A Qualitative Study of Professional Identity Formation of International Medical Graduate Resident Physicians
Bibliographic Data
Purpose: International medical graduates (IMGs) comprise nearly 25% of the physician workforce in the United States.1 Professional identity formation (PIF) is increasingly recognized as a key element of medical training, including residency.2 However, there remains a gap in the literature addressing the PIF of IMG residents who have additional challenges due to their multiple marginalized identities and biases against non-White, non-male, and immigrant physicians. Method: Using a constructivist grounded theory approach, we conducted semistructured individual interviews with 15 IMG resident physicians working in an academic medical system in the United States. Four participants were also underrepresented in medicine. Data collection and analysis were iterative to support the theoretical sampling consistent with constructivist grounded theory.3 We analyzed the data using a constant comparison approach and identified themes by consensus. Results: Participants described how their professional identity is expected to conform to the ideal image of an American doctor, historically White and male. PIF was more challenging because of structural barriers due to immigrant status. Participants reported additional challenges if they did not look or sound like a White American. In addition, female participants experienced further PIF challenges because of their gender. However, participants also reported that being non-White, immigrant, and female could be assets in the care of diverse patient populations. Discussion: Our findings revealed that the intersectionality of race, gender, and immigration poses both additive challenges and advantages to IMG residents in their PIF. This study proposes to reframe the conventional residency training of IMGs based on a deficit model of assimilation and calls for critical reflection on the assumption of a standardized American medical professionalism historically based on an ideal centered around a White, male physician. Significance: Our study answers the call to address intersectionality of PIF in medical education4,5 with empirical data. Our findings suggest that residency programs could shift from a deficit model to a “cultural wealth” model,6 which incorporates the assets IMG residents bring to enhance the care of diverse patient populations. Acknowledgments: The authors wish to thank the volunteer participants, Tom Kariyil and Nadia Samaha, for assisting with transcription, and Nikita Deshpande for recruiting and interviewing some participants
Accreditation · Cognitive reframing · Ethnic group · Graduate medical education · Grounded theory · IMG · Immigration · Intersectionality · Medical education · Political science · Qualitative research · Sociology · Workforce · Diversity and Career in Medicine · Gender Studies · Global Health Workforce Issues · Medical Education and Admissions · Medicine · Psychology · Social Psychology · Gerontology
| Citation velocity | historical |
|---|---|
| Highly cited | No |