title: Exploring the experiences and coping strategies of international medical students.
abstract: BACKGROUND
  Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills.
  
  
  METHODS
  This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia.
  
  
  RESULTS
  Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p < 0.001) variations between student performances in multiple choice questions, short answer questions and objective structured clinical examinations (70.3%, 49.7% & 61.7% respectively), indicating existence of communication issues.
  
  
  CONCLUSIONS
  Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.
authors.affiliation: Medical Education Unit, School of Medicine, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia. bunmi.malauaduli@utas.edu.au
authors.forename: Bunmi S
authors.initials: BS
authors.lastname: Malau-Aduli
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003625:Data Collection; D005260:Female; D017144:Focus Groups; D006801:Humans; D038622:Internationality; D008297:Male; D013337:Students, Medical / Q000523:psychology*; D013648:Tasmania; D055815:Young Adult