Educational challenges faced by international medical graduates in the UK

Figures & data

Table 1 The major barriers faced by IMGs in this study

Lack of understanding of the NHS system and values

• Lack of experience in utilizing administrative protocols, hospital policies and guidelines

• Lack of understanding of the medicolegal framework in the UK

• Difficulty with integration into the new community of practice and work environment

The different learning environment in the UK

• Experiential learning in the UK vs. more didactic teaching in the country of origin

• Lack of direct guidance

• Need for more self-directed learning in the UK

Difficulty with receiving feedback

• Feedback perceived to be negative and associated with shame

• Poor relationship with supervisors

The feel of being undervalued by colleagues

• IMGs inappropriately perceived as incompetent doctors due to their lack of knowledge of the health care system

• IMGs feeling of occasionally treated as outsiders in the work environment

Others

• Communication skills in challenging situations (end-of-life and resuscitation decisions)

• Dealing with medical emergencies

• Handling ethical scenarios

Abbreviations: IMG, international medical graduate; NHS, National Health Service.

Table 2 Suggestions for further action from the IMGs’ perspective

Shadowing or clinical attachment

• Lasting for months

• Supervised hands-on experience

Induction program

• Lasting for days (or 1 week)

• Topics focusing on NHS values, medicolegal issues, smooth integration and transition, etc.

• Comparative teaching model

Improving supervision and mentorship

• Enhanced mentorship in the first job in the UK

• More frequent educational meetings to address on-going challenges

• Educating supervisors and consultants on IMG needs

Improvements to the PLAB exam

• Including more assessment areas on NHS values

Others

• Raising the awareness of NHS staff on IMG learning needs

• “Buddying system” between new and senior IMGs

• Counseling of IMGs prior to coming to the UK

Abbreviations: IMG, international medical graduate; NHS, National Health Service; PLAB, Professional and Linguistic Assessments Board.