title: International medical graduates: a qualitative exploration of factors associated with success in the clinical skills assessment.
abstract: BACKGROUND
  International medical graduates (IMGs) are known to have significantly lower first attempt pass rates at the clinical skills assessment examination (CSA) than UK graduates. Whilst much has been published concerning higher fail rates in this group, there has been very little exploration of factors associated with success.
  
  
  OBJECTIVE
  This research aims to identify and explore factors associated with success in the CSA.
  
  
  METHODS
  Telephone interviews with 10 IMGs who had passed the CSA on their first attempt were undertaken. Participants were current or recent (previous academic year) GP trainees in Scotland. Transcripts of the interviews were analysed by a thematic analysis approach.
  
  
  RESULTS
  Six main themes emerged from the data analysis. These were insights into the challenges, a proactive approach, refining consultation skills, learning with UK graduates, valuing feedback and supportive relationships. Conclucions: This research adds the much-needed voice and experience of IMGs to a current area of uncertainty and challenge in medical education. It provides some insights into potential solutions to the issues and will be of interest to both trainees and those involved in their education.
authors.affiliation: a NHS Education for Scotland , Centre for Health Science , Inverness , UK.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Ragg
authors.affiliation: a NHS Education for Scotland , Centre for Health Science , Inverness , UK.
authors.forename: Jeremiah O'
authors.initials: JO
authors.lastname: Rourke
authors.affiliation: a NHS Education for Scotland , Centre for Health Science , Inverness , UK.
authors.forename: Ronald
authors.initials: R
authors.lastname: MacVicar
mesh_terms: D000124:Achievement; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004501:Education, Medical; D004521:Educational Measurement; D004522:Educational Status; D005550:Foreign Medical Graduates; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D036301:Qualitative Research; D012606:Scotland
keywords: Clinical skills assessment; differential attainment; international medical graduates; licensing examinations