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For most of his colleagues, it would have been a routine part of the training to become a family physician. But as he began his first night on call in obstetrics, the medical-school graduate from abroad was frantic.

“He was in tears, saying he did not know what to do,” a supervising physician told the researchers behind a revealing new Canadian study. “He’d been sent into the delivery room to take care of deliveries … and he had never even seen a lady with her clothing off.”

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It was one striking example of a culture clash the Alberta study suggests is common for graduates of foreign medical schools who do two-year family-medicine residencies here.

Some balk at being taught by female doctors, struggle with the nuances of English, use inappropriate body language, are uncomfortable with the mentally ill — or unfamiliar even with the concept of patient confidentiality, the researchers found.

He’d been sent into the delivery room to take care of deliveries … and he had never even seen a lady with her clothing off

Many of the “international medical graduates” (IMGs) also are highly educated, have rich cultural perspectives and strong characters, reported colleagues who were surveyed for the study.