International medical graduates’ experiences of clinical competency assessment in postgraduate and licensing examinations: A scoping review

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dc.contributor.authorHynes, Helen
dc.contributor.authorMcCarthy, Nora
dc.contributor.authorWiese, Anél
dc.contributor.authorSweeney, Catherine
dc.contributor.authorGambhir, Nitin
dc.contributor.authorFoley, Tony
dc.contributor.authorBennett, Deirdre
dc.contributor.funderVirginia Conrick
dc.contributor.funderUCC Librarian
dc.date.accessioned2026-05-26T15:00:01Z
dc.date.available2026-05-26T15:00:01Z
dc.date.issued2026
dc.description.abstractBackground International Medical Graduates (IMGs) represent a substantial proportion of the medical workforce globally and are known to face difficulties in their working lives, including differential attainment in assessment. This scoping review explores existing literature relating to IMGs’ experiences of clinical competency assessments and identifies gaps in current knowledge. Methods Following the Arksey and O’Malley framework for scoping reviews we examined peer-reviewed literature published between 2009 and 2025, without language restrictions. Three independent reviewers contributed to each stage of the process. The British Education Index, the Education Resources Information Center (ERIC), PubMed, Psych Info, Scopus, and Soc Index were searched. Forwards and backwards citation searching and a grey literature search were also performed. Results We identified 44 publications which met the inclusion criteria. These described the experiences of over 7200 IMGs, who had received their primary medical qualifications in 54 named countries, spanning all 6 world regions as defined by the World Health Organisation. Most sources were from the United Kingdom, Australia, and Canada. The review identified three headline categories which summarise the factors that impacted on IMGs’ assessment experiences: internal and personal factors; external and social factors; and institutional and systemic factors. Notable evidence gaps included the impact of age, gender, country of primary medical qualification, years since last in practice, and lower levels of language proficiency on IMGs’ experiences of assessment. Our review reveals the need for further research from a broader range of medical specialties and from a wider geographic spread to improve our understanding of this important topic. Conclusion This scoping review maps the experiences of IMGs in relation to clinical competency assessment and offers useful insights highlighting both positive and negative influences, which could inform future assessment methodologies and support interventions for IMGs. By creating fairer and more supportive assessment pathways, healthcare systems can harness the full potential of IMGs, ensuring their valuable skills and diverse experiences are retained for the benefit of all patients.en
dc.description.sponsorshipWe would like to acknowledge the contribution of Virginia Conrick, UCC Librarian, who assisted with devising the search strategy.
dc.description.versionPublished Version
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0338282
dc.identifier.authororcidHynes, Helen§0000-0002-6471-7807
dc.identifier.authororcidMcCarthy, Nora§0000-0002-4709-8290
dc.identifier.authororcidWiese, Anél
dc.identifier.authororcidSweeney, Catherine§0000-0002-2073-9457
dc.identifier.authororcidGambhir, Nitin
dc.identifier.authororcidFoley, Tony§0000-0003-3205-3871
dc.identifier.authororcidBennett, Deirdre§0000-0002-4469-9138
dc.identifier.citationHynes, H, McCarthy, N, Wiese, A, Sweeney, C, Gambhir, N, Foley, T & Bennett, D 2026, 'International medical graduates’ experiences of clinical competency assessment in postgraduate and licensing examinations: A scoping review', Plos One., vol. 21, no. 4, e0338282. https://doi.org/10.1371/journal.pone.0338282
dc.identifier.doi10.1371/journal.pone.0338282
dc.identifier.issn1932-6203
dc.identifier.issued4
dc.identifier.journaltitlePlos One.
dc.identifier.otherRIS: urn:0A9DA612AF0CC323A31136E94EAC51AD
dc.identifier.otherORCID: /0000-0003-3205-3871/work/215853186
dc.identifier.otherORCID: /0000-0002-6471-7807/work/215853293
dc.identifier.otherORCID: /0000-0002-4469-9138/work/215853678
dc.identifier.otherORCID: /0000-0002-4709-8290/work/215853977
dc.identifier.otherORCID: /0000-0002-2073-9457/work/215854131
dc.identifier.urihttps://hdl.handle.net/10468/18899
dc.identifier.volume21
dc.language.isoen
dc.publisherPublic Library of Science
dc.relation.urihttps://www.scopus.com/pages/publications/105037429488
dc.relation.urihttps://www.scopus.com/pages/publications/105037429488?origin=resultslist
dc.rights© 2026, Hynes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.accessrightsopen access
dc.rights.licensenameAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.statusPeer reviewed
dc.subjectAustralia
dc.subjectCanada
dc.subjectClinical competence
dc.subjectEducational measurement
dc.subjectEvidence gap
dc.subjectForeign medical graduates
dc.subjectGraduate
dc.subjectHealth care system
dc.subjectHumans
dc.subjectLanguage ability
dc.subjectMale
dc.subjectUnited Kingdom
dc.subjectWorld Health Organization
dc.subject[Medicine]
dc.subjectarticle
dc.titleInternational medical graduates’ experiences of clinical competency assessment in postgraduate and licensing examinations: A scoping reviewen
dc.typeArticle (peer-reviewed)
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