OBJECTIVES: To inform the current level of research about alternative career pathways for international medical graduates and synthesize knowledge of the barriers, facilitators and potential outcomes of alternative career pathways for international medical graduates. METHODS: We searched MEDLINE, EMBASE, Scopus, and Google Scholar for relevant publications to February 2020. From 809 articles, after two levels of screening, 23 articles were selected. We conducted thematic content analysis and reported the findings of the study following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. RESULTS: All 23 articles reported on alternative careers for international medical graduates in either the United States or Canada. A variety of study methods were noted, including original research, scoping reviews, reports for organizations, and commentaries. Studies incorporated a variety of methods, including surveys, focus groups, interviews, analysis of administrative documents, and program evaluation. Many potential benefits of alternative careers were reported for both international medical graduates and stakeholders. Barriers to pursuing alternative careers included both individual- and systemic-level barriers. Facilitators included skill-building workshops, targeted bridging programs, connecting with employers, supporting organizations, and international medical graduates. CONCLUSIONS: The scarce literature on alternative career pathways indicates that this research is beneficial for both international medical graduates and their host countries. Initiating capacity building programs for alternative career pathways for international medical graduates might be a worthy investment for host countries, especially in underserved areas. Pilot initiatives incorporating bridging programs for international medical graduates are recommended.