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The paper aims to analyse how the medical profession, the pro‐competition organisation, and the rural community have responded to the rural doctor shortage with reference to international medical graduates (IMGs) as reported in Australian newspapers.

Utilising the commercially available database LexisNexis during 2003, the author keyed in “overseas trained doctors” and retrieved 641 Australian newspaper articles. The qualitative data analysis software NVivo2 has assisted the author to organise the data, informed by critical realism and narrative analysis.

While the medical profession is undoubtedly committed to serving the health needs of the Australian public, the medical community is less than united in addressing the rural doctor shortage, especially through the employment of large numbers of IMGs. The handling of IMGs has led to tensions not only between the locally trained and IMGs, but also between rural and non‐rural doctors, and between younger and established doctors. The medical professional institutions seemed relatively detached from the adverse consequences of the shortage of doctors in the rural community. This contrasts the efforts demonstrated by the Rural Doctors Association and the rural community.

This paper concludes with a critical realist and narrative analysis and resolving of the rural doctor shortage and recommends close communication and consultation among the diverse interest groups rather than their engaging in blaming one another. This would be an obvious starting point to address the rural doctor shortage, which may partly be achieved by the effective use of services by IMGs.

Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as not merely a scientific endeavor, but a social one as well. Medicalization is a “process whereby more and more of everyday life has come under medical dominion, influence, and supervision” (Zola, 1983, p. 295); previously these areas of everyday life were viewed in religious or moral terms (Conrad & Schneider, 1980; Weeks, 2003). More specifically, medicalization is the process of “defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to ‘treat’ it” (Conrad, 1992, p. 211). Sociologists have used this concept to describe the shift in the site of decision-making and knowledge about health from the lay public to the medical profession.

Doctor–medical institution collaboration (DMIC) services are an emerging service mode in focal online health communities (OHCs). This new service mode is anticipated to affect user satisfaction and doctors' engagement behaviors. However, whether and how DMIC occurs is still ambiguous because the topic is rarely examined. To bridge this gap, this study explores doctors' participation in DMIC services and its effects on their online performance, as well as its effect on patients' evaluation of them on OHC platforms.

The authors propose hypotheses based on structural holes theory. A unique dataset obtained from one of the most popular OHCs in China is used to test the hypotheses, and difference-in-differences estimation is adopted to test the causality of the relationship.

The results demonstrate that providing DMIC services improves doctors' online consultation performance and patients' evaluations of them but has no significant effect on doctors' knowledge-sharing performance on OHC platforms. Doctors' knowledge-sharing performance and consultation performance mediate the relationship between participation in DMIC services and patients' evaluation of doctors. Regarding doctors' participation in DMIC services, its impact on doctors' consultation performance and patients' evaluation of them is weaker for doctors with higher professional titles than for doctors with lower professional titles.

The findings clarify the value creation mechanisms of online collaboration between doctors and medical institutions and thereafter facilitate doctors' participation in DMIC services and enhance the sustainable development of OHCs.

This paper aims to explore what Chinese doctors have learned in authentic medical practice, what they want to learn, and the dynamics behind their professional learning in working contexts.

The paper uses Narrative Inquiry, qualitative data which were collected by open‐ended face‐to‐face interviews and participative observation. Seven doctors from three hospitals in Shandong province were purposefully invited. Each participant was interviewed at least once, and all interview recordings were transcribed into research texts. The author narrated and re‐narrated stories of one chosen participant named Li Hengyang (pseudonym).

The paper finds that Chinese doctors divided their learning into two kinds: “professional” and “non‐professional”. The intrinsic‐motive‐driven learning of medical knowledge and techniques was attributed to “professional” and the extrinsic‐motive‐driven learning of “other things” was treated as “non‐professional”. The resultant force of intrinsic and extrinsic motives caused a performance disorder, a vague sense of professional identity, and involuntary expressive behaviours. The author finally pointed out that Chinese doctors' professional learning in working contexts is, to some extent, identity‐oriented.

Single theoretical perspective constrained the analysis; future research may use different theoretical perspectives besides Goffman's theatrical performance theory.

The paper presents identity‐oriented learning of Chinese doctors and the dynamics behind it, which have practical implications for Chinese doctors, medical professional educators and national medical policy makers.

Although Chinese doctors' training and education have been explored a lot, their professional learning in working contexts was rarely studied before.

This study aims to investigate the perceived role of the Islamic medical care practice of Muslim doctors in Malaysian Muslim-friendly private hospitals.

Data were collection through self-administered questionnaires voluntarily submitted by the respondents. The survey covered selected major Muslim-friendly private hospitals in the country in the states of Kedah, Johor, Penang, Selangor, Kelantan and Kuala Lumpur. The non-probability purposive sampling was used, as the respondents and locations of the survey areas were predetermined.

Five dimensions of the Muslim-friendly medical care practice were identified, namely, medical etiquettes, physical examination, proper cleansing process of blood and body fluids, proper handling and treatment of infectious diseases and doctors’ advice to Muslim patients. The findings also indicate that the scale development analysis produced excellent results which can be used for reproducible or repetitive medical care purposes and for integration facts and figures for inclusion into wider medical care policy and practices.

The results from the study can further develop Islamic medical care practices and enable medical service providers to upgrade their performances to an enviable strategic status.

Islamic medical care is a new mode of healthcare service market, as there are very few studies on this topic from the perspective of Muslim patients or no obvious facts are known. This study has first explored Muslim doctors’ perceived role in Islamic medical care practice in Malaysian Muslim-friendly private hospitals. This empirical study can immensely contribute to the further development of Islamic medical care practice for Muslim doctors in particular and for the Muslim-friendly hospital service marketing strategy in general.

“Becoming” a doctor involves the acquisition of medical knowledge, skills and professional identity. Medical professional identity formation (MPIF) is complex, multi-factorial and closely linked to societal expectations, personal and social identity. Increasingly, doctors are required to engage in leadership/management involving significant identity shift. This paper aims to explore medical professional identity (MPI) and MPIF in relation to doctors as leaders. Selected identity theories are used to enrich the understanding of challenges facing doctors in leadership situations and two concepts are introduced: medical leader identity (MLI) and medical leader identity formation (MLIF) and consideration given to how they can be nurtured within medical practice.

A rapid conceptual review of relevant literature was carried out to identify a set of relevant concepts and theories that could be used to develop a new conceptual framework for MLI and MLIF.

MLIF is crucial for doctors to develop as medical leaders, and, like MPIF, the process begins before medical school with both identities influenced, shaped and challenged throughout doctors’ careers. Individuals require support in developing awareness that their identities are multiple, nested, interconnected and change over time.

This paper draws on concepts from wider literature on professional identity, in relation to how doctors might develop their MLI alongside their MPI. It offers a new perspective on MPI in the light of calls on doctors to “become and be healthcare leaders” and introduces the new concepts of MLI and MLIF.

The purpose of this paper is to outline the “Hybrid” “International” Emergency Medicine (HIEM) programme, which is an ethical pathway for the recruitment, employment and training of Emergency Medicine doctors; with a rotation through the NHS on a two-year medical training initiative with a Tier 5 visa, “earn, learn and return” programme. The HIEM programme offers an advantage to the Tier 2 visa by combining training, education and employment resulting in new learning to help improve the health system in Nepal and provide continued cultural support, clinical and leadership development experience in the UK NHS. Finally, this programme also provides a Return on Investment to the NHS.

A shortage of doctors in the UK, combined with a need to develop Emergency Medicine doctors in Nepal, led to a UK Emergency Medicine Physician (PS) to facilitate collaboration between UK/Nepal partners. A mapping exercise of the Royal College of Emergency Medicine curriculum with the competencies for the health system and quality improvement leaders and partners with patients produced a “HIEM programme”. The HIEM programme aims to develop first-class doctors to study in Emergency Departments in the UK NHS while also building trainee capability to improve the health system in Nepal with a research thesis.

The HIEM programme has 12 doctors on its programme across years one and two, with the first six doctors working in the UK NHS and progressing well. There are reports of high levels of satisfaction with the trainees in their transition from Nepal to the UK and the hospital is due to save £720,000 (after costs) over two years. Each trainee will earn £79,200 over two years which is enough to pay back the £16,000 cost for the course fees. Nepal as a country will benefit from the HIEM programme as each trainee will submit a health system improvement Thesis.

The HIEM programme is in its infancy as it is two years through a four-year programme. Further evaluation data are required to assess the full impact of this programme. In addition, the HIEM programme has only focussed on the development of one medical speciality which is Emergency Medicine. Further research is required to evaluate the impact of this model across other medical and surgical specialties.

The HIEM programme has exciting potential to support International Medical Graduates undertake a planned programme of development while they study in the UK with a Tier 5 visa. IMGs require continuous support while in the UK and are required to demonstrate continued learning through continuous professional development (CPD). The HIEM programme offers an opportunity for this CPD learning to be structured, meaningful and progressive to enable new learning. There is also specific support to develop academic and research skills to undertake a thesis in an area that requires health system improvement in Nepal.

This is the first time an integrated clinical, leadership, quality improvement and patient partnership model curriculum has been developed. The integrated nature of the curriculum saves precious time, money and resources. The integrated nature of this “hybrid” curriculum supports the development of an evidence-based approach to generating attitudes of collaboration, partnership and facilitation and team building in medical leadership with patient engagement. This “hybrid” model gives hope for the increased added value of the programme at a time of global austerity and challenges in healthcare.

Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. The purpose of this paper is to explore how organisational culture in Nigerian medical organisations influences doctors’ WLB and examine the implications of supportive and unsupportive cultures on doctors’ WLB.

The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of Nigeria in order to elicit WLB challenges within the context of organisational culture.

The findings show that organisational culture strongly influences employees’ abilities to use WLB policies. Unsupportive culture resulting from a lack of support from managers, supervisors, and colleagues together with long working hours influenced by shift work patterns, a required physical presence in the workplace, and organisational time expectations exacerbate the challenges that Nigerian medical doctors face in coping with work demands and non-work-related responsibilities. The findings emphasise how ICT and institutions also influence WLB.

The paper addresses the underresearched SSA context of WLB and emphasises how human resource management policies and practices are influenced by the complex interaction of organisational, cultural, and institutional settings.

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship.

The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey.

The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication.

Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication.

To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour.

The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship.

This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.