title: Acculturation Needs of Pediatric International Medical Graduates: A Qualitative Study.
abstract: Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children.
  
  
  METHODS
  In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries. The focus group transcripts were analyzed using open and focused coding methodology.
  
  
  RESULTS
  The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.
authors.affiliation: a Department of Pediatrics , University of Illinois-Chicago , Chicago , Illinois , USA.|b Department of Internal Medicine , University of Illinois-Chicago , Chicago , Illinois , USA.
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Osta
authors.affiliation: a Department of Pediatrics , University of Illinois-Chicago , Chicago , Illinois , USA.|b Department of Internal Medicine , University of Illinois-Chicago , Chicago , Illinois , USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Barnes
authors.affiliation: c Department of Sociology , University of Illinois-Chicago , Chicago , Illinois , USA.
authors.forename: Regina
authors.initials: R
authors.lastname: Pessagno
authors.affiliation: d Department of Medical Education , University of Illinois-Chicago , Chicago , Illinois , USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Schwartz
authors.affiliation: d Department of Medical Education , University of Illinois-Chicago , Chicago , Illinois , USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Hirshfield
mesh_terms: D000069:Acculturation; D004503:Education, Medical, Graduate; D005260:Female; D017144:Focus Groups; D005550:Foreign Medical Graduates / Q000523:psychology*; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000193:education*; D036301:Qualitative Research; D014481:United States
keywords: International medical graduates; acculturation; needs assessment; pediatric graduate medical education