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dc.contributor.authorMathews, Mariaen_US
dc.contributor.authorRyan, Danaen_US
dc.contributor.authorRandall, Ellenen_US
dc.contributor.authorMarshall, Emily Garden_US
dc.contributor.authorGoldsmith, Laurie J.en_US
dc.contributor.authorJones, Lorien_US
dc.contributor.authorLavergne, M. Ruthen_US
dc.contributor.authorSnadden, Daviden_US
dc.contributor.authorScott, Ianen_US
dc.contributor.authorWong, Sabrina T.en_US
dc.contributor.authorStringer, Katherineen_US
dc.contributor.authorHorrey, Kathleenen_US
dc.contributor.authorGrudniewicz, Agnesen_US
dc.identifier.citationMathews, M., Ryan, D., Randall, E., Marshall, E. G., Goldsmith, L. J., Jones, L., Lavergne, M. R., Snadden, D., Scott, I., Wong, S. T., Stringer, K., Horrey, K. & Grudniewicz, A. (2022). "At the mercy of some of the regulations": the impact of the residency match and return of service requirement on the early-career decisions of international medical graduates in Canada. Human Resources for Health, 20(1), 15-.
dc.description.abstractBackground: Return-of-service (ROS) agreements require international medical graduates (IMGs) who accept medical residency positions in Canada to practice in specified geographic areas following completion of training. However, few studies have examined how ROS agreements influence career decisions. We examined IMG resident and early-career family physicians’ perceptions of the residency matching process, ROS requirements, and how these factors shaped their early career decisions. Methods: As part of a larger project, we conducted semi-structured qualitative interviews with early-career family physicians and family medicine residents in British Columbia, Ontario and Nova Scotia. We asked participants about their actual or intended practice characteristics (e.g., payment model, practice location) and factors shaping actual or intended practice (e.g., personal/professional influences, training experiences, policy environments). Interviews were transcribed verbatim and a thematic analysis approach was employed to identify recurring patterns and themes. Results: For this study, we examined interview data from nine residents and 15 early-career physicians with ROS agreements. We identified three themes: IMGs strategically chose family medicine to increase the likelihood of obtaining a residency position; ROS agreements limited career choices; and ROS agreements delayed preferred practice choice (e.g., scope of practice and location) of an IMGs’ early-career practice. Conclusions: The obligatory nature of ROS agreements influences IMG early-career choices, as they necessitate strategically tailoring practice intentions towards available residency positions. Existing analyses of IMGs’ early-career practice choices neglect to distinguish between ROS and practice choices made independently of ROS requirements. Further research is needed to understand how ROS influences longer term practice patterns of IMGs in Canada.en_US
dc.relation.ispartofHuman Resources for Healthen_US
dc.rights© The Author(s) 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver (http://creativeco applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_US
dc.title"At the mercy of some of the regulations": the impact of the residency match and return of service requirement on the early-career decisions of international medical graduates in Canadaen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.description.versionPublished versionen_US
dc.subject.keywordsPost-Graduate Medical Educationen_US
dc.description.acknowledgementThis study was supported by Canadian Institutes of Health Research (R-PJT-155965).en_US
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