737 - Bridging the Gap: Enhancing International Medical Graduates’ Onboarding and Transition Through a Web-Based Manual in a Pediatric Residency Program

Publication Number: 3713.737

Oluwabusayomi Joy. Ayantoyinbo, Bronxcare Health System, Bronx, NY, Bronx, NY, United States; Youmna Faheem, Icahn School of Medicine at Mount Sinai, Bronx, NY, United States; Mohamed Ghamry, BronxCare Health System, Bronx, NY, United States; Emmy Kristine Trinidad, BronxCare Health System, Bronx, NY, United States; Susannah Shiny Karnati Karnati, Bronxcare Health System, Bronx, NY, United States; Nestor Trujillo, Bronx Care Health System, Bronx, NY, United States; Ibrahim Kak, Bronxcare Health System, New York, NY, United States; Savita Manwani, Bronx Care Health System, Bronx, NY, United States

Background: Transitioning into U.S. pediatric residency is particularly challenging for International Medical Graduates (IMGs), who must rapidly adapt to new health-care systems, documentation standards, and institutional workflows. At BronxCare Health System, a community hospital in the South Bronx, all 44 pediatric residents are IMGs. Prior to this project, orientation was fragmented across emails and brief sessions, resulting in inconsistent preparedness, poor information retention, and a heavy reliance on senior residents for guidance.

Objective: To evaluate the impact of a centralized web-based onboarding manual (BCPedsGuide.com) on resident preparedness, satisfaction, and access to clinical resources, with a focus on facilitating IMG adaptation to the U.S. residency environment.

Design/Methods: A pre-intervention survey assessed onboarding clarity, resource access, and preparedness across all postgraduate years. Based on findings, we developed a mobile-friendly website containing rotation objectives, institutional workflows, EMR access instructions, emergency protocols, and key contact lists. The site was launched in July 2025 and shared via resident group chats and email. Post-implementation surveys assessed perceived usefulness, relevance, and navigation ease. Web analytics tracked page views by clinical section.

Results: The manual was distributed to all 44 residents. Post-implementation survey results across all PGY levels showed marked improvement: average onboarding satisfaction rose from 2.8/5 to 4.5/5 (a 1.7-point, ~60% relative increase). Residents rated content relevance 4.4/5 and overall helpfulness 4.5/5; 84.6% found the manual easy to navigate and 96.2% would recommend it to incoming residents. Workflow guides, EMR instructions, and contact directories were most frequently accessed. Web analytics showed over 380 homepage views in the first month, with the highest engagement in "Nursery" and "Floor" rotations. Qualitative feedback highlighted smoother adaptation to the U.S. hospital system and reduced dependence on senior residents for routine guidance.

Conclusion(s): Implementing a centralized, web-based onboarding manual significantly improved orientation quality and facilitated transition for an IMG pediatric residency cohort. The initiative standardized institutional knowledge, enhanced preparedness, and reduced onboarding confusion. Ongoing updates and multimedia integration are planned to sustain engagement and further support IMG adaptation in future training cycles.

Pre-intervention vs Post-intervention Onboarding Satisfaction Rating
Pre-intervention vs Post-intervention Onboarding Satisfaction Rating

Likelihood of Recommending Manual to Incoming Residents
Likelihood of Recommending Manual to Incoming Residents