Thriving as an IMG in emergency medicine: What I’ve learned
Dr Ajith Thampi has made the journey from International Medical Graduate (IMG) to FACEM. With experience across regional and metropolitan settings, and a deep commitment to supporting international and local medical graduates, Ajith draws meaning from the many stories shared by the doctors he mentors. These conversations, he believes, are what make the work and life rich and rewarding. Read about what he learned along the way.
As international medical graduates (IMGs), especially those working in emergency medicine in Australia, we often find ourselves navigating a space that’s full of opportunities — but not without its complexities.
It’s a journey of learning, unlearning, adapting, and slowly finding your rhythm in a system that can sometimes feel unfamiliar. But over time, with the right mindset and support, many of these challenges become opportunities — and our contributions grow far beyond our initial role.
“Many IMGs bring with them experience from environments where clinical care is delivered with limited resources and great ingenuity.”
Your perspective matters
Many IMGs bring with them experience from environments where clinical care is delivered with limited resources and great ingenuity. While adjusting to a new system takes time, these experiences can add significant value, especially in an increasingly stretched healthcare environment.
The perspective of having worked in different systems, with different constraints and challenges, may not always be recognised upfront. But it often offers practical insights, particularly when aligned with local standards. At the core there should be a consistent commitment to excellent and safe patient care. That’s what opens doors and builds credibility.
Find support and offer it when you can
One of the things that has helped me most has been surrounding myself with people who understand, support, and challenge me. Sometimes that’s formal mentorship. Sometimes it’s a study group or a peer who’s just a few steps ahead. If you’re not sure where to start, start small. Reach out to someone. Ask questions. Make a connection.
“Study groups, casual case discussions, and those hallway debriefs often do more than just help us prepare for assessments. They build friendships and support networks that last well beyond training.”
Study groups, casual case discussions, and those hallway debriefs often do more than just help us prepare for assessments. They build friendships and support networks that last well beyond training. And as you find your footing, sharing what you’ve learned with others can be just as grounding.
Understanding the system helps everything else settle
The emergency medicine training structure in Australia is well laid out, but can appear confusing initially. There are clear handbooks, pathways, and policies published by ACEM, but it does take some time to understand how they all fit together.
Once I started taking the time to really read the documents and ask the right people questions, I began to feel more in control. It’s helpful to know where you sit in the bigger picture, what’s expected of you, and what will actually help you progress. That kind of clarity is empowering.
Care for yourself along the way
Emergency medicine is exciting, but it’s also demanding. When you add the pressure of adapting to a new system, the emotional load can quietly build. Taking care of your mental and physical health isn’t just a good idea, it’s essential.
“And don’t forget to notice the small wins. Recognise your progress. Let yourself feel proud of the moments that once felt out of reach.”
Hospitals often offer wellness resources, but informal support can be just as powerful. Finding people you can check in with regularly, people who really get it, can help you feel less alone. Making time for what brings you joy outside of medicine — sport, creativity, time with family or friends — helps maintain balance and keeps you grounded.
And don’t forget to notice the small wins. Recognise your progress. Let yourself feel proud of the moments that once felt out of reach.
Some things are worth speaking up about
Not everything will go smoothly and, at times, you might encounter microaggressions, bias, or behaviours that don’t sit well with you. When something feels significant, know that you do have options — peer support, supervisors, DEMTs, HR, or diversity and inclusion committees.
Most situations can be diffused simply by asking questions or clarifying intent. At other times, you may want to take a more formal path. It’s important to reflect on what feels worth pursuing, and how to do so in a way that protects your wellbeing.
“It doesn’t take a senior title to make meaningful contributions. Many of us find our first opportunities through education, departmental projects, quality improvement, or simply suggesting something helpful at the right moment.”
Contribute where you are
It doesn’t take a senior title to make meaningful contributions. Many of us find our first opportunities through education, departmental projects, quality improvement, or simply suggesting something helpful at the right moment.
If you’re curious about engaging with the College, there are more flexible options now than ever before — short-term working groups, feedback sessions, committee experience programs and even writing for College publications. Over time, you’ll find the spaces where your voice and experience can make a difference.
Into the future
Emergency medicine is a space full of energy, impact, and growth. As IMGs, we bring with us a different lens, sometimes shaped by struggle, but also by strength and adaptability.
Let’s keep showing up, working hard, and building this space, not for ourselves, but for the community, today and into the future.
