The life of an IMG
One of the things most international doctors think about when making their decision to move to another country is what life would look like working in a place that is unfamiliar and out of their comfort zone. Apart from the fact that there are differences in the way that medicine is practiced in different countries, the contrast in cultures and ways of expression also adds to the complexity.
In all however, given time, many people are able to adapt both their practice and lifestyle to that which is most appropriate to their current situation in a foreign land. Whilst it is important to acclimatize to one’s environment, one needs not compromise on those values that one holds dear as long as they are not at odds with what is obtainable in the new environment.
The first few months
In the early days when you start working in the UK, you will find that there are a whole lot of differences in the way things are done compared to your home country. It might at first be daunting, but people are generally nicer to you when they perceive that you are willing to learn. In addition, you must remember that professional hierarchy in the UK health sector is not so much about being a boss than it is about being able to take decisions based on the knowledge and skill you have acquired. Never be ashamed to learn from people who you may take to be junior to you. They could save your ass!
To give a personal example, my first day at the job as a locum SHO in general medicine was one of the most confusing days in my career. There I was in charge of medical patients scattered around different wards in a hospital which I literally just stepped my feet on. At the start I thought I would at least have some other colleagues who would be able to help me out on that day but to my surprise I was alone with a locum consultant who was also on his first day in that hospital. So there was basically no one to guide me. I had no knowledge of the wards or how things operated in this hospital. However luckily for me, in one of the wards was a very kind nursing sister who helped in guiding me through a few things. I struggled for a few weeks but tried as much as possible to ask questions when I was confused. As time went on the friction on my wheels diminished and things got easier.
The key to getting things right is willingness to learn. It’s not the case that you are deficient, it’s just that you are in a new environment and you need to get familiar with things. Think of it like buying a new phone of a different brand from the one you had before. You will have to unlearn a few thing to be able to learn the new things.
Day to day work as a ward doctor
Once you get the hang of things life as a hospital doctor is generally bearable. How busy you are on a day to day basis will depend on your specialty and on the hospital you work in. People generally work in teams of consultants, registrars, SHOs (FY2 upwards) and FY1s. Most IMGs start to work as SHO as they usually have completed their FY1 equivalent in their home country before gaining full GMC registration. In these teams, no one person is expected to know-it-all. Collaboration is the keyword. It is useful to know your duties and learn to do them well but also assist others where you can. As a general guide familiarize yourself with the GMC good medical practice. You might need to reflect on this somewhere along the line in your practice.
In many places, the day would typically start with a team meeting or a multidisciplinary team (MDT) meeting (depending on specialty and hospital) and then ward round which could be consultant, registrar or other junior doctors ward rounds. After the ward round the junior doctors tend to embark on carrying out the tasks (jobs) from the ward round and the consultant goes off to do “grown-up” business (clinics, admin or management). The general management of patients is usually the responsibility of the junior doctors.
Most international doctors integrate perfectly into the UK medical profession and general society. In fact international doctors contribute immensely to the rich diversity and they play a vital role in keeping the NHS afloat. Without foreign trained doctors, the NHS could never survive. So the next time you doubt yourself, remember this. As you make your journey remember to have your eyes on the bigger picture, ensure you take concrete steps to advance your career while you make your contributions to the system.