TULIP: The UK Life Induction Programme

Introduction: The UK's NHS relies heavily on the contributions of doctors trained outside of the UK; approximately half of non-consultant doctors are international medical graduates (IMGs). The transition from one healthcare system to another, a new professional culture and personal life in the UK can present significant challenges for these highly experienced professionals. We investigated the experiences of IMGs adapting to the NHS and propose a bespoke induction program designed to facilitate a smoother integration. Methods: A survey of IMGs working in the UK was carried out, exploring the difficulties encountered during their transition. Questions focused on key areas, such as communication skills, financial challenges, everyday necessities and understanding workplace dynamics. The survey also assessed the perceived impact of these challenges on IMGs’ adaptation and potential, the resources they utilised and their willingness to engage in a structured induction program. Results: 157 survey responses of IMGs who had already been working in the UK indicated that they face a multitude of challenges, with many reporting difficulties in adapting to the nuances of communication styles preferred in the UK, managing financial complexities and navigating daily life. Only 9% of respondents had any induction from their employing organisation. Importantly, 48% of respondents reported feeling ‘depressed or lost’ during their transition, with 31% stating ‘maybe’. Almost half believed that these challenges prolonged their adaptation to the NHS, potentially hindering their professional development. Most IMGs expressed a strong interest in participating in a structured induction program, with many even stating they would be willing to pay for such a resource, especially if it offered Continuing Professional Development points. Thus, we created TULIP - The UK Life Induction Programme, which proposed the following: • Pre-arrival resources: online modules covering essential information about UK culture, customs and practical aspects of daily life; • Communication skills: workshops on effective communication with patients and their relatives, colleagues and other healthcare professionals; • Financial management: understanding payslips, taxation and managing finances in the UK; focusing on financial literacy and ways to save money; • Navigating the NHS: training on NHS policies, procedures and ethical guidelines; • Workplace dynamics and support: workshops addressing bullying, harassment and conflict resolution; mentorship opportunities with experienced NHS professionals; • Essential services: support in arranging housing and schools as well as registering with GPs and dentists, etc. Conclusion: A well-structured induction program can significantly ease the transition for IMGs entering the NHS, leading to faster adaptation, enhanced professional performance and overall improved wellbeing. While traditional NHS induction programmes may cover some of the areas proposed in TULIP, it is important to acknowledge that IMGs have a broader and more sensitive need for induction unique to people who have not previously lived and worked in the UK. By addressing the specific challenges faced by IMGs, the NHS can better support these essential members of the workforce and ensure that they can contribute to their full potential. TULIP aims to bridge the gap between international training and UK practice, fostering a more inclusive and supportive environment for all healthcare professionals

Abstract licence: CC BY-NC-ND

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