International graduates have positive experiences of GP training, but face challenges that domestic students do not
NHS England commissioned Ipsos’ Health and Social Care team to undertake qualitative research to better understand the challenges International Medical Graduates (IMGs) face during their training to be a GP, and what additional support they may need on their journey through their career as a GP.
The report found that overall experiences of the GP Training Programme are positive, but that IMGs encounter additional challenges relating to induction, relocation, transition into the workforce and navigating the visa system.
The research provides important evidence that will help inform the development of national and local initiatives designed to better support and retain the IMG GP workforce.
Retaining international doctors in the workforce after they qualify is key to improving access to NHS GP services for patients.
Ipsos carried out 53 interviews with international medical graduates who were either in the final year of GP specialty training, or who had already completed GP specialty training. The interviews sought to understand their experiences and views of transitioning into working in primary care in England.
The research found that participants were globally mobile. As well as studying in another country, they often had spent time working in other health systems, and this was not always the same health system where they completed their core medical degree. The route taken to GP specialty training in England was rarely a direct one, and participants had moved to England for a number of reasons, for example, following a spouse, or acting on recommendations from peers and colleagues. The decision to work as a GP was driven by perceptions of the GP role as well as practical considerations around the training programme.
Participants spoke positively of colleagues and peers with whom they studied and worked. The sense of camaraderie and mutual support was highly valued. The training structure, including the provision of one-to-one supervision and rotations, was also appreciated and seen to offer the variety of learning opportunities participants wanted.
However, some struggled to balance the life administration that comes with moving to a new country alongside the demands of the training programme. Experiences of transitioning from training to employment were often tied to immigration issues. The requirement of a work visa and whether a GP practice that could sponsor a work visa could be found were primary considerations when looking for work as a GP. Other factors such as location, the type of role, the practice, and the working environment were also considered when looking for work after GP training.
When reflecting on experiences in work, participants working in primary care enjoyed the role and the colleagues they worked with, in line with some of the motivations to train as GPs. However, expectations about the working hours were not always met, and some of the cultural and communication challenges faced during training were also prevalent during employment.
