Exploring life satisfaction difference between domestic and international medical graduates: Evidence from a national longitudinal study

Background: Studies of doctors' life satisfaction (subjective well-being) have largely overlooked the specific experiences of international or overseas trained doctors. This study explores any difference in life satisfaction and its determinants between international and domestic medical graduates (i.e. IMGs vs. DMGs), in Australia (a major destination country). Methods: We pooled eight waves of data from the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of Australian doctors (2009-2016). Life satisfaction was measured on a standard 10-point scale. We applied Oaxaca and Ransom's linear decomposition method to evaluate factors associated with any observed difference in satisfaction between the two groups of doctors. Results: IMGs were more likely to report lower life satisfaction than DMGs (mean 7.37 vs 7.48, p-value < 0.001). The well-being gap (of 0.11) was largely attributable to the groups' differences in observable characteristics such as psychosocial and demographic factors. Most notably, the IMG group was worse off with respect to self-reported financial security, exposure to work-related psychosocial risk factors, and community integration. Conclusion: Our study highlights the importance of the workplace and community context in understanding the life satisfaction difference between IMGs and DMGs. The study results may have important implications for policies and programs that seek to promote the integration and retention of IMGs.