The proportion of international medical graduates (IMGs) in Ireland has increased from 13.4% in 2000 to over 33% in 2010. Many of their countries of origin have different cultures, expectations of the doctor–patient relationship and communication styles than Ireland. These differences can adversely impact on the quality of care provided by IMGs. There is a lack of research on the impact of cultural differences on communication in the Irish context.

Semi-structured interviews were conducted with 16 IMGs in Drogheda Department of Psychiatry. Transcripts were analysed using nVivo10, a specialised computer programme for conducting qualitative analysis and analysed thematically.

General themes emerged relating to IMG experience of cultural differences in medicine and psychiatry and cultural differences in communication. IMGs did not find their proficiency in English to be a barrier to communication but did find accents, culture-specific sayings and non-verbal cues to be challenging. Differences in doctors’ status relative to patients and different expectations of the doctor–patient relationship were challenging and, at times, frustrating and annoying. It was generally recognised that training in cross-cultural communication skills would be beneficial to new IMGs although a small minority recognised no such issues. Significant differences in attitude to patient confidentiality in Ireland versus the country of origin were identified.

Consideration should be given to providing specific cross-cultural communication skills training for all IMGs training in Ireland focusing not just on verbal and non-verbal communication but also differences in the doctor–patient relationship, patient and relative expectations and medical confidentiality requirements.