From language troubles to the female body, foreign doctors training in Canada can face challenges: study

May 22, 2016

By Tom Blackwell, National Post |

For most of his colleagues, it would have been a routine part of the training to become a family physician. But as he began his first night on call in obstetrics, the medical-school graduate from abroad was frantic.

“He was in tears, saying he did not know what to do,” a supervising physician told the researchers behind a revealing new Canadian study. “He’d been sent into the delivery room to take care of deliveries … and he had never even seen a lady with her clothing off.”

It was one striking example of a culture clash the Alberta study suggests is common for graduates of foreign medical schools who do two-year family-medicine residencies here.

Some balk at being taught by female doctors, struggle with the nuances of English, use inappropriate body language, are uncomfortable with the mentally ill — or unfamiliar even with the concept of patient confidentiality, the researchers found.

Many of the “international medical graduates” (IMGs) also are highly educated, have rich cultural perspectives and strong characters, reported colleagues who were surveyed for the study.

But the authors say residency programs — whose on-the-job training is required to become a licensed doctor — should recognize the transition difficulties and incorporate “medico-cultural” education into their curriculums.

“In some countries, males look after males and females look after females,” said Olga Szafran, associate research director in the University of Alberta’s family-medicine department and the study’s lead author.

“(But) we can’t be selective in the kind of patients that our physicians end up treating. If you’re not familiar with the anatomy of the opposite sex, it’s very difficult to end up in the delivery room and deliver a baby.”

Canada relies heavily on IMGs, with graduates from medical schools outside North America making up about a quarter of practising physicians.

Universities here typically reserve a set number of residency spots for those foreign doctors, with the Edmonton faculty training about a dozen in family medicine a year, said Szafran.

Her study does not specify countries of origin, but the top five sources of IMGs countrywide in 2012 were South Africa, India, Libya, the U.S. and Pakistan, according to a Canadian Medical Association report.

The Alberta team admit their research was “qualitative,” not an empirical study with statistically significant results. They conducted interviews or held focus groups with the doctors who supervise family medicine trainees, with nurses and other health professionals who work alongside them and with both Canadian and international residents.

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