International doctors at CMFT

Dr Sujesh Bansal

Trust International Tutor & Consultant Anaesthetist

Central Manchester University Hospitals

Supervising International doctors:

points to consider

Dr Sujesh Bansal

Trust International Tutor & Consultant Anaesthetist

Central Manchester University Hospitals

A typical year in NHS

• 300 million consultations • 70 million outpatient appointments • 21 million people visit A&E department • 5 million emergency admissions • 7.6 million elective admissions

A typical year in NHS

GMC, 2014

13,150 new doctors

MTI Scheme

MTI Scheme

MTI Scheme

Entry Points for International Doctors into the UK Clinical Practice

Pre MMC: Entry Points

EEA

Post MMC: Entry Points

IMG

IMG

IMG

CF’s

Doctors according to their PMQ, GMC 2013

ST trainee or

College Tutor

Speciality School

GMC, SOMEP 2014

Deanery trainee

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Support Structure: Deanery trainee

ST trainee or

College Tutor

Speciality School

Non-UK qualified

DOCTOR

Tier 5 visa

Max 2 years in UK

Through PLAB

Tier 2 visa

EEA Graduate

? Already on SR

SASG

Clinical Fellows

Deanery trainee

Clinical Fellows

Consultant

Deanery trainee

International Fellow

MTI Scheme

• Approval by DME, HEE-NW, RCoA

• Sponsored by AoMRC

• Tier 5 visa (max 2 years stay in UK)

• Training & support as NTN trainee

• Can appear for speciality examinations

• 3 years speciality experience

• Our experience: – Motivated, Attitude, Experienced

– > 50% returned to home country

Central Manchester University Hospitals

CMFT ~ 70 – 80 international doctors recruited every year

New starters Nov 2013 - Oct 2014

All grades 283

British 171

non-British 112

Europe 49

outside Europe 63

Clinical Fellows 159

British 84

non-British 75

Europe 25

outside Europe 50

CF: Aspirations

Clinical Fellows/ EEA Fellows:

1st job in UK

Tertiary UK clinical experience

CV : for ST jobs / Consultant job

Specialist experience

Coasting…

Speciality experience:

Post-CCT experience

CESR

Education

MTI International Fellows:

UK experience, UK career

Challenges

IMG – Do not prejudge

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Enhanced Educational Supervision

• Initial meeting with ES / IAC

• Frequent meeting with ES/Peer Buddy

• 3 - 6 monthly ES report

– WPBA (CBD, DOPs, ACEX, ALMAT)

– MSF

– Logbook

– CPD matrix

– Encourage Study Leaves

– Audit/QI

CLINICAL

Management & QI Projects

Research

Teaching

‘Online’ Induction

Supervisors

INCREASED SUPPORT

Peer ‘Buddy’

‘Online’ Induction

CMFT International Induction

#lha14

Online training is a resource efficient method

UK wide interest of CMFT International Programme

Enhanced Induction

• E-LfH Induction for International Doctors

• Corporate/ Clinical/ ANTT/ BLS/ Pain

• Trust Email i.d.

• IT software training & various passwords

• Transfer training (Inter/Intra)

• A&E session

• ITU session

• IMPACT/? ALERT / ALS

C P D

• 10 to 30 days of study leave

• £700 / year

• Internal

– Audit & Clinical effectiveness day

– Journal club

– Morbidity & mortality meetings

– FRCA Preparation Courses

– Free days organised by the Trust / Deanery / Locally

• External

– Specialist societies

**Annual Appraisal**

• Trust Employees

– Concerns re. poor engagement

• 12 monthly appraisal (9-15 months)

• Agree on appraisal date on induction

– Birthday, Previous ARCP date, Pragmatic approach

• Contact for Equiniti portfolio

• Bespoke workshop on Equiniti portfolio

• Maintain portfolio (Online + Paper)

• All CS/ES paperwork

Management

• Use Trust policy

• Involve CS, ES, Tutors, CD, MD

• Advice from Postgraduate Medical Education Department

– Simon Carley, Mark Forrest, Sujesh Bansal

• Might need to involve

– Human Resources

– Occupational Health

Our experience: Issues

• Independent lists (worked as SAS)

• Not called for help in A&E (worked as SAS)

• Not understanding the work culture (NEW)

• No UK experience in transfer, A&E, solo (NEW)

• Attitude

• Motivation

• WPBA, CPD, Teaching

How can we ensure that international doctors progress in

their professional career?

CLINICAL

Management & QI Projects

Research

Teaching

CLINICAL

Examination & International Doctors

• Additional training for international medical graduates to enable their adaptation to the UK healthcare system.

• Diversity of examiners and actors, the type of cases included in the examination and the feedback given to candidates

• Deaneries: – Additional training support

– Rotation in proven stronger training hospitals

– Trainers are given additional support.

Know the Challenges

• What does IMG wishes to achieve over the next few years?

• What training or resources would this require?

• Would this need a change in their current job?

• Strengths?

• Weaknesses? why ?

resources, further training, personality, systemic, remedies?

• What guidance or help do they need? Who? How?

• Clinical/training/organisational.

Enhanced Educational

Supervision & Appraisal to

develop relevant PDP

Enhanced Induction

& Support

Robust Recruitment