After the process of migration and settlement of healthcare professionals in a new clime, especially for medical doctors in the UK, there is a barrage of important information that is needed to thrive.
These information can be classified as the “Known knowns” i.e. in the general knowledge, “Known unknowns” (not so in the general knowledge and you can do without them) and the “Unknown unknowns” – which are not in the public knowledge but you are expected to know them and not knowing them can be detrimental. This article would highlight the “Unknown unknowns” information, which are crucial but needs a lot of digging deep to have them in plain sight. Some are listed below.
The importance of clinical attachment and being affiliated with a consultant in the country of settlement. For instance, in the UK there is a recognised gap in the clinical field, and one of the ways to fill this is creation of the Medical support worker (MSW) role. Working as a MSW, can serve as an opportunity to obliterate a clinical gap on the career path of a doctor, while completing the licensing exams of the country. It can also serve as a form of apprenticeship (like a clinical attachment) to get to know the system and create a network within it.
Next, is to be aware about the nitty gritty of your work or sick leave entitlements. This is because in some trusts, it is mandatory to have some form of leave after each posting and the application for this should come 6 weeks before the proposed date of leave. However, if you don’t know or don’t ask about this from your HR or colleagues, no one will tell you and you might as well later find out that you are working overtime at your own loss.
Another important program to ensure smooth transitioning into the system is the Induction usually organised by the employing party to intimate new workers on the routine(s) of the facility. If one is fixed for you, do make it a point of duty to attend and get as much clarifications as possible.
Wherever you find yourself or in whatever situation; do not hesitate to ask questions!
After completing paperwork and now resumed, always make sure to handover appropriately at the end of every shift no matter how tired you are. If possible, document the name of personnel, sign and stamp. This would help to avoid legal court cases or serve as a back up in occurrence of such.
Documentations are legal documents, so do them properly and ensure it contains the 3 details representing you or the patient that make it valid. Remember, Anything not written in the notes wasn’t done. Even if because of the surrounding circumstance a particular information wasn’t initially written or an additional information couldn’t be documented immediately, make it a point of duty to document before you leave the facility at the end of your shift. This could be done in retrospect, clearly stating the surrounding circumstance.
Proper documentation saves lives, document appropriately always!
In countries where systems work, every procedure needs evidence of proficiency. This is why, to confidently carry out some comfortable procedures such as Femoral Stab, Permcath insertion and so on (even though back home, they are no big deal) – the Direct Observation of Procedural Skills (DOPS) is needed. You might not know or hear about this, until one of those rare occurrences where something goes wrong and the first thing you’ll be asked to provide is your proof of passed supervision. Likened to this as well is the completion of specified mandatory training.
Better safe than sorry, ensure you have completed your mandatory training and DOPS before carrying out any technical bedside procedure that ideally needs supervision. This saves a lot of trouble.
Also, on the wards, you need to be accustomed to your facility’s protocol in all cases, especially those within your own purview. For instance, different facilities commonly have a similar VTE prophylaxis standing order for every hospital admission. Please, always ensure to cross check that these orders are being followed for all patients, at all times.
Likewise, as much as the goal is to be patient-centric always, never chew more than you can bite. Always act within your means and level, escalate to seniors and management when necessary. When you’re alone in an understaffed environment, you’d be doing yourself and the facility a lot of good by carrying the management along on this and happenings at your duty post.
Oversight, Ignorance or Negligence are inexcusable. Stay informed, stay alert!
Next, the importance of Insurance in the healthcare sector, especially as healthcare professionals in a system that is prone to litigation cannot be overemphasized. Some forms of insurance come with some employment in certain trusts, but the generally provided one is usually not enough. It’s often advised to get another one that offers more coverage, in case of the unknown.
Beyond the healthcare system, you also need to put other aspects of life into consideration, owing to the fact that you are resident in a new environment. Therefore, don’t stay in survival mode for too long, have a viable plan to grow economically. This you can achieve by tracking expenses and saving on unimportant expenses; growing credit (and/or getting a credit card); building wealth through property ladder, owning homes and other legal means. Also, it’s worthy of note that there are check and balance processes in place for all of these: Do not try to beat the system, building takes time.
Don’t get too comfortable… don’t lose focus… aim to do more… It is achievable.
Finally, be a shining light to show and guide other peoples path to success in all ramification. Pass on the knowledge you have acquired over time. Let us all learn from the Indians and Pakistanis; who exponentially replicate and help themselves in all aspects wherever they find themselves.
About Author:
Dr. Mat is a Tutor of clinical medicine, guiding IMGs through their examinations and practice pathway in the UK. He can be reached via AOMAroyals@gmail.com or @Aomaroyals on twitter.
