Snelgrove Huon, Kuybida Yuriy, Fleet Mark, McAnulty Greg
Education Training and Development, St Georges's Healthcare NHS Trust, Blackshaw Road, Tooting London, SW17 0QT, UK.
Clinical fellow in Anaesthesia, Frimley Park Hospital NHS Foundation Trust, Frimley Camberley, Surrey, UK.
BMC Med Educ. 2015 Mar 17;15:50. doi: 10.1186/s12909-015-0331-4.
European health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London?
We did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor's acclimatisation to the British system.
Acclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience.
Hospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for international staff to critically reflect on practice with local staff to acclimatise more effectively.
欧洲卫生系统越来越依赖那些在其他国家获得初级医学资格的卫生专业人员提供的服务。最近，从欧盟来的具备完全资格的专科医生数量大幅增加，他们为英国国家医疗服务体系（NHS）的卫生人力资源需求提供短期或长期解决方案。这些医生往往担任高级顾问职位。因此，NHS不得不学会应对欧盟医生的外派和回国问题，这已成为其自身服务提供能力的一个持续动态特征。我们开展了一项定性研究，以探究具有麻醉专业资格的欧盟医生抵达英国在NHS从事临床工作的适应经历。我们提出的问题是：在其他欧洲国家接受培训的专科注册麻醉师在伦敦一家大型医院适应英国行医过程的体验如何？
我们对非英国、具有欧盟资格且完成专科培训认证的医生进行了个人访谈，这些医生在英国医学总会注册，并可作为专科麻醉师在NHS执业。所有医生都是在英国伦敦一家大型NHS教学医院工作期间接受访谈的。我们分析了访谈记录中的定性数据，以确定有关资深医生适应英国体系的主题和模式。
对于那些觉得自己缺乏恰当支持的医生来说，将适应过程视为临床专业知识的转移存在问题。医生们寻求不同机会，以分享基于他们以往经验的更广泛护理观点。
医院将适应视为一个高度个体化过程的观念，可能会对新体系中的临床工作和学习提供理想化的看法。社会文化理论表明，我们应为国际工作人员创造定期学习机会，以便他们与当地工作人员批判性地反思实践，从而更有效地适应。
