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Achieving equity for International Medical Graduates: a systematic review.

Sangeeta G Saxena1, Elizabeth Tisdell2, Elana Farace3

  • 1Department of Public Health, Coastal Carolina University, Conway, SC, United States.

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|August 7, 2025
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Foreign-born International Medical Graduates (FIMGs) need tailored acculturation interventions to succeed in new health systems. This systematic review identifies effective strategies to improve FIMGs' integration and patient outcomes.

Keywords:
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Area of Science:

  • Medical Education
  • Health Systems Research
  • Cultural Competency

Background:

  • Foreign-born International Medical Graduates (FIMGs) face significant acculturation challenges in host countries.
  • FIMGs are crucial for addressing physician shortages in high-income nations.
  • Successful assimilation of FIMGs can enhance healthcare system productivity and patient outcomes.

Purpose of the Study:

  • To systematically review literature on acculturation interventions for FIMGs.
  • To identify strategies that facilitate better assimilation of FIMGs into host country health systems.
  • To inform interventions that improve FIMG productivity, satisfaction, and patient care.

Main Methods:

  • Systematic review following PRISMA guidelines.
  • Searched PubMed, Embase, PsycINFO, CINAHL, and Web of Science.
  • Included studies from January 2000 to October 2021 using keywords related to IMGs and discrimination/microaggressions.

Main Results:

  • 46 studies were included, categorized into interventions, FIMG perceptions, and trainer perspectives.
  • Review incorporates online interventions adapted during the COVID-19 pandemic.
  • Effective acculturation requires training in clinical protocols, host country culture, communication, language, and self-awareness.

Conclusions:

  • Further research is needed to tailor interventions for FIMGs from diverse backgrounds.
  • Acculturation training requires theoretical frameworks and comprehensive support systems.
  • Enhancing host health systems' preparedness to accept FIMGs is essential for successful integration.