Premium
Equal, global, local: discourses in Taiwan's international medical graduate debate
Author(s) -
Ho MingJung,
Shaw Kevin,
Liu TzuHung,
Norris Jessie,
Chiu YuTing
Publication year - 2015
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.12619
Subject(s) - globalization , sociology , political science , context (archaeology) , critical discourse analysis , politics , public relations , public administration , law , paleontology , ideology , biology
Context With the globalisation of medicine, the role of international medical graduates (IMGs) has expanded. Nonetheless, the experiences of native‐born IMGs remain under‐researched. In Taiwan, public controversy has unfolded around IMGs educated in Poland, calling into question the meaning(s) of equality in policy and medicine. In focusing on the return of IMGs to their countries of origin, this study adds to the growing literature concerning equality and globalisation in medical education. Objectives The primary research aim was to analyse how stakeholders in the IMG debate use equality in their arguments. The authors set out to frame the dispute within the recent history of Taiwanese medical governance. An overarching objective was to contribute a critical, historical view of how discourses of globalisation and equality construct different policy approaches to international medical education. Methods The authors performed a critical discourse analysis of a public policy dispute in Taiwan, assembling an archive from online interactions, government reports and news articles. Coding focused on stakeholders' uses of equality to generate broader discourses. Results International and domestic Taiwanese students conceived of equality differently, referencing both ‘equality of opportunity’ and ‘equality of outcome’ within localisation and globalisation frameworks, respectively. The dominance of localisation discourse is reflected in hostile online rhetoric towards Poland‐educated IMGs. Conclusions Rhetorical disagreements over equality in medical education trace shifting state policies, from earlier attempts to remove barriers for IMGs to the present‐day push to regulate IMGs for acculturation and quality assurance. The global Internet had a double‐sided influence, facilitating both democratic political mobilization and the spread of hate speech. The policy debate in Taiwan mirrors discourses in Canada, where IMGs are likewise conceived either as globally competent physicians or as lacking in merit and technical competence. Future research could investigate the discursive formation and evidential basis of policies regulating international medical education.