The challenges faced by early-career international medical graduates in general practice and the opportunities for support: a mixed methods study

Abstract

Background: Recruiting and retaining International Medical Graduates (IMGs) has been identified as a key component in addressing the ongoing workforce crisis in general practice. However, research shows IMG General Practitioners (GPs) face unique challenges compared to their UK-trained counterparts, impacting their welfare, retention in the workforce, and ability to provide patient care. Aim: This study examined the challenges facing early-career IMG GPs, the help and support they access and want to access, and their perceptions and utilisation of the help and support available. Design and setting: A mixed-methods study that collected primary data in an online survey and interviews between March and May 2023. Method: Early-career IMG GPs based in South West England were invited to complete an online survey consisting of 5-point Likert-scale and free-text questions. Interviews were completed with key informants and some survey respondents. Qualitative data were analysed thematically. Data from the survey and interviews were analysed and merged using a convergent parallel design. Results: Based on 29 survey replies and 9 interviews, four interrelated themes were identified: (i) communication and language, (ii) racism, unequal treatment, and developing coping mechanisms (iii), exclusion and being ‘othered’, and (iv) adapting to new ways of living and working. Although some IMG GPs access help and support, many feel this is insufficient and poorly accessible. Conclusion: IMG GPs face interrelated and unique challenges in their personal and professional lives and do not feel adequately supported by the NHS. Addressing this disconnect will be vital to sustaining the general practice workforce.