Context Soft Landing: An International Medical Graduate (IMG) Paediatric response to the Medical Workforce Race Equality Standard (MWRES)

Soft Landing (SL) is a National Paediatric voluntary and peer to peer innovation and online support hub. It is a grass roots model which aligns with MWRES indicators relating to differential attainment (DA) in IMGs. It supports a ‘soft landing’ for overseas paediatricians, long into their training. It was set up two years ago by two IMG paediatric trainees who had survived and thrived the transition to working in the NHS.

SL has grown to provide a UK wide network of IMG paediatric representatives alongside a core team, who are credible and networked to identify challenges and deliver support.

Issue/Challenge The first MWRES was published in 2021, identifying substantial discrimination across 11 indicators, affecting BME doctor’s whole career path. Particular mention was made relating to need for better support for IMGs. The majority of IMG doctors identify as BME.

As of 2020 the GMC have granted registration to more doctors with primary medical qualifications from overseas than UK graduates.

Our organisation’s founders experienced structural discrimination and inequality and took practical steps to address it by setting up SL.

Assessment of issue and analysis of its causes

A national survey of IMG paediatricians to characterise the cohort, identify challenges and their training needs.

Meetings with RCPCH, GMC, HEE and Trust’s identified, despite a desire to address this discrimination, a lack of action.

SL activities directly addresses key indicators set out in the MWRES via 1:1 or via workshops or webinars. Post events survey, feedback and focus groups have informed the design and delivery of our support

Impact We have achieved the following deliverables which address MWRES action points and indicators:

• contributed the paediatric section of the National IMG induction document and developed our own RCPCH endorsed IMG virtual induction ‘For Paediatricians New to the NHS’

• Addressing MWRES indicators 4a–4c focusing on differential attainment at various stages: By running ARCP and portfolio webinars for IMGs, virtual interview practice for IMGs applying for ST1/2/3/4 and Sub–specialties in paediatrics, and MRCPCH exam preparation for IMGs.

• MWRES Indicator 1C focusing on under–representation in academic careers; SL virtual events aim to inform and network IMGs interested in academic careers.

Intervention SL now has a well-established public profile with IMG paediatricians, high attendance and positive feedback from our events and courses, and good engagement and desire to support SL activity from statutory bodies; HEE, GMC, and other key stakeholders; RCPCH.

Involvement of stakeholders, such as patients, carers or family members:

We are a peer led National Paediatric organisation; IMGs are involved in supporting each other.

Key Messages Customised training, peer support and mentoring are powerful tools to ensure equality among the workforce. Resulting in IMG paediatric doctors fulfilling their potential, leading to better patient outcomes.

Lessons learnt Committed clinicians volunteering time has limited capacity for delivery, and securing funding and administrative support at an early stage of development supports long term sustainability.

Measurement of improvement Over 150 attendees at our induction with 80-90% excellent feedback. 100+ attendees to virtual events. Qualitative data including thematic analysis showed strong theme of better understanding of Portfolios and ARCP and so assumed better outcomes.

Moreover, there was a strong theme of having a better understanding of the cultural differences between the NHS and overseas, which resulted in self-reported improvement in workplace performance.

We regularly receive feedback from IMGs who took part in our mock interview practices that our courses have helped them succeed.

Strategy for improvement We have put together a strong 5- year sustainability plan that includes fundraising and recruiting more enthusiastic team members though a competitive interview process. In addition we are expanding our scope of work with RCPCH in an official partnership including administrative support.

Aiming to further address DA data and explore more areas of work and improvement.