By Dr. Domenica Garcia Dumler and Dr. Ligia Moschen Nascente Chanock
Recipient Team of the 2024 Grant Opportunity for J-1 Physicians: Well-being Projects Supporting Foreign National Physicians
We are two members of the Children’s National IMG (International Medical Graduate) Taskforce, which was one of five projects awarded funding by the 2024 Intealth Well-being Grant Opportunity. The taskforce was initially formed at Children’s National Hospital in 2021 with a mission to optimize the experience of IMG residents and fellows by establishing a network of peer and faculty mentors. Our objectives include providing guidance and support during the transition to the United States and assisting with onboarding, familiarization with the U.S. healthcare system, mentorship, career development, and legal awareness. We are very grateful to have been awarded the 2024 Intealth Well-being Grant to support our ongoing mission, which has allowed us to expand and advance our pre-existing program.
A primary focus of the taskforce is to welcome incoming IMG residents and fellows to our institution. When you arrive in the United States to start training as an IMG resident/fellow, the promise of a career, evidence-based patient care, funded research, world-renowned physicians to learn from, and more, can be diminished by a gnawing sense of discomfort. Everything is different, which is exciting and promising, but also everything is different. While you are trying to adjust to the culture shock in a new country where one does not always feel welcome, you are simultaneously learning how to provide care in a new health care system, often in a non-native language. Additionally, you are learning what is expected from medical trainees and new concepts such as family-centered rounds and frequent feedback. While immersed in gratitude for this rare opportunity, some IMGs may feel pressure to hide their challenges, blend in with peers, and minimize their own needs. Thus, it is groundbreaking to find other IMG voices that celebrate you, that help you grow, that validate your struggles and your worth. Making this community stronger makes each individual IMG resident, fellow, and faculty member more likely to reach their goals and contribute more meaningfully and effectively to their patients, peers, and institution.
These were the feelings that inspired the development of the IMG taskforce back in 2021. One of our first initiatives was to compile a welcome packet for IMGs that contained practical information on critical topics such as medical licensing, hospital onboarding, housing, opening a bank account, commuting, and getting health insurance. Every year, we updated and expanded the packet. We also hosted virtual happy hours shortly after Match Day, so that incoming IMG trainees could connect with our IMG community early on. In addition, we hosted in-person gatherings during intern and fellow orientation week and throughout the academic year.
In order to facilitate community building within our large academic institution spread over different campuses, we also created the IMG Face Sheet. This resource is a roster of IMG trainees and faculty members, including their photograph, contact info, and a short bio. We asked that IMG faculty and trainees submit their own information according to their personal preferences and comfort level, including where they are from, where they completed their previous training, and if they required a visa at any point in their journey. Each year, we email all trainees and faculty in our institution and ask whoever is interested in joining the IMG community to voluntarily submit their information. That way, people who are not strictly IMGs but were born outside of the United States or have other types of personal experiences that link them to the IMG community are welcome to participate in all of our activities.
Since receiving the 2024 Intealth Well-being Grant, we developed more online connection resources, including a resident group chat. We established an academic arm of the taskforce, through which we have begun a literature review, started developing questionnaires to assess burnout and well-being, and are utilizing a quality improvement approach for our new onboarding efforts for IMGs. We also promoted our first speed-mentoring event, in which IMG faculty and trainees were able to connect face-to-face and have meaningful conversations. We plan to host speed mentoring events twice a year moving forward.
A future focus of our taskforce is scholarship. We would like to disseminate what we have learned from our experiences and collaborate with similar groups from other institutions. One of our priorities is to investigate the existing support systems for IMG trainees throughout the country, which would inform the creation of a toolkit for training programs to increase support for IMG trainees. Next year, we will begin to implement pre-and post-surveys to assess metrics such as burnout, well-being, and perception of program culture. We also plan to continue to expand the taskforce by establishing an inter-institutional network of IMG support groups.
We have come a long way since we first started our pediatric training in the United States, and as members of the taskforce. Throughout our journey, we have learned many lessons:
-
-
- Programs seeking to strengthen support for IMG candidates during recruitment might consider sharing information about any existing IMG-focused resources, involving IMG faculty members in recruitment activities, and facilitating early connections between incoming trainees and the institution’s IMG community.
- It is important to find common ground between IMG well-being initiatives and institutional priorities; this allows for institutional support and longevity of IMG interest groups.
- We have found that the most essential aspect of IMG well-being is having personal connections to peers and mentors, which promotes a sense of belonging. Making an effort to know each other personally matters!
-
The Children’s National IMG Taskforce has significantly enhanced the well-being of our IMG residents and fellows by fostering community and creating recognition amongst peers and leadership. IMG interns especially reported feeling more supported and connected than last year’s intern class, a finding supported by increased participation and positive feedback from event surveys. Interns noted that their transition to the United States was much smoother and that they felt connected to the group and reassured by having direct access to people who could help them. Several incoming residents noted that they ranked our program higher due to the specific IMG support sessions we hosted during interview season and found the onboarding resources we sent out extremely helpful. The speed mentoring sessions and processing events were particularly well-received, providing opportunities for IMGs to share experiences and build relationships with peers and mentors, and find emotional and professional development support. Several IMGs made important professional connections at these events. IMGs were also given career opportunities through the Intealth Well-being Grant initiative, such as attending the Intealth Board of Trustees meeting and presenting online for Intealth’s inaugural IMG Well-being Day.
Through this experience, we have come to appreciate even more the importance of community and mentorship in medical training. In what we have experienced as a time of change for IMGs in the United States, our team is committed to furthering efforts to support wellness at our institution and to share our model with other institutions to enhance IMG support and appreciation nationwide. We are grateful for the opportunity this grant gave us to enhance and grow the support and initiatives provided through the Children’s National IMG Taskforce.
The Intealth Well-being Grant Opportunity awards grants of up to $5,000 to J-1 physician-led projects supporting the well-being of foreign national physicians at their host institutions. In 2024, Intealth announced the winning projects of its second annual Well-being Grant Opportunity for J-1 Physicians: Well-being Projects Supporting Foreign National Physicians. The grants were awarded to five projects. This entry is about one of those projects. For more information on this initiative and details about this project, click here.