“This impacts women more than men”: The (in)direct relationship of gender and medical registration for international medical graduates (IMGs) in Aotearoa New Zealand

Abstract

This paper explores the gendered dimensions of medical licensing for international medical graduates (IMGs) in Aotearoa New Zealand.  Using an exploratory sequential mixed methods approach, the research draws on 24 interviews with IMGs and 9 local experts, alongside an online questionnaire of 80 IMGs, to analyse disparities in licensing experiences and professional outcomes.  While only 38% of questionnaire respondents who identified as women had achieved medical registration, 80% of men were licensed.  Despite these disparities, the majority of participants did not explicitly perceive gender as a barrier, highlighting the indirect and often unacknowledged nature of gendered disadvantages.  Women, particularly those who migrated as spouses, frequently delayed their medical licensing process due to caregiving responsibilities and inflexible registration requirements.  Applying a capabilities approach to mobility justice, this paper argues that medical registration policies in Aotearoa New Zealand inadvertently reproduce gendered and racialised inequalities by privileging IMGs from high-income, Global North countries while overlooking the constraints faced by caregivers and those trained in the Global South.  More equitable licensing processes would consider alternative pathways for those with career interruptions, greater flexibility in recent clinical experience requirements, and mechanisms to address structural biases in eligibility criteria.