title: Systems-based aspects in the training of IMG or previously trained residents: comparison of psychiatry residency training in the United States, Canada, the United Kingdom, India, and Nigeria.
abstract: OBJECTIVE
  International medical graduates (IMGs) account for a significant proportion of residents in psychiatric training in the United States. Many IMGs may have previously completed psychiatry residency training in other countries. Their experiences may improve our system. Authors compared and contrasted psychiatry residency training in the U.S. to that of Canada, the United Kingdom, India, and Nigeria. The study also highlights the systems-based features that may have an impact on the adaptation of IMGs (especially previously-trained) to U.S. psychiatry residency.
  
  
  METHODS
  Individuals who are familiar with psychiatry residency training in the United States and were previously trained in other countries synthesized information available on websites, official documents, and previous literature, as well as their experiences with past training.
  
  
  RESULTS
  Psychiatry residencies vary considerably in all five countries in terms of the duration of training, curriculum, clinical experience, psychotherapy training, research experience, supervision, and evaluation processes. Residency training in the U.S., Canada, and the U.K. is well-structured and has more psychotherapy training. The U.K. has enhanced exposure to community psychiatry. The U.K., India, and Nigeria have increased emphasis on psychopathology. Training in India and Nigeria has a higher quantity of clinical work, less record-keeping, less emphasis on patient autonomy, and a mandatory prospective clinical research requirement.
  
  
  CONCLUSIONS
  The provision of services and training is substantially influenced by national mental health policies, culture, and local traditions. Despite numerous commonalities, there are some differences in psychiatry training among all five countries. Awareness of these differences in education, systems, and interactions may help psychiatric educators to understand IMGs (especially those previously-trained) as they adapt to U.S. training.
authors.affiliation: Dept. of Internal Medicine andPsychiatry, Southern Illinois University School of Medicine, Springfield, IL, USA. drgauravjain@gmail.com
authors.forename: Gaurav
authors.initials: G
authors.lastname: Jain
authors.forename: Mir Nadeem
authors.initials: MN
authors.lastname: Mazhar
authors.forename: Aghaegbulam
authors.initials: A
authors.lastname: Uga
authors.forename: Manisha
authors.initials: M
authors.lastname: Punwani
authors.forename: Karen E
authors.initials: KE
authors.lastname: Broquet
mesh_terms: D002170:Canada; D002568:Certification; D002983:Clinical Competence; D003158:Community Psychiatry / Q000193:education; D003431:Cross-Cultural Comparison; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005550:Foreign Medical Graduates; D006801:Humans; D007194:India; D007396:Internship and Residency; D009549:Nigeria; D011570:Psychiatry / Q000193:education*; D011613:Psychotherapy / Q000193:education; D012106:Research / Q000193:education; D006113:United Kingdom; D014481:United States