Exploring experiences of work-related inequitable treatment among international medical graduates (IMGs): A sequential explanatory mixed methods study

Background: International medical graduates (IMGs) are an essential workforce for many high-income countries worldwide and are often recruited to fill workforce shortages. Studies identify workplace discrimination as a major challenge for IMGs. However, little detailed exploration has been undertaken on this issue. Methods: We designed a sequential explanatory mixed methods study to explore details of inequitable treatment perceived by IMGs in Australia. An online survey was distributed to IMGs across Australia. We analysed data descriptively and tested for significant demographic differences against the primary discrimination variable using tests of association (t-test and chi-squared tests). Following analysis, individual interviews were undertaken by telephone, teleconference or face-to-face. Thematic analysis was conducted on qualitative study components. All data was triangulated to assess areas of congruence and difference and to gain fuller understanding of the data. Results: We surveyed and interviewed 286 and 36 IMGs respectively. Most survey respondents reported that IMGs were disadvantaged when compared to Australian graduates, primarily due to registration and bureaucratic processes. Institutions/organisations and senior staff were implicated as major perpetrators of discrimination. Subtle experiences of interpersonal discrimination were reported by > 75% of those reporting discrimination in the last five years. Statistically significant associations (p