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2.
GMS J Med Educ ; 38(5): Doc88, 2021.
Article in English | MEDLINE | ID: covidwho-1337616

ABSTRACT

Introduction: In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments. Project outline: The preparatory course consists of 10 modules. On Fridays, individual cases are discussed in small groups and specific examination techniques are trained. On Saturdays, illnesses are simulated by simulated patients. After each encounter, faculty experts, psychologists and peer group members provide the participants with 360° feedback. Due to the COVID-19 pandemic, the course which had been established 2 years beforehand has now been switched to an online class within one week. Friday units were visualized in power-point presentations and tutorial videos were discussed. On Saturdays, the cases were simulated by simulated patients and transmitted via a telemedicine platform. Results: The course could be conducted without interruptions (75 hours of in-class tuition and 75 hours of online tuition). In the oral evaluation the participants criticized telemedicine as a medium for imparting of practical skills. 7/22 (32%) of the participants underwent the knowledge examination and 6/7 (86%) of them passed it (versus 18/19 of the participants of in-class tuition (95%)). Discussion: There was a clear preference for in-class tuition. It was noted that the telemedical setting entailed some restrictions. However, the switch to online classes did not affect the pass rate. Conclusion: The switch from in-class to online units was feasible. The gained insights were taken into account when conceiving the online semester at our faculty and especially the tuition with the support of simulated patients.


Subject(s)
COVID-19 , Curriculum , Education, Medical , Foreign Medical Graduates , Internet , Licensure, Medical , Pandemics , Clinical Competence , Educational Measurement , Germany , Guidelines as Topic , Humans , Physical Distancing , Schools, Medical , Seasons
3.
J Immigr Minor Health ; 23(6): 1364-1368, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1328642

ABSTRACT

In this brief note from the field, we address an essential issue of non-inclusion of Foreign Medical Graduates (FMG) practicing in the US into the healthcare disaster response in the current pandemic. Because FMGs represent a significant share of the entire country's physician workforce, it seems not prudent to ignore the need to address the current immigration barriers affecting the crucial healthcare needs during this pandemic. Being subjects of the ongoing complex bureaucracy complicated by recent anti-immigrant steps, FMGs that practice for years on temporary (H1B) visas cannot fully join COVID-19 forces. In addition, these physicians face multiple challenges related to their health protection, protection of their immediate family, job security, and the potential risk of being deported. We believe that physicians' immigration status should no longer be disregarded outside of academic interest. It carries the same importance as other public health issues, especially in severe healthcare crises like this pandemic.


Subject(s)
COVID-19 , Foreign Medical Graduates , Emigration and Immigration , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
4.
GMS J Med Educ ; 38(5): Doc88, 2021.
Article in English | MEDLINE | ID: covidwho-1295610

ABSTRACT

Introduction: In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments. Project outline: The preparatory course consists of 10 modules. On Fridays, individual cases are discussed in small groups and specific examination techniques are trained. On Saturdays, illnesses are simulated by simulated patients. After each encounter, faculty experts, psychologists and peer group members provide the participants with 360° feedback. Due to the COVID-19 pandemic, the course which had been established 2 years beforehand has now been switched to an online class within one week. Friday units were visualized in power-point presentations and tutorial videos were discussed. On Saturdays, the cases were simulated by simulated patients and transmitted via a telemedicine platform. Results: The course could be conducted without interruptions (75 hours of in-class tuition and 75 hours of online tuition). In the oral evaluation the participants criticized telemedicine as a medium for imparting of practical skills. 7/22 (32%) of the participants underwent the knowledge examination and 6/7 (86%) of them passed it (versus 18/19 of the participants of in-class tuition (95%)). Discussion: There was a clear preference for in-class tuition. It was noted that the telemedical setting entailed some restrictions. However, the switch to online classes did not affect the pass rate. Conclusion: The switch from in-class to online units was feasible. The gained insights were taken into account when conceiving the online semester at our faculty and especially the tuition with the support of simulated patients.


Subject(s)
COVID-19 , Curriculum , Education, Medical , Foreign Medical Graduates , Internet , Licensure, Medical , Pandemics , Clinical Competence , Educational Measurement , Germany , Guidelines as Topic , Humans , Physical Distancing , Schools, Medical , Seasons
6.
Hum Resour Health ; 19(1): 29, 2021 03 03.
Article in English | MEDLINE | ID: covidwho-1115227

ABSTRACT

BACKGROUND: Since the 2008 recession, Ireland has experienced large-scale doctor emigration. This paper seeks to ascertain whether (and how) the COVID-19 pandemic might disrupt or reinforce existing patterns of doctor emigration. METHOD: This paper draws on qualitative interviews with 31 hospital doctors in Ireland, undertaken in June-July 2020. As the researchers were subject to a government mandated work-from-home order at that time, they utilised Twitter™ to contact potential respondents (snowball sampling); and conducted interviews via Zoom™ or telephone. FINDINGS: Two cohorts of doctors were identified; COVID Returners (N = 12) and COVID Would-be Emigrants (N = 19). COVID Returners are Irish-trained emigrant doctors who returned to Ireland in March 2020, just as global travel ground to a halt. They returned to be closer to home and in response to a pandemic-related recruitment call issued by the Irish government. COVID Would-be Emigrants are hospital doctors considering emigration. Some had experienced pandemic-related disruptions to their emigration plans as a result of travel restrictions and border closures. However, most of the drivers of emigration mentioned by respondents related to underlying problems in the Irish health system rather than to the pandemic, i.e. a culture of medical emigration, poor working conditions and the limited availability of posts in the Irish health system. DISCUSSION/CONCLUSION: This paper illustrates how the pandemic intensified and reinforced, rather than radically altered, the dynamics of doctor emigration from Ireland. Ireland must begin to prioritise doctor retention and return by developing a coherent policy response to the underlying drivers of doctor emigration.


Subject(s)
Attitude of Health Personnel , COVID-19 , Emigration and Immigration , Job Satisfaction , Pandemics , Physicians , Professional Practice Location , Adult , Economic Recession , Emigrants and Immigrants , Foreign Medical Graduates , Humans , Ireland , Motivation , Qualitative Research , SARS-CoV-2 , Travel
8.
Int J Health Policy Manag ; 10(10): 660-663, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-916627

ABSTRACT

Research in assessing the global and asymmetric flows of health workers in general, and international medical graduates in particular, is fraught with controversy. The complex goal of improving health status of the citizens of home nations while ensuring the right of health workers to migrate generates policy discussions and decisions that often are not adequately informed by evidence. In times of global public health crises like the current coronavirus disease 2019 (COVID-19) global pandemic, the need for equitable distribution and adequate training of health workers globally becomes even more pressing. Brugha et al report suboptimal training and working conditions among Irish and foreign medical doctors practicing in Ireland, while predicting large-scale outward migration. We comment on health personnel migration and retention based on our own experience in this area of research. Drawing from our examination of medical migration dynamics from sub-Saharan Africa, we argue for greater consideration of health workforce retention in research and policy related to resource-limited settings. The right to health suggests the need to retain healthcare providers whose education was typically subsidized by the home nation. The right to migrate may conflict with the right to health. Hence, a deeper understanding is needed as to healthcare worker motives based on interactions of psychosocial processes, economic and material determinants, and quality of work environments.


Subject(s)
COVID-19 , Physicians , Africa South of the Sahara , Cross-Sectional Studies , Emigration and Immigration , Foreign Medical Graduates/psychology , Foreign Medical Graduates/supply & distribution , Humans , Ireland , SARS-CoV-2
9.
Rural Remote Health ; 20(3): 6027, 2020 09.
Article in English | MEDLINE | ID: covidwho-802005

ABSTRACT

CONTEXT: Physicians who migrate globally face a daunting series of time-consuming, labor- and resource-intensive procedures to prove their clinical competency before being allowed to practice medicine in a new country. ISSUES: In this commentary, we describe licensing barriers faced by physician-migrants based on the authors' experiences, and reflect also on rapidly implemented measures to address COVID-19 pandemic related workforce shortages. We offer recommendations for potential reductions in bureaucratic regulatory barriers that prohibit mobilization of international medical graduate talent. LESSONS LEARNED: Licensing boards and authorities should strive for standardized, competency-based basic professional recognition. Professional medical societies are well-positioned to guide such competency-based recognition as a more organized, international collaborative effort across specialties. The COVID-19 pandemic facilitated cross-state and international licensing in some regions, highlighting a key opportunity: streamlining professional recognition requirements is achievable.


Subject(s)
Coronavirus Infections/epidemiology , Credentialing/organization & administration , Foreign Medical Graduates/standards , Pneumonia, Viral/epidemiology , Transients and Migrants , Betacoronavirus , COVID-19 , Clinical Competence/standards , Credentialing/standards , Humans , Internationality , Pandemics , SARS-CoV-2 , Time Factors
11.
Med Educ Online ; 25(1): 1821463, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-759781

ABSTRACT

The SARS-CoV-2 pandemic has left a huge impact on the career perceptions of trainees and medical students globally. The cancellation and/or replacement of sub-internships in the United States (US) with a virtual alternative offer a different experience. We explore the impact of this issue on international medical graduates (IMGs) who are planning to apply to a US residency program in the near future.


Subject(s)
Coronavirus Infections/epidemiology , Foreign Medical Graduates/psychology , Internship and Residency/organization & administration , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , Humans , Pandemics , SARS-CoV-2 , United States
12.
J Grad Med Educ ; 12(4): 507-511, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-745231

ABSTRACT

BACKGROUND: The start of a new academic year in graduate medical education will mark a transition for postgraduate year 1 (PGY-1) residents from medical school into residency. The relocation of individuals has significant implications given the COVID-19 pandemic and variability of the outbreak across the United States, but little is known about the extent of the geographic relocation taking place. OBJECTIVE: We reported historical trends of PGY-1 residents staying in-state and those starting residency from out-of-state to quantify the geographic movement of individuals beginning residency training each year. METHODS: We analyzed historical data collected by the Accreditation Council for Graduate Medical Education in academic years 2016-2017, 2017-2018, and 2018-2019, comparing the locations of medical school and residency programs for PGY-1 residents to determine the number of matriculants from in-state medical schools and out-of-state medical schools. International medical school graduates (IMGs) were shown separately in the analysis and then combined with out-of-state matriculants. US citizens who trained abroad were counted among IMGs. RESULTS: The total number of PGY-1s increased by 10.3% during the 3-year time period, from 29 338 to 32 348. When combined, IMGs and USMGs transitioning from one state or country to another state accounted for approximately 72% of PGY-1s each year. Approximately 63% of USMGs matriculated to a residency program in a new state, and IMGs made up 24.6% to 23.1% of PGY-1s over the 3-year period. CONCLUSIONS: Each year brings a substantial amount of movement among PGY-1s that highlights the need for policies and procedures specific to the COVID-19 pandemic.


Subject(s)
Coronavirus Infections , Internship and Residency , Pandemics , Pneumonia, Viral , Professional Practice Location , Betacoronavirus , COVID-19 , Coronavirus Infections/virology , Education, Medical , Education, Medical, Undergraduate , Foreign Medical Graduates , Humans , Pneumonia, Viral/virology , SARS-CoV-2 , United States , Workplace
13.
Acad Med ; 95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments): S82-S87, 2020 12.
Article in English | MEDLINE | ID: covidwho-744585

ABSTRACT

International medical school graduates (IMGs) play a vital role in the health care system of the United States. They constitute roughly one-quarter of the physician workforce, comprising a significant proportion of the primary care providers in high-need rural and urban areas, where they provide equal and, in some instances, better care than U.S. graduates. Nonetheless, they face a series of hurdles in entering U.S. residency programs and throughout their training experiences.IMGs must expend significant resources to obtain Education Commission for Foreign Medical Graduates certification, which includes Steps 1, 2 Clinical Knowledge and 2 Clinical Skills of the United States Medical Licensing Examination. They encounter the uncertainty of matching and, if successful, obtaining a visa to enter the United States. Once here, they need to adapt to the complexities of the health care system and familiarize themselves with the cultural nuances, professional behaviors, and communication skills of another country. They encounter biases and microaggressions and lack support groups and mentors. Those who choose an academic career are less likely to obtain leadership positions.This Perspective provides an overview of these challenges and highlights opportunities for change at local and national levels. Specifically, it identifies strategies that would assist IMGs before entry, at entry, during training, at the transition to practice, and in practice. The current COVID-19 pandemic highlights the shortage of physicians in the United States and illustrates the importance of ensuring that IMGs, who are essential health care workers, feel welcome, valued, and recognized for their contributions.


Subject(s)
COVID-19 , Foreign Medical Graduates/psychology , Health Workforce/legislation & jurisprudence , Internship and Residency/methods , Workplace/psychology , Acculturation , Certification , Foreign Medical Graduates/legislation & jurisprudence , Humans , Internship and Residency/legislation & jurisprudence , United States
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