Table 3. Study characteristics
Study Date Location of study Type of research Methods Sample/size
Alberta International Medical Graduate Association27 2019 Canada Report Workshops followed by surveys 22 IMGs who attempted to become licensed for three or more years and had failed were either unemployed or underemployed (i.e., working in a medical clinic or elsewhere and making <$20/h). Also, IMGs who were not interested in pursuing licensure or seeking an alternative career as a short-term goal were included.
American Academy of Physician Assistants32 1993 Florida, USA Report N/A N/A
Anderson & Gilliss41 1998 USA Report N/A N/A
Bhimji31 2010 Alberta, Canada Commentary N/A N/A
Bhuiyan23   Ontario, Canada Mixed method study Surveys, interviews, and literature review and analysis of evaluation reports A total of 67 in four cohort groups; 25 men and 42 women from over 24 different countries
Blain, Fortin & Alvarez28 2017 Canada and Quebec Qualitative study Semi-structured interviews 31 IMGs who hold degrees from outside the USA and Canada
Bourgeault, Neiterman, Lebrun, Viers & Winkup20 2010 Canada Report Interviews and document analysis 176 IEHPs from British Columbia, Manitoba, Ontario, and Quebec, including IMGs (67), IEN (70), and ITM (39)
Cawley37 1994 Maryland, USA Letter to editor N/A N/A
Covell, Neiterman & Bourgeault29 2016 Canada Qualitative study Scoping review (Arksey & O'Malley16) 407 literature sources
Fasser & Smith38 1992 USA Report N/A N/A
Flowers & Olenick39 2014 Florida, USA Report N/A N/A
Fowkes, Cawley, Herlihy & Cuadrado36 1996 US Report N/A N/A
Grossman & Jorda40 2006 Florida, USA Report N/A N/A
Howard, Garman & McCann26 1995 USA Quantitative study A case-control study through objective evaluation measures through 3 tests: Test Item Bank, Objective Structured Clinical Examination, and Clinical Performance Examination 32 unlicensed IMGs who had graduated between 2-35 years earlier from medical schools in the Philippines, China, India, Cambodia, Mexico, Central America, South America, Poland, Hungary, or the Soviet Union; 6 recent graduates of the University of Southern California Physician Assistant Program as controls
Jablonski22 2016 Canada Quantitative study Cross-sectional design for capturing risk factors for the employment of IMGs; Cohort studies for the identification of risk factors for securing residency spots while utilizing the Access Centre N=8,373 Non-English or French-speaking individuals
Jones33 2015 USA and Canada Commentary N/A N/A
Liebich34 2007 Australia, but relevant to Canada Report N/A N/A
Lim Consulting Associates12 2013 Canada Report Interviews Series of interviews with occupational contacts (13 respondents), immigrant-serving organizations (12 respondents), and related organizations and internationally educated physicians (13 respondents)
Magnus35 2008 Ontario, Canada Commentary N/A N/A
Ministry of Health and Long-Term Care21 2012 Ontario, Canada Report Interviews; focus groups; surveys; analysis of the administrative data 52 PAs (32 IMG-stream) 41 supervising physicians 33 administrative representatives, including Clinical Director/Manager/Other Administrative, Medical Administrator, CNO/Professional Practice, CEO/Executive Director Hospital Team survey: 148 Hospital Team focus groups: 13 sites Patient/Client satisfaction surveys: N/R Hospital administrative data CHC Purkinje administrative data PEPA PA encounter reports Physician Supervision time analysis
Neiterman, Bourgeault & Covell30 2017 Canada Qualitative study Scoping review (Arksey & O'Malley16) 148 articles/reports
Smith & Fowkes25 1983 USA Quantitative study Surveys administered in person, by telephone, and by mail 736 unlicensed IMGs in California, USA
Wick24 2015 USA Quantitative study Descriptive statistics and chi-square analysis or Fisher exact test to summarize outcomes All IMGs (total 39) who completed the program through 2013 were included in the study; graduation year was collapsed into two categories (1991-2005, n=18; and 2006-2013, n=18)

Note: CEO = chief executive officer; CHC = community health center; CNO = College of Nurses of Ontario; IEN = Internationally Educated Nurse; IMG = international medical graduate; ITN =Internationally Trained Nurse; NP= nurse practitioner; N/A = not applicable; PA = physician assistant; PEPA = Physician-Employed Physician Assistant; US = United States; USA = United States of America.

Int J Med Educ. 2021; 12:45-63; doi: 10.5116/ijme.606a.e83d