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Health and wellbeing of international medical graduates: Acculturation into the Tasmanian rural and remote context


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Terry, DR 2014 , 'Health and wellbeing of international medical graduates: Acculturation into the Tasmanian rural and remote context', PhD thesis, University of Tasmania.

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Australia has experienced health workforce shortages, especially in rural and
remote areas. In addition, rural and remote populations suffer the lowest levels of
health access, the highest levels of medical practitioner maldistribution and the
greatest health disadvantage in Australia. As a result, the recruitment of overseas
trained doctors, also known as international medical graduates (IMGs) is one
government strategy to fill these gaps. Currently, the medical workforce remains
heavily dependent on IMG recruitment; however, their retention in these areas
remains challenging. It is reported, IMGs seek to relocate into more metropolitan
areas once compulsory services obligations are complete. This requires continued
recruitment of new IMGs; however it remains an implausible solution.
The study aims to examine the experiences and challenges of IMGs living and
working in rural and remote Tasmania. As such, the research attempts to respond
to the following research questions: 1). What are the enablers and barriers IMGs
face as they live and work in Tasmania? 2). What are the acculturation process and
strategies which facilitate trust, co-operation and connections between IMGs, other
health care professionals and the community? 3). What are the strategies used by
IMGs to improve community engagement and integration? and 4).What
acculturation strategies and barriers are observed by key informants who support
IMGs in Tasmania?
A number of key theoretical concepts and frameworks underpin this study to
address the aims of the study. This includes the internationalisation and
globalisation of health workforce; acculturation; and human and social capital of
migrants in new social and workplace environments. These theories draw attention
to the challenges of acculturation and identity, which migrants, those in the health
workforce and particularly IMGs face in new cultural and healthcare contexts.
The study used a mixed method approach employing a double stage sequential
explorative design to collect data for the study. Data were collected through an IMG questionnaire, and face-to-face semi-structured interviews with Tasmanian IMGs
and key informants, who recruit, support and act as educators and advisors to
IMGs. The study gathered 105 returned questionnaires (response rate 30%), while
interviews were conducted with 45 participants recruited through purposive
snowball sampling. The interview data were analysed using thematic analysis and
Critical Discourse Analysis by way of NVivo v10.0. In addition, descriptive statistics
and inferential statistics were used to analyse the questionnaire data using
Statistical Package for Social Science (SPSS) 20.0.
The study provided insight into the everyday experiences of IMGs within hospital
and rural community settings and how this impacts acculturation, cultural shock
and adaptation. It provided a comprehensive understanding of the social and
psychological indicators of successful integration, settlement and life satisfaction
while highlighting hospital and community challenges. Lastly, it has outlined the
importance of identity-community transformation and how connections within a
community are vital in establishing extensive social and support networks and the
development of greater social capital; greater cross-cultural adaptation; reducing
local stigma; and increasing positive cultural attitudes.
The research provides insight into the complexities and principal motivators why
IMGs are staying or leaving Tasmania. The study delivers greater insight into the
needs, desires and challenges encountered by IMGs locally, nationally and
internationally, while offering an understanding for policy augmentation to not only
aid recruitment and the retention of IMGs, but also to maintain their and the
community’s health and wellbeing.

Item Type: Thesis - PhD
Authors/Creators:Terry, DR
Keywords: international medical graduates, health workforce, rural, professional challenges, social challenges, acculturation
Copyright Holders: The Author
Copyright Information:

Copyright 2014 The Author

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