Abstract:

Background:
The NHS in the UK is supported by a large number doctors who graduated abroad. These International Medical Graduates (IMGs) contribute up to 40% of the junior doctor workforce in the UK (GMC 2020). However, due to systematic and educational differences, many IMGs can lack confidence and knowledge of the UK healthcare system and the requirements of junior doctors. Moreover, many factors contribute towards the stress IMGs face when relocating and adjusting to a new culture (Kalra et al., 2012). A number of these issues may be mitigated with remote education before the journey to the UK physically begins.

Aims:
The overall aim was to produce and deliver a series of live digital teaching sessions delivered online in order to improve the knowledge and confidence of IMGs looking to continue their career as a doctor in the UK.

Objectives:
To improve international medical graduate understanding of UK Healthcare system
To improve international medical graduate understanding of common junior doctor duties
To improve international medical graduate confidence working within UK Healthcare system

Methods:
A course was created an NHS educational department using the guidelines from the UK foundation programme and expectations of junior doctors in the UK. The course was advertised amongst international universities. A pre-course questionnaire and post-course questionnaire was sent out to all participants for the course. The course questionnaire assessed several aspects expected of junior doctors in the UK including confidence in handling ward rounds, common requests, oncall shifts, emergencies and how to escalate situations. Participants would select on a likert scale between 1 and 5 from least confident to most confident in each aspect. The data was then analysed in SPSS and T-Test performed to ascertain statistical difference between the questionnaires.

Results:
145 IMGs from 43 countries completed the pre and post-course questionnaires in their entirety. Both pre and post course questionnaires illustrated normal variance of data. Confidence of knowledge across all parameters including assessment of emergencies, prioritisation, conducting ward rounds, making referrals, and escalating concerns improved from 25% and 48%. The area with greatest improvement was management of bleeps by 48% showing a statistical significance (p=<0.05). The area with least improvement from was confidence in assessment of emergencies with a 25% increase (p=<0.05).

Conclusion:
This study shows that it is possible to aid in the preparation of IMGs for entering a new country and healthcare system with a digital course. Many difficulties face IMGs moving to a new country, including uncertainty of the healthcare system they are entering itself. Confidence in the knowledge greatly improved with a simple series of interactive live sessions. This study demonstrates the positive impact these sessions can have which is necessary for a growing IMG workforce.

References:
[1] General Medical Council. State of medical education and practice in the UK. GMC, 2020:15-25. www.gmc-uk.org/about/what-we-do-and-why/data-and-research/the-state-of-medical-education-and-practice-in-the-uk
[2] Kalra G, Bhugra DK, and Shah N. Identifying and addressing stresses in international medical graduates. Acad Psychiatry. 2012; 323-329

Keywords:

NHS, IMG, Education, Healthcare training.