Structural barriers have a profound impact on IMGs' relational and emotional lives. What might appear as a personal hardship-such as family separation-is in fact a consequence of structurally imposed constraints. Participants pointed to concrete areas where institutional practices could change, including formalized mentorship structures, stronger institutional accountability, more explicit inclusion practices, and policy advocacy. Addressing these inequities will require institutional engagement, with implications for sustaining the US physician workforce.
Ma et al. (Mon,) studied this question.