A21 Navigating the NHS Beast: Empowering International Medical Graduates (IMGs) Through High-Fidelity Simulation

Introduction: Recent data from the General Medical Council (GMC) highlight the significant presence of International Medical Graduates (IMGs) in the NHS, comprising 52% of new entrants in 2022 [1]. Despite their robust clinical knowledge, IMGs face higher referral rates to the GMC, possibly due to their unfamiliarity with the NHS [2]. It is therefore vital to improve on the integration and retention of IMGs who have a key role in alleviating the high pressure on the workforce within the NHS. Methods: A survey was conducted among IMGs to identify their learning needs and exposure to simulation training. Five scenarios utilising high-fidelity manikin and simulated actors were developed, including mental capacity assessment, end-of-life escalation, cardiac arrest event, anaphylaxis management and sepsis recognition whilst working with a challenging colleague. Pilot sessions, each involving six IMG participants, were conducted. Post-scenario debriefings targeted key curriculum themes, ranging from A to E assessment to escalation of care. Feedback was collated using a questionnaire featuring a mix of open and closed questions graded on a 5-point Likert scale. Results: Survey findings reported that 45% of respondents had no prior exposure to simulation training, while 7% were uncertain about its concept. 96% expressed keen willingness to attend simulation sessions if provided the opportunity. Participant feedback indicated high satisfaction with content and delivery, with increased confidence in managing acutely unwell patients and navigating challenging situations related to human factors. Many found the debriefing sessions particularly helpful in addressing areas of improvement. Suggestions for program improvement included pre-session information, run-through of an A to E assessment and a mix of live and manikin simulated patients for enhanced realism. Discussion: The transition of IMGs to a new country, lacking an established support system, presents an undeniably daunting challenge. Beyond disparities in healthcare systems, language and cultural differences further compound the integration process. To address this, we prioritised tailored training to meet the unique needs of IMGs. Simulation training has emerged as a transformative tool, offering a safe environment to develop technical and non-technical skills while mitigating risk to patient safety. Moreover, the program aims to instill concepts of human factors, equipping IMGs to navigate common medical, ethical, and legal challenges within the NHS. Feedback collected represents a limited sample size. A collaborative effort with stakeholders to secure support and resources will ensure the effectiveness and sustainability of future simulation sessions for IMGs. Ethics statement: Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable. References 1. The General Medical Council. The state of medical education and practice in the UK: workplace experiences 2023. [Internet]. 2023. Available from: https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/the-state-of-medical-education-and-practice-in-the-uk. [Accessed 29 April 2024]. 2. Lane J, Shrotri N, Somani BK. Challenges and expectations of international medical graduates moving to the UK: An online survey. Scottish Medical Journal. 2024;00369330241229922. Acknowledgments: We express our sincere appreciation to the members of the Simulation Faculty at University Hospital Coventry and Warwickshire for their invaluable contributions to this project. Their dedication made this project possible and provided support to international medical graduates throughout their journeys.