95% of internationally trained doctors did not receive inter-cultural supports

Posted on: 02 February 2023

A lack of inter-cultural supports for internationally trained doctors coming to work in Irish hospitals is putting further pressure on our already fragile health care system, according to new research from Trinity Business School. 

A survey of 369 internationally trained doctors working across 34 public hospitals on their experience of living and working in Ireland found that 95% of respondents did not get inter-cultural training from their host hospital. The study was recently published in the journal Cogent Business & Management. 

It found that internationally trained doctors are not very well adjusted to working and living in their new host country. This finding is likely to be influenced by the clear lack of organisational support from the host hospitals, according to the paper.

The study also found that internationally trained doctors find it difficult to distinguish between their general and work adjustment, with some reporting that excessive working hours meant that the hospital was more or less their home. These long working hours are likely to negatively impact on cultural adjustment, and are also likely to result in burnout, according to the paper. These issues also affect the recruitment and retention of internationally trained doctors, the author adds.

Dr Eimear Nolan, Assistant Professor, Trinity Business School, explains: “Respondents did not feel they had support from the their host hospitals to assist their cultural transition to working and living in Ireland. Largely they came to Ireland from their home country with little to no knowledge of what it was like to live and work in Ireland  from a cultural perspective. They were left to navigate the various facets of adapting to a new culture on their own.”

Key findings: 

1. 56% said they did not have a realistic preview of what life would be like working and living in Ireland
2. 95% did not receive any inter-cultural training upon arrival in Ireland from the host hospital.
3. 63% said they did not get a realistic overview of their role prior to departure
4. 62% of the participants reported difficulty understanding Irish accents 

“Organisational support is vital when it comes to successful cross-cultural adjustment as it prepares and helps doctors on their transition to a new culture, helping them adjust to the work place, adjust to living in Ireland, and adjust to interacting with patients and peers. If internationally trained doctors are not supported in their cultural transition, it increases the likelihood of them leaving the country, posing yet another risk to our already fragile health care system.

“When attracting expatriate workers, it is common practice within multinational companies to provide pre-departure training and post-arrival training to the employee. The rationale behind this is, if we prepare them for the differences and support them on their adjustment process it will increase the likelihood of a successful assignment. Such cultural training has been shown to reduce the turnover rates, while increasing satisfaction and performance among expatriate workers.

“There is a major crisis in healthcare happening in Ireland. There are not enough beds to meet demands and equally not enough medical staff to service our hospitals. With our ever increasing reliance on internationally trained doctors to help fill staffing shortages, it is clear from this study that policies and procedures need to be put in place and implemented to support the cultural transition of such doctors. Otherwise, recruiting and retaining these doctors will become increasingly difficult, to the point where we see current staff shortages worsen even more.”

The full paper, Eimear Nolan (2023) The cultural adjustment of self-initiated expatriate doctors working and living in Ireland, Cogent Business & Management, can be viewed at this link.  

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