The foreign medical graduate in Ontario: An empirical and theoretical enquiry.

摘要

This project is a social-psychological investigation of foreign-trained physicians seeking medical licensure in Ontario during the 1980's. Erving Goffman's works provide both a methodology and a theory for understanding the experiences of these physicians who undergo evaluation and seek to upgrade their abilities in order to meet Canadian medical standards. We look at the foreign-trained physician's pursuit of a license as a "moral career.".;To further understand the interplay of external and internal factors in this type of "moral career," Goffman's concept of the "total institution" was employed. Although developed through study of the inmates of a carceral institution, the analogous powerlessness and discomfort of these foreign-trained physicians allow us to substantiate Goffman's claim as to the generic nature of the "total institution." The fate of the foreign-trained physicians' career quest was further analyzed with Goffman's model of "cooling out," as the "social organization of loss" conducted by the requalification system.;Goffman's work is shown to be highly relevant for empirical research in settings of structured inequality. The project has developed insight into the patterns of experiences of mostly immigrant subjects grappling with a powerful institution. We have examined the process and outcomes of a group of people confronting an institution whose purpose is to deny the majority of them their medical career.;Our method followed Goffman's specification of the dual loci of careers: data were gathered on their "internal," subjective reactions to requalification and on their situation's "external," objective parameters. Foreign-trained physicians were interviewed and field research was conducted on their requalification experiences. The Ontario health care system's disposition toward these physicians was examined through analysis of policy initiatives, the operation of the requalification institution and through interviews of evaluators.