Transition experiences of internationally qualified health care professionals: A narrative scoping review

Abstract

Background: The migration of health care professionals exposes the individual to a variety of challenges as they adjust to the host country's workforce system. While there is a growing body of literature on the individual transition stage of internationally qualified health care professionals, little is known about the overall process and how each stage interacts with the others.

Aim: To examine what is known about factors impacting transition experiences of internationally qualified health care professionals at various stages from pre- to post-arrival in their new country.

Design: Scoping review incorporating narrative synthesis was conducted.

Data sources: A range of databases were searched, including CINAHL, Medline, Scopus, and ProQuest, as well as reference lists.

Review methods: The adapted framework methodology described by the Joanna Briggs Institute informed this review. The review included qualitative and quantitative primary peer-reviewed research studies focusing on transition experiences of internationally qualified health care professionals. Included studies were analysed and synthesised using a three-step narrative synthesis.

Results: A total of 48 studies were included in the review from nursing, medicine, dentistry, physiotherapy, occupational therapy, and midwifery, with the majority from nursing. The majority of the internationally qualified health care professionals migrated from Philippine, India, and South Africa to the US, UK, Canada, and Australia. Four themes emerged from the review: misguided migration (pre-arrival), a shocking reality (early arrival), challenging accreditation and orientation (registration), and multidimensional work challenge (post-registration). Identified issues impacting the transition experience of internationally qualified health care professionals across different disciplines and nations were generally similar.

Conclusions: Misinformation resulted in unexpected realities upon arrival in destination countries, ineffective accreditation procedures during registration and inadequate support in destination countries led to workplace challenges. With ongoing recruitment of international health care workers, a holistic approach that considers the various stages of transition is necessary to assist in establishing new identities and integrating into the destination country's workforce. This includes informing internationally qualified health professionals accurately about professional and cultural expectations in host countries prior to migration, implementing culturally specific training upon arrival in the destination country, developing and implementing effective accreditation and registration policies, and providing structured mentorship and support following employment.

Keywords: Adjustment; International health care professionals; Migration; Scoping review; Transition experience.