Enhancing Integration of Internationally Educated Health Professionals in the Healthcare Workforce: Implications for Regulators

Abstract

Background

Many Western countries rely on internationally educated health professionals (IEHPs) to complement the domestically educated workforce and meet healthcare workforce needs. Traditionally, health regulators have focused on potential registrants’ required technical competencies rather than their cultural and workplace integration. As a result, the workplace integration experience of IEHPs has not been well studied, nor have systems evolved to enhance the workforce integration experience with the objective of optimizing delivery of patient care.

Objective

This study sought to examine and characterize the workforce integration of IEHPs into Canadian health systems with particular emphasis on implications for regulators.

Methods

We recruited IEHPs as well as representatives from regulatory bodies and health systems to participate in semistructured interviews over the telephone. Interviews were recorded, and transcripts were used for qualitative analysis, coding, and generation of themes related to IEHPs’ integration into the Canadian workforce.

Results

A total of 48 individuals, including 29 IEHPs and 19 representatives from health regulatory bodies and health systems, participated in this study. Six major themes were identified, highlighting various roadblocks to successful integration of IEHPs. Themes concerned roadblocks to integration, including IEHPs’ unmet complex personal integration needs, that mastery of domestic professional culture is essential, that social/contextual skills and communication (not just language) skills are crucial, and that patient-centeredness and interprofessionalism in Canada often are very different that those in IEHPs’ home countries.

Conclusion

Additional work is required to support IEHPs as they become a more prominent component of the healthcare workforce in many jurisdictions, including the United States, the United Kingdom, Australia, New Zealand, and Ireland.