Achieving Equity for International Medical Graduates: A Systematic Review

Sangeeta Gopal Saxena^1*Elizabeth Tisdell²Elana Farace³Thomas Godfrey³Betsy Aumiller³Esther Dell³Omrana Pasha Razzak⁴Bernadette Nirmal Kumar⁵Kristin K Sznajder³

• ¹Coastal Carolina University, Conway, United States
• ²Penn State Harrisburg, Middletown, United States
• ³Penn State Milton S. Hershey Medical Center, Hershey, United States
• ⁴City College of New York (CUNY), New York City, United States
• ⁵Norwegian Institute of Public Health (NIPH), Oslo, Norway

Foreign-born and foreign trained International Medical Graduates(FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help IMGs assimilate better in their host country systems. This improves their productivity and satisfaction, allows health systems to be more accepting of IMGs, and most importantly, enhances patient outcomes. The studies included in this review fall into three groups - acculturation interventions for IMGs, IMGs' perceptions of interventions they found useful and perspectives of trainers of IMGs on 'what works'.This review also includes interventions that pivoted to the online mode during the Covid-19 pandemic, making the findings relevant, as this is likely to be the norm in the future. Although much work has been done over the past two decades, more needs to be done. Interventions need to be tailored to suit unique needs of IMGs from 22+ countries, long term, life course related changing needs need to be addressed, and health systems need to be prepared to accept FIMGs.