Subtheme 1: Stress and Burnout.

The demanding nature of medical internships leads to high-stress levels and burnout among MIMGs. These pressures arise from various factors, such as heavy patient loads and the emotional challenges of patient care. The impact of these stressors can be significant, impacting not only the interns’ physical and mental well-being but also their professional performance and the quality of care they deliver.

The heavy patient loads that MIMGs must manage contribute significantly to their stress levels. Interns are often responsible for numerous patients, each requiring detailed attention and care. The sheer volume of patients can be overwhelming, making it difficult for interns to provide the level of care they aspire to. MIMG 6 discussed the emotional impact of managing critical cases and patient deaths:

“Losing a patient or dealing with critical cases back-to-back was emotionally draining. It affected my ability to stay focused and positive.” (MIMG 6)

Constant exposure to severe and often distressing medical conditions can be emotionally challenging for interns. Dealing with patient deaths, critical illnesses, and the associated family demands adds a layer of stress that is difficult to manage, especially for those in the early stages of their internship.

The absence of adequate support from senior staff and mentors exacerbates the stress and burnout experienced by MIMGs. When interns do not receive sufficient guidance and assistance, they can become overwhelmed by their responsibilities. This lack of support can lead to helplessness and frustration, further intensifying their stress. MIMG 11 highlighted the challenges of working without adequate support from senior staff:

“There were times when I felt completely lost and overwhelmed because there wasn’t enough support from senior staff. It made an already tough job even harder.” (MIMG 11)

When support systems are weak or absent, interns may struggle to find solutions to complex medical issues, leading to increased anxiety and a sense of inadequacy. The pressure to perform well despite these challenges can contribute significantly to burnout.

The emotional demands of patient care are another critical factor contributing to stress and burnout among interns. They must navigate the delicate balance between maintaining professional detachment and providing compassionate care. This balancing act becomes particularly challenging when faced with patients’ suffering and the accompanying emotional responses from their families. MIMG 4 shared her experience of emotional exhaustion due to these demands:

“The emotional demands of patient care were overwhelming. It was hard to keep going when you constantly see people in pain and distress.” (MIMG 4)

Constant exposure to suffering can lead to emotional exhaustion, characterised by feelings of helplessness and emotional detachment from work. This state of emotional exhaustion is a core component of burnout and significantly impacts interns’ ability to engage empathetically with patients.

In conclusion, stress and burnout are pervasive challenges that MIMGs face during their internships. Long working hours, heavy patient loads, the emotional demands of patient care, and the lack of adequate support from senior staff all contribute to the high level of stress and burnout experienced by these interns.

Subtheme 2: Discrimination.

Feeling discriminated against, isolated, and lonely is a common experience among MIMGs during their internships, especially for those who face discrimination, are unfamiliar with the local case presentation style, or struggle with clinical note-writing. These feelings of isolation can can be exacerbated by being away from family and friends and by the demanding nature of the internship. The absence of a social support network and integration challenges further heighten these feelings, making it challenging for interns to deal with their multifaceted challenges.

Many MIMGs have reported experiencing subtle and overt forms of discrimination due to their international medical education. This discrimination often manifests itself as a lack of trust or confidence from colleagues and supervisors who may question the quality of their training. This skepticism can leave MIMGs feeling marginalized and isolated in their professional environment. MIMG 5 shared their experience with discrimination:

“I often felt that my colleagues and even some supervisors looked down on my education because I studied Indonesia. It was as if they doubted my abilities initially, which made me feel very isolated.” (MIMG 5)

MIMG 7 discussed the compounded sense of isolation they felt, not only because they were unfamiliar with local practices but also because of the subtle discrimination they experienced:

“I felt like I was always a step behind because I wasn’t familiar with the local practices. On top of that, there was this unspoken bias against my international training. It made connecting with others and feeling like part of the team hard.” (MIMG 7)

MIMG 10 and MIMG 11 emphasised the lack of support and understanding from peers, which led to profound feelings of loneliness:

“Most of my peers didn’t understand the challenges I was facing. They had their own cliques and support systems, and I often felt left out and lonely because I was struggling to keep up with the local standards.” (MIMG 10)

“Being away from my support network back home was tough. On top of that, dealing with the subtle discrimination because I graduated abroad made it even harder. It felt like a constant battle to prove myself, and it was incredibly isolating.” (MIMG 11)

MIMG 2 talked about the psychological impact of isolation and the feeling of not belonging:

“There were times when I questioned my decision to come back. The isolation and the feeling that I didn’t belong here because of my different training background took a huge psychological toll on me.” (MIMG 2)

This sense of being undervalued and scrutinised adds to the emotional burden, making it more difficult for MIMGs to build professional relationships and find their place within the medical team.

Additionally, MIMGs often face challenges in adapting to the local case presentation style, which can differ significantly from what they were accustomed to abroad. The nuances in case presentation, the expectations of supervisors, and the communication style within the medical team can create additional stress and a sense of inadequacy. MIMG 3 described their struggle with adapting to the local case presentation style:

“The way cases are presented here is quite different from what I was used to. I often felt out of place during rounds because I wasn’t sure if I was meeting the expectations. This made me feel very self-conscious and isolated.” (MIMG 3)

The pressure to conform to new standards while managing the inherent stress of the internship can lead to feelings of loneliness and isolation. MIMGs may hesitate to seek help or admit their difficulties, further compounding these feelings.

Writing clinical notes in a format that is both clear and acceptable to local standards is another area where MIMGs may struggle, particularly in hospitals without information systems. Differences in documentation practices can lead to confusion and an increased workload as they try to adapt to the expected format. This unfamiliarity can result in criticism from supervisors and colleagues, further isolating the intern. MIMG 9 highlighted the challenge of adapting to local clinical note-writing practices:

“I found it difficult to adapt to the style of writing clinical notes here. My notes were often critiqued, and I felt like I was constantly falling short. It was disheartening and made me feel very isolated.” (MIMG 9)

The need to continually adjust and improve their documentation practices, often without adequate guidance or support, can contribute to a sense of professional isolation.

Subtheme 3: Policy and bureaucratic hurdles.

Policy and bureaucratic hurdles present significant structural challenges for MIMGs. Obtaining the necessary documentation, registration, and other administrative requirements can be a lengthy and cumbersome process. These procedures often involve navigating complex and sometimes inefficient administrative systems, which can delay the start of clinical rotations and add to the stress of MIMGs. MIMG 3 shared their frustration with the bureaucratic process, MIMG 5 emphasised the inefficiency of the system, and MIMG 8 pointed out the lack of clear guidelines:

“The paperwork was overwhelming. It felt like I was constantly filling out forms and waiting for approvals, which delayed my ability to start rotations on time.” (MIMG 3)

“I spent weeks trying to get all the necessary documents in order. The process was slow and disorganised, which made it difficult to focus on my training.” (MIMG 5)

“There was a lot of confusion about what documents were needed and where to submit them. The lack of clear guidelines made the process very stressful.” (MIMG 8)

Subtheme 4: Inadequate infrastructure.

Inadequate infrastructure in hospitals and clinics is another major challenge faced by MIMGs. This includes outdated or malfunctioning equipment, insufficient medical supplies, and overcrowded facilities. These conditions can hinder their ability to provide effective patient care and negatively impact their learning experience. MIMG 7 discussed the frustration of working with inadequate equipment, MIMG 10 highlighted the shortage of medical supplies, and MIMG 6 spoke about the overcrowded facilities:

“Sometimes we had to work with equipment that was either broken or outdated. It was frustrating because it affected the quality of care we could provide.” (MIMG 7)

“There were times when we ran out of essential medical supplies, which made it difficult to perform even basic procedures. It was very demoralising.” (MIMG 10)

“The wards were often overcrowded, and it was challenging to manage so many patients with limited resources. It added to the stress and made it hard to learn effectively.” (MIMG 6)

Subtheme 5: Low incentives.

Low financial incentives are a critical issue for MIMGs, especially when they are burdened with student loans from studying abroad, unlike local graduates. The stipends or salaries provided during internships are often insufficient to cover living expenses and repay these loans, causing significant financial stress. MIMG 2 discussed the financial strain, MIMG 9 pointed out the disparity in earnings, and MIMG 11 highlighted the impact on her plans.

“The stipend we receive is barely enough to cover my living expenses, let alone pay back my study loans. The financial stress is overwhelming.” (MIMG 2)

“Compared to what I might earn abroad, the incentives here are quite low. It’s hard to stay motivated when you’re struggling financially.” (MIMG 9)

“The low pay makes it difficult to save for the future or even plan for additional training. It feels like a constant struggle to make ends meet.” (MIMG 11)

Subtheme 6: Non-compliance with Flexi-Hour Rules Compared to Studying Abroad.

Many MIMGs report that the flexi-hour rules, intended to provide a balance between work and rest, are often not adhered to in Malaysia. This non-compliance results in excessively long working hours, contributing to fatigue, burnout, and a reduced quality of life. MIMG 4 shared their experience with the non-compliance of flexi-hour rules, MIMG 7 compared the situation to their experience abroad, MIMG 8 described the impact on their health, MIMG 10 emphasised the inconsistency, and MIMG 2 highlighted that these extended hours lead to chronic fatigue, diminishing the interns’ ability to perform optimally:

“The flexi-hour rules are supposed to ensure we get adequate rest, but they are rarely followed. We end up working long hours without proper breaks.” (MIMG 4)

“When I was studying abroad, there were strict regulations about work hours, and they were enforced. Here, the rules exist but are not implemented, which makes it very tough.” (MIMG 7)

“The long hours and lack of rest take a toll on our health. I’ve seen colleagues burn out because the flexi-hour rules are not respected.” (MIMG 8)

“There’s a big gap between the policies on paper and what happens on the ground. It’s frustrating to know that the rules are there but not enforced.” (MIMG 10)

“There were days when I felt completely drained. The workload was immense, and there was little time to rest or recover.” (MIMG 2)

The lack of sufficient rest periods means that interns do not have adequate time to recuperate between shifts, leading to a cumulative effect of fatigue and decreased mental acuity. This continuous cycle of exhaustion compromises the interns’ health and increases the risk of medical errors, ultimately affecting patient safety.

Subtheme 7: Communication Barriers.

Communication barriers present a significant challenge for MIMGs during their internships. These barriers stem from differences in medical terminology, difficulties in understanding abbreviations, and unclear instructions from specialists, often exacerbated by high-stress communication styles. Such issues can hinder effective communication, lead to misunderstandings, and contribute to the stress and anxiety experienced by MIMGs.

One of the primary language-related challenges for MIMGs is adjusting to the different medical terminologies used in Malaysia compared to those they encountered during their studies abroad. Medical jargon can vary significantly between countries, and terms familiar to local graduates may be entirely new to MIMGs. This discrepancy can lead to confusion and errors in understanding patient conditions, treatment plans, and medical procedures. MIMG 5 described their struggle with adapting to the local medical terminology:

“I struggled with medical terminology in Malay. While I could converse in basic Malay, explaining complex medical conditions was challenging.” (MIMG 5)

This challenge is compounded when MIMGs must quickly learn and apply these terminologies in high-pressure clinical environments. The learning curve can be steep, and the constant need to translate and interpret unfamiliar terms can slow their workflow and undermine their confidence.

In addition to different terminologies, MIMGs often struggle with understanding the abbreviations commonly used in Malaysian medical settings. Medical abbreviations are widely employed for efficiency, but they can vary greatly between countries and even between institutions within the same country. For MIMGs, unfamiliar abbreviations can significantly hinder effective communication and understanding. MIMG 3 highlighted the confusion caused by local abbreviations:

“The abbreviations used here were different from what I learnt abroad. I often had to ask for clarification, which made me feel inexperienced and slowed me down.” (MIMG 3)

The need to constantly seek clarification can be frustrating and time-consuming, adding to the overall stress of the internship. It also places MIMGs in a difficult position, where they may hesitate to ask questions for fear of appearing incompetent.

Another major issue related to language barriers is the difficulty in understanding instructions from specialists. In high-stress environments, specialists may give rapid or unclear instructions, sometimes speaking in a high tone, which can be intimidating for interns. This communication style can make it challenging for MIMGs to grasp the necessary information, leading to potential misunderstandings and errors. MIMG 6 shared their experience with unclear instructions from specialists:

“Specialists would often give instructions very quickly and sometimes in a high tone. It was hard to catch everything they said, and I was afraid of making mistakes because I didn’t fully understand their directions.” (MIMG 6)

The combination of unclear instructions and an intimidating communication style can create a stressful learning environment where MIMGs feel anxious about making errors and uncertain about their performance.

Subtheme 8: Different work culture.

The hierarchical nature of the medical field in Malaysia can create a significant gap between mentors and mentees. This strict hierarchy is commonly observed, and the relationships between senior doctors and interns are often formal and rigid. This structure can inhibit open communication and limit opportunities for MIMGs to seek guidance and mentorship. MIMG 1 described the challenges posed by this hierarchical structure:

“The strict hierarchy made it difficult to approach senior doctors with questions or concerns. There was always a sense of distance, and I often felt intimidated.” (MIMG 1)

This gap can leave MIMGs feeling unsupported and isolated. They may hesitate to seek help or clarification, fearing negative repercussions or appearing incompetent. The absence of a close mentor-mentee relationship can impede the learning process and negatively impact the overall internship experience.

Medical protocols in Malaysia are tailored to the local demographic and disease variants, which can differ significantly from what MIMGs are accustomed to abroad. For instance, certain tropical diseases or conditions prevalent in Malaysia may not be as common in the countries where these graduates studied. As a result, MIMGs must quickly adapt to new protocols and treatment guidelines, which can be challenging without prior exposure. MIMG 5 highlighted the difficulties in adapting to these different medical protocols:

“I had to learn about diseases and treatment protocols that were completely new to me. The learning curve was steep, and it was challenging to adapt quickly while managing a busy workload.” (MIMG 5)

The need to rapidly acquire knowledge about local medical conditions and adapt to different treatment protocols can be overwhelming. This challenge is compounded by the pressure to perform effectively in a clinical environment where mistakes can have serious consequences.

The high public demand for healthcare services in Malaysia, coupled with a general lack of respect for MIMGs, adds another layer of complexity to cultural adaptation. Patients and their families often have high expectations and can be critical or dismissive towards interns, especially those perceived as less experienced or foreign-trained. MIMG 3 shared their experience with the high public demand and lack of respect:

“Patients and their families sometimes questioned my competence because I studied abroad. It was disheartening to face such skepticism and disrespect while trying to provide the best care I could.” (MIMG 3)

This lack of respect can erode MIMGs’ confidence and contribute to feelings of inadequacy and frustration. The high demand for services also means interns are constantly under pressure to meet expectations, often with limited resources and support.

Subtheme 1: Self-motivated.

Maintaining a positive outlook and focusing on long-term goals can help MIMGs stay motivated. They push through difficult times by reminding themselves of their purpose and the end goal.

“I kept reminding myself why I chose this profession and focused on the end goal. It helped me stay positive and motivated.” (MIMG 6)

“Despite the challenges, I always reminded myself why I chose this path. Keeping my end goal in mind helped me stay focused and motivated, even on the toughest days. It was my passion for medicine that kept me going.” (MIMG 4)

“Staying positive was crucial for me. I would often set small, achievable goals for each day, which helped me feel a sense of accomplishment and kept my spirits high. This mindset made the difficult times more manageable and kept me resilient.” (MIMG 9)

Subtheme 2: Flexibility.

Being open to new experiences and willing to learn from mistakes is essential. Adapting to different clinical settings, medical protocols, and cultural practices requires flexibility.

“I realized that flexibility was key. I had to adapt quickly to new protocols and ways of working and being open-minded helped me manage these changes better.” (MIMG 3)

“Adjusting to the local work environment was challenging, especially when it came to learning the specific practices and protocols here. Initially, it felt like I had to unlearn some habits from abroad and adapt to new ways of handling cases and documentation. Embracing flexibility and actively seeking guidance from colleagues helped me integrate better and become more competent in this new setting.” (MIMG 4)

“The transition to the new work-learn environment was not easy. I had to adapt quickly to different clinical practices and communication styles that were unfamiliar to me. It required a lot of flexibility and openness to feedback. By staying proactive and continuously asking for advice, I managed to align my approach with local standards and improve my performance over time.” (MIMG 6)

Subtheme 3: Seeking Support.

Support from peers, mentors, and colleagues is invaluable for MIMGs. Building a network of supportive individuals can provide both emotional and practical assistance. MIMG 8 mentioned that connecting with family and friends, even remotely, offers emotional support and a sense of belonging. MIMG 10 suggested forming peer support groups with fellow interns and colleagues, which allows MIMGs to share experiences, offer advice, and provide emotional support. MIMG 4 emphasised the importance of seeking guidance from mentors who can help MIMGs navigate the complexities of the internship by offering valuable insights, encouragement, and practical advice.

“Keeping in touch with my family and friends back home was crucial. Their support kept me grounded and gave me the strength to keep going.” (MIMG 8)

“Having a group of friends who were going through the same thing made a huge difference. We supported each other and shared tips on how to handle tough situations.” (MIMG 10)

“My mentor was incredibly supportive. He provided valuable insights and advice that helped me navigate the internship successfully.” (MIMG 4)

Subtheme 4: Continuous Professional Development.

Engaging in continuous professional development through courses, workshops, and self-study ensures that MIMGs remain competent and confident in their medical practice. MIMG 11 participated in pre-internship crash course, which helped her to refresh her knowledge in clinical practices. Additionally, MIMG 9’s practice of reflecting on his daily experiences and learning from mistakes enables MIMGs to grow professionally and improve their practice:

“I attended crash-course workshops and read extensively to stay updated with the latest medical practices. It boosted my confidence and competence.” (MIMG 11)

“I kept a journal in Facebook where I reflected on my daily experiences. It helped me learn from my mistakes and grow as a doctor.” (MIMG 9)

Subtheme 5: Personal Self-Care Practices.

Maintaining a healthy work-life balance and engaging in self-care activities are essential for managing stress and avoiding burnout. MIMG 1 practised regular physical exercise and pursued hobbies to provide a necessary break from work demands, helping to reduce stress. MIMG 2 relied on prayer and other relaxation techniques to manage stress and maintain mental well-being:

“I made it a point to exercise regularly and take short breaks to relax. It really helped me manage stress.” (MIMG 1)

“Practicing mindfulness and prayer helped me stay calm and focused. It was a great way to manage the stress of the internship.” (MIMG 2)

Subtheme 6: Effort to understand the policy and guidelines.

To cope with policy and bureaucratic hurdles, MIMGs often sought assistance from administrative staff, peers, and mentors who could guide them through the processes. Keeping detailed records and staying organized helped manage the administrative workload.

“I sought help from the administrative staff and my peers who had gone through the process before...we are contract officers. Keeping detailed records and staying organized helped me manage the paperwork more efficiently.” (MIMG 5)

“Despite the overwhelming bureaucracy, I stayed organized and kept track of all the required documents. This systematic approach helped me navigate the process more smoothly.” (MIMG 7)

“I learned to be patient and persistent. Each step forward was a small victory that kept me motivated to push through the bureaucratic red tape.” (MIMG 9)

These strategies highlight the importance of organizational skills and persistence in overcoming bureaucratic obstacles.

Subtheme 7: Work with less.

When dealing with inadequate infrastructure, MIMGs learned to be resourceful and innovative. They collaborated with colleagues to find alternative solutions and make the best use of available resources.

“We often had to be resourceful and find creative solutions to make do with what we had. Working closely with colleagues helped us find ways to overcome these limitations.” (MIMG 7)

“Sometimes, improvisation was key. We found ways to work around the lack of equipment and still provide the best care possible.” (MIMG 10)

“Pooling resources and collaborating with other departments helped us mitigate the impact of infrastructure deficiencies. It fostered a sense of teamwork and problem-solving.” (MIMG 3)

These responses illustrate the importance of collaboration and creativity in managing infrastructure challenges.

Subtheme 8: Part-time work.

To cope with financial strain, MIMGs often took on additional part-time work, applied for financial aid, and practiced strict budgeting.

“I took on part-time work as grab driver whenever off duty to manage the financial strain. Budgeting carefully also helped me make ends meet.” (MIMG 2)

“Living frugally and seeking financial assistance from bank were necessary steps to cope with the low stipend, especially to buy car.” (MIMG 4)

“Joining financial literacy programs helped me manage my finances better and plan for the future despite the low pay.” (MIMG 6)

These strategies demonstrate the proactive steps MIMGs take to manage their finances and reduce financial stress.

Subtheme 9: Time management.

MIMGs focused on time management and prioritised rest whenever possible to cope with the long working hours and lack of rest. They also advocated for their rights and sought support from peers and supervisors to ensure fair treatment.

“I focused on managing my time effectively and prioritized rest whenever possible. I also spoke up about the need for fair treatment and sought support from my peers and supervisors.” (MIMG 4)

“Effective time management and advocating for better working conditions were crucial. We needed to ensure our health was not compromised.” (MIMG 7)

“Forming a support network with colleagues helped us collectively address issues related to work hours and seek solutions together.” (MIMG 8)

These approaches emphasize the importance of self-advocacy and collective action in addressing work-hour challenges.

Subtheme 10: Understand Organization Culture.

To bridge the gap created by the hierarchical structure, MIMGs sought to establish respectful and open communication channels with their mentors. They also looked for unofficial mentors among more approachable senior colleagues.

“I tried to establish a respectful relationship with my mentor and sought guidance from more approachable senior colleagues who could offer support.” (MIMG 1)

“Finding unofficial mentors, if you know Dr Iliana Medicorp who were willing to guide me informally helped bridge the hierarchical gap and provided valuable insights.” (MIMG 3)

“Building trust through consistent performance and respectful communication helped me gain the support of my mentor.” (MIMG 5)

These responses highlight the importance of building trust and seeking informal mentorship to navigate hierarchical challenges.

Subtheme 11: Adhere to local clinical practice guidelines.

MIMGs engaged in self-directed learning and participated in local training sessions to adapt to different medical protocols. They also sought advice from local colleagues who were familiar with the prevalent diseases and treatment protocols.

“I spent extra time studying local disease patterns and protocols. Attending local training sessions also helped me adapt more quickly.” (MIMG 2)

“Seeking advice from local colleagues who were experienced with the prevalent diseases and protocols was invaluable. Their insights helped me adjust my approach.” (MIMG 5)

“Self-directed learning and collaboration with experienced local doctors helped me understand and adapt to the different medical protocols.” (MIMG 6)

These strategies emphasize the importance of continuous learning and collaboration in adapting to new medical protocols.

Subtheme 12: Sensitive about high public demand.

MIMGs focused on building their professional reputation through consistent performance and patient-centred care to cope with high public demand and the lack of respect. They also educated patients about their qualifications and training to build trust and respect.

“I focused on providing the best care possible and building my professional reputation. Educating patients about my qualifications helped build trust.” (MIMG 3)

“Demonstrating competence and empathy in patient care helped me gain the respect of patients and their families over time.” (MIMG 9)

“Consistency in my work and taking the time to communicate effectively with patients gradually earned their respect and trust.” (MIMG 10)

These responses highlight the importance of professionalism and patient education in gaining respect and managing public demand.

Subtheme 13: Improve communication skill.

Language barriers, including unfamiliar medical terminology, difficulties with abbreviations, and unclear instructions from specialists, pose significant challenges for MIMGs during their internships in Malaysia, particularly for those who graduated from Indonesia. These barriers can lead to misunderstandings, errors, and increased stress, affecting both patient care and professional relationships. Here are some strategies MIMGs employ to overcome these challenges:

“The medical terminology here was quite different from what I learned abroad. To cope, I created a glossary of terms and abbreviations notes. I would review it regularly and ask my colleagues for explanations whenever I encountered unfamiliar terms. This proactive approach helped me gradually become more comfortable with the local terminology.” (MIMG 1)

“Understanding the local medical jargon and slang was one of the toughest challenges for me. Sabahan working at Kelantan, can you imagine? Kelantanese dialect is tough to understand..I will ask senior interns who could explain the terms in simpler language. I also made a habit of noting down any new terms I came across and looked them up later to build my understanding.” (MIMG 7)

Providing a targeted language training short course focused on the medical terminology and abbreviations used in Malaysia could help MIMGs become more familiar and comfortable with local jargon.

In addition to different terminologies, MIMGs often face difficulties in understanding the abbreviations commonly used in Malaysian medical settings. Medical abbreviations are widely used for efficiency, but they can vary significantly between countries and institutions within the same country. For MIMGs, unfamiliar abbreviations can hinder substantially effective communication and understanding.

“The abbreviations used here were different from what I learnt abroad. I often had to ask for clarification, which made me feel inexperienced and slowed me down.” (MIMG 3)

“The abbreviations and specific terms used in clinical notes were overwhelming at first. I reached out to my peers and supervisors to clarify any confusion and made use of online medical dictionaries. I also participated in team discussions and asked questions during meetings to get familiar with the common terminology used in practice.” (MIMG 9)

Another major issue related to language barriers is the difficulty of understanding instructions from specialists. In high-stress environments, specialists may give rapid or unclear instructions, sometimes speaking in a high tone, which can be intimidating for interns. This communication style can make it challenging for MIMGs to grasp the necessary information, leading to potential misunderstandings and errors.

“Having a supervisor who took the time to explain things clearly made a huge difference. They didn’t get frustrated when I asked questions, which helped me learn faster and feel less anxious.” (MIMG 8)

Encouraging specialists and supervisors to communicate clearly and patiently, avoiding the use of high tones, can create a more supportive learning environment. Clear and concise instructions can help reduce misunderstandings and build confidence among MIMGs.