title: Ego identity development in physicians: a cross-cultural comparison using a mixed method approach.
abstract: BACKGROUND
  The purpose of this study was to examine the career decision-making process of International Medical Graduates (IMGs). There are two main types of IMGs who apply for licensure in Canada. Canadian International Medical Graduates (CIMGs) were Canadian citizens before leaving to study medicine in a foreign country, in comparison to those non-CIMGs who had studied medicine in a foreign country before immigrating to Canada. Given that their motivations for becoming a doctor in Canada may differ, it is important to examine how they decided to become a doctor for each group separately.
  
  
  METHODS
  A total of 46 IMGs participated in a semi-structured interview - 20 were CIMGs and 26 were non-CIMGs.
  
  
  RESULTS
  An iterative process of content analysis was conducted to categorize responses from five open-ended questions according to the Ego Identity Statuses theory of career decision-making. Event contingency analysis identified a significant difference between CIMGs and non-CIMGs, Fisher's exact test (1) = 18.79, p < .0001. A total of 55% of CIMGs were categorized as identity achieved and 45% as foreclosed; 100% of non-CIMGs were classified as identity foreclosed.
  
  
  CONCLUSIONS
  About half of the Canadian citizens who had studied medicine in a foreign country had explored different careers before making a commitment to medicine, and half had not. No IMGs, however, who studied medicine in another country before immigrating to Canada, had explored various career opportunities before selecting medicine.
authors.affiliation: Medical Education and Research Unit, University of Calgary, Faculty of Medicine, 3330 Hospital Dr, N,W,, Calgary, AB, Canada. tnaberan@ucalgary.ca
authors.forename: Tanya N
authors.initials: TN
authors.lastname: Beran
authors.forename: Efrem
authors.initials: E
authors.lastname: Violato
authors.forename: Sonia
authors.initials: S
authors.lastname: Faremo
authors.forename: Claudio
authors.initials: C
authors.lastname: Violato
authors.forename: David
authors.initials: D
authors.lastname: Watt
authors.forename: Deidre
authors.initials: D
authors.lastname: Lake
mesh_terms: D000328:Adult; D002170:Canada; D003431:Cross-Cultural Comparison; D004532:Ego; D005260:Female; D005550:Foreign Medical Graduates / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010820:Physicians / Q000706:statistics & numerical data*; D013223:Statistics as Topic / Q000379:methods*