Working in the NHS can be an immensely rewarding experience but can also pose some unique challenges. Dr Maiedha Raza and Mr Solyman Hassouna of Maraz Healthcare offer some advice for International Medical Graduates on how to navigate culture within the NHS.

For International Medical Graduates (IMGs) it can be difficult to understand how to work within the complex environment that is the NHS workplace. Sometimes small things can make a big difference.

Here are some ideas based on the experience of other IMGs.

Adapting to teamworking

Regardless of the job you are undertaking in the NHS, it is always important to remember that you are always part of a broader team. It's helpful to take some time to get to know your colleagues as individuals as well as team members. Take time to get to know their preferred names and how you can contact them for help if needed. If you manage to find some time, taking a team coffee break together can be a great way to help build rapport and the sense of working together on a shared goal. 

Since the NHS has no hierarchy, it is useful to remember that all healthcare professionals have skills that build upon and complement each other. This means you may turn to another colleague for help, and that colleagues may also turn to you for guidance or support. Working in this way helps promote respect and leads to an effective and harmonious team working environment. Each team member brings specific skills and experiences that can and should be drawn up on.

There will also be staff who have vast experiences in specific areas gained over many years eg. ward clerks, nurses and admin staff. It is also useful to link in with these staff members to ask for advice as they will have seen many doctors rotate through their departments and may have some useful tips for you on how to navigate the clinical environment.

Balancing your work and home life

Working in a high paced environment like the NHS can come with its own fair share of stress. It's critical that you strike the right work life balance to prevent burn out in the long term. Take advantage of moving to a new area and explore what is on offer. Don't be afraid to become active members of the local community by joining groups or clubs that may interest you. This will also help with relating to your patients with regards to their demographics and recognising local landmarks that might crop up in conversation. An active social life outside of medicine also goes a long way to looking after your wellbeing.

Tackling language barriers

Undoubtedly, the biggest cultural challenges faced by IMGs when entering the NHS are issues surrounding communication. For many IMGs, language can be a barrier to understanding both colleagues and patients alike. It's always helpful to recognise that this may be an issue and take time to really understanding what is trying to be communicated. There is no shame in asking them to help you understand what they are trying to say. If you feel unsure about what they are trying to say, ask them directly in a friendly approachable manner. On the whole, people will happily take time to make sure you both understand each other when asked. 

To help improve your English, it can also be useful to watch and listen to British TV and radio. Listening to local radio can be a great way to pick up on local and regional accents and colloquialisms. The more interacting and engaging with people you do, the easier it will become. This is not just in a medical setting but also through social groups and daily conversation. Joining a local language support group may be a great way to do this.

We work offer a communication skills course as part of Medical Protection membership. The course aims at building better communication with patients and colleagues and explores the most common communication issues and how to tackle them. This is done from the perspective of a clinician and an expert patient, and with it the experiences of both sides in the NHS. 

About the author

Dr Maiedha Raza is a GP and communications skills tutor. She has experience teaching and supervising medical students and healthcare professionals delivers a Communications Skills Course for IMGs which is included in Medical Protection membership. Mr Solyman Hassouna is an expert patient and runs the communication skills courses with Dr Raza.