International medical graduates in transition

Background:  Medical migration is now more frequent, and raises complex issues concerning the standards of practice and transitions required for doctors. The challenges faced by international medical graduates have been acknowledged through the proliferation of orientation programmes designed within hospitals. This paper discusses and evaluates a pilot orientation programme for doctors in Victoria, Australia, called Transition in Practice.

Methods:  Drawing on theories of active reflection and situated learning, the programme entailed fortnightly meetings for new international medical graduates at a metropolitan hospital in Victoria. The programme comprised a series of informal discussion sessions where doctors were facilitated to actively reflect on everyday practical challenges in their hospital work. Local medical and non-medical staff were invited to each session. Data comprised doctors’ reflections about new insights gathered at the conclusion of each session.

Results:  Thematic analysis of 55 evaluation cards revealed that participants benefited from the programme by learning directly from invited staff members’ descriptions of their roles and their specific areas of practice. Participants gained increased awareness of the differences between their past and present work environments, and greater insight into the complexities of the local system. Participating doctors became actively involved in their own orientation process, generating new topics for future discussions.

Conclusion:  This programme successfully integrated experiences and views of both international medical graduates and local hospital staff to generate a greater understanding of each other and of the workplace. The programme used simple, inexpensive methods that tapped into the resources that both international medical graduates and local staff bring to the workplace.