From Palm Trees to Pine Trees: One IMG’s experience

IMG…International Medical Graduate. ‘A physician who has received their medical degree from a location outside of their current country of practice.’

This is not a term that I had ever identified with in my medical career until this point. Not a term that I gave a second thought to until now, where it has basically defined my identity as a part of the NHS.

My name is Aisha and I am a proud Saint Lucian, A fact that you would most certainly gather within 5 minutes of meeting me, as I never miss an opportunity to brag about my beautiful Saint Lucia. I would also consider myself to have a second home on Jamaican soil as I had the privilege of living there for 5 years while attending medical school.

Earning a medical degree from the University of the West indies (UWI), Mona Campus and practicing medicine in my early career, in my beautiful island home of Saint Lucia meant that I never really felt out of place. I was always Home. The term IMG was far from my mind indeed…until of course moving to the United Kingdom to pursue my medical career further.

I went through the requisite processes (examinations and professional registration) and was able to finally secure a post in a busy Orthopaedic department in London. ‘This is it!’, I thought. ‘This is the beginning of fulfilling my dreams!’, ‘the first rung in the ladder to becoming a Trauma & Orthopaedic consultant’. The excitement and butterflies continued as I realised that all I had to do was put my best foot forward, work hard and be a team player. Essentially what I have been doing in my career thus far. The anticipation continued to build when I imagined receiving one of those NHS lanyards that I had seen being donned by some of my fellow UWI grads who had made the trek. Maybe even a ‘Hello my Name is’ badge. I was all set to present myself in the best way possible, shine my metaphorical shoes, re-braid my hair, get my edges just right ( you know…the vital stuff!). It honestly felt like the first day of school all over again. What could stop me with my ‘can do’ attitude? This was going to be amazing!!!

Soon, those first day butterflies turned into jitters which then extended to first week and first month worries of not ‘getting it’. The trauma meeting dress-down I received in my second week regarding NHS specific guidelines, which I was just learning has stuck with me and still makes me cringe…three years later. I sometimes felt like another language was being spoken. There were ‘simple’ abbreviations and terms casually thrown around that went over my head, yet everyone else seemed to understand (P.O.C, Edan, MOF’d). The fear of not knowing or looking ‘less than ‘or silly or like I did not have it all together or deserve to have the role that I had worked so hard for, kept me from asking for clarification. It was at this time that ‘IMG’ gained a whole new meaning for me. 

The term ‘IMG’, although a simple identifier, somehow made me feel ‘othered‘ initially. It felt like three letters pointing to my inadequacies. However, is different inherently a bad thing?

This paradigm shifted completely after a much needed catch- up with some fellow Lucians, who I was lucky to have known since childhood and had made the move to work in the NHS before me. These Ladies have now become my sounding board, my support system and my home away from home. I realized that I was not alone in what I was feeling, not by a long shot as many of their struggles when starting in the NHS closely mirrored my own. A wave of relief washed over me as I heard the words ‘you are not alone’ and surprised when I was encouraged to ask those ‘silly’ questions because on a whole, people want to help you to succeed.

During these catch-ups, I was also reminded that my perspective and my experiences in health care were not something to hide or anything that would hold me back, but actually my superpower! My background allowed me to better interact with patients and colleagues who looked just like me, like my Mother, my Father, my Sister, or Aunty Flora who lives down the road.

Working in healthcare in the Caribbean also made me resourceful and forced me to manage my precious time. Surely these are critical qualities and skills needed to grow and thrive in the NHS.

Everyone’s journey through their medical career looks different. A medical career, specifically one in a surgical field, is most definitely not a ‘one size fits all,’ as I have come to see more and more during my time in the U.K. Many have forged their own paths and carved out their niche in different areas of surgery. The roadmap I see myself following is obtaining a national training number and pursuing specialty training in Trauma and Orthopedics.

Unlike many of my U.K.-trained peers, I have not had the same early exposure to the portfolio-based competencies that underpin progression within the NHS. These frameworks, embedded into medical school curricula and early postgraduate training, often mean that U.K. graduates begin their specialty applications with a more structured understanding of expectations. At times, this has made me feel as though I am playing catch-up, constantly working to bridge a gap I did not initially know existed. A gap that may very well  be further widened by proposed impending changes in the higher specialty training recruitment process, further moving the goalpost for myself and other IMG’s alike.

However, I approach this challenge with that same ‘first day of school’ energy. I have made it a priority to actively seek out the many resources available to support IMGs like myself. Programs such as SurgIn by Melanin Medics, which I am privileged to be a part of, have provided invaluable guidance in navigating the complexities of surgical training. I am also grateful to be surrounded by senior colleagues, who I have been introduced to, through hospital placements as well as community networking events, who are not only experienced but are also genuinely willing to offer mentorship and support.

Being an International Medical Graduate in the U.K. is not without its challenges, but it is also a journey full of growth, and remarkable opportunity. Along the way, remember this: you are not alone. Don’t be afraid to ask for help. Seek out community - it exists, and it is stronger than you think. 

You belong here. Not in spite of your story, but because of it.

As you settle in, grow, and find your place, I encourage you to look back and extend a hand to those coming after you. Just as others may have helped you, be the support and reassurance for someone else starting their own journey. We rise by lifting others and in doing so, we create a stronger, more inclusive future for all IMGs.