International Medical Graduates Who Have Been Disciplined: Further Causes and Methods to Improve Quality of Care
Considering the limitations of the data, the authors were unable to determine when the physicians in their sample began practicing in Canada. Further, there was no discussion of information bias; that is, Alam and colleagues did not explain the main causes of the disciplinary ac tions, nor any actions IMGs took to remedy the situations. It would have been helpful to report location of training, which could have influenced the results. If physicians were trained according to Canadian requirements, that might affect the findings as well. Other studies have described confounding adjustments for disciplinary actions.
Newly qualified NAMGs and IMGs alike improve their skills through the organizational culture of training environment along with regular training, as they are skilled in medicine but unable to look after patients’ safety and care.4 The standard of care can get better through different strategies like orientation programs, through which practical challenges are overcome for both IMGs and NAMGs.5 Additionally, mentorship to all graduates through teaching, supervision, guidance, and regular performance assessment allows IMGs to integrate more easily into their new communities,6 which alleviates transitional challenges. Particular courses designed to meet the needs of IMGs with respect to overcoming barriers like language, culture, socialization, and hospital environment can also help.7 Alam and colleagues should have explored these and other potential contributors to their findings.