Research shows that many foreign doctors do not feel well prepared to join the NHS

Many overseas doctors feel lost, anxious and unready to care for patients after joining the NHS because they are not being looked after properly, research has found.

Many international medical graduates (IMGs) believe the NHS is not helping them prepare for life as a doctor in Britain and the practical aspects of moving to a new country, a survey has found.

Nearly six in ten (58%) of those surveyed felt their induction was inadequate, and almost half (48%) were apprehensive about starting clinical roles in Britain.

The Medical Protection Society (MPS), which surveyed 737 IMGs in England, said the results showed too many foreign-trained doctors were “still being professionally and personally let down” by the NHS.

One physician said, “I was very anxious and worried because I was working clinically without an induction and (a) very short period of shadowing… I was just lost.”

Another said, “I asked several times about induction and was always told that I would just learn on the job and that ‘it would be fine.’”

There has been a sharp increase in the number of foreign doctors coming to work in the UK. More than one in three (36%) medics in the NHS in England now come from abroad, mostly from India, Pakistan, Egypt and Nigeria.

Just over half of doctors starting work in the UK in 2022 came from abroad.

The research showed:

• 38% said they didn’t have enough time to shadow other doctors to gain valuable insights.

• 45% received no training about cultural differences between the NHS and their country of origin and what is acceptable in the UK compared to their home country.

• 48% indicated that they did not receive sufficient knowledge or training upon induction before they could start clinical work.

• 51% received no help or advice with practical matters after moving to the UK, such as finding a place to live, opening a bank account, registering with a GP or paying council tax.

• 41% said they felt alone and isolated.

• 38% questioned their decision to work in the NHS.

Professor Jane Dacre, the chair of the MPS, said some trusts “have established exemplary induction programs for IMGs and are leading the way. But the fact remains that too many IMGs are still being let down by building trust. This cannot continue. Those who serve the NHS deserve more.”

She urged all NHS providers to adopt and implement the 2022 guidelines for inductions, called Welcoming and Valuing IMGs, to improve the situation.

Dr Sai Pillarisetti, chair of the British International Doctors Association postgraduate committee, said the findings “highlighted a lack of support outside of clinical practice, leading to loneliness and anxiety”.

He said: “The quality of the induction provided has a direct impact on patient wellbeing and safety, and embedding the learning around cultural competence and UK best practice will help address any variations in communication and clinical practice.”

The General Medical Council, which regulates the medical profession, backed Dacre’s call. Tista Chakravarty-Gannon, head of Welcome to UK Practice, said: “It is vital that we equip (IMGs) to be successful from the outset. The MPS survey sadly confirms that a comprehensive induction process remains sporadic and in some cases lacking.”

NHS England has published a long-term workforce plan which, if fully implemented, will see a major increase in the number of home-trained doctors, nurses and other clinical staff by 2038. However, healthcare staffing experts expect the NHS to be heavily reliant on overseas staff for the foreseeable future as the plan takes time to pay dividends.