Quality Standards of Transitional Programmes for International Medical Graduates: An International Modified Delphi Study to Develop a Theory-Based Framework

Murillo-Zepeda, Carlos; Pearson, Mark; Ellawala, Amaya

Abstract

Background: Interventions aimed at supporting international medical graduates during the transition to host countries facilitate adjustment to these new workplace environments. Despite the progress made on clarifying the mechanisms operating behind successful interventions, there is still a theory-practice gap that stems in part from lack of guidance on their design and implementation. Therefore, this study sought to develop and validate a set of standards to enhance the quality of the design and implementation of programmes aimed at supporting the transition of international medical graduates to the host countries' healthcare and educational systems. Methods: A modified e-Delphi method was applied for this study. Initially, a literature review was carried out to identify potential participants. Subsequently, a preliminary questionnaire was developed by adapting the key assumptions of a programme theory. Then, the consensus panel was assembled including researchers and programme directors with expertise in training international medical graduates. Participants' ratings were polled iteratively over two rounds, and items with a consensus agreement above 50% in the relevance criterion were included in the final set of standards. Results: The response rate was 16% (20/119). Most panellists were from European countries and the majority held professor positions in urban, university-based settings. This set of quality statements emphasise the importance of organisational culture and the responsibility of host-institutions to support the transition of IMGs to the new workplace environment. Conclusions: This project provides a validated theory-based framework to inform decisions on the design and implementation of programmes aimed at supporting the transition of international medical graduates to the host countries' healthcare and educational systems. Further research endeavours should evaluate the impact of this set of standards on adjustment outcomes.

Citation

Murillo-Zepeda, C., Pearson, M., & Ellawala, A. (2025). Quality Standards of Transitional Programmes for International Medical Graduates: An International Modified Delphi Study to Develop a Theory-Based Framework. Clinical Teacher, 22(3), Article e70092. https://doi.org/10.1111/tct.70092

• Journal Article Type: Article
• Acceptance Date: Mar 19, 2025
• Online Publication Date: Apr 6, 2025
• Publication Date: Jun 1, 2025
• Deposit Date: Apr 22, 2025
• Publicly Available Date: Apr 7, 2026
• Journal: Clinical Teacher
• Print ISSN: 1743-4971
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 3
• Article Number: e70092
• DOI: https://doi.org/10.1111/tct.70092
• Keywords: International medical graduates; Transition; Residency; Postgraduate medical education; Quality standards
• Public URL: https://hull-repository.worktribe.com/output/5131368