International medical graduates: defining the term and using it consistently

There were 281 million migrants worldwide in 2020, representing 3.6% of the world’s population and a 0.1% increase from 2019.1 Like the rest of the population, doctors are migrating in larger numbers.2 Although not a precise measure of migration, the Organization of Economic Cooperation and Development (OECD) estimated in 2019 that almost half a million (16%) doctors practising in the 26 countries of the OECD were international medical graduates (IMGs).3 This proportion increased to 19% in 2023.2 The ongoing worldwide conflicts are also likely to increase doctors’ voluntary or forced migration. IMGs experience broadly similar challenges,4 have lower pass rates in postgraduate exams,5 are more likely to experience discrimination4 6 and have a higher rate of complaints made against them compared with domestic medical graduates (DMGs).7 Medical regulators, including the UK’s General Medical Council (GMC), have been attempting to address these challenges.8 However, there is no universal agreement on the terms used to describe this population of migrating doctors.9 In addition, there are subgroups within the larger group of these migrating doctors who might have different educational, professional and sociocultural needs. It is therefore crucial to accurately define the terms describing the larger group and each subgroup, for example, when reporting on numbers of IMGs, describing experiences of IMGs, conducting research related to IMGs, instigating interventions designed to support IMGs and when measuring progress made to address some of the challenges they face.10 Finally, using consistent terminology allows stakeholders, including policymakers, members of the public and scholars, to locate the relevant literature and join the same ‘conversation’.11