有用处。