What workplace challenges do foreign-born radiologists face in the US?

Foreign-born faculty members face numerous challenges when joining radiology departments in the United States, according to a new analysis published in the Journal of the American College of Radiology.

"Physicians and medical professionals from foreign lands are an integral part of the medical system in the United States," wrote lead author Neeraj Lalwani, MD, of Wake Forest University and Baptist Health in Winston-Salem, North Carolina, and colleagues. “Similar to any other medical specialty, radiology has also attracted many foreign-born physicians, and some of them have made exemplary contributions to academia as faculty members."

Unfortunately, the authors noted, some of the challenges these specialists may face include loneliness and assimilation, professionalism and communication skills.

Loneliness and assimilation

Because of the change in geography, culture and perhaps a lack of social support, foreign-born radiologists may feel lonely, which can translate to workplace isolation.

“The consequences of workplace isolation are similar to burnout and may lead to diminished creativity, productivity, morale, and job satisfaction,” Lalwani and colleagues wrote.

To combat loneliness, the authors suggest foreign-born radiologists establish professional and social networks and get a better understanding of local culture including sports, history and geography.


Professionalism, the authors noted, may have a different context in the United STates than in the foreign-born radiologists’ home countries. Still, it is very important to maintain professionalism as it “mandates control” of emotional situations.

“Reinforcing professionalism is a process, a journey. It requires motivation, internal drive, and a desire for engagement,” the authors noted. “Commitment to lifelong learning and professional development, honesty to patients and patient confidentiality, improving the quality of and access to care, just distribution of finite resources, and up-to-date scientific knowledge are the fundamental responsibilities of a medical professional.”

Communication skills

Poor communication skills are “among the biggest challenges foreign-born faculty members may encounter,” the authors wrote. Importantly, limited English proficiency is not the cause of poor communication. The authors attribute poor communication to cultural differences and a sense of feeling “alien.” This may leave the foreign-born faculty feeling intimidated and prevent them from sharing ideas.

However, the researchers did not completely rule out the need for proficiency in English and accent reduction. Accents can negatively impact educational activities despite “great skills and knowledge.” Some institutions have established programs that underscore accent reduction or modification.

“Despite opportunities to become fully integrated into American academic programs, there are challenging obstacles, particularly in programs that do not attract international scholars,” the researchers concluded. “These challenges can prevent foreign-born faculty members from fully realizing their potential to have a positive impact on academia if they are not effectively supported.”