Transition to work: A qualitative exploration of Australian-trained international dietetic graduates' career trajectories.

BACKGROUND: Interest in the role of employability in student-dietitian transitions is increasing. However, little is known about the cross-cultural transition-to-work experience of Australian-trained dietetic graduates of international backgrounds, as well as strategies to optimise work-readiness. The present study aimed to explore graduates' career narratives and identify employability capitals that enabled successful transitions to work. METHODS: A qualitative interpretive approach was employed via a cultural lens. Eighteen participants from five Asian countries who had graduated from an Australian university within 3-15 years, with work experience in Australia or in their respective home countries, took part in in-depth interviews. Thematic analysis was performed, guided by the graduate capitals based approach. RESULTS: Transition-to-work was dynamic and non-linear; four themes and 12 subthemes identified: (1) upon graduation, participants felt ambivalent about their decision to either stay in Australia or return home, influenced by graduate visa restrictions, and individual perceptions of their ability to mobilise cultural strengths to gain employment; (2) to get a foot in the door, participants demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities in Australia and their home countries; (3) regardless of which country they worked, graduates reported struggling with their cross-cultural identities in the workplace; and (4) eventually, these graduates appreciated their ethnic capital, thrived in their work and extended a helping hand to their junior cross-cultural dietitians. CONCLUSIONS: Initiatives facilitating connections to the host country and supporting cultural and ethnic capital development, along with ongoing research reviewing employability capital applications, will benefit cross-cultural dietetic graduates and the communities they potentially will serve.

'I feel many of my reflections are forced': a mixed methods qualitative study of international medical graduates' perspectives on reflection in UK general practice training.

BACKGROUND: UK general practice training requires trainees to evidence clinical competencies through reflective writing entries in online portfolios. Trainees who complete their medical degree in the UK experience reflection as an undergraduate, whereas 80% of international medical graduates (IMGs) have no previous experience of reflection. AIM: To explore international graduates' perspectives on the positive and negative aspects of reflection in the context of postgraduate GP training. DESIGN & SETTING: Qualitative 'free text' survey data obtained in 2021 was analysed with themes further explored by semi-structured interviews conducted 2022-2023. METHOD: Participants were IMGs with experience of the UK GP training scheme. Verbatim open question survey data underwent content analysis. Broad themes identified were used to develop the interview topic guide. A geographically dispersed, purposive sample of participants were recruited for semi structured interviews. Interview and survey data were then analysed thematically. RESULTS: 433 participants data sets are included: 422 of 485 responses to a UK wide survey including open questions and 11 interview transcripts. IMGs considered reflection to provide an effective approach for learning, an opportunity for self-assessment and professional development and a means of developing self-awareness. Concerns were expressed about how time-consuming recording reflection is, how its mandated aspect makes it forced, and fears regarding the medico-legal consequences of reflective writing. CONCLUSION: Despite a lack of previous experience in reflection, most international graduates showed an understanding of the benefits of reflection in GP training. However, the challenges of reflection must be addressed, to avoid devaluing reflection for clinical learning.

From bad to worse: examining the deteriorating labour market outcomes of international graduates in Australia.

International graduates have been shown to experience comparatively poor outcomes in their transition to the host labour market after course completion. In Australia, international graduates typically fare worse than domestic graduates in the labour market, with new evidence pointing to a deterioration in their relative labour market position over the years. The contributing factors for the deterioration, however, remain unclear. In this article, we analysed unique large-scale survey data from the Australian Graduate Survey to identify the factors underlying the deteriorating labour market outcomes of international graduates from 2000. Our findings indicate that the deteriorating labour market outcomes of international graduates can be largely linked to the declining share of these graduates who are a citizen or permanent resident of Australia. The rising percentage of international graduates who are non-native English-speakers also played a role, albeit a modest one. These findings call attention to the persistent labour market disadvantage of international graduates and highlight the inadequacies of existing policies aimed at temporary retention and stronger English language skills in promoting labour market integration.

Post-Graduation Work Visas and Loopholes: Insights into Support Provision for International Graduates from the Perspectives of Migration Agents, Universities, and International Graduates.

Background: Major host countries of international students such as Australia, Canada, New Zealand, the UK, and the US have introduced post-study work rights as a strategic policy to both enhance their destination attraction and support international students' post-graduation work experiences. While this policy is generally welcomed by both host institutions and international students, little is known about the support mechanism for the growing cohort of international student graduates who stay in their countries of study on temporary graduate visas, especially in relation to major concerns such as post-graduation work, visa application, and migration pathways. Objective: This article fills an important gap in the existing literature. It aims to assess the role of universities in supporting their international alumni on temporary visas. Research Design: It is derived from a study that includes 50 interviews with university staff, agents, and international graduates. It uses positioning theory as a conceptual framework. Results: The findings of the study raise concerns about the scope of university advice. It reports loopholes which legitimize the practices of migration agents to the conditions that enable them to exercise their exclusive rights in providing work-migration nexus advice to international students and graduates, making this cohort vulnerable to exploitation of unethical agents. The study provides the evidence base to develop recommendations for related stakeholders in improving the post-graduation experiences of international student graduates who remain in the host countries on temporary visas.

Relationships between racial discrimination, social isolation, and mental health among international Asian graduate students during the COVID-19 pandemic.

Objectives: Racial aggression against Asians and the implementation of state-wide stay-at-home orders during the COVID-19 pandemic may have negatively impacted mental health in Asian international graduate students in the United States, yet these relationships are unknown. Therefore, this study was conducted to investigate these relationships. Participants: Data were collected from 177 participants from four universities. Methods: On-line survey was used to assess perceived racial discrimination related to the COVID-19, daily racial discrimination during the pandemic, home boundness and loneliness, and depression and anxiety. Results: Daily racial discrimination was associated with an increased risk for depression. Home boundness was related to fewer depression symptoms (B = -0.728) and fewer anxiety symptoms (B = -0.558). Higher symptoms of loneliness (B = 0.377) were related to more depression symptoms. More loneliness (B = 0.257) was related to more anxiety symptoms. Conclusions: The findings can help university stakeholders to create a guideline for the development and implementation of resource programs for Asian international graduates.

International graduates' experiences of reflection in postgraduate training: a cross-sectional survey.

BACKGROUND: Reflection is a key component of postgraduate training in general practice. International medical graduates (IMG) are thought to be less familiar with reflection, with international medical schools favouring more didactic methods of education. AIM: To explore IMGs' experiences of reflection prior to and during GP training and the support available for developing skills in reflection. DESIGN & SETTING: A cross sectional survey was sent to IMGs undertaking GP training in 12 of the 14 UK regions, from March to April 2021. METHOD: A pre-tested self-administered online questionnaire was used to collect data on experiences of reflection, both prior to and during GP training, and the support available for developing skills in reflection. RESULTS: In total, 485 of 3413 IMG trainees completed the questionnaire (14.2% response rate, representative of national demographics). Of these, 79.8% of participants reported no experience of reflection as an undergraduate and 36.9% reported no formal training in reflection during GP training. The majority (69.7%) of participants agreed that reflection was beneficial for their training and 58.3% reported that the best support in reflection came from their supervisors. Experience of reflection, opinions on the benefits, and best sources of support all varied by where the responders' primary medical qualification (PMQ) was obtained (all P values<0.01). CONCLUSION: Most IMGs have not experienced reflection prior to commencing UK GP training. There is diversity in experience and culture within this group that must be considered when tailoring educational interventions to support IMGs in their transition to UK GP training.

Country of qualification is linked to doctors' General Medical Council performance assessment rate, but is it linked to their clinical competence?

Mehdizah and colleagues recently described the prevalence of General Medical Council regulatory performance assessments by doctors' country of primary medical qualification. This article has caused anger within the UK-international medical community because it identifies graduates of certain countries with significantly raised prevalence.The present article comments on evidence from published Royal College of General Practitioners' data that support these conclusions. However, in an increasingly international age of medical education, the ambiguity of attributions of qualifying from a certain country needs addressing. Some medical students of British nationality, for example, who fail to obtain a place at a UK medical school, train in medical schools abroad, and thus may be identified as international medical graduates.Please see related article: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-017-0903-6 .

Proposal of the implementation of an international pharmacy graduate preliminary examination.

At present, graduates of international pharmacy schools can apply to take the Korean Pharmacist Licensing Examination after passing a review by the Accreditation Board of the Pharmacy Schools and Licenses. However, since the educational content of different schools and the roles of pharmacists differ from country to country, a preliminary examination might be necessary before the Pharmacist Licensing Examination. To prepare to implement a preliminary examination for foreign pharmacy graduates in Korea, we summarized the preliminary examinations used in four other countries and presented a proposal for a preliminary examination. Data were collected via the internet and through telephone interviews with appropriate persons. The proposal was revised after a public forum. There are preliminary examinations in the USA, Canada, Australia, and the United Kingdom, and these involve written, oral, practice, and English proficiency tests. We proposed that the Korean preliminary examination consist of a written test on basic pharmacy, a test in the Korean language, and an interview. The preliminary examination should include suitable items that effectively evaluate international graduates. Graduates of international pharmacy schools who have an ability equivalent to graduates of Korean pharmacy schools should be eligible to write the Korean Licensing Examination.