Introduction:

The population of NHS doctors who have received their medical education outside of the United Kingdom is growing. 29% of General Practitioners (GPs) are International Medical Graduates (IMGs) and in the Midlands this increases to 37% [1]. IMGs make up a large proportion of the workforce, therefore, at Royal Wolverhampton Trust (RWT) we have designed the paediatric IMG simulation day involving workshops and scenarios with a large focus on non-technical skills and debrief. Other topics include the NHS structure, training in paediatrics in the UK, common abbreviations, colloquialisms, and roles within healthcare.

One of the biggest challenges IMGs face when joining the UK workforce is adjusting to the NHS systems. In addition, any simulation-based education (SBE) opportunities available to IMGs would have been specific to their previous country’s healthcare system. In response to this and previous IMG training needs analysis conducted with Clinical Fellows at RWT, the SimWard RWT simulation team piloted an IMG-specific simulation-based education programme to tackle some of the challenges IMGs may experience and, therefore, assist transition into the NHS.

Methods:

We undertook a retrospective review of pre- and post-course questionnaire answers with regards to confidence in communicating with patients and colleagues, handover skills, delivering unexpected news and how to escalate to seniors. We also asked about previous experience with simulation and their understanding of the role of debrief.

Results:

A total of 9 candidates were surveyed. 6 had worked in the UK for <1 year, 2 for 1-2 years and 1 for 2-3 years. Confidence levels improved in all areas after participating in the course with free-text comments such as:

“This session was very informative with regards to breaking bad news, communicating with parents and colleagues”, “It was worthwhile” and “Wonderful simulation”.

Discussion:

This course provides an excellent opportunity for paediatric IMGs to build on their confidence early in their career in the NHS. Feedback received has been consistently positive and meets the training needs of those attending the course. Due to the positive feedback of this course, further courses have been scheduled to align with regional paediatric starting dates, with the aim to improve candidates’ confidence in several essential non-technical skills and, consequently, lead to improved safety and retention of doctors in the NHS. This course has also been used as a blueprint for the adult acute simulation fellows to design an IMG course for their doctors.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Baker C. NHS staff from overseas: statistics. House of Commons Library; 2021.