# Integrated challenges for IMGs as they migrate and move into general practice careers in rural Australia: a multi-staged qualitative study

## TL;DR

This study explores the challenges faced by international medical graduates (IMGs) as they move into rural general practice careers in Australia and suggests the need for better support systems.

## Contribution

The study identifies three distinct stages of challenges for IMGs in rural general practice and highlights the need for coordinated strategies to support them.

## Key findings

- IMGs face challenges in three temporal stages: migrating and acclimatising, moving to new workplaces and communities, and training as a specialist GP in rural areas.
- Cross-cutting themes include complexity and frustration, and reliance on informal information exchange among IMGs.
- Limited access to tailored information, mentorship, and training, as well as lack of recognition of past experience, hinder IMGs' career progression.

## Abstract

International medical graduates (IMGs) are important to supplement domestic workforce gaps in rural general practice in Australia. However, there is no evidence about how to support IMGs longitudinally to achieve such careers. This research aimed to explore the integrated challenges for IMGs across the pathway from migrating to specialising as a general practitioner (GP) in a rural location, to inform what coordinated strategies might be needed.

A qualitative participatory action research study of multi-staged one-hour semi-structured qualitative interviews and two-hour focus groups exploring IMG experiences from migration to pursuing rural GP careers in Australia. Participants had different roles across the prevocational and vocational rural general practice training system; IMGs were prioritised. An initial focus group in February 2025, consulted a 10-person Project Advisory Group. Data were transcribed and deductively and inductively coded for themes. Between March and May 2025 further focus groups and interviews were done with 31 wider participants, to deepen thematic insights. In July 2025, the Project Advisory Group we re-consulted to refine and confirm the themes.

Overall, 68% of respondents were IMGs; 46% from towns < 15,000 population and a range of roles across rural general practice training. We found three temporal stages representing different challenges: migrating and acclimatising; moving to new workplaces and communities; and training as a specialist GP in a rural location. Cross-cutting themes were complexity and frustration and the informal exchange of information and advice from other IMGs over these stages. Sub-themes identified specific issues at each stage including, limited access to relevant and tailored information for planning their life and career, limited GP career mentorship and tailored training advice and insecure pathways with variable quality supervised learning. IMGs also lacked recognition of past training and experience and had limited opportunities to address skills gaps through nuanced learning to help them adjust to the scope and responsibilities involved in rural GP careers.

IMGs may experience three-staged challenges and specific issues as they navigate the pathway to establishing a rural GP career in Australia. To mitigate an overreliance on informal supports between IMGs, targeted and coordinated resources, education and training may be needed.