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International and American medical graduates in a U.S. pediatric residency program: A qualitative study about challenges during post-graduate year 1

机译:美国儿科住院医师计划的国际和美国医学专业毕业生:关于研究生一年级挑战的定性研究

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Background: In the United States (U.S.), international medical graduates (IMGs) and American medical graduates (AMGs) confront work-related and adjustment challenges during post-graduate year one (PGY-1) of residency. Aim: To understand the challenges that IMGs and AMGs confronted during PGY-1 of a U.S. pediatric residency program from the perspective of the residents themselves. Methods: A purposive sample of PGY-1, PGY-2, and PGY-3 residents participated in three semi-structured focus groups (N=18). The data were analyzed inductively using a grounded theory approach to identify and verify emergent themes. Results: IMGs confronted work-related and adjustment challenges during PGY-1 that included practicing medicine in the U.S., communicating with medical supervisors and nursing staff, communicating with patients, and relocating to the U.S. AMGs confronted work-related challenges that included medical decision-making and medical licensing. Conclusion: The work-related and adjustment challenges that IMGs and AMGs confronted during PGY-1 suggest that the culture of residency socializes IMGs and AMGs regarding professional expectations and responsibilities. Increased awareness of this socialization process among residency program directors, and interventions based on concrete recommendations, can help enhance PGY-1 for IMGs and AMGs across the medical specialties.
机译:背景:在美国(美国),国际医学专业毕业生(IMG)和美国医学专业毕业生(AMG)在研究生第一年(PGY-1)居住期间面临与工作相关的挑战和适应挑战。目的:从居民本身的角度了解IMG和AMG在美国小儿住院医师项目PGY-1期间面临的挑战。方法:PGY-1,PGY-2和PGY-3居民的目标样本参加了三个半结构性焦点小组(N = 18)。使用扎实的理论方法对数据进行归纳分析,以识别和验证紧急主题。结果:IMG在PGY-1期间面临与工作和调整有关的挑战,其中包括在美国练习医学,与医疗主管和护理人员进行沟通,与患者进行交流以及搬迁到美国。AMG面临与工作相关的挑战,包括医疗决策,制作和医疗许可。结论:在PGY-1期间,IMG和AMG面临的与工作相关的和调整方面的挑战表明,居住文化使IMG和AMG在职业期望和责任方面社交化。住院医师项目主管对这种社会化过程的意识增强,并根据具体建议采取干预措施,可以帮助增强医学专业中IMG和AMG的PGY-1。

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