Ten times harder

by Hana Bashir

International medical graduates have been made to feel they are not as talented as their British counterparts

Location: International
Last reviewed: 8 December 2021
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‘I’m not a racist Hana, but foreign doctors just aren’t as good.’

I remember it so vividly, though it’s been years, and I realise now that although I didn’t think so at the time, this was a life-altering moment for me.

I’d spent my whole life thinking I was smart. I was top of my class at every level, went to one of the best medical schools in Sudan, then worked very hard to pave my career.

It was a curveball to be told I was inherently a worse doctor. I started thinking so too; maybe they are better, perhaps they possess a quality that I will never have through some mysterious work of nature.

I recently read something that describes me perfectly: ‘I’ve heard that there’s a bird without legs that can only fly and fly, and sleep in the wind when it is tired. The bird only lands once in its life... that’s when it dies.’ (Days of being wild, a film by Wong Kar-Wai).

If I land, I’ll die.

Working 10 times harder became my default. Ten times as hard to be just as good, but 10 times as hard doesn’t work: it burns you out – 10 times as hard still isn’t good enough.

I moved to the UK and was fortunate enough to start in a job where so many people believed in me. I started believing in myself, and I finally came to a point in my life where I could say; I am as good as I try to be. (Shout out to all the fantastic people in Derriford hospital.)

Through my IMG (international medical graduate) support and differential attainment work, I have spoken to many other colleagues, and they all recognise the same feeling.

They think they are expected to fail and therefore must work harder to prove themselves – this is an immense pressure and why differential attainment and IMG support matter.

No one should feel they are expected to fail, no matter what they do.

A comprehensive support package is a must. I had already tailored an IMG induction for the department, but I felt a deanery-wide comprehensive support package was needed.

I am now the vice-chair of an IMG network across all specialties and across the south-west, initiated and supported by Health Education England, which promises to be instrumental in enhancing the experiences of IMGs in our region. A peer support network should provide a safe space for IMGs to express their unique challenges and similar stories.

I organised an IMG-targeted study day for new paediatric IMGs in the region in September and there has been so much enthusiasm from the deanery in making this happen. The Southwest deanery is truly a deanery receptive to positive change.

Most importantly, I feel we are changing perceptions; all junior doctors from all backgrounds require support at times. It’s not that IMGs need more all the time, they need different types of support, and the sooner we understand this the more effective that support becomes.

The causes of differential attainment are still poorly understood. Still, most studies showed the most effective measures to combat it happen at a personal level and through positive personal relationships. The change starts with all of us. Let us all be the change we want to see in the NHS.

Hana Bashir is a specialty trainee 4 in paediatrics in the Southwest