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5 feelings you’ll experience as a new IMG in the NHS

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International medical graduate PLAB PLABBER work in NHS GMC registration

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The rules, guidelines and criteria for working as a doctor in the UK change frequently. Please make sure you check the latest official guidance before taking action.

You may be here because you are about to start your new job, if so, congratulations! 

Or you may be one of those people who plan really far ahead and would like more information about what it’s like to start work in the NHS as an IMG. In that case, welcome! Your forward thinking is an important quality of being a successful IMG in the UK.

Whatever situation you are in, we hope this article will help prepare you for the emotional rollercoaster that many IMGs go through when they start working in the NHS.

The feelings we discuss here are based on not only our own personal experiences when we first started in the UK, but also on the experiences of many others shared by friends in real life, on Facebook, or by email.

We hope that by helping you prepare yourself early on, you will be able to adapt much faster and smoother than we did!

You may feel… anxious

We’ve read post after post on FB, and received email after email, from IMGs who are terrified of making a mistake at work. Will you lose your license? Be deported? Jailed?

Anxiety can also be centred around what other people think. Will you be criticised? Demoted? Fired?

Being worried shows that you are a conscientious doctor who obviously cares about your patients and your job, but being overly anxious can affect your performance and make you more prone to mistakes and criticism which can turn this fear into a self-fulfilling prophecy and vicious cycle.

Anxiety can be crippling so finding ways to cope is extremely important. It’s essential to get on top of this emotion since there are many more things to be anxious about in our medical careers such as exams, applications to specialty training, interviews, appraisals, incidents, etc. 

Building up our resilience to anxiety and external pressures is a skill that we must learn as doctors.

Resources to manage anxiety

If you feel that anxiety is affecting your ability to function, please don’t be ashamed to recognise that you need outside help. Your mental health is tremendously important to your well-being so make an appointment with your GP to discuss how to manage it.

You may feel… inadequate

One of the most dangerous things you can do for your confidence and self-esteem is to constantly compare yourself to others, especially those that have been working in the NHS for longer than you. If you do this, you will fill yourself with feelings of inadequacy because you’re not able to perform at the same level.

The first step to managing this, is to accept that in the beginning you will not be as efficient as your peers. That’s just how it is.

Accept that you will not have as good rapport with the team as those who have been there longer. Accept that you will take longer to arrange a CT scan compared to those more junior to you.

This is not because you are inadequate.

This is simply because you are NEW.

And this is completely normal.

The issue is almost never due to inadequate clinical knowledge, but rather the shock of a new system, not knowing the local guidelines, and not knowing what is expected of you. Once you adjust to the system, you will be just as good as the other members of your team!

If you’re having a hard time, try to remember these 2 important points:

  • The GMC approved your registration and granted you a license to practice in the UK so you are competent to do your job.
  • Your CV got past the shortlisting phase and the interview panel deemed you to be the best applicant for this job. You deserve to be here.

Remember these things because you are not being fair to yourself when you compare yourself to UK graduates or IMGs who have been working in the NHS for a few years. Be kind to yourself and give it some time.

What if you lack knowledge?

You may be well aware of the basics, but there is so much to learn in each specialty that you will inevitably find gaps in your knowledge.

That’s fine, nobody is expected to know everything, but you are expected to strive to be better.

All you need to do is read more and find the answers to questions you can’t answer. Lifelong-learning is part of being a doctor after all!

Make time each week to study cases and bring a reference book to work every day. This is why I highly recommend having a pocket reference book like the Oxford Handbook for the Foundation Programme (Amazon link). It contains the presentation, examination, clinical management, prognosis, and some pathophysiology of many common conditions you’ll encounter which are highly condensed into a very portable book. It serves as a great reference point whenever you are in doubt and was my go-to book at work.

Related: 12 essential items for IMGs working in the NHS

You may feel… marginalised

Group of doctors walking away

When you start a job in a new place, you will meet some lovely friendly people who are very welcoming to newcomers, and you will meet people who take a lot more time to warm up to you. Rarely, you may also meet people who are cynical, abrasive, and seem to take pleasure in watching you stumble.

It’s easy to take a cold attitude personally, and even easier to blame it on “racism” or “discrimination”, but doing this means that you contribute to the barrier between you and the other person without finding a solution.

Try to reflect on these situations later on and find out what the real cause of the problem is rather than simply blaming it on racism.

Take a step back and try to approach the situation with an open mind. Perhaps the other person is simply stressed and not coping with it very well and needs extra support. Give them the benefit of the doubt and try to be the bigger (more professional!) person. We have no control over other people’s actions, but we certainly have control over our own emotions and actions.

How to build rapport with your colleagues

It would be nice if everyone was warm and welcoming right from the beginning, but that’s just not how life works and you will have to make an effort to integrate yourself into the team.

Here are some tips to achieve that:

  • Ask everyone’s names, try to remember them, and greet them when you see them. It means so much to people when you show that you remember their name.
  • Bring in some treats for the team like cookies or cake.
  • Offer to make tea or coffee for colleagues at meetings or when you’re free and they’re clearly busy.
  • Offer to help colleagues with tasks at work or swapping shifts for important life events.

Is there really no racism in the NHS?

We have not personally encountered racism at work before, and many IMGs have had long happy careers in this country without facing any discrimination.

Also, when it comes to things like applying to specialty training, there is little room for racism, sexism or other bias to influence your application. That’s because the process is very transparent and objective.

But sadly racism does still exist in the NHS, just like it does in any country all over the world. If you think that there is real discrimination towards you because of race, sex or any other reason, just remember this: you do not have to accept discrimination at work.

There are ways that it can be dealt it. Accusations of this type are very grave and they are taken seriously.

Here are some resources to combat discrimination:

You may feel… homesick

Starting work in a new system is one thing, doing it in a new country is quite another! 

While you are feeling anxious, inadequate and marginalised, you are bound to sorely miss your loved ones, the weather, the food, and even the TV shows and music.

We’ve all been there as IMGs. The days at work when thinking of home brings tears to your eyes, the cold nights where you feel alone, the heart pangs of seeing photos of your friends back home celebrating weddings and birthdays. 

The pain of missing home is real!

But don’t forget the hardships that you went through to get here. The exams, paperwork, and even the discouragement. You rose above all that and now here you are living your dream! 

You should celebrate your success and view this as an exciting time, a whole new chapter to your life. When you have this mindset, it’s much easier to enjoy your life in the present than mourn your life in the past.

Ways to cope with being homesick and enjoy your new life

  • Talk or video chat with your friends and family back home regularly.
  • Have lunch with your colleagues, get to know them and make new friends! Locate restaurants with your home foods and invite them for a meal.
  • Plan your annual leave in advance, swap out your on-calls early enough so you can take 2-3 weeks off to travel back home.
  • Explore your local area. The UK has a lot to offer in both cities and the countryside! Find the beauty in a long walk or the joy in watching a live musical.
  • Take up a new hobby. With less working hours compared to your home country, you’ll have a lot more free time to learn new skills or engage in recreation. I learned to cook and enjoy trying new recipes and experimenting with new ingredients!

Eventually, you will feel… accomplished!

Once you’ve been working in the NHS for a few weeks or months, you will get used to how the system works and your abilities will really start to shine! 

Your colleagues will come to appreciate you as a valued member of the team and you will feel like a true NHS doctor and not just “a doctor from overseas”.

It does take time to get to this stage so please be patient. You’ll stumble at certain points but pick yourself back up, tackle your negative feelings one-by-one, and you too can find your way here just like many of the IMGs who came before you.

Just remember to pay it forward whenever a new doctor joins. There’s nothing more hurtful than someone who has been in your shoes as a newbie who treats you like an outsider. Let’s be kind to each other and help one another

How you can help new doctors

  • Start a blog or write a guest post about your experience.
  • Join an IMG Facebook group and answer questions from newcomers. You can find a list of IMG Facebook groups in our Useful Links page here.
  • Start an IMG mentoring program at your hospital.
  • Organise regular IMG induction sessions for your trust.

These efforts will be truly appreciated by new IMGs and can look good on your CV or portfolio too!

Conclusion

Working in a new country with a new system and culture is both exciting and terrifying.

You may feel one or all of these negative feelings at first, but because you’re now aware these things can happen, you can mentally prepare yourself. Doing so will hopefully allow you to overcome these emotional obstacles faster than we did!

If you need additional support, there are resources available for you that we’ve listed above. We hope you find them helpful, and always remember: you are not alone on this journey!

Disclosure: There are some affiliate links in the article above. This means that at no additional cost to you, we may earn a commission if you make a booking or purchase by clicking on the link. We only recommend products and services that we use ourselves or have proven success amongst IMGs.

You might also like

Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.

free

Looking for a step-by-step guide?

Subscribe to the Savvy IMG and grab your FREE 2-year roadmap to UK residency as an IMG.

free

6 Responses

  1. I’m in the very beginning of my first UK job (which I could get mostly based on the steps outlined here in your website!), and have been feeling overwhelmed most of the time indeed. However, most colleagues and staff are very supportive and understanding of my newbie status in the NHS, with a reassuring attitude towards me. I believe confidence will build, with time and focus.
    Thank you the post!

    1. Well done Rodrigo! I’m really glad you are in a supportive department, it’s great to know a fellow IMG is being treated well 🙂 It does take time, and some effort too, but you will really thrive as a doctor in the NHS. Wishing you all the best!

    1. Hi there, only if you want to have a Philippine license. Personally, we never intended to practise in the Philippines so we did not take the PLE prior to PLAB.

  2. Hi Dr. Nick! I’m a 3rd year BS Biology student at Bicol University, Philippines and I’m planning to study medicine but I haven’t yet decided which medical school to apply to. I was wondering if you could tell me where you graduated medicine and if that university really helped you prepare for working in the UK.

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Privacy Overview

This Privacy Policy sets out how we, The Savvy IMG, collect, store and use information about you when you use or interact with our website, thesavvyimg.co.uk (our website) and where we otherwise obtain or collect information about you. This Privacy Policy is effective 13th November 2019.

Contents

  • Summary
  • Our details
  • When you visit our website
  • When you use our website
  • Marketing communications
  • Information obtained from third parties
  • Disclosure and additional uses of your information
  • How long we retain your information
  • How we secure your information
  • Transfers of your information outside the European Economic Area
  • Your rights in relation to your information
  • Changes to our Privacy Policy
  • Children’s Privacy

Summary

This section summarises how we obtain, store and use information about you. It is intended to provide a very general overview only. It is not complete in and of itself and it must be read in conjunction with the corresponding full sections of this Privacy Policy.

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Our details

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When you visit our website

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You can view Teachable's privacy policy here https://teachable.com/privacy-policy

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Transfer and storage of your information

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Marketing communications

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When signing up for content, registering on our website or making a payment, we will use the information you provide in order to contact you regarding related content, products and services.

We will continue to send you marketing communications in relation to similar goods and services if you do not opt out from receiving them.

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Information obtained from third parties

This section sets out how we obtain or collect information about you from third parties.

Information received from third parties

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It is also possible that third parties with whom we have had no prior contact may provide us with information about you.

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For example, we would have a legitimate interest in processing your information to perform our obligations under a sub-contract with the third party, where the third party has the main contract with you. Our legitimate interest is the performance of our obligations under our sub-contract.

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Information obtained by us from third parties

In certain circumstances (for example, to verify the information we hold about you or obtain missing information we require to provide you with a service) we will obtain information about you from certain publicly accessible sources, both EU and non-EU, such as Companies House, online customer databases, business directories, media publications, social media, and websites (including your own website if you have one.

In certain circumstances will also obtain information about you from private sources, both EU and non-EU, such as marketing data services.

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Legitimate interests: Sharing relevant, timely and industry-specific information on related business services.

Where we receive information about you in error

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Disclosure and additional uses of your information

This section sets out the circumstances in which will disclose information about you to third parties and any additional purposes for which we use your information.

Disclosure of your information to service providers

We use a number of third parties to provide us with services which are necessary to run our business or to assist us with running our business

These include the following: Internet services, IT service providers and web developers.

Our third-party service providers are located both inside and outside of the European Economic Area.

Your information will be shared with these service providers where necessary to provide you with the service you have requested, whether that is accessing our website or ordering goods and services from us.

We do not display the identities of our service providers publicly by name for security and competitive reasons. If you would like further information about the identities of our service providers, however, please contact us directly by email and we will provide you with such information where you have a legitimate reason for requesting it (where we have shared your information with such service providers, for example).

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Legitimate interest relied on: where we share your information with these third parties in a context other than where is necessary to perform a contract (or take steps at your request to do so), we will share your information with such third parties in order to allow us to run and manage our business efficiently.

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Disclosure and use of your information for legal reasons

Indicating possible criminal acts or threats to public security to a competent authority

If we suspect that criminal or potential criminal conduct has been occurred, we will in certain circumstances need to contact an appropriate authority, such as the police. This could be the case, for instance, if we suspect that we fraud or a cyber-crime has been committed or if we receive threats or malicious communications towards us or third parties.

We will generally only need to process your information for this purpose if you were involved or affected by such an incident in some way.

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interests: preventing crime or suspected criminal activity (such as fraud).

In connection with the enforcement or potential enforcement our legal rights

We will use your information in connection with the enforcement or potential enforcement of our legal rights, including, for example, sharing information with debt collection agencies if you do not pay amounts owed to us when you are contractually obliged to do so. Our legal rights may be contractual (where we have entered into a contract with you) or non-contractual (such as legal rights that we have under copyright law or tort law).

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interest: enforcing our legal rights and taking steps to enforce our legal rights.

In connection with a legal or potential legal dispute or proceedings

We may need to use your information if we are involved in a dispute with you or a third party for example, either to resolve the dispute or as part of any mediation, arbitration or court resolution or similar process.

Legal basis for processing: our legitimate interests (Article 6(1)(f) of the General Data Protection Regulation).

Legitimate interest(s): resolving disputes and potential disputes.

How long we retain your information

This section sets out how long we retain your information. We have set out specific retention periods where possible. Where that has not been possible, we have set out the criteria we use to determine the retention period.

Retention periods

Server log information: we retain information on our server logs for 3 months.

Correspondence and enquiries: when you make an enquiry or correspond with us for any reason, whether by email or via our contact form or by phone, we will retain your information for as long as it takes to respond to and resolve your enquiry, and for 36 further month(s), after which point we will archive your information.

Newsletter: we retain the information you used to sign up for our newsletter for as long as you remain subscribed (i.e. you do not unsubscribe).

Membership: we retain the information you used to sign up for our memberships for as long as you remain subscribed (i.e. you do not unsubscribe).

Criteria for determining retention periods

In any other circumstances, we will retain your information for no longer than necessary, taking into account the following:

    • the purpose(s) and use of your information both now and in the future (such as whether it is necessary to continue to store that information in order to continue to perform our obligations under a contract with you or to contact you in the future);
    • whether we have any legal obligation to continue to process your information (such as any record-keeping obligations imposed by relevant law or regulation);
    • whether we have any legal basis to continue to process your information (such as your consent);
    • how valuable your information is (both now and in the future);
    • any relevant agreed industry practices on how long information should be retained;
    • the levels of risk, cost and liability involved with us continuing to hold the information;
    • how hard it is to ensure that the information can be kept up to date and accurate; and
    • any relevant surrounding circumstances (such as the nature and status of our relationship with you).

How we secure your information

We take appropriate technical and organisational measures to secure your information and to protect it against unauthorised or unlawful use and accidental loss or destruction, including:

  • only sharing and providing access to your information to the minimum extent necessary, subject to confidentiality restrictions where appropriate, and on an anonymised basis wherever possible;
  • using secure servers to store your information;
  • verifying the identity of any individual who requests access to information prior to granting them access to information;
  • using Secure Sockets Layer (SSL) software to encrypt any payment transactions you make on or via our website;
  • only transferring your information via closed system or encrypted data transfers;

Transmission of information to us by email

Transmission of information over the internet is not entirely secure, and if you submit any information to us over the internet (whether by email, via our website or any other means), you do so entirely at your own risk.

We cannot be responsible for any costs, expenses, loss of profits, harm to reputation, damages, liabilities or any other form of loss or damage suffered by you as a result of your decision to transmit information to us by such means.

Transfers of your information outside the European Economic Area

Your information may be transferred and stored outside the European Economic Area (EEA) in the circumstances set out earlier in this policy.

We will also transfer your information outside the EEA or to an international organisation in order to comply with legal obligations to which we are subject (compliance with a court order, for example). Where we are required to do so, we will ensure appropriate safeguards and protections are in place.

Your rights in relation to your information

Subject to certain limitations on certain rights, you have the following rights in relation to your information, which you can exercise by writing to the data controller using the details provided at the top of this policy.

  • to request access to your information and information related to our use and processing of your information;
  • to request the correction or deletion of your information;
  • to request that we restrict our use of your information;
  • to receive information which you have provided to us in a structured, commonly used and machine-readable format (e.g. a CSV file) and the right to have that information transferred to another data controller (including a third-party data controller);
  • to object to the processing of your information for certain purposes (for further information, see the section below entitled Your right to object to the processing of your information for certain purposes); and
  • to withdraw your consent to our use of your information at any time where we rely on your consent to use or process that information. Please note that if you withdraw your consent, this will not affect the lawfulness of our use and processing of your information on the basis of your consent before the point in time when you withdraw your consent.

In accordance with Article 77 of the General Data Protection Regulation, you also have the right to lodge a complaint with a supervisory authority, in particular in the Member State of your habitual residence, place of work or of an alleged infringement of the General Data Protection Regulation.

Further information on your rights in relation to your personal data as an individual

You can find out further information about your rights, as well as information on any limitations which apply to those rights, by reading the underlying legislation contained in Articles 12 to 22 and 34 of the General Data Protection Regulation, which is available here:http://ec.europa.eu/justice/data-protection/reform/files/regulation_oj_en.pdf

Verifying your identity where you request access to your information

Where you request access to your information, we are required by law to use all reasonable measures to verify your identity before doing so.

These measures are designed to protect your information and to reduce the risk of identity fraud, identity theft or general unauthorised access to your information.

How we verify your identity

Where we possess appropriate information about you on file, we will attempt to verify your identity using that information.

If it is not possible to identity you from such information, or if we have insufficient information about you, we may require original or certified copies of certain documentation in order to be able to verify your identity before we are able to provide you with access to your information.

We will be able to confirm the precise information we require to verify your identity in your specific circumstances if and when you make such a request.

Your right to object

You have the following rights in relation to your information, which you may exercise in the same way as you may exercise by writing to the data controller using the details provided at the top of this policy.

  • to object to us using or processing your information where we use or process it in order
  • to carry out a task in the public interest or for our legitimate interests, including ‘profiling’ (i.e. analysing or predicting your behaviour based on your information) based on any of these purposes; and
  • to object to us using or processing your information for direct marketing purposes(including any profiling we engage in that is related to such direct marketing).

You may also exercise your right to object to us using or processing your information for direct marketing purposes by:

  • clicking the unsubscribe link contained at the bottom of any marketing email we send to you and following the instructions which appear in your browser following your clicking on that link;
  • sending an email to info@thesavvyimg.co.uk, asking that we stop sending you marketing communications or by including the words “OPT OUT”.

Sensitive Personal Information

‘Sensitive personal information’ is information about an individual that reveals their racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, genetic information, biometric information for the purpose of uniquely identifying an individual, information concerning health or information concerning a natural person’s sex life or sexual orientation.

Our website does not allow you to register any ‘Sensitive Information’, however if we ask for this, you will be considered to have explicitly consented to us processing that sensitive personal information under Article 9(2)(a) of the General Data Protection Regulation.

Changes to our Privacy Policy

We update and amend our Privacy Policy from time to time.

Minor changes to our Privacy Policy

Where we make minor changes to our Privacy Policy, we will update our Privacy Policy with a new effective date stated at the beginning of it. Our processing of your information will be governed by the practices set out in that new version of the Privacy Policy from its effective date onwards.

Major changes to our Privacy Policy or the purposes for which we process your information

Where we make major changes to our Privacy Policy or intend to use your information for a new purpose or a different purpose than the purposes for which we originally collected it, we will notify you by email (where possible) or by posting a notice on our website.

We will provide you with the information about the change in question and the purpose and any other relevant information before we use your information for that new purpose.

Wherever required, we will obtain your prior consent before using your information for a purpose that is different from the purposes for which we originally collected it.

Children’s Privacy

Because we care about the safety and privacy of children online, we comply with the Children’s Online Privacy Protection Act of 1998 (COPPA). COPPA and its accompanying regulations protect the privacy of children using the internet. We do not knowingly contact or collect information from persons under the age of 18. The website is not intended to solicit information of any kind from persons under the age of 18.

It is possible that we could receive information pertaining to persons under the age of 18 by the fraud or deception of a third party. If we are notified of this, as soon as we verify the information, we will, where required by law to do so, immediately obtain the appropriate parental consent to use that information or, if we are unable to obtain such parental consent, we will delete the information from our servers. If you would like to notify us of our receipt of information about persons under the age of 18, please do so by contacting us by using the details at the top of this policy.