“That’s your patient. There’s your ventilator”: exploring induction to work experiences in a group of non-UK EEA trained anaesthetists in a London hospital: a qualitative study

Abstract

BackgroundEuropean health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London?MethodsWe did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor’s acclimatisation to the British system.ResultsAcclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience.ConclusionsHospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for international staff to critically reflect on practice with local staff to acclimatise more effectively.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0331-4) contains supplementary material, which is available to authorized users.

Migration motives and integration of international human resources of health in the United Kingdom: systematic review and meta-synthesis of qualitative studies using framework analysis

“…Research on integration of international HRH has focused on the migrants’ life journeys before and after the entry to the UK [ 23 , 24 , 27 , 29 , 37 ], their transition to work [ 33 ], their induction/adaptation/support training [ 17 , 22 , 33 , 38 – 40 ], career aspirations, progression and job satisfaction [ 27 , 28 , 37 , 41 ]. The main themes identified during adaptation and integration for the three groups of migrants are presented in Fig.…”

“…Migrant nurses were mostly female, reflecting the nursing workforce globally and gender can be a confounding factor in analysing the interpretations on how the participants perceive their journeys and work environment [ 31 , 37 ]. Female doctors found it difficult to find jobs and were more likely to be ‘re-domesticated’ with longer gaps in employment [ 37 ], and less satisfied with their career progression compared to nurses [ 38 ].…”

“…Victims of discrimination reacted either by ignoring it and focusing on their career development or they accepted it and stopped aspiring [ 27 , 51 ]. Doctors from the EU reported discrimination in training, job opportunities and some discrimination from colleagues but none from patients [ 35 , 38 ], whilst ethnic minority doctors from Europe found the UK more welcoming [ 34 ].…”

Process-oriented evaluation of an international faculty development program for Asian developing countries: a qualitative study

“…Therefore, to maximize the credibility of the data collection, all fellowship participants were interviewed both individually and in a group to reach data saturation. Furthermore, there are studies that report meaningful results using data collected from participants of similar size [ 31 , 54 – 56 ]. Third, because the data were collected when the fellowship was in progress, the findings might be more focused on learning during the program rather than transfer after completing the program.…”

A qualitative exploration of anesthesia trainees' experiences during transition to a children's hospital

“…Rather than choosing a quantitative research method, where the questions we might ask would be restricted by our preexisting knowledge, we chose a qualitative research method that would give us the best chance of gaining new knowledge (19). Qualitative methods are well suited to investigating complex human interactions in their natural setting, rather than in an experimental environment (17,18,20), and have been used to investigate aspects of anesthesia practice, including medical education (2,4,9,14,19,21), expertise (16,22), communication (2,23), workplace stress (7,24,25), performance appraisal (22,26), and patient safety (27).…”