From Arrival to Integration: Thriving in Your First NHS Year as an IMG

April 25, 2025

Joining the NHS as an international medical graduate (IMG) is a milestone filled with excitement, ambition, and sometimes, uncertainty. Your first year in the UK is critical - not just for settling in professionally, but for building a foundation for a long, successful career. This guide brings together expert resources from the BMA, NHS Employers, GMC, and others to provide you with tailored, step-by-step support through your first year in your new NHS job.

✈️ Before You Arrive: Preparation & Planning

Get Ready for the Transition to the NHS

Before you land in the UK, there are a few key steps to take to ensure a smooth transition into the NHS system.

Visa and GMC Registration: Secure your Health and Care Worker visa and ensure your General Medical Council (GMC) registration is in place before you leave your home country. This will be your ticket to work in the UK.
GMC Values: Understanding the GMC's core values is key to your practice in the UK. The GMC sets out the ethical standards expected of all doctors, including international medical graduates. Familiarise yourself with the GMC Good Medical Practice guidelines, which outline the standards of professional behaviour expected in the UK. As a new doctor, these values will guide you through your clinical work, ensuring you provide compassionate and safe care to your patients.
Secure Your Contract and Start Date: Confirm your contract with the NHS Trust and clarify your exact start date. Make sure all contractual paperwork is in order, including a clear understanding of your role and expectations.
Induction Information: Ask your NHS Trust about their induction process. You’ll need to know what support is available on arrival, who your key contacts are, and what you should bring with you (such as passport, documents for NHS registration, etc.).

🏡 Arrival & Setting Up: Your First Week in the UK

Get Comfortable in the UK Quickly

Your first few days and weeks in the UK are crucial for settling into both your new environment and your job. Here's what you should prioritise:

Accommodation: Not many trusts provide short-term housing, so our advice is to secure short term rental in the first instance. This will give you the best chance to explore and find the best location to settle, whether that's close to the hospital, or a short commute. For long term rentals, use platforms like Rightmove or Zoopla to start your search, then begin making connections to estate agents as quickly as possible. The market moves fast, so doing this before you start work can be advisable. Start early, as housing in some areas can be competitive.
Banking: Setting up a UK bank account is essential. For quick setup, Monzo and Revolut are ideal for IMGs. Alternatively, bigger banks can offer special accounts for international workers, although you may wish to choose a more ethical option like Triodos, Nationwide or Coop Bank.
National Insurance Number (NIN): Check your Visa has provided your NIN. If not, apply for your NIN as soon as possible, which you’ll need to work and pay taxes in the UK.
Healthcare: Register with a local GP as soon as possible. This is crucial for your health and any non-urgent medical needs that may arise. Don't worry though, the NHS is free at the point of care, so there will be no charges for signing up.
Mobile & Internet: You can buy a SIM card in most UK shops - GiffGaff and EE are popular choices among international doctors. Once you are settled, you can explore a long term contract option, which can be cheaper in the long run.
Transport: Getting familiar with public transport and applying for a railcard can make your daily commute more affordable. For your family, the 16-25 Railcard, the Two-Together Railcard, or the Family & Friends Railcard offers great discounts for train travel locally and nationally.

🏥 NHS Induction & Onboarding: Getting to Know the System

Understanding Your Role and Responsibilities

The NHS induction is your first real step into the medical system. Good induction programs are essential to your success, helping you integrate into your department and understand the NHS’s systems, values, and expectations. Here’s what to expect:

General NHS Orientation: Most Trusts offer a comprehensive introduction to NHS policies, procedures, and medical record systems. Pay attention to how patient information is managed (e.g., patient record systems like SystmOne or Cerner). Take time on your own to orientate yourself with the building and departments. You can request additional shadowing to help you in these first weeks.
Cultural Sensitivity & Communication Training: Effective communication is at the heart of NHS practice. Training in cultural competency, dealing with diverse patient backgrounds, and understanding the different regional dialects within the UK can be very useful. Take time to chat with local colleagues about dialects, accents, and get familiar with how the MDT communicates. Every trust or service will have it's intricancies.
Role-Specific Induction: Expect an overview of your specific role within the team, how you’ll interact with patients, the multidisciplinary teams (MDTs), and key personnel (e.g., consultant, ward managers). You can also take the front foot and get to know your team, ask for a chat over a coffee when possible, and involve yourself in the team.
Shadowing: This is often part of the induction process. You’ll likely be paired with an experienced colleague for the first few weeks. This “shadowing” period helps you learn the ropes and get used to the way your new Trust operates. If you feel that additional shadowing would be beneficial for you, then ask for this.
Access to Resources: Some Trusts offer an IMG champion or buddy, someone to help guide you through the induction and integration process. This can be vital as a point of contact to help with questions, big and small. If you havenot been allocated one, then this does not necessarily mean that one would not be available, perhaps your service are just not aware, so explore.

👩‍⚕️ Clinical Practice: Your First 6 Months

Stepping into Clinical Work in the NHS

The first few months in clinical practice will be filled with learning, adaptation, and growth. Here are some key areas to focus on:

Supervision and Support: You may start under close supervision, which is normal and helpful. You’ll be supported by both senior doctors and supervisors, so it’s important to ask for feedback regularly. Your nursing colleagues are often an excellent point of support, and know how things are done, be sure to ask for their support. In the NHS, everyone, no matter their grade or profession, should be approachable for support, so don't hold back when you need to raise a question, or need support.
Portfolio Development: Make sure you’re actively building your portfolio from day one. This is particularly crucial if you’re working towards the Portfolio Pathwway (formerly known as CESR - Certificate of Eligibility for Specialist Registration) or preparing for your next career step in the NHS.
Ask Questions: Never hesitate to ask for clarification or further training if you’re uncertain about a procedure or a specific task. NHS teams are generally supportive, and it’s important to demonstrate an eagerness to learn.
Clinical Safety: Early in your career, patient safety is paramount. Stick to protocols, seek guidance when unsure, and always prioritise patient care.

📑 Know Your Rights: Join the BMA

Support Through the British Medical Association

Becoming a member of the British Medical Association (BMA) is one of the best decisions you can make for your career and wellbeing. Here's why:

Visa and Immigration Support: The BMA offers guidance for IMGs on work visas, immigration law, and any changes to the rules. Having this support can make all the difference as you settle in.
Workplace Rights: The BMA advocates for fair working hours, salary expectations, and safe working conditions, ensuring that you're not subjected to unfair practices.
Contract Review: Before you sign anything, the BMA provides expert advice on understanding and negotiating your contract, particularly as it relates to salary, benefits, and responsibilities.
Health and Wellbeing: The BMA offers confidential counselling, wellbeing resources, and support services that help you navigate life as an IMG, including mental health and career stress.
Legal Protection: The BMA also offers legal representation should you need it—be it for disputes, complaints, or GMC investigations.

For full benefits, you can join the BMA via this link.

🌱 Career Development & Progression in the NHS

Mapping Your Career Path

The NHS offers a variety of career pathways for IMGs. Understanding your options from day one can help you build a roadmap for success:

Specialist and Associate Specialist (SAS) Grade: If you don’t want to enter formal training programs, Specialist Grade roles can be a great way to continue gaining senior experience, work autonomously, and build a rewarding career whilst progressing to Consultant.
Consultant Pathway: Many IMGs choose to pursue a Consultant role, either via the Portfolio Pathway (formerly known as CESR - Certificate of Eligibility for Specialist Registration) route or through training. Understanding these pathways early will help you plan ahead. Your colleagues can offer advice based on their first hand experinece, and you will be allocated a mentor/supervisor who can discuss the best course of action for your NHS career.
Training Posts: After working in the UK for some time, you may decide to apply for a specialty training post (e.g., core medical training). This route can lead to a long-term career in a specialist field.
Continuing Professional Development (CPD): As an NHS doctor, you’re entitled to study leave and support to attend courses or conferences. Keep a record of all CPD activities for your portfolio. Be sure to discuss your SPAs when job planning, so as to ensure the best impact on the service and patient outcomes, as well as your own development and career growth.

🧠 Wellbeing and Support Networks

Thriving as an IMG in the NHS

Living and working in a new country can be challenging, so it’s vital to prioritise your mental and physical wellbeing. Here’s how you can seek support:

Peer Networks: Many NHS Trusts have specific IMG groups or mentorship programs to help you connect with colleagues who have walked the same path.
Diaspora Medical Networks: Groups such as the British International Doctors’ Association (BIDA) and the African Caribbean Medical Society (ACMS) provide an invaluable support network. There are often local network groups for IMGs.
Freedom to Speak Up: This is a critical initiative that ensures you have a confidential and safe space to raise any concerns about bullying, discrimination, or patient safety.

🏅 Shadowing, Training & Continuous Professional Development

Taking Advantage of Ongoing Learning Opportunities

E-Learning for Healthcare (eLfH): The NHS offers a free e-learning platform that covers a broad range of topics, from clinical skills to communication.
Study Leave: As part of your NHS contract, you’ll be entitled to study leave. Be sure to take full advantage to attend courses, conferences, or engage in research.
Shadowing Advanced Practitioners: Shadowing more experienced colleagues in specific areas can give you exposure to various specialties and is highly recommended for those interested in further career advancement.

🚨 Managing Paperwork & Revalidation

Stay Organised with Documentation

Throughout your time in the NHS, you’ll need to maintain key documents for revalidation and career progression:

Documentation for Appraisal: Keep a log of all your clinical work, feedback from supervisors, and any professional development activities. Appraisals take place annually, and you should speak with your employer to establish their process and protocols.
Revalidation: Be mindful of your revalidation deadlines, which occur every five years. Keep track of your CPD, training, and assessments to ensure smooth revalidation.

🛡️ Indemnity Cover: MDU and MPS

Protecting Yourself with Indemnity Insurance

Indemnity cover is a vital consideration for every doctor in the UK, particularly for IMGs, who may be unfamiliar with the nuances of medical malpractice protection in the UK.

MDU & MPS: The Medical Defence Union (MDU) and Medical Protection Society (MPS) are the two leading indemnity providers for doctors in the UK. You’ll need to be covered by one of these organisations for the duration of your career to ensure you're legally protected in case of any claims or complaints.
Choosing Your Provider: It’s important to compare the available options and choose the one that best suits your career. MPS and MDU offer support for both NHS and private practitioners, and can assist in legal defence if needed. Explore more here.

🗣️ Seeking Advice or Whistleblowing: Knowing Your Rights

Support & Protection When Things Aren’t Right

As an IMG, you may find yourself in situations where you need to seek guidance or raise concerns about your workplace. The NHS has several systems in place to support you:

Seeking Advice: If you feel unsure about your practice, don’t hesitate to ask your senior colleagues, supervisors, or the BMA. You can also seek advice from your Trust's HR department or the GMC, who can offer expert guidance on professional conduct or specific medical concerns.
Whistleblowing: The NHS has a Freedom to Speak Up policy to protect workers who raise concerns about patient safety, malpractice, or other unethical behaviour. As an IMG, this protection is crucial, and you can raise concerns confidentially without fear of retaliation. The NHS also offers a Whistleblowing Hotline for confidential support.

🎉 Final Words: You’re Part of Something Bigger

Being an IMG in the NHS is a unique and rewarding journey. Your contribution matters not only to the healthcare system but to the communities you serve. As you continue to grow in your role, remember that the NHS offers boundless opportunities for learning, leadership, and career progression.

You belong here, and we’re excited for you to thrive in your new NHS job!

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Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
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When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

CV Preparation with a bespoke session with one of our specialists
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Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:

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When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

CV Preparation with a bespoke session with one of our specialists
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HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

CV Preparation with a bespoke session with one of our specialists

Application support with expert knowledge of NHS specialisms & recruitment practice

At least two video calling interview preparation sessions

Contract and offer negotiations for salary, relocation packages, tenure and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:

Document gathering and checking

COS and Visa Application support if applicable

Support sourcing short- and long-term accommodation

Travel Arrangements

Family support for finding schools and any other aspects of pastoral care

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Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or MRCP are most encouraged to apply.CCT in Medical Oncology or equivalent experience, including CESR pathway candidates.
The salary will be between £105,504 and £139,882 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

Provide high-quality specialist care to melanoma patients attending the Kent Oncology Centre.
Attend relevant MDT meetings and coordinate treatment planning with other specialists.
Participate in departmental research initiatives and contribute to national and local clinical trials.
Contribute to training and supervision of junior doctors and participate in clinical governance activities.

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The area offers the best of both worlds: urban living in towns like Maidstone and Tunbridge Wells, and tranquil countryside villages such as Lenham or Goudhurst.

HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure, and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:

Document gathering and checking
COS and Visa Application support, if applicable
Support sourcing short- and long-term accommodation
Travel arrangements
Family support for finding schools and any other aspects of pastoral care

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Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.

JOB REQUIREMENTS AND DETAILS

This oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or MRCP are most encouraged to apply.
Anyone with an interest in upper and lower GI oncology should apply.
The salary will be between £105,504 and £139,882 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

Provide systemic therapy services for patients with upper and lower GI cancers across UHMB sites.
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Lead and contribute to acute oncology services across the Trust (no on-call required).
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LIFE IN LANCASHIRE AND SOUTH CUMBRIA

The area is rich with excellent schools, convenient rail and road links, and beautiful scenery for outdoor enthusiasts. Historically, the region has played a key role in British shipbuilding and industrial development and today combines coastal charm with cultural heritage and modern living.

HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

CV Preparation with a bespoke session with one of our specialists
Application support with expert knowledge of NHS specialisms & recruitment practice
At least two video calling interview preparation sessions
Contract and offer negotiations for salary, relocation packages, tenure and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:

Document gathering and checking
COS and Visa Application support if applicable
Support sourcing short- and long-term accommodation
Travel Arrangements
Family support for finding schools and any other aspects of pastoral care

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