International Medical Graduate (IMG) research
Medical Protection is a member-owned organisation, and we’re committed to ensuring that we provide the best possible protection and services for our members. Research is at the heart of our promise to members to treat them as individuals and use our experience and expertise to help them practise safely and with confidence.
We undertook two research projects with IMGs in 2021 to learn more about their experiences of UK medical practice, their indemnity and training needs, and how we can best support them.
Here we talk about some of the things we learnt that are helping us put in place extra support and resources for IMG doctors in the UK.
Where do doctors go for information about moving to UK medical practice?
The most popular sources of information are colleagues who are already practising in the UK and social media groups, especially on Facebook. It is also quite common to research the General Medical Council (GMC), the UK healthcare system, and sometimes the medicolegal/ethical environment. A minority of doctors talked to recruitment organisations who specialise in helping doctors relocate to the UK. Some doctors pointed out that while there is lots of information available on social media, they had concerns about how complete and accurate it is.
How prepared do IMGs feel to practise in the UK when they start their first role?
Around half the doctors we surveyed said they had very little knowledge of how the UK healthcare system works, and most felt it was a gap in their knowledge to some extent. Other common gaps in knowledge included GMC ethical guidance, employment law, patient behaviour, and life in the UK. Understanding of how medical negligence works in the UK was higher.
As a result, IMGs said they could have felt better equipped to practise in the UK. In particular, they would have benefited from a stronger induction into the UK healthcare system/NHS, and more support in understanding the cultural and communication differences that come with practising in the UK.
What are the biggest challenges for IMGs?
The doctors we spoke to highlighted the different cultural ways of working, particularly the difference in patient/doctor interactions and managing patient expectations compared to the country they were practising in previously. The way doctors communicate between themselves can be different too, and it can initially be challenging to deal with differences in language and meaning.
IMG doctors also said their desire to settle in and progress in their new role sometimes meant they took on too much before they were ready, or they didn’t know when or how to ask for help. Plus, they worried that litigation is more common in the UK, so there is sometimes the need to practise in a certain way to avoid complaints or criticism.
What would IMG doctors have benefited from when they started work in the UK?
IMG doctors thought many challenges could be overcome if they could get expert information on things like the NHS system, culture and communication differences, and patient/doctor relationships before they started in their first post.
What do IMGs know about the need for medical indemnity and protection?
Unsurprisingly, most IMGs are not familiar with how indemnity works in the UK and the role of Medical Defence Organisations (MDOs) before they arrive. They usually learn from colleagues about the importance of MDO membership alongside NHS indemnity. When they become more familiar with the role of MDOs, they value the advice, protection, security, and legal support membership provides.
How are we acting on these findings?
We’ve taken steps to address IMG needs before and after coming to the UK, by:
- establishing this website as a single point of information about the different stages of the transition to UK medical practice, helping IMGs understand the steps they need to take, fill gaps in their knowledge, and access support and resources from UK organisations and IMG communities
- running free live virtual events for IMGs and presenting at other conferences and events, so we can help doctors understand where challenges may lie and how to overcome them
- raising awareness of the need for indemnity and professional protection before IMGs come to the UK, so they are aware of the benefits of joining an MDO as soon as they have secured their first post
- providing more information to our members and potential members, so they fully understand the benefits of Medical Protection membership and how to access them, including the wide range of essential skills and communications courses we offer to help doctors avoid complaints and criticism
- introducing a new communications skills course especially for IMG members, to help them develop tools and techniques for clear, effective communication in a wide range of scenarios
- appointing an IMG relationship manager at Medical Protection, so potential members have a single point of contact if they have questions about indemnity, membership, and the application process
- championing the interests of IMGs within the UK healthcare system.