Introduction:

IMG (International Medicine Graduate) doctors play a key role in the NHS and in Children’s Services they account for approximately one third of the medical workforce [1]. Despite this, the support they receive when starting to work in the United Kingdom is often suboptimal, making the transition extremely challenging [2]. This is often reflected in the higher number of referrals to the GMC (General Medical Council) compared to UK trained colleagues [3]. We explored the feelings of IMGs around the time they were newly employed in the NHS and the option of tailored simulation scenarios as a key tool to help them integrate.

Methods:

A survey was distributed to IMGs working in the KSS (Kent, Surrey and Sussex) Deanery with the goal of establishing how challenging they found it to start working in the NHS, whether they felt targeted simulation sessions would be useful, the best time for these to be offered and what topics would be most beneficial to cover.

Results:

We collected a total of 32 responses: 90% of respondents reported having found it challenging to start working in the NHS, with nearly a third of them stating it was an extremely stressful time. All respondents felt that targeted simulation sessions would be helpful, with just under half preferring these to be incorporated into their induction and the remaining shortly after this. Communication was felt to be the biggest challenge by 30 out of 32 respondents, shortly followed by how to escalate and ask for help (27 out of 32 respondents), cultural aspects and hand overs (24 and 23 out of 32 respondents respectively). Approximately two thirds of the interviewed would like to see ‘How to deal with difficulties within the team’ to also be addressed. 85% of the respondents who had attended simulations before felt this would be a suitable tool to help IMGs settle into the NHS.

Discussion:

Our survey confirmed that IMGs that are newly employed by the NHS face significant stress and need more support, especially with regards to communication, asking for help and escalating concerns, and cultural aspects related to the job.

Simulation has been widely recognised to be an excellent tool for training in healthcare and tailored scenarios have been designed and implemented in the Paediatric KSS Deanery to support newly joining IMGs integrating into the NHS.

Ethics Statement:

As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

References

1. General Medical Council Data Explorer, General Medical Council. Available from: www.gmc-k.org/doctors/register/search_stats.asp. Accessed 29 September 2024.

2. Lane J, Nitin Shrotri, Somani BK. Challenges and expectations of international medical graduates moving to the UK: An online survey. Scott Med J. 2024;69(2):53–58. doi: 10.1177/00369330241229922.

3. Jalal M, Bardhan KD, Sanders D, Illing J. International: Overseas doctors of the NHS: migration, transition, challenges and towards resolution. Future Healthc J. 2019 Feb;6(1):76–81. doi: 10.7861/futurehosp.6-1-76.