5 An area of concern is the marked disparity in success rates of IMGs in medical licensing examinations which allow them to practise in their chosen specialty, often after lengthy programmes of specialty training. 4 This group of doctors, which constitutes around a quarter of the medical workforce, 1 face particular challenges in training, support and assessment. There are an increasing number and proportion of international medical graduates (IMGs), the term for doctors who gained their primary medical qualification (PMQ) overseas and most of whom are from low-income countries, 1 working in the health services of high-income countries such as the UK, 2 North America 3 and Australia. The think aloud interviews enabled us to explore the thought processes of trainee doctors while answering these ‘live’ questions from the UK applied knowledge test in general practice. The multiple-choice questions used during the interviews were selected from the UK Membership of the Royal College of General Practitioners Applied Knowledge Test on the basis that they showed differences or similarities in performance when comparing UKGs and IMGs based on previous test results. We interviewed doctors during specialty training for general practice used an inductive grounded theory approach. ![]() This is the first study exploring reasons for differences in performance between UK graduates (UKGs) and international medical graduates (IMGs) in a licensing examination using in-depth cognitive (think aloud) interviews.
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