# Helping International Medical Graduates Transition to the National Health Service: A Two-Cycle Quality Improvement Project (QIP)

## TL;DR

This study aimed to help international medical graduates transition to the UK NHS by improving their confidence through training and mentorship.

## Contribution

A two-cycle QIP using online, in-person, and handbook methods to support IMGs transitioning to the NHS.

## Key findings

- The induction handbook increased confidence levels significantly with a mean increase of 1.56.
- In-person workshops showed the highest confidence increase with a mean of 2.60.
- Non-UK doctors face significant challenges transitioning to the NHS, requiring structured support.

## Abstract

International medical graduates (IMGs), when transitioning to the UK National Healthcare Service (NHS), typically get little constructive criticism for their work and have little opportunity to grow in their careers. Therefore, this quality improvement initiative's main goal was to increase the confidence of recently qualified physicians and IMGs as they transitioned to the NHS by using three systems: online instruction, in-person seminars, and an introduction guidebook. Our Quality Improvement Project (QIP) underwent two Plan, Do, Study, Act (PDSA) cycles to better IMGs' transition to the NHS, mimic a resident physician's life, comprehend the portfolio system, increase competency, and lessen imposter syndrome. Three different formats were used for each PDSA: induction manuals, online instruction, and in-person practical workshops. The surveys were filled out by 40 individuals in all, including nine UK national IMG students studying in Bulgaria and 31 recently graduated IMG physicians. The handbook showed improvement in confidence level, a mean increase of 1.56 (standard deviation (SD) 1.043, 95% confidence interval (CI) 0.238-2.173), p-value < 0.001, inperson workshop had a mean increase of 2.60 (SD 1, 95%CI 2.817-3.013, p-value < 0.001) and online sessions showed an increase across all teaching. This QIP brought to light the many difficulties experienced by non-UK-qualified doctors when they transitioned to practice in the UK. For IMGs, it is essential to implement an induction program in addition to ongoing instruction and mentorship.