Assessing International Medical Graduate (IMG) Proficiency in Procedural Skills During a 12-Week Clinical Field Assessment

Assessment and training of procedural skills are critical components of medical education; however, there is limited research pertaining to International Medical Graduates (IMGs). This study aims to quantify IMG physicians’ exposure to and competency in procedural skills during a 12-week clinical field assessment (CFA) in the Saskatchewan International Physicians Practice Assessment (SIPPA) program. We analyzed data from skill evaluation forms completed by SIPPA preceptors of IMGs enrolled between 2017 and 2023. Descriptive statistics were calculated to assess exposure and competency across 66 procedures. Data from 299 participants were reviewed. Procedural competencies were categorized by exposure level as: high (80-100%), moderate (40-79%), low (20-39%), and very low (<19%). High-exposure procedures included injections, EKG interpretation, cerumen removal, and laceration repair. Moderately exposed procedures included lumbar puncture, central line insertion, and slit lamp examination. Low- to very-low-exposure procedures included thoracentesis, phlebotomy, and intraosseous needle insertion. Procedural exposures for all 66 items were generally consistent across 2017-2023, with minor variations observed. Our study identified areas where IMGs demonstrate higher exposure and competency, especially in common procedures, highlighting the need to focus on specialized procedures with lower exposure. The variability in procedural exposure suggests the need for standardized training protocols to ensure comprehensive skill development.