International Medical Graduate (IMG) GPST1 trainee, Yorkshire

I completed my medical school from the Philippines in 2016 and went back to my home country, Nepal, where I worked across various specialties as a House Officer. Unlike most of my colleagues who were inspired to explore their passion for general practice early on in their careers, I happen to be someone who discovered the beauty and potential of general practice about a year or so ago. My journey into GP training as an International Medical Graduate (IMG) has exposed me to a huge range of opportunities while concurrently navigating certain challenges along the way.  

Decision – After completing my Professional and Linguistic Assessments Board [PLAB] test, I felt quite overwhelmed with the wealth of opportunities available in the NHS and it took me some time to decide which specialty to pick.  A lot of research and reading into each speciality guided my decision-making process and the more I understood how primary health care works in the UK, the more I was attracted to it. I was particularly drawn in by the diversity, flexibility, and work life balance that general practice offers. I also felt that as a GP it would potentially enable me to pursue additional roles alongside my clinical responsibilities and give me space to pursue my hobbies and weave my interests outside my profession. Above all, being a part of my patients’ long-term journey of health and well-being was the greatest pulling factor for me.

Pathway - Following the successful outcomes of my PLAB exams and GMC registration the next step was to organise my Certificate of Readiness to Enter Speciality Training (CREST) form. The CREST form served as the evidence of my foundation level competencies to practice medicine and required sign off (attestation) by the Specialist/Consultant that I worked under during my few years of medical practice in Nepal. It is important to remember that the consultant signing off the CREST form is required to be registered on the ‘Specialist Register’ [or equivalent] at the county of practice.  After my CREST form approval, I undertook the Multi – Speciality Recruitment Assessment (MSRA) exam.

One of the challenges I faced during this process was a certain level of self-doubt about entering the NHS on a speciality training role (as opposed to a junior house officer role). I am among one of the few IMGs who have chosen this pathway of direct entry into specialty training, which naturally made many of my seniors and colleagues nervous and doubtful about the prospects of my success. While I was cautioned, even discouraged, by many well-meaning fellow doctors about the GP training pathway, after my first month as a trainee, I can confidently say that I am very glad to have made this decision and I know I will love this training journey.

Choice – Another big dilemma for me was choosing the right deanery. As someone with no family or friends in the UK it was difficult for me to ask anyone’s opinion about the locations, deaneries or care settings. I would stare at the list of options I had for hours on end without any idea on how to make my decision. I was familiar with the Pennine GP scheme as I had watched consultation videos of Dr Matt Smith, one of the Training Programme Directors of the Pennine scheme. Those videos really helped me prepare for PLAB 2 exams and I think that was the first spark to pull me towards GP land. When asking for advice on various groups on social media, I’d heard good reviews.

Experience – Given I am just about one month into my training, I feel it is a bit early for me to share my experience as a GP trainee as I have just stepped into this journey. However, I can proudly say that I have had a good start and my experience has been amazing so far. I feel very well supported by my seniors and colleagues and, I really like how the multidisciplinary team function with a great level of cohesion. I am looking forward to developing my clinical skills further and tailoring my career in medical education and leadership.  

Sharing – I have been actively involved in guiding my colleagues from Nepal who are venturing into the same journey of PLAB to training. When I realised that there were only two candidates including me who sat their MSRA exam in Nepal, I knew I had to do something to share the knowledge I had gained through my own experience with my colleagues. This mission materialised when I worked closely with consultancy group touring across five big cities of Nepal sharing information on the PLAB to training pathway. These sessions were well attended by medical students and Junior (and some senior) doctors. I found it very rewarding to see that the information I shared was useful to my fellow colleagues in making informed decision about their career and post graduate training. I have seen a keen interest among Nepalese doctors to pursue a career in General Practice in the UK and I will keep providing support and advice to this community as best as I can.