Warwick Christopher
Health Education, Kent, Surrey & Sussex, UK.
Educ Prim Care. 2014 Mar;25(2):84-90. doi: 10.1080/14739879.2014.11494252.
International medical graduates (IMGs) form a vital group of general practitioners (GPs) in the NHS. They are known to face additional challenges above and beyond those faced by UK medical graduates in the course of their GP training. Whilst they are a heterogeneous group of professionals, their views on what they need to learn, and how they are supported, are often distant from those of the educators responsible for planning their education. This study was undertaken, through narrative-based focus groups, to explore the issues which matter to the IMGs, in an attempt to empower their voices about their experiences in GP training, and to see what lessons could be drawn from these views. The findings confirmed the central importance, and considerable challenge involved, in making an effective transition into the culture of the NHS and UK general practice. The IMGs felt that induction needed to be an on-going, iterative process of learning which continued throughout training, with a more effective individualised learning needs analysis at the start of GP training. Lack of sophisticated language skills was highlighted as a real concern. Recognition that their lack of knowledge about the NHS at the start of training should not be seen as an indicator of deficiency, but a clue to what they needed to learn were also key messages. IMGs also felt the earlier in their training they undertook a GP placement, the quicker they would start to understand the culture of general practice in the UK. Further work following on from this research should include how to manage change in the educational network for these barriers to be overcome.
国际医学毕业生（IMGs）是英国国家医疗服务体系（NHS）中至关重要的全科医生群体。众所周知，在全科医生培训过程中，他们面临着比英国医学毕业生更多的挑战。尽管他们是一个多样化的专业群体，但他们对于需要学习的内容以及如何获得支持的看法，往往与负责规划其教育的教育工作者的看法大相径庭。本研究通过基于叙事的焦点小组进行，旨在探讨对国际医学毕业生至关重要的问题，试图增强他们对全科医生培训经历的发言权，并看看能从这些观点中吸取哪些教训。研究结果证实了有效融入英国国家医疗服务体系文化和英国全科医疗文化的核心重要性以及其中涉及的巨大挑战。国际医学毕业生认为入职培训需要是一个贯穿整个培训过程的持续迭代学习过程，在全科医生培训开始时进行更有效的个性化学习需求分析。语言技能不够熟练被视为一个切实令人担忧的问题。认识到他们在培训开始时对英国国家医疗服务体系缺乏了解不应被视为能力不足的指标，而是他们需要学习内容的线索，这也是关键信息。国际医学毕业生还认为，他们在培训中越早进行全科医生实习，就能越快开始理解英国全科医疗的文化。基于这项研究的后续工作应包括如何应对教育网络中的变化，以克服这些障碍。
