Issues for clinicians training international medical graduates: a systematic review

Louis S Pilotto, Geraldine F Duncan and Jane Anderson-Wurf
Med J Aust 2007; 187 (4): 225-228.


Objective: To ascertain the specialised communication issues clinicians need to understand when preparing international medical graduates (IMGs) for clinical practice in Australia.

Study design: Systematic review.

Data sources: A series of searches using MEDLINE (1990–2006) was conducted with relevant keywords. Literature from countries with experience in the integration of IMGs into their medical workforces was included. All except four articles were published between 1997 and 2006.

Study selection: The initial search identified 748 articles, which reduced to 234 evidence-based English language articles for review. Of these, only articles relating to postgraduate medical training and overseas trained doctors were selected for inclusion.

Data extraction: Titles and abstracts were independently reviewed by two reviewers, with a concordance rate of 0.9. Articles were included if they addressed communication needs of IMGs in training. Any disparities between reviewers about which articles to include were discussed and resolved by consensus.

Data synthesis: Key issues that emerged were the need for IMGs to adjust to a change in status; the need for clinicians to understand the high level of English language proficiency required by IMGs; the need for clinicians to develop IMGs’ skills in communicating with patients; the need for clinicians to understand IMGs’ expectations about teaching and learning; and the need for IMGs to be able to interact effectively with a range of people.

Conclusion: Training organisations need to ensure that clinicians are aware of the communication issues facing IMGs and equip them with the skills and tools to deal with the problems that may arise.

  • Louis S Pilotto1
  • Geraldine F Duncan2
  • Jane Anderson-Wurf3

  • Rural Clinical School, University of New South Wales, Wagga Wagga, NSW.



We thank CoastCityCountry Training Limited for funding our research project. We also thank Jennifer Price (Librarian, Rural Clinical School, Faculty of Medicine, University of NSW) for assistance with library searches and retrieval.

Competing interests:

None identified.

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