PDF(Pubmed)
Abstract：
BACKGROUND: International medical trainees, including residents and fellows, must cope with many challenges, such as differences in cultural hierarchical systems, languages, and acceptance. Nonetheless, the need for adjustment perpetuates even after training is completed abroad. When some international trainees return to their countries of origin, they continue to face adjustment challenges due to reverse culture shock. Others must make many further readjustments. This study presents an exploration of the adjustment and coping strategies of international medical learners after returning to their countries of origin upon completion of their programs.
METHODS: This study employed a qualitative approach grounded in interpretivism and utilised inductive thematic analysis following Braun and Clarke\'s method. Semi-structured, in-depth individual interviews were employed to explore the participants\' coping strategies. Participants included international medical learners who were (1) international medical graduates who had already returned to their countries of origin, (2) non-Canadian citizens or nonpermanent residents by the start of the programs, and (3) previously enrolled in a residency or fellowship training programme at the University of Toronto, Ontario, Canada.
RESULTS: Seventeen participants were included. Three main themes and seven subthemes were created from the analysis and are represented by the Ice Skater Landing Model. According to this model, there are three main forces in coping processes upon returning home: driving, stabilising, and situational forces. The sum and interaction of these forces impact the readjustment process.
CONCLUSIONS: International medical learners who have trained abroad and returned to their countries of origin often struggle with readjustment. An equilibrium between the driving and stabilising forces is crucial for a smooth transition. The findings of this study can help stakeholders better understand coping processes. As healthy coping processes are related to job satisfaction and retention, efforts to support and shorten repatriation adjustment are worthwhile.
METHODS: This study employed a qualitative approach grounded in interpretivism and utilised inductive thematic analysis following Braun and Clarke\'s method. Semi-structured, in-depth individual interviews were employed to explore the participants\' coping strategies. Participants included international medical learners who were (1) international medical graduates who had already returned to their countries of origin, (2) non-Canadian citizens or nonpermanent residents by the start of the programs, and (3) previously enrolled in a residency or fellowship training programme at the University of Toronto, Ontario, Canada.
RESULTS: Seventeen participants were included. Three main themes and seven subthemes were created from the analysis and are represented by the Ice Skater Landing Model. According to this model, there are three main forces in coping processes upon returning home: driving, stabilising, and situational forces. The sum and interaction of these forces impact the readjustment process.
CONCLUSIONS: International medical learners who have trained abroad and returned to their countries of origin often struggle with readjustment. An equilibrium between the driving and stabilising forces is crucial for a smooth transition. The findings of this study can help stakeholders better understand coping processes. As healthy coping processes are related to job satisfaction and retention, efforts to support and shorten repatriation adjustment are worthwhile.
摘要：
背景：国际医学学员，包括居民和研究员，必须应对许多挑战，例如文化等级制度的差异，语言,和接受。尽管如此，即使在国外完成培训，调整的需求也会长期存在。当一些国际学员返回原籍国时，由于反向文化冲击，他们继续面临调整挑战。其他人必须进行许多进一步的调整。本研究探讨了国际医学学习者在完成课程后返回原籍国后的调整和应对策略。
方法：本研究采用了以解释主义为基础的定性方法，并按照Braun和Clarke的方法进行了归纳主题分析。半结构化,采用深入的个人访谈来探索参与者的应对策略。参与者包括国际医学学习者，他们是（1）已经返回原籍国的国际医学毕业生，（2）非加拿大公民或非永久性居民在项目开始时，（3）以前在多伦多大学参加过住院医师或奖学金培训计划，安大略省,加拿大。
结果：17名参与者被纳入。从分析中创建了三个主要主题和七个子主题，并以溜冰者着陆模型为代表。根据这个模型,在回家后的应对过程中有三种主要力量:开车，稳定,和情境力。这些力量的总和和相互作用会影响重新调整过程。
结论：在国外接受培训并返回原籍国的国际医学学习者经常为重新调整而苦苦挣扎。驱动力和稳定力之间的平衡对于平稳过渡至关重要。这项研究的结果可以帮助利益相关者更好地理解应对过程。由于健康的应对过程与工作满意度和保留率有关，支持和缩短遣返调整的努力是值得的。
方法：本研究采用了以解释主义为基础的定性方法，并按照Braun和Clarke的方法进行了归纳主题分析。半结构化,采用深入的个人访谈来探索参与者的应对策略。参与者包括国际医学学习者，他们是（1）已经返回原籍国的国际医学毕业生，（2）非加拿大公民或非永久性居民在项目开始时，（3）以前在多伦多大学参加过住院医师或奖学金培训计划，安大略省,加拿大。
结果：17名参与者被纳入。从分析中创建了三个主要主题和七个子主题，并以溜冰者着陆模型为代表。根据这个模型,在回家后的应对过程中有三种主要力量:开车，稳定,和情境力。这些力量的总和和相互作用会影响重新调整过程。
结论：在国外接受培训并返回原籍国的国际医学学习者经常为重新调整而苦苦挣扎。驱动力和稳定力之间的平衡对于平稳过渡至关重要。这项研究的结果可以帮助利益相关者更好地理解应对过程。由于健康的应对过程与工作满意度和保留率有关，支持和缩短遣返调整的努力是值得的。
