[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-506532-105":59,"doc-detail-506532-en":129},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":122,"head_meta":124,"extra_data":126,"updated_unix":128},105,"en","supporting-international-medical-graduates-transition-to-their-host-country-realist-synthesis","Supporting international medical graduates' transition to their host-country - Realist synthesis","","Realist synthesis examines interventions designed to support international medical graduates (IMGs) as they transition into host-country workplaces and training pathways. The evidence highlights the likely challenges IMGs face, including communication barriers, cultural adjustment, practical constraints, team integration, and hierarchical structures that can increase risks related to fitness to practice. The synthesis applies context–mechanism–outcome reasoning to explain why interventions work or fail across settings, informing implementation and guiding development of ongoing, theory-informed induction approaches.",{"@graph":69,"@context":121},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/supporting-international-medical-graduates-transition-to-their-host-country-realist-synthesis/506532/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/supporting-international-medical-graduates-transition-to-their-host-country-realist-synthesis/506532.png","ImageObject",300,407,{"name":92,"@type":93},"Angel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05",true,{"@type":101,"interactionType":102,"userInteractionCount":4},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107,113,117],{"name":108,"@type":109,"acceptedAnswer":110},"What challenges do international medical graduates (IMGs) commonly face during transition?","Question",{"text":111,"@type":112},"Research suggests difficulties with communication, culture, practical issues, teamwork, and hierarchical structures. These challenges can contribute to a higher risk of referral for fitness to practice.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"Why does this document use a realist approach?",{"text":116,"@type":112},"It adopts realist synthesis to fully explore interventions through theoretical considerations and evidence synthesis. The method explains why interventions work or not and what is likely to be effective when implemented elsewhere.",{"name":118,"@type":109,"acceptedAnswer":119},"What research questions does the synthesis aim to answer?",{"text":120,"@type":112},"It identifies which interventions support IMG workplace transition, how and why they are effective, what factors enable successful transition, and what theory explains intervention success to support wider future interventions.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},506532,1791166133,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":138,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":128,"read_time":143},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Supporting international medical graduates' transition to their host-country:  \nRealist synthesis  \nIntroduction  \nInternational Medical Graduates ( IMGs)–those who have gained their primary medical qualifications from countries outside of the host county in which they work, have been playing an increasingly crucial role over the past years in ensuring effective healthcare delivery1. For example, in the UK, more than a third of registered doctors have gained their medical qualification from outside the UK2. This number has risen since 2014 , with a particular increase in European medical graduates applying for registration1.  \nConcern has grown around the regulation and professional practice of those who qualified outside of the host-country. Research suggests that IMGs are likely to face difficulties with communication, culture, practical issues, team working and hierarchical structures3 , which in turn may lead to a greater risk of referral for fitness to practice4.  \nWhilst recommendations arising from research have been made concerning IMG transition5-8 , the area is underdeveloped. Existing interventions, such as induction programmes and communication skills courses are currently being implemented8 , often at a regional rather than organisational level. For example, half day programmes are often implemented without sufficient consideration of what is likely to work, or how much training is appropriate. Combined with the probability that educators do not have specific experience with the particular needs of IMGs9-11 , this can pose a problem for those involved in developing interventions to support IMG  \ntransition.  \nResearch is needed to provide guidance on implementation and on the most effective ways to facilitate IMG transition to new work environments, both theoretically and empirically8, 12. Another issue to recognise is that doctors indifferent stages of transition will face different problems and different training needs 13. For example, the initial move to a host county can cause culture shock and cross-cultural adjustment difficulties. Once an individual has been living in the country for some time , however, they are likely to have developed personal resources, social support and adequate coping strategies. Employers should understand the needs of their IMGs in order to support them14. The induction of IMGs needs to be an ongoing , iterative process of learning which continues throughout training, perhaps through ‘ buddying’ or peer support 5, 14.  \nIf resources are to be invested in ongoing, rigorous interventions, it is important to understand what interventions work within a given context and what produces the desired outcome. A recent systematic review on this subject recommended an exploration of theory and evidence in their search of educational interventions for IMGs8. These processes of effective transition at the workplace level have, up until now, been taken for granted 1.  \nThis synthesis provides the needed explanation by adopting a realist approach15. It enables interventions to be fully explored, through theoretical considerations and synthesis of evidence, so that details of interventions are explored in depth to enhance understanding about why interventions work, or not, and what is likely to be effective if implemented elsewhere.  \nWhilst the focus of this synthesis is on medical graduates, graduates from other healthcare professions have not been excluded from analysis. Lessons learnt from  \nlooking at common forms of intervention across the healthcare professions can help us to further understand the conditions in which the interventions trigger differing mechanisms to generate both wanted and unwanted outcomes 16.  \nMethod  \nThe aim of this synthesis was to explore and synthesise evidence relating to interventions developed to enable IMGs to make a successful transition to the workplace.. The research questions were i) to identify what interventions have been used to support the transition o","cbCaisERP9v2Iby0","https://ap.wps.com/l/cbCaisERP9v2Iby0","pdf",498700,37,"English","# Introduction\n# Method\n# Design\n## Initial programme theory","[{\"question\":\"What challenges do international medical graduates (IMGs) commonly face during transition?\",\"answer\":\"Research suggests difficulties with communication, culture, practical issues, teamwork, and hierarchical structures. These challenges can contribute to a higher risk of referral for fitness to practice.\"},{\"question\":\"Why does this document use a realist approach?\",\"answer\":\"It adopts realist synthesis to fully explore interventions through theoretical considerations and evidence synthesis. The method explains why interventions work or not and what is likely to be effective when implemented elsewhere.\"},{\"question\":\"What research questions does the synthesis aim to answer?\",\"answer\":\"It identifies which interventions support IMG workplace transition, how and why they are effective, what factors enable successful transition, and what theory explains intervention success to support wider future interventions.\"}]","Supporting international medical graduates' transition to their host-country - Realist synthesis | PDF",93]