Background: The number of international medical students studying in China has largely increased over the past decades. However, few studies have addressed the difficulties that the international medical students face and there is a dearth of information on understanding the difficulties these students confront during their social integration in host countries. Therefore, the aim of this study was to investigate the international medical students’ difficulties to build social networks during their studying overseas. Methods: This study was designed primarily with the aim of enhancing understanding of the International Bachelor of Medicine and Bachelor of Surgery (MBBS) students’ difficulties in social networks building. 26 MBBS students from year-3 and year-4 were asked by the question: what are the difficulties to establish the social networks you face? Thematic analysis was conducted by MAXQDA. Results: The result of the individual interviews revealed that language barriers, (lack of) communication skills, personality factors, intercultural differences and study pressure were key factors that hindered the MBBS students’ adaptation to the Chinese culture and social networks building in China. Conclusions: This study reveals several potential coping strategies which could promote the social inclusion and cultural integration of the MBBS students, including providing interactive language training programs, organizing diverse programs enhancing intercultural communication, maintaining strong support networks and endeavoring the MBBS students to actively engage themselves in their learning and living environments. In conclusion, the provision of interactive learning environments, diverse social network opportunities and, moreover, maintaining social support and nurturing cultural integration, would greatly promote social integration and benefit international medical students.