Document Type



Doctor of Education (EdD)


Adult Education and Human Resource Development

First Advisor's Name

Thomas G. Reio Jr

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Hilary Landorf

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Maria Olenick

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Emily Anderson

Fourth Advisor's Committee Title

Committee Member


Foreign Educated Physician, Essentialism, Liminality, Othering, Phenomenology, Transformative Learning, Underemployment, Migration, Identity, Push & Pull Factors

Date of Defense



There are as many as 65,000 unlicensed foreign born and trained doctors across the United States who are credentialed in their home countries but unable to practice in the U.S. The primary goal of this study was to describe and understand an understudied human experience: the lived experience of unlicensed foreign educated physicians who are present in the U.S. as they retrain for non-physician primary care roles.

The theoretical frameworks undergirding the study are Jack Mezirow’s Transformative Learning Theory (TL), also referred to as Perspective Transformation as well as the complimentary perspectives of Otherness and Liminality theories.

Seven FEPs were purposively sampled and chosen for this study. A ten-questionnaire instrument was developed. While site selection was an important consideration during the initial iteration of the methodology, due to disruption by the COVID-19 pandemic, interviews were conducted using ZOOM video conferencing technology. Participants were interviewed using the semi-structured interview protocol.

Data were collected via 45-70 minute one-on-one interviews. A coding table consisting of five columns was designed for use in this study. The column headings included the participants’ pseudonym, direct quotes, units of meaning, deductive quotes, and notes. A separate table was used for each participant. As units of meaning emerged from the direct quotes, they were coded and organized by topic.

From the topics, three main themes were generated (a) Migratory Patterns of FEPs (b) Beliefs about Obstacles and Challenges, and (c) Beliefs about Reclaiming the Self. The data were inductively and deductively thematically analyzed. Validity and Reliability were promoted by use of a) Member Checking, b) use of Rich, Thick Description, c) Theoretical Triangulation, and d) Clarifying Bias (bracketing & reflectivity).

Results revealed that FEPs all experienced, though to varying degrees, all ten phases of Transformative Learning. Participants also, without exception experienced feelings of ambiguity, translocal identity, and self-doubt, particularly during the BSN phase of the BSN to MSN program. These feelings were all characteristic of Transformative, Othered and Liminal experiences.

Findings also revealed that participants experienced a reclamation of the self, having endured the threshold, liminal, and othered encounters. Both Theory and Practice may be enriched through this research, as TL, Otherness and Liminality theories have not been extended to undergirding research around unlicensed FEPs. Future research is warranted as there are significant gaps in the formulation of a comprehensive body of knowledge around the phenomenon.





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