Knowing your limits and boundaries as an IMG

When you start out in UK medical practice, you’ll be keen to get stuck into your new role and make a good impression but it’s important to know your limits and continue to develop your skills. Dr Beth Walker BSc MBBS MSc MRCP DLM LLB offers her tips for striking the right balance. 

Taking up a new post in the NHS is an exciting time and, as in any new job you’ll be keen to make a good impression. In Getting the most out of your NHS interview, Dr Alam suggests some of the support you might need from colleagues particularly in the first few weeks in a new role, but the most important thing is to make sure you have the ability and experience to perform the tasks asked of you.

Competency, in professional terms, is defined as the ability to perform the tasks and roles required to the expected standard. It can be applied to a doctor at any stage in their career and it also encompasses the need to keep up to date with changes in practice and systems that can impact on it.

You may feel embarrassed or nervous admitting you do not feel competent to do something and it can be hard to resist the temptation or pressure to say “yes”. Undertaking new tasks is a necessary part of your professional development but it is important that this is done in a structured and supported manner. It is crucial that you do not take on responsibility for tasks you are not competent to do; asking for support or training first is essential to maintain patient safety.

It can be particularly difficult to speak up when a senior colleague asks you to perform a procedure or do something where you feel out of your depth.  This is an experience most junior doctors can relate to, no matter the stage of their training.  However, the overriding principle is laid out in the  GMC’s guidance Good Medical Practice (paragraph 14): ‘you must recognise and work within the limits of your competence.’  Recognising your own limitations is a key principle underlying safe clinical practice.  If you feel like you’re being asked to do something that is outside your level of expertise or experience, you should explain this and seek advice, rather than attempt to undertake the task.

Medical Protection also has a free, 24/7 helpline that you can call to speak with one of our advisers for medicolegal advice. 

Failing to ask for help can have serious consequences. The potential impact on patient safety is the most obvious, but there can be other ramifications for doctors too whether that’s just the immediate stress of struggling with a situation, an effect on confidence or risk to your professional welfare, for example if the situation leads to a complaint.   

Survival Tips

• Recognise and work within the limits of your competence
• Don’t feel nervous to ask for help and support from your colleagues
• Keep your professional knowledge and skills up to date
• In an emergency, wherever it arises, you have a professional duty to offer assistance, taking account of your own safety and competence, and the availability of other options for care.
  

Our advice is always to speak up if you are not comfortable and to accept help and teaching from other health professionals where appropriate. Asking for help is not a sign of weakness, as Emma Wheatley discusses in her article for the BMA, but an opportunity to improve your skills.

About the author

Beth qualified as a doctor from University College London in 2011 and gained varied clinical experience post Foundation through completing ACCS Acute Medicine and undertaking higher specialty training in palliative medicine. Beth obtained a MSc in Medical Education in 2016 and teaching remains a big passion of hers.

Throughout her career, she has been fascinated by medical law and ethics. She completed the Graduate Diploma in Law and Diploma in Legal Medicine alongside working as a doctor. Beth joined Medical Protection in January 2020 as a Medicolegal Consultant, working to advise and support doctors with a wide range of medicolegal issues arising from professional practice.