BMJ 2014;348:g3424 doi: 10.1136/bmj.g3424 (Published 5 June 2014)
Page 1 of 1
Letters
LETTERS INTERNATIONAL MEDICAL GRADUATES
Improving the coaching and mentoring of IMGs Rahul (Tony) Rao consultant psychiatrist South London and Maudsley NHS Foundation Trust, London SE5 8RS, UK
With both parents being staff and associate specialist doctors, since the early 1960s I witnessed the trials and tribulations experienced by the first immigrants working in the NHS.1 Not only did they face stark career choices, they often worked in shortage specialties such as geriatrics and psychiatry, sometimes with a lifetime of feeling that the NHS could have served them better.
In the past 50 years, the thorny matters of racism and discrimination have raised their heads above the medical parapet. This problem will never truly disappear, and a “bottom up” approach that provides support to international medical graduates (IMGs) as soon as they start working in the NHS may be useful. It is difficult (but not impossible) for recruitment processes to cut across race, ethnicity, country of origin, and country of primary medical qualification.2 The same goes for offering training to improve communication skills.3 Many IMGs grow up in a cultural environment with little scope for discussion. This is further limited by the lack of opportunity to develop patient centred communication skills in a busy clinical environment. Bad habits can die hard, and IMG trainees working in the UK should be nurtured into a broader perspective on doctor-patient communication, rather than seeing doctor-patient interactions as simply question and answer sessions.
The NHS can also do much to improve coaching and mentoring of IMGs and European Economic Area doctors qualifying outside the UK. Whatever we do to increase numbers of UK medical graduates, shortage specialties will continue to rely on IMGs.4 Whether the problem is measured by patient complaints or examination pass rates, we must deal with it head on. Competing interests: Associate dean for staff and associate specialist doctors, London Deanery (2008-2011), associate dean for equivalence, Royal College of Psychiatrists (2010-2012) associate/partner on PMETB/GMC registration panel (2007-2014). Full response at: www.bmj.com/content/348/bmj.g2838/rr/695720. 1 2 3 4
Moberly T. Minority report: how the UK’s treatment of foreign and ethnic minority doctors needs to change. BMJ 2014;348:g2838. (22 April.) Rao R. The structured clinically relevant interview for psychiatrists in training (SCRIPT): a new standardized assessment tool for recruitment in the UK. Acad Psychiatry 2007;31:443-6. NHS Health Education. Communication Skills Resources. www.londondeanery.ac.uk/ professional-development/professional-support-unit/communication-skills. Fazel S, Ebmeier KP. Specialty choice in UK junior doctors: is psychiatry the least popular specialty for UK and international medical graduates? BMC Med Educ 2009;9:77.
Cite this as: BMJ 2014;348:g3424 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS INTERNATIONAL MEDICAL GRADUATES
Improving the coaching and mentoring of IMGs Rahul (Tony) Rao consultant psychiatrist South London and Maudsley NHS Foundation Trust, London SE5 8RS, UK
With both parents being staff and associate specialist doctors, since the early 1960s I witnessed the trials and tribulations experienced by the first immigrants working in the NHS.1 Not only did they face stark career choices, they often worked in shortage specialties such as geriatrics and psychiatry, sometimes with a lifetime of feeling that the NHS could have served them better.
In the past 50 years, the thorny matters of racism and discrimination have raised their heads above the medical parapet. This problem will never truly disappear, and a “bottom up” approach that provides support to international medical graduates (IMGs) as soon as they start working in the NHS may be useful. It is difficult (but not impossible) for recruitment processes to cut across race, ethnicity, country of origin, and country of primary medical qualification.2 The same goes for offering training to improve communication skills.3 Many IMGs grow up in a cultural environment with little scope for discussion. This is further limited by the lack of opportunity to develop patient centred communication skills in a busy clinical environment. Bad habits can die hard, and IMG trainees working in the UK should be nurtured into a broader perspective on doctor-patient communication, rather than seeing doctor-patient interactions as simply question and answer sessions.
The NHS can also do much to improve coaching and mentoring of IMGs and European Economic Area doctors qualifying outside the UK. Whatever we do to increase numbers of UK medical graduates, shortage specialties will continue to rely on IMGs.4 Whether the problem is measured by patient complaints or examination pass rates, we must deal with it head on. Competing interests: Associate dean for staff and associate specialist doctors, London Deanery (2008-2011), associate dean for equivalence, Royal College of Psychiatrists (2010-2012) associate/partner on PMETB/GMC registration panel (2007-2014). Full response at: www.bmj.com/content/348/bmj.g2838/rr/695720. 1 2 3 4
Moberly T. Minority report: how the UK’s treatment of foreign and ethnic minority doctors needs to change. BMJ 2014;348:g2838. (22 April.) Rao R. The structured clinically relevant interview for psychiatrists in training (SCRIPT): a new standardized assessment tool for recruitment in the UK. Acad Psychiatry 2007;31:443-6. NHS Health Education. Communication Skills Resources. www.londondeanery.ac.uk/ professional-development/professional-support-unit/communication-skills. Fazel S, Ebmeier KP. Specialty choice in UK junior doctors: is psychiatry the least popular specialty for UK and international medical graduates? BMC Med Educ 2009;9:77.
Cite this as: BMJ 2014;348:g3424 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
