Cross-cultural adaptation in healthcare: examining expatriate doctors’ strategies and challenges in Wales

Purpose This study examines the cross-cultural challenges experienced by expatriate doctors working within an National Health Service (NHS) Health Board in Wales, with particular attention to how they navigate adaptation in professional and social contexts. Design/methodology/approach The study adopts a qualitative research design based on semi-structured interviews with expatriate doctors employed at a Welsh NHS health board. Data were analysed thematically to explore participants' experiences of communication, relocation, workplace practices and organisational support during their adaptation process. Findings The findings indicate that expatriate doctors face persistent challenges related to language and communication nuances, relocation and social isolation, and adjustment to flatter professional hierarchies. Successful adaptation was facilitated by individual factors such as personality traits (notably extraversion and open-mindedness), access to social and familial networks, and prior exposure to the UK healthcare system. Participants consistently highlighted the absence of structured cross-cultural training as a barrier to smoother professional integration. Originality/value By focusing on self-initiated expatriate doctors in a Welsh healthcare context, the study extends existing research on cross-cultural adaptation in healthcare beyond commonly examined settings. It offers practical insights for improving onboarding, cross-cultural training and institutional support mechanisms, with implications for staff wellbeing, retention and patient care outcomes within the NHS.