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Open Access Highly Accessed Research article

International medical graduates (IMGs) needs assessment study: comparison between current IMG trainees and program directors

Rachelle Zulla2, Mark Otto Baerlocher1 and Sarita Verma2*

Author Affiliations

1 Diagnostic Radiology Residency Training Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

2 Postgraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

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BMC Medical Education 2008, 8:42  doi:10.1186/1472-6920-8-42

Published: 29 August 2008



International Medical Graduates (IMGs) training within the Canadian medical education system face unique difficulties. The purpose of this study was to explore the challenges IMGs encounter from the perspective of trainees and their Program Directors.


Program Directors of residency programs and IMGs at the University of Toronto were anonymously surveyed and asked to rate (using a 5-point Likert scale; 1 = least important – 5 = most important) the extent to which specific issues were challenging to IMGs and whether an orientation program (in the form of a horizontal curriculum) should be implemented for incoming IMGs prior to starting their residency.


Among the IMGs surveyed, Knowledge of the Canadian Healthcare System received the highest mean score (3.93), followed by Knowledge of Pharmaceuticals and Hospital formularies (3.69), and Knowledge of the Hospital System (3.69). In contrast, Program Directors felt that Communication with Patients (4.40) was a main challenge faced by IMGs, followed by Communication with Team Members (4.33) and Basic Clinical Skills (4.28).


IMGs and Program Directors differ in their perspectives as to what are considered challenges to foreign-trained physicians entering residency training. Both groups agree that an orientation program is necessary for incoming IMGs prior to starting their residency program.