I have worked alongside International Medical Graduates throughout my career and I know how much they add to the NHS. They arrive in in the UK ready to work yet face pressure that others do not see.
They must adjust to a new system while proving themselves to colleagues and patients. Many feel isolated. Many feel unsure about expectations. Many worry about looking unprepared in a system that can feel unsympathetic to their situation.
At MDDUS, I hear about these concerns directly from our members. Our survey found that 58 percent of IMGs have faced racist microaggressions and most choose not to report them. These experiences erode confidence and shape how doctors settle into practice.
Challenges that look minor on their own can create strain when they come at once. Housing, banking, transport, induction and local language all matter. Several speakers at our event in Edinburgh noted how these pressures sit alongside the attainment gap and wider cultural barriers. As Professor Nitin Gambhir said, the gap stems from system design and uneven support rather than ability.
The GMC spoke about clearer communication and more open decision making. Too many IMGs enter regulatory processes with fear. Questions raised about referrals, microaggressions and how to raise concerns showed how trust depends on fairness being visible.
Dr Chris Provan from the RCGP set out the practical issues that make the first months hard. Accommodation, childcare and learning how UK general practice works can all create friction. IMGs need clearer job pathways and better induction.
We also heard about the IMG Simulation Collaborative. Dr Achyut Valluri explained how simulation can give IMGs space to rehearse situations they may not have met before. It strengthens communication, escalation and decision making in a safe setting and builds confidence.
By the end of the event the discussion had moved towards three areas for possible action. They were not formal recommendations, but they gave direction.
The first was a national approach to IMG induction linked to real work. The second was stronger supervision, with training, protected time and clearer guidance. The third was easier access to help, including support for wellbeing, advice on education and clarity on regulatory issues.
These proposals reflect what IMGs say they need and MDDUS will continue to contribute to this work.
I was proud to chair this event to bring people together because our members tell us these issues matter. The event set a direction and I look forward to working with colleagues across healthcare to reach an agreed plan. For our part we will keep supporting doctors who face these pressures and use our insight to inform the debate.
IMGs bring skill and resilience to Scotland’s NHS. I believe they deserve support that matches that strength. The focus now needs to shift towards practical action.
This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.