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If you are an IMG, you may find British colleagues and patients difficult to communicate with, even if you speak English naturally. You may feel that someone is giving you a strange answer, or appears offended by something you have said. You cannot quite put your finger on what is going on, but it is as if you have missed something somewhere. Well, here are a few tips to help you. This is not meant to be patronising, as people brought up in the UK have also had to learn this as children, often the hard way.
The British are indirect and too polite to ask for what they really want. For instance, if you offer someone a lift in your car, they may come out with some rigmarole about how they don't want to trouble you or take you out of your way, and would you mind awfully, but really, yes, please, they do want a lift. Equally, the British may not like to give orders or be too dictatorial. Hence, if someone says, "I think it would be a good idea to get some milk", they could be suggesting that they want you to obtain the milk.
It is considered rude in social situations to ask adults their age. (It is different with patients, of course.) It is also not done for adults to disclose their age. It is a polite joke to assume that adults are younger than they actually are. The other day, I was talking to a nurse acquaintance obviously in her fifties, who said she had known a particular friend since they were 11 and that it was a long time. I said, "Yes - 10 years is a long time", implying that I thought she was 21. She laughed and told me her real age - 59. You will find that very elderly people will happily tell you their age, particularly if they are still in good health. You are meant to disagree that they could possibly be that old, with phrases such as, "You never are. I don't believe that."
The British love their innuendoes - double meanings, with one usually being rude. Watching the Carry On films is a good way to familiarise yourself with this brand of humour. As children, we would laugh hysterically at a sentence such as, "I didn't think you'd do it". This is because "do it" is also an expression for having sexual intercourse. Then there is a joke that goes, "She asked me for an innuendo, so I gave her one."
When asked, "How are you?" the only acceptable answer is along the lines of, "Fine, thank you." You should not go into detail about any ailments, even with another doctor. However, if you really are feeling unwell, you can add something like, "Well, actually, I'm a bit under the weather today." If someone greets you with, "Hi - are you all right?" you can answer with, "Yes, thank you", or simply say, "Y'all right?" back, as it really just means hello.
There is so much more I could tell you, but it will have to wait for another day.
Have you every experienced any difficulty communicating in the UK? Any funny examples that caught you out?