Practising medicine in two countries: South African physicians in Canada

This qualitative study examines the pre- and post-migration practice experiences of 73 physicians trained in South Africa who have relocated to Canada. The aims are to explore the workings of two different healthcare systems from an insider standpoint and to address the medical autonomy debate as it relates to international medical graduates (IMGs). While study respondents reported practice frustrations in both countries, they generally preferred working in a socialised health insurance environment that grants wider accessibility than a two-tiered system that favours a privileged few. Concerns such as family safety and opportunities for children also contributed to more satisfaction with Canada. We discuss our findings in relation to a broader international context and the sociological literature on medical autonomy. We argue that IMGs face different autonomy issues from other physicians and stress the need to broaden sociological inquiry of medical work by investigating how autonomy interfaces with other neglected aspects of physicians' work and non-work lives.