title: Cultural transition of international medical graduate residents into family practice in Canada.
abstract: OBJECTIVE
  To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice.
  
  
  METHODS
  This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically.
  
  
  RESULTS
  Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles.
  
  
  CONCLUSIONS
  Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.
authors.affiliation: Department of Family Medicine, University of Alberta, Canada.
authors.forename: Jean A C
authors.initials: JA
authors.lastname: Triscott
authors.affiliation: Department of Family Medicine, University of Alberta, Canada.
authors.forename: Olga
authors.initials: O
authors.lastname: Szafran
authors.affiliation: Department of Family Medicine, University of Alberta, Canada.
authors.forename: Earle H
authors.initials: EH
authors.lastname: Waugh
authors.affiliation: Department of Family Medicine, University of Alberta, Canada.
authors.forename: Jacqueline M I
authors.initials: JM
authors.lastname: Torti
authors.affiliation: Department of Family Medicine, University of Calgary, Canada.
authors.forename: Martina
authors.initials: M
authors.lastname: Barton
mesh_terms: D002170:Canada; D003142:Communication; D054521:Cultural Competency; D003479:Curriculum; D004501:Education, Medical / Q000379:methods; D005194:Family Practice / Q000193:education / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D005550:Foreign Medical Graduates / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000458:organization & administration*; D007407:Interviews as Topic; D008297:Male; D018802:Patient-Centered Care / Q000458:organization & administration; D010821:Physicians, Family / Q000458:organization & administration*
keywords: Canada; cultural competency; family practice; foreign medical graduates