BMJ Awards 2020: Workforce and wellbeing

Dedicated programme narrowed career development gap

Differential attainment between British and international medical graduates (IMGs) has long been identified by the General Medical Council.

Often, hospitals locally employ IMGs to fill non-training service posts (trust doctors).They are a vital part of the workforce, many bridging rota gaps, but little attention has been paid to their own training needs.

Between August 2017 and 2018, the Royal Bournemouth Hospital employed 44 trust doctors in medicine; 68% were IMGs. Of these, 23% progressed to get a training post compared with 57% of UK graduates.

Michael Vassallo, consultant physician, says: “We developed a programme to enhance educational opportunity, mitigate culture shock, promote career development and equal opportunity, reduce differential attainment and improve patient care.” A dedicated director was appointed responsible for organising recruitment, induction, educational supervision, and appraisal.

IMGs also set up an international doctors’ support initiative group. This had five work streams: induction, integration and wellbeing, forum, teaching, and careers advice. New recruits were mentored by current IMGs during the pre-induction and induction period.

“Between August 2018 and 2019, 38% of IMGs got training posts, halving the differential attainment gap,” says Vassallo.

All IMGs had named educational and clinical supervisors and over 90% had appraisals completed. “Trust doctors were very positive about this proactive approach to their welfare, says Vassallo.

“This shows that having a dedicated programme with senior leadership improves the support and experience of IMGs and can reduce differential attainment.”

Trust-wide effort achieved positive culture shift

Four in five junior doctors regularly experience excessive work related stress and one in four say their job has a serious negative impact on their mental health. Evidence suggests that dealing …