Induction package for trainees
Induction package for trainees
copied from Dr @Omar Alam and International Medical Graduates (IMGs) in the UK
An induction post for trainees who are starting as GPST1 / IMT trainees as their first job in the NHS
As you all might be aware , I am strongly against this :
However, some colleagues were still keen to go for GP training and IMT training directly from their home countries and are now starting in August. Some have contacted me as they're very worried.
I cannot guarantee that you will have a stress-free journey however I am hoping this post will help you plan everything in detail to avoid complications I have personally witnessed in trainees.
VISAS
When you're accepted for a post let the visa team know that you need to come to the UK ASAP hence need a COS as a priority. As you will have to quarantine for 10 days, will need a few days to sort out accommodation, open a bank account and settle into the system of living in the UK ( so I would say 10 days for quarantine plus 7 days for settling in )
Try to come to the UK as soon as you get your visa. Even if its a few days in advance.
Ideal travel date - at least 3 to 4 weeks before your training post starts.
I don't know how feasible this will be
TRAVEL
ensure you are out of quarantine a few days before your training post actually starts.
AS SOON AS YOU FIND OUT YOUR ROTATIONS AND THE TRUST SENDS YOU THE JOINING PAPERWORK ( usually in June )
OCCUPATIONAL HEALTH
If you don't have proof of vaccinations, you will need to be vaccinated here and have a screening blood test. Some trusts arrange an appointment with occupational health and allow doctors to start. Some state that they need to wait for their antibody test before you start work.
Read the occupational health section here:
So ensure you inform the trusts occupational health team ASAP about your vaccination status. Also ask if you will be allowed to start work while your appointment/ results are pending.
WHAT TO INFORM HR AND ROTA TEAM - AS SOON AS YOU GET THE EMAIL FROM THE TRUST WITH JOINING LETTERS
Let them know that this is your first post in the NHS. The team expects GPST 1, IMT 1 trainees to have completed their foundation training ( they don't understand the fact that you can still get into these training post without completing foundation training in the UK). You need to inform them about this ASAP so that
1. They could possibly arrange shadowing for you a week before you start
2. They don't start you on call on your first day. Let them know that you have no idea about the system and need some time to settle in.
3. The on call managers are aware of the fact that you're new. I know a trust where the registrar didn't turn up and the IMT 1 doctor was asked to carry the registrar bleep for a few hours as he was the senior most doctor. Luckily he had a reasonable experience in the NHS and he knew how to escalate unwell patients. The consultant turned up in a few hours to carry the bleep.
4. rotas are realeased 6 weeks in advance so ensure you have had these conversations before mid June.
Please note that the HR and rota team cannot guarantee that you will not be on call initially. You could possibly start with nights on your very first day or start with on calls in a few days / 2 to 3 weeks.
Trusts have a template rota and add doctors to the rota. They usually ensure there is at least one trainee SHO with a FY1 /ACP to ensure the FY1 and ACP are well supported. You're expected to support them but they usually talk to the registrar directly.
ANNUAL LEAVES
Book them as soon as you get your rota.
https://m.facebook.com/groups/IMGs.in.the.UK/permalink/2829898273709862/
ACCOMMODATION
Contact the accomodation team in the trust and ask if they have accommodation available. You can ask HR about the contact details
You will most probably be quarantining in the first 10 days. Ensure you get a UK SIM with good Internet package so that you can
1. Communicate with estate agents to sort out your accomodation
2. Book viewings for the day you leave quarantine
My guideline on accommodation in the UK
http://omarsguidelines.blogspot.co.uk/2017/05/my-guideline-on-accommodation-in-uk.html
My experience of finding an accommodation to rent - 2020:
https://omarsguidelines.blogspot.com/2020/05/my-experience-of-finding-accommodation.html
DRIVING
Bring your local license as well as your international license. Take driving lessons as soon as you get out of quarantine and aim to get a cheap car so that commuting is not an issue. You will save a lot of money and time on travelling this way. Plus you will have the freedom on going on nice drives when you're off work. Doing this before starting your job will help you focus on your job.
BEFORE YOU START
YOU should have
1. Bank account
2. Taken a few driving lessons and if possible, bought a car
3. Sorted out your accomodation
4. Sorted out your occupational health appointments
5. Sorted out your shadowing- preferably shadow a week before you start
6. Have your rota which shows that you're not on call in the first one week.
EMAILS AND COMMUNICATION
Remember to follow every phone conversation or face to face conversation with an email.
Like you have met HR who has agreed that you can shadow for a week.
You should email them along these lines " hello , thank you for meeting me at such short notice. I feel very assured now. Just to confirm what we discussed, I am to shadow Dr **** from the 20th of July to the 28th of July. He will be
On the ward from 0900 to 1700 from the 20th to 24th of July
On call from 0900 to.2100 from the 24th to 28th of July.
Can you also send Dr *** email address to me so that I can get in touch with him "
The same goes for any phone conversations you have with estate agents, etc.
STARTING WORK
With the aforementioned things sorted out , you can now focus 100% on work.
This is my blog on how to manage on calls , ward jobs , clerking , etc
https://omarsguidelines.blogspot.com/?m=1
TEACHING
Remember to keep an eye on teaching sessions which are mandatory for trainees. You will have induction in the trust
Induction for your training post.
Weekly IMT/ GPST 1 teaching
Mandatory regional teaching
Book these on your rota as soon as you get an email about an upcoming teaching session.
Keep travel receipts to get those reimbursed
ARCP - Annual Review of Competence Progression
This is an annual assessment of trainees.
This website has everything a trainee needs to achieve before their ARCP
https://www.jrcptb.org.uk/training-certification/arcp-decision-aids
http://omarsguidelines.blogspot.com/2018/06/arcp-in-core-medical-training.html
A team of consultants sits in a panel and goes through the trainees portfolio. They then judge whether the trainee is competent to progress or not.
E portfolio
Keep on top your portfolios from day 1.
http://omarsguidelines.blogspot.co.uk/2017/03/maintaining-your-e-portfolio.html
The ARCP panel will make a decision whether you're competent enough to progress based on what you have ticked off. It is very easy to tick everything off provided you're well settled.
Non availability of mentors
Be aware that a lot of colleagues are willing to help. However sometimes the rotas are made in a such a way that we do not get to meet quite often. Especially because of the pandemic where meeting outside work was not allowed- restrictions are now easing though.
Supervisors and TPD
This is where your supervisor and TPD will come in.
The TPD is the consultant in charge of training.
You will have 2 supervisors:
Clinical supervisor- who will support you in that rotation.
Educational supervisor - who will support you throughout your time at that trust ( for one year).
The educational supervisor and clinical supervisor for the first rotation are the same.
So let's say your rotations are cardio , gastro and renal.
Dr X who's a cardiology consultant will be your educational supervisor for the whole year and your clinical supervisor whilst you're rotating in cardiology.
Dr Y who's a gastro consultant will be your clinical supervisor whilst rotating in gastro
Dr Z who's a renal consultant will be your clinical supervisor whilst rotating in renal.
These are your support. Please talk to them early if you're stuck. It's best to escalate early rather than later.
YOUR PDP
Make a personal development plan on your portfolio before you meet your supervisors.
A PDP should be realistic and achievable
My PDP for respiratory when I did core medical training ( now replaced by IMT ) was :
1. Attend outpatient clinics
2. Do procedures - Pleural aspiration, chest drain insertion, pleurodesis
3. QIP
4. prepare for PACES
5. learn NIV
6. Sit in difficult consultations with the view of starting to lead them on my own after supervision.
I did all of these ( although I sat for my PACES in my second year of training).
As you can see , these are realistic and achievable
Here is another example
https://m.facebook.com/groups/IMGs.in.the.UK/permalink/4035996043100073/
Bullying
https://omarsguidelines.blogspot.com/2020/01/bullying-and-stress-in-nhs.html
This happens. Be aware of the escalation policy of your trust.
A request from trainees working here
Please ensure your new trainee colleagues are well supported. I have noticed that some well settled IMGs tend to just mock new colleagues who have just started and don't help them a lot. Be the mentor you wanted to have when you started. Be friendly. You can help them in so many ways
1. Setting an IMG representative system
https://m.facebook.com/groups/IMGs.in.the.UK/permalink/1482509245115445/
2. Showing them your portfolio. Helping them navigate through it.
Not only will you help your colleagues settle well , you will also make them confident and better doctors. This kindness will then continue when they do the same when they're well settled.
I hope this helps. I am a ST4 trainee registrar in acute medicine at Hull Royal Infirmary and have worked in Harrogate , York and Scarborough. I know those trusts well- especially Hull and Scarborough ( where I continue to locum every weekend) . Let me know if I can help with anything.
Again , as I mentioned before it will be a rough ride. I have seen a lot of colleagues struggle. I am a very optimistic person but we have to be realistic here. It will be a stressful journey especially the first one year of your training but then you will be able to gain confidence.
Ps - I will keep adding to the list so please comment below. I plan to make a full induction pathway for new trainees to make their life and career as smooth as possible.
The ideal timeline
You come to the UK in early July
You quarantine for 10 days
As soon as you get out of quarantine you book viewings for properties
Visit occupational health by second week and get your screening tests , etc done.
You sort out your bank account - by 15th July
You buy a car by 20th July
Shadow from the 20 July to the 4th of August
I have made this post here instead of a blog post because I wish to keep editing it with your comments. Once we have made a post which is approved by everyone, I will share it :)
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