Strengthen IMG resident transition and support

Your IMG Navigator results identified an opportunity to strengthen how your program supports incoming IMG residents. Use these action items and resources to improve pre-arrival planning, build effective onboarding and provide consistent clinical, cultural and mentorship support.

The goal:

Legal visa limitations can restrict incoming IMG applicants from arriving earlier than the allowable 30-day pre-arrival window for in-person orientation or bootcamp sessions. Programs can overcome these limitations by moving preparation into virtual formats and maximizing the allowable 30-day pre-arrival window.

Action items:

1. Keep processes running early and efficiently so the IMG applicants can arrive on time within the allowable 30-day pre-arrival window.
2. Provide virtual orientation content, asynchronous modules, and scheduled remote meetings that do not require an in-person presence.
3. Deliver condensed in-person onboarding immediately following the applicant’s lawful arrival.

Resources:

• Intealth’s Pre-Arrival Information​ resources: Guidance outlining the allowable 30-day pre-arrival window, document handoffs, and arrival protocols for incoming exchange visitors.

The goal:

Helping IMG applicants adjust to practicing in the U.S. healthcare system should be built directly into the program fabric as proactive support rather than reactive remediation. Moving beyond general advice to active practice helps trainees build trust and obtain patient buy-in within a U.S. patient-centered care model. Hard-wiring these processes ensures consistency.

Action items:

1. Pre-arrival: Maximize the allowable 30-day pre-arrival window by providing a structured onboarding checklist, virtual orientation content, and asynchronous modules covering documentation, common workflows, and team roles.
2. Post-arrival clinical support: Embed early, hard-wired support during the first months of training, including orientations to local clinical workflows, EMR/billing basics, and escalation pathways.
3. Communication coaching: Provide targeted coaching on U.S. patient-centered care, including plain-language explanations, shared decision-making, and navigating cultural expectations without stereotyping.
4. Feedback mechanism: Build time during the first 90 days for direct observation, feedback, and coaching.
5. Mentorship: Assign a dedicated faculty member to act as the IMG faculty liaison to maintain hard-wired, consistent support and/or establish an IMG staff/faculty mentorship program.

Resources:

• AMA’s IMG Physician Toolkit​(need to be an AMA Member to access): A resource hub providing practical guidance on state medical board regulations, licensing pathways, and practice integration for IMGs.
• Intealth’s Transition to Residency & Beyond​ resource hub: A collection of guides and tools assisting international medical graduates with navigating cultural integration, professional communication, and clinical adaptation in the U.S. healthcare environment.
• Intealth’s Well-Being Resources​: A dedicate hub providing tools, literature, and frameworks focused on the mental health, resilience, and needs of international medical graduate applicants.
• Intealth’s Journeys in Medicine​: A collection of real-world narratives and insights from IMG applicants navigating the U.S. healthcare system.
• Katz C, Barnes M, Osta A, Walker-Descartes I. The Acculturation Toolkit: An Orientation for Pediatric International Medical Graduates Transitioning to the United States Medical System​. MedEdPORTAL. 2020;16:10922.: A published, peer-reviewed educational toolkit providing structured orientation frameworks and acculturation modules specifically designed to support international medical graduates transitioning into U.S. clinical environments.
• Washington University’s How to Support your IMG Trainees​ best practice guide: Institutional best-practice literature highlighting actionable mentoring frameworks, feedback strategies, and localized support workflows.