BACKGROUND International medical graduates (IMGs) now comprise a significant part of the Australian workforce. However, their perspective on strategies to facilitate their effective integration into the Australian health care system have not been adequately explored. This article presents the findings from qualitative research that explored IMGs experience before, during, and after their involvement in the observer program, a hospital based pre-employment program for IMGs conducted in the Department of Medicine at the Redland Hospital, Queensland. METHODS An iterative, qualitative research methodology was utilised, using open ended interviews with IMGs about their experience and involvement with the observer program. The interviews were transcribed verbatim and thematically analysed. RESULTS The participants asserted that, due to the Australian need for IMGs, it is in Australia's interests to ensure an effective and efficient process for the integration of IMGs. Strategies they believed would improve this process included providing information to IMGs before departure from their country of origin, improving website information, providing more support for bridging courses, funding more observer programs, providing an IMG liaison officer at hospitals, reducing the difficulties associated with passing the Australian Medical Council examination, providing support for IMGs' families, and relaxing the rules about when and where IMGs can practise medicine. DISCUSSION The participants' perspectives on desirable changes to the Australian system that would facilitate IMGs' integration are presented. It is stressed that these findings represent the perspectives of IMGs only, and that any and all changes to the process of integration of IMGs must have as a primary benchmark the aim of ensuring that the highest quality of medical care is provided to the Australian population.