International Medical Graduate Update

Dear Colleagues,

As we welcome new colleagues and International Medical Graduates (IMGs) into the heart of our NHS family in Scotland, we must shine a light on the strides we're making together to ensure their smooth transition into the wider team. This commitment not only enriches our workforce but ensures the highest quality of patient care and innovation within our health services.

A Warm Scottish Welcome to Our International Colleagues

ਜੀ ਆਇਆਂ ਨੂੰ, خوش آمدید, સ્વાગત છે,  أهلاً وسهلاً, Witamy

The strength and diversity of our NHS lie in the vibrant mix of skills and perspectives that IMGs bring. From leadership roles to frontline services, their contribution is invaluable. However, adapting to a new medical and cultural environment poses challenges, and it's our goal and responsibility to ease this transition.

Spotlight on Current Induction and Pastoral Support Initiatives

We're proud to highlight a range of initiatives aimed at supporting our IMG colleagues:

Welcome to UK Practice (WtUKP)

Adapting to UK medical practice can be hard for any doctor, regardless of where you’re from or how experienced you are. This free workshop is designed to help doctors new to the UK, by offering practical guidance about ethical scenarios you may encounter, and the chance to connect with other internationally qualified doctors. Every IMG new to NHS Scotland can access this workshop.

NES IMG support

IMG support activities are coordinated by our associate postgraduate dean for International Medical Graduates. The team have introduced and developed a wide range of resources and initiatives aimed at supporting IMGs in Scotland.

A significant effort in supporting medical professionals, developed by NES in partnership with Directors of Medical Education (DMEs) across health boards, is the Softer Landing Safer Care (SLSC) program. This is a framework for a 2-week shadowing period for IMGs at the start of their post, so they have sufficient time to acclimatise to working in the NHS whilst an individualised action plan is agreed between them and their Educational Supervisor. During this time, this aim is that the trainee should be supernumerary to the rota, or otherwise without any lone on-call commitments. This initiative provides a recommended framework that health boards are encouraged to adopt to ensure that doctors only work within their competence level.

Scotland Deanery also offers a range of enhanced support options for International Medical Graduates (IMGs) in Scotland with a dedicated webpage on the Scotland Deanery site. The webpage offers resources on training pathways, living in Scotland, and understanding roles within the NHS, along with links to a buddy scheme, a Facebook support group, and details about the orientation activities. The pre-induction webinars, held biannually in June and January, serve as interactive Q&A sessions, while the orientation events, conducted in August and February, provide a platform for IMGs to establish support networks. These initiatives aim to integrate with existing health board inductions and cover important topics like e-portfolios, curriculum, and cultural intelligence.

The Scottish Trainee Enhanced Programme (STEP) is an induction initiative started in 2015, specifically designed for General Practice (GP) trainees in Scotland who gained their primary medical qualifications outside the UK. STEP offers a comprehensive two-day induction, blending in-person and virtual sessions within the first six weeks of a trainee's program. It emphasises establishing a supportive relationship between trainees and their educational supervisors (ES), who also attend, enhancing their understanding of the trainees' unique challenges and needs.

The program has benefited over 400 international medical graduate (IMG) GP trainees and 300 GP educational supervisors by addressing specific challenges IMGs face through sessions on cultural competence, communication skills, exam preparation, and wellbeing among others.

Importantly, STEP reflects the significant role of IMGs in Scotland's primary care sector, with a notably high proportion of GP trainees being IMGs in recent years. Following its success in GP training, the program expanded to psychiatry in 2018 and is now extending across all specialities in Scotland. This expansion is led by speciality training boards, aiming to ensure equitable access to induction and support for all trainees.

Commencing in August 2024 is the new WINS (Welcoming IMGs New to Scotland) programme. This all-day face-to-face event will be offered regionally and hopes to capture the content and feedback from our STEP and orientation programmes. WINS will be offered to all speciality trainees, SAS and locally employed colleagues new to NHS Scotland.

From dedicated web resources to orientation events and the Softer Landing Safer Care framework, NES is at the forefront of providing a structured welcome and ongoing support to our IMG colleagues in Scotland.

Local Innovations

Across NHS Boards, initiatives such as boot camps, simulation sessions, and enhanced induction programmes exemplify our commitment to a supportive, inclusive environment. Scottish IMG support Network links all health board IMG leads and champions who co-ordinate these activities.

Centre for Workforce Supply (CWS)

The Centre for Workforce Supply recently completed a review of all IMG support activities within NHS Scotland and has established a National IMG Induction Working Group, involving key figures from NES and health boards, to enhance the support framework for International Medical Graduates (IMGs) in Scotland. This group has laid out several strategies aimed at improving the integration, support, and induction processes for IMGs. The group's recommendations focus on improving the coordination between various IMG support networks to ensure a unified approach, refining the process for accurately identifying IMGs in need of support and helping to ensure IMGs can participate in crucial "Welcome to UK Practice" programs. They also emphasise the importance of creating and disseminating visual resources to raise awareness of the support available, making better use of existing communication channels, and evaluating feedback from recent induction events to enhance future offerings. Additionally, the group suggests potentially exploring induction options for IMGs while they are still in their home countries, thus preparing them for a softer landing within their work environments. These recommendations aim to create a more supportive, integrated, and effective environment for IMGs transitioning into Scotland's healthcare system.

Facing Challenges Head-On

Despite these efforts, we recognise hurdles such as varying levels of engagement and the need for more streamlined identification and support mechanisms for IMGs. Addressing these challenges is not just about maintaining standards but about nurturing a workforce that feels valued, understood, and supported.

Call to Action: Recommendations for a Brighter Future

We stand at a crossroads, with the opportunity to further enhance our support for IMGs. Recommendations include better integration of support networks, increasing awareness of available resources, and exploring innovative induction methods, including pre-arrival training.

Your Role in This Vital Journey

Every member of our NHS Scotland team plays a crucial role in this journey. Whether by participating in mentorship programs, attending workshops to better understand the needs of IMGs, or simply extending a warm welcome to your international colleagues, your actions make a difference. If you’re interested in making a difference, please sign up to the CWS Medical Network for more information on recruiting and supporting IMGs, including a series of learning sessions you can join virtually.

Looking Ahead

As we move forward, let's keep the conversation going. Engage with the initiatives, provide feedback, and share your experiences. Together, we can ensure that every IMG feels at home in Scotland, ready to contribute to our shared mission of excellence in healthcare.

Warm regards,
Scotland Deanery Contributors:

• • Greg Logan Scottish Clinical Leadership Fellow
  • Andrea Kwek, Head of programme- workforce, Centre for workforce supply.
  • Nitin Gambhir, Lead Dean Director