When Kirti Singhal first arrived in the UK from India at the end of 2020, she was met by the usual and frequently daunting challenges which face doctors who have qualified overseas and who have little to no experience of the NHS.

Yet, to gain GMC registration and awaiting dates to complete her Royal College of Paediatrics and Child Health exams, Dr Singhal’s situation was further complicated by the fact the UK had re-entered lockdown shortly after her arrival, which made finding clinical attachments almost impossible.

Today, Dr Singhal is a clinical fellow in the paediatric intensive care unit at St George’s Hospital in southwest London, a fact she credits in large part to the trust giving her the opportunity to gain hands-on experience through the MSW (medical support worker) programme.

SINGHAL: Communication skills enhanced

‘I believe if I had not been enrolled in the MSW, I would probably have had much more difficulty getting a date for my clinicals,’ says Dr Singhal.

‘[The MSW programme] helped me develop my communication skills with the patients, it gives you practice on how to examine patients and you always get immediate feedback from the consultant because you’re always with them. It is a very good stepping stone to gain NHS work experience.’

Introduced during the height of the pandemic, the MSW programme aims to give doctors, including IMGs (international medical graduates), the chance to work in supervised, supporting roles in the NHS, while working towards the completion of assessments such as the PLAB (professional and linguistic assessments board) examinations and, ultimately, medical registration.

BABATOLA: Confidence has grown

The success of the programme, which was rolled out across England following a successful pilot, has meant NHS England has confirmed it will continue to fund the scheme until the end of March 2023.

St George’s paediatrics unit was the first department in southwest London to adopt the MSW programme and has this year seen six IMG doctors join the scheme, of which four have since gone on to complete their GMC registrations.

The trust’s clinical director for children’s services and consultant neonatologist Sijo Francis (pictured top) was instrumental in implementing the MSW programme at St George’s roughly 12 months ago.

Having qualified in South Africa before coming to the UK, Dr Francis says he understands the challenges facing doctors coming from overseas such as cultural differences and unfamiliarity with NHS working practices. ‘I thought this is a really great idea,’ he says.

‘Rather than having doctors coming from overseas paying lots of money for courses on how to pass the PLAB exams, we get them into a hospital, train them ourselves [and] give them opportunities to learn by experience.’

Doctors who sign up to the MSW programme are normally contracted to work under supervised conditions for six to 12 months. Without GMC registration, there are understandable limits to the responsibilities they can be entrusted with, and support workers are unable to prescribe medication or manage patients without direct supervision.

Dr Francis says, however, that incorporating highly skilled overseas doctors into an existing workforce has huge benefits for the doctors and the trusts taking them on.

‘The feedback from colleagues in the ward has been spectacular. Because this is a new role it’s effectively additional workforce that we haven’t had before [and] it has actually taken a huge load off the clinical team by having an additional group of people who are very highly skilled,’ says Dr Francis.

‘We’ve used [support workers] within their licence, but we’ve also seen this very much as an opportunity to train so [we’ve given] them access to the same training programme that our junior doctors have and tried to give them opportunities to do additional courses or have some additional time off to study.’

Originally from Nigeria, Taiwo Babatola is participating in the MSW at St George’s, having moved to the UK in February 2021.

Having recently passed her first PLAB exam, Dr Babatola says she hopes to pursue a career in general practice eventually, specialising in paediatrics, and credited the support and experience she gained through the MSW programme.

‘I’ve learned so much working in the NHS and I have more confidence and examine patients more because I work under supervision and there are people [other staff] we can call on at any time,’ she says.

‘I’m so grateful for this opportunity to join the NHS and make a difference. Thank you to all my colleagues and clinical supervisors for believing in me and continuing to support me throughout this programme.’

With IMGs now making up more than half of new GMC registrations each year, the BMA has continued to call for greater resources and support to be provided to those students and doctors seeking further education and training or a new career in the UK.

This year saw the association launch its affiliate membership programme which aims to provide doctors with a broad range of advice, guidance and practical support to help them in their transition to the NHS before they arrive.

For St George’s and many other trusts, the MSW programme is not simply a short-term fix for boosting staff numbers, but an opportunity to invest in the doctors of the future and the NHS.

Twenty per cent of those who have enrolled on the MSW programme are refugee doctors. The experience they gain helps to alleviate the challenges they would likely have faced in accessing clinical attachments, says the BMA.

‘The key measure of success is that we don’t keep people in these roles,’ says Dr Francis.‘We want these doctors to become successful and leave the MSW programme and go on and become a fully fledged doctor in our community.’

More information about how the BMA is supporting IMGs through its international affiliate membership