Evidence map›Paper›PMID 39160554›Full record

SynthesisBMC medical education2024

Predictors for success and failure in international medical graduates: a systematic review of observational studies.

Inge Schabort, Meisam Abdar Esfahani, Rachel Couban, Nia Wyn Roberts, Carl Heneghan, Neha Arora, Vahid Ashoorion

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medical education, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Inge SchabortDepartment of Family Medicine, McMaster University, 1280 Main Street West, DBHSC 5th floor, Hamilton, ON, L8S 4L8, Canada. ischabo@mcmaster.ca.
Meisam Abdar EsfahaniHealth Research Methodology, McMaster University, Hamilton, ON, Canada.
Rachel CoubanFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Nia Wyn RobertsNuffield Department of Population Health, Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
Carl HeneghanCentre for Evidence-Based Medicine, University of Oxford, Oxford, UK.
Neha AroraDepartment of Family Medicine, McMaster University, 1280 Main Street West, DBHSC 5th floor, Hamilton, ON, L8S 4L8, Canada.
Vahid AshoorionMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternational Medical Graduates (IMG) are an essential part of the international physician workforce, and exploring the predictors of success and failure for IMGs could help inform international and national physician labour workforce selection and planning. The objective of this study was to explore predictors for success for selection of IMGs into high stakes postgraduate training positions and practice and not necessarily for informing IMGs.

methodsWe searched 11 databases, including Medline, Embase and LILACS, from inception to February 2022 for studies that explored the predictors of success and failure in IMGs. We reported baseline probability, effect size in relative risk (RR), odds ratio (OR) or hazard ratio (HR) and absolute probability change for success and failure across six groups of outcomes, including success in qualifying exams, or certificate exams, successful matching into residency, retention in practice, disciplinary actions, and outcomes of IMG clinical practice.

resultsTwenty-five studies (375,549 participants) reported the association of 93 predictors of success and failure for IMGs. Female sex, English fluency, graduation recency, higher scores in USMLE step 2 and participation in a skill assessment program were associated with success in qualifying exams. Female sex, English fluency, previous internship and results of qualifying exams were associated with success in certification exams. Retention to work in Canada was associated with several factors, including male sex, graduating within the past five years, and completing residency over fellowships. In the UK, IMGs and candidates who attempted PLAB part 1, ≥ 4 times vs. first attempters, and candidates who attempted PLAB part 2, ≥ 3 times vs. first attempters were more likely to be censured in future practice. Patients treated by IMGs had significantly lower mortalities than those treated by US graduates, and patients of IMGs had lower mortalities [OR: 0.82 (95% CI: 0.62, 0.99)] than patients of US citizens who trained abroad.

conclusionsThis study informed factors associated with the success and failure of IMGs and is the first systematic review on this topic, which can inform IMG selection and future studies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42021252678.

Indexed as

Foreign Medical GraduatesObservational Studies as TopicClinical CompetenceEducation, Medical, GraduateFemaleHumansInternship and ResidencyInternational medical graduatesInternational trained physiciansPredictors

Identifiers

PMID39160554
PMCPMC11334406

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.