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FMLM TSG Leadership Webinar for International Medical Graduates

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Summary

This on-demand teaching session is designed for medical professionals with a focus on assisting international medical graduates. The speakers share their individual experiences in various national roles, with one speaker serving as an adviser to the GMC (General Medical Council). The session includes valuable insights from several accomplished individuals, including an internal medicine trainee in the West Midlands and a pediatric trainee from Sudan who co-founded a national project to support international medical graduates in the UK. There are also discussions about leadership experiences, reflections, policy writing, and involvement in healthcare management, all of which provide a comprehensive learning resource for medical professionals seeking to broaden their knowledge. The attendees will have an opportunity for interactive participation during a Q&A session at the end.

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Description

This event is a unique opportunity for international medical graduates to gain valuable insights into leadership in the medical field and network with like-minded professionals hearing first hand how our speakers have overcome challenges and forged inspirational careers.

Learning objectives

  1. By the end of the session, participants should be able to identify strategies for assisting international medical graduates transition into the NHS system.
  2. They should comprehend the key challenges faced by international medical graduates in the healthcare context and existing support mechanisms.
  3. Participants should be able to understand the relevance of different leadership journeys, including those of the speakers, in relation to healthcare management and leadership.
  4. They should develop an improved understanding of supportive projects such as 'Soft Landing', in the context of aiding international medical graduates transitioning into the NHS.
  5. Ultimately, participants should be able to take away key insights on professional development, leadership within healthcare, and fostering an inclusive community in the healthcare sector for international medical graduates.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

That's where I am. So I think the screen is frozen guys, uh which is what's coming through. So I think it's back. So those of you who have basically missed out everything I've just said uh in short, because the screen had frozen in short, it's been a long journey doing lots of national roles. And I've got a, I got a main focus on trying to help international medical graduates and I'll probably finish by saying that I have been very fortunate in my life with lots of slices of luck and being there. But uh uh yeah, so that's where I am. So that's a little about me and I'll let the other people speak and give their views and go from there. And obviously, if you missed out on anything, I've said, you can ask me questions and I'll come back to that. Thank you, Partha. Uh I'm sorry for anybody who's having technical difficulties. Um The session was recorded anyway, so we'll be able to play that back those parts. But Patho essentially was just telling us about his er fantastic experience he's had in multiple different roles and that's in clinical nonclinical roles and his current capacity as advisor to the GMC and specifically about IM GS as well. Um So thank you for that path and we're gonna come back to you to ask you some questions actually and do a bit of a deep diver into your leisure experience, both when you were training and also now as well. So next, we're just gonna go to HBAB Isa Bob if you just wanted to turn your camera on, I'm happy to go next Caine if yeah, if that sort of helps. Um That's ok. Yeah, so above, if you just turn your camera off for a second, we'll come back to you. Let's go to Rachel next, who's a member of our trainee skiing group. We're happy to talk about her leadership experiences and reflections. Um Hi, everyone. My name is Rachel and it's uh really nice to be here really heartening, to be honest to see. Um just the attendance and those of you who signed up, I'm really sorry about the connection. Um And yeah, please, I can see a lot of you are vocal on the chat. So just please keep letting us know if there's anything sort of stopping you from hearing us because um just so that the speakers are also there. Um So my name is Rachel Ray. I'm currently an internal medicine trainee in the West Midlands scenery. Um My introduction is going to be much shorter than part only because I feel like I've done much less, but I arrived in the UK in 2019. I'm Sri Lankan by background, but um went to medical school in the South India and I came, did the whole sort of club journey and then did my foundation training in seven dry. I then took a year out as a clinical Innovation fellow in the 17. Um during which time I really got to pursue my interests in sort of teaching and quality improvement um and leadership. And it was actually during this time that I realized that um especially sort of getting into the space of healthcare management and leadership was going to be um something important to me. And something I think I realized I'd be able to advocate um for IM GS in. Um I then um got into internal medicine training in the main scenery. And during this time, II pursued a qualification and I did a post graduate certificate in um healthcare leadership and management at Kiel. Um But I think most interestingly, last year, I did the National Medical Directors Clinical Fellowship. So I was at NHS England um in the medical workforce team uh working alongside Celia Ingham Clark and alongside fellows at WTE directorate now, previously, ee um and during this time, I uh helped to found and run uh a national forum for sharing and learning of best practice for international medical graduates. So we began with about a trust and this was a forum just for workforce leads initially and then we expanded it to include 25 trusts uh from all across the UK sharing ways in which they've been able to support uh international medical graduates working at their trust. Um During this time, I also got involved in helping to write a policy to support locally employed doctors and um the evaluation for the medical support worker program. And most recently um took up the role um the inaugural role really of the I MG lead for the trainee steering group. So I'm obviously very passionate about IM GS um helping to support them, developing them and they are possible. Um Yeah, increasing just opportunities and awareness to help them succeed. Um And really, really looking forward to sort of engaging with you all as this webinar proceeds. Thank you so much for sharing your experiences, Rachel and I had no idea that you were fellow Kiel alumni as well. It's fantastic to hear um all the hard work that you've been doing and we've seen it first hand on the trainee steering group as well. So again, uh if you've got some questions for those of you who've just joined, uh we're gonna come to a specific part where we ask Rachel some questions. Uh and also we'll be doing a dedicated Q and A at the end of this session as well. So feel free to hold on to those or um you can comment in the chat and we can try and come back to those later. So we next wanted to go to um Hab if you're ready. Um So Hab is, is a senior. Can you hear me? Ok? Yes, we can hear you. Fantastic. Hi. Um Good evening everyone. And thank you very much for the invitation for this amazing um webinar today. My name is HBAB ISA. I'm ST seven pediatric trainee in Oxford. I'm an I MG um pediatrician who came over from Sudan and one of the founders of Soft Landing project, which is the National Health for International Medical Graduates here in the UK, the pediatricians. So regarding the leadership journey, um it's like a continuous learning journey. It has been a continuous learning journey for me and it will continue to be so, so soft landing has been found in it uh founded in 2021. We are almost running into our four year now. Uh I, one of the founder and the other co-founder is Nadia Basar who is a pen trainee in London as well. Our basic idea was like uh when I came over to the UK transitioning into the NHS system, it took me about 3 to 6 months to get my head around the differences, how to adjust my practice and how to work productively with the other team with a diverse workforce. So I just kind of started to work with Nadia among the Sudanese pediatric um whatsapp group giving like informed sessions about top tips, what to do, what to expect and how to transition softly into the N HSI. Remember after, after the second webinar, the feedback was overwhelmingly positive. People were like opening up to us, speaking about their struggles in the, in the first job in the NHS, how do they um like how and even how the top tips has helped them to, to adjust their practice accordingly. And then I remember during the lockdown when Nadia just spoke about, let's, let's just take this um um like initiative into a national level. Let's involve all the other nationalities who work in pediatrics, uh all the I MG doctors. And um since then, I remember when we drafted the proposal for self landing the workshops and the webinars that we, we intended to uh hold and we have been delivering monthly webinars to support international medical graduates since then. Um So, like we started as a very small group. I remember the first time when we thought about writing an email to the R CPC H President, Doctor Camilla Kingon to, to just suggest to, to give her an idea about what are we planning to do and how many and the times that we needed, we just sat down and proof read each single word that we are writing to her because we were so shaky as new uh young leaders in the NHS. Um At that time, I was doing a clinical fellow job in London and I secured my training post a year after that. Um So it was lockdown, it was COVID, it was like a very challenging time for everyone, but especially for international medical graduates. Um So funding has been growing from strength to strength and we are currently having more than 15 regional whatsapp groups to support I MG pediatricians all over the UK. And um we got the opportunity to go and speak to head of schools all over the UK. And we got invited to so many uh pediatric school board meetings. Afterwards, we got involved with the R CPC H recruitment uh board. We got uh a very uh kind invitation from the R CPC H President to present our perspective into the um elements of recruitment into pediatrics. And I was just, I just would like to take this opportunity to uh send my um very hard uh hard where my best wishes is R CPC president and to the whole team of soft landing because they have been working tirelessly behind the scene in order to get our project running. And it's just hard for me to see how the, how we have been received uh from the college and from all the colleagues uh uh in pediatrics all over the UK. Thank you hab for your inspiring story. It's great to hear how you banded together. And I know pediatric soft landing as a pediatric trainee has done so much, good, inspired so many of us to, to better support our I MG colleagues as well. And we'll finally go to our last speaker. So we've talked a lot about initiatives to support IM GS on the ground. And someone who's done that excellently in the northeast is Doctor Samir Ahmed, who's gonna speak a bit about his own journey as an I MG. Uh Thanks very much for uh for inviting me and thanks uh F uh the, the uh II, remember like a few years ago uh getting a, an email from FML M about opportunities uh to join the leadership fellowship program. And uh yeah, going through the details and stuff. I realized that as a, as a le doctor or as an SAS doctor, it's really difficult. Uh you can't uh I mean, it's very difficult to meet those criterias and stuff. So give it up and uh I'm finally uh glad to be here where I am and uh join you guys today. So like Baha, um I've uh come from India as well. Uh I did my master's in anesthesia and then moved uh as an international fellow in Newcastle. Uh first worked as a locally employed doctor, as a trust doctor and then as a SAS doctor and then completed my seizure program uh to join as a consultant and uh uh uh those who know me uh will, will see it will, will think of me. And I, and I, and I think as that I'm a bit of an introvert as well. But uh my leadership journey started with uh kind of a need and uh standing up to the need. Uh I remember once I finished my exams, the fellowship and anesthesia exams quite struggled quite a lot. But when finally finished it, I was quite keen to help out uh my junior colleagues who were doing that and uh then you worked a lot with them, a lot of practice and stuff. And then when they finally gave the exams and when I was looking at the results, it was uh it was like a light bulb moment for me that uh you know, you look at the names and uh uh the names of those who passed and the names of those who failed. And uh it was really heartbreaking. And uh then I ki I kind of started looking into it much deeper. I didn't even know the term differential attainment at that time. And then looking further and further, I found that this, it's a complex thing but it arises uh from a lack of support and the lack of uh resources which are given to I MGS. Yeah. And uh that started my journey and uh when I was looking into it further talking to a lot of other people. Uh and what I realized that is for Im GS when the foundation itself is not that strong because when they're not supported, uh when they are start, when they are starting their journey in the NHS that just sets them on the wrong foot and that carries on. Uh And that's how I thought focusing on the, on that part when the s come in, give them a good support so that uh you know, they can hit the ground running and uh help reduce this differential attainment. And uh II spoke to one of my colleagues, my colleagues and they were like, yeah, you should speak to the CD and see how things go from there. And when I spoke to the CD, he was really welcoming of the ideas and uh uh thought that I was best placed at that time as a doctor. And uh as I lived experience of was gone through and uh made me the EMG lead for the direct, we started doing some work, good, good feedback and the other departments got interested as well. The DM was keen to know what we were doing. So I presented into the uh presented the work in uh the clinical director's group meeting and then the exact trust uh meeting and uh then they felt that yeah, this role should be extended. And uh that's how I became a I am G lead for the trust. And then then at the same time, I came across uh Suja and Professor Mall who was doing a lot of work uh to bring up some National Guidance. And uh that's uh that's how I got some more mentors and met Partha almost at the same time as well. I think uh having really good mentors helps as well. And that uh kind of made me contribute a lot to the National Guidance uh for Induction. And uh also now I'm also part of the led National Strategy Group uh which has just started as well. So yeah, this is a bit unorthodox journey uh not as a trainee or as a consultant, but as a led N SAS doctor. And then uh yeah, taking that was up from there. Thank you so much for sharing that story. Samira having worked with you on other projects. I know as well. It's fantastic to hear about your experience and some of the barriers and adversity you face, but also how you've overcome them and it's inspiring to all of us in this school. I suppose. I'm not an I MG but I can definitely um if not relate to some of those struggles, really want to see how I can support my I MG colleagues. So thank you to all of our speakers for those brief um bios or intros. I'm sure many of you have read more about our speakers before um the webinar, but we thought we'd give you a flavor of some of the life story that they come with and that'll help pepper some of your questions as well. Now we're gonna go on to the targeted question, but I'd like all our speakers to turn their cameras back on for this part because we hope to engage in some dynamic discussion as as well. So we'll target our questions to, to each speaker, but then the other speakers are free to also answer that as well. And of course, bringing in their rich lived experience as well. So pathway, we'll start with yourself if that's OK. So the question we had in mind were um you've talked about your journey going to from different hospitals, your clinical roles, your nonclinical roles. Um But I'm curious about what are, what are some of the biggest challenges that you faced in becoming a leader in your field as an I MG? Um And how you've overcome those challenges as well. Uh So I think the first thing to say is that, you know, uh you need, we need to be stop beating around the bush when we say that, you know how Im Gs looked at and lots of leaderships pay a lot of lip service that they, you know, are they all love all Im Gs and you are here to help and it's not the truth. Uh I think the biggest challenge is people do have a differential view towards you, not always but a lot of differential views are there. Uh We have the creation as me and Samir and Rachel have discussed in separate other forums. We have the creation of a workforce called L EDS in this country didn't exist, right? And they are stacked with IM GS. So at the moment, uh if you look at it and you've seen my very clear position on that, you know, there's a lot of debate going on about PA S and I can see lots of organizations trying very hard to accommodate PA S make jobs for them and pay a lot of attention. You've got seniors saying we should be kind towards PA A S and II get that. That's absolutely right. But my view is very simple. If you showed that degree of uh kindness and showed that degree of career progression towards Im Ds here, you've done much better. You've got a readymade workforce here and it takes a lot of courage to be away from your country, be away from your loved ones and be in a different country. So I think uh those challenges that you say is that is battling against that sort of notion. And also I think there is a general view that if you come from another country, your education isn't that good enough. Uh And you're not that up to the standards of everybody else. So you do have to prove yourself double over. Um How do you battle against it? I think uh I would say ship is a big thing and I don't say that likely I've been blessed to have fantastic consultants in between all of this and I, that's why, you know, me, Samir, we strongly believe that we are IM GS and we have a responsibility via the system to pay back. Right. I'm in a position of considerable power because of the positions I hold in different organizations and I would encourage a lot of seniors. There are plenty of senior Im GS in this, in this country who can do a lot of good. So I think the challenges are finding those allies and finding to uh work towards. How do you, you know, wrinkle sa guptas just put a fantastic comment. That's exactly how it should be. You know, if you're L EDS and, well, you got to be given the same system, the same chance and that, you know, is up to us fine allies and fine I MG seniors will be willing to step up. You don't get to a senior position and pull up the ladder. That's not the dictionary, uh of how it should work. Uh You know, I, I've been through plenty of tough times. Uh, you're on your own, away from your parents, away from your family. Uh Really tough. I don't think people see that. So, um, ship amongst each other is very important, fine people. And one thing I would also say you come from a different countries, have different views, right about your views towards other religions, your views towards other countries, you know, the, whatever, whatever the politics of your own country. When you come here, you're one, you have to forget all these divides and work together as one and the power is in togetherness. And I think I will, I cannot emphasize that strongly. Uh I have had plenty of comments about where I come from. I'm a Hindu by background, I'm very proud of my religion, but here it's never matters, it never should matter. Uh It doesn't matter who you come from where your country is. We are all together in a different country and we should look after each other. So that's my way of saying how you battle those challenges. And I cannot emphasize that strongly enough to every single I MG. Uh Here, you're one, you know, you can enjoy your India and Pakistan games, but you still are one that's very important, refreshing opinions there. And I totally agree with you the importance of ship, both intra ship between Im Gs are coming across, but also between um kind of going across the border to, to other specialties as well and perhaps um some key points there about not just paying lip service, I suppose. And actually um taking some action to support Im Gsi. Just wanted to go to any of the other speakers to see if you've had any specific challenges. Samir. I know you mentioned um a few points in your bio about how you've had some adversity when you first came to the UK. And I'm just curious to hear about how you've overcome some of those obstacles that you've faced. Yeah. Uh as uh as, again, pa I was saying um when you come from a new country, it's uh it's uh cause II never had any friends or here or any family here. I just came by myself and uh when you start that journey, all alone, uh it's a different ball game and uh that's, that's how you, you know, be, was also saying about finding those that right, support that consultancy had, which, you know, helped him and support him. And I think you, you, uh you actively need to pursue and uh seek out those kind of people who can support you. Uh This is a journey which uh, yeah, most of it is, uh, you know, dealt with alone but uh a lot of it has to be, have, you know, some kind of support, some kind of friendship. And I think, uh I was quite lucky with that with my department, uh, you know, having a very good support system. And, uh though I still see a lot of departments are kind of having a, like a two tier system there. Uh, the locally employed doctors are more for, uh, you know, clerking in jobs and uh very service based jobs. And uh so the, whereas the trainees are given preference and I'm, I it varies from place to place and stuff and uh it depend on, depending on the training opportunities. But uh if, if that's not the right job for you move on to the next job and uh try and find that support where you can uh climb the ladder and get on to the, you know, the career progression stage. Thank you. Thank you. And that is an interesting perspective to talk about the harsh reality perhaps of somewhat exists in some hospitals, as you said, of a two tier system. Um Rachel, I just wanted to come to you next for your questions. So we've talked a lot about challenges and perhaps a bit about opportunities or ways to overcome those challenges. Um But I wanted to know what are some key opportunities for leadership that you see is attainable for more junior Im GS. There's a lot of chat in the comment. Uh Sorry, there's lots of comments in the chat saying, but what can I actually do? I've just arrived to the UK, I don't have a lot of experience. So, yeah, what are some key opportunities for leadership that you can see is attainable and what existing networks or mentors help helped you in gaining your leadership exposure? Yeah, I'm going to try and answer this and answer some questions that were raised in the chat as well. Um I think, you know, they do overlap. So I think one good thing about I MD that come to the country now. Uh I think because of sort of leaders who have sort of gone before and people who have been quite vocal like Pa or Samir. Um there's very much now, I think increased awareness of the challenges I MG face even before they come to the country. And I do sometimes meet colleagues on the board who have networks um and Facebook groups that have been set up even to help them go through the club journey, which can also be quite stressful. So I would say that the kind of connections that you cultivate right from that stage from when you apply to the UK, when you apply for your GM registration, when you apply for your club, um and the kind of contacts you make there are are very, very important and that in itself can be a good network. I think there is hopefully now more led groups in hospitals, there should be really because we are seeing a greater number of of I MG is coming in and they tend to like s said, take up led posts, there should be a forum or there should be a meet up in your hospital. And if you are, if any of you are sort of new uh to a hospital or you've been working as sort of an led in your trust for some time, I strongly encourage you to actually find out if there is a forum like this. And if not, I think this in itself is a great opportunity to sort of step up and be a leader because we do need IM GS who are L EDS who are trainees to actually take up that charge and start the group, even in your hospital, advocate for kind of um your rights, your supervision, your training opportunities. That's essentially what happened in my old hospital where sort of a group of led doctors got together. They approached the DM E and they said, look, we realized that, you know, we kind of can see there is a difference here and we'd like to sort of form a group, we'd like to meet monthly and we'd like to have regular conversations with you about opportunities that we feel should be given to us. And that was really welcomed. So I'd say that's firstly, um sort of a leadership opportunity that actually any one of us can actually step up to and kind of take. Um So recently I completed the fellowship program, which is the National Medical Directors Clinical Fellowship and I can put details of it in the chart, but that's a great opportunity for any sort of leadership minded um trainees led doctors and SAS doctors because it is open to all those groups to really sort of immerse yourself in an organization for a year. Um And you can really sort of choose to then work on projects that are close to your heart. So for me, it was sort of supporting led, supporting IM GS and then you can actually really choose to sort of immerse yourself in those programs and try and make a difference there and really kind of continue that work based on the sort of year you've had. So because I've re rejoined training now, but I've had this sort of fantastic year. I'm really sort of passionate about continuing some of the work from last year. So I'm still going to work on things like led support and support for IM GS. Um There was a question about sort of P GC and I think my answer to that and honestly anyone else can feel free to chip in here is that I really think there is, it's really valuable. So sometimes to do a job like a teaching fellow job or a leadership fellow job, um especially sometimes as a break in between your stages of training because a lot of these jobs come with funded uh post graduate certificates. So it actually can really make a difference in your specialty applications and you don't have to worry about finding it yourself, especially teaching fellow jobs because you can get post graduate certificate in. Um I think it's sort of teaching from the university you're affiliated with. Um And if you're someone who's not sort of very sort of hell bent on just moving from one training thing to the next, I think, taking a year out and kind of immersing yourself in leadership, immersing yourself in teaching, getting that PG cert as a qualification and just kind of taking a step back from the clinical and just doing all this work will also just, um, yeah, just kind of brighten up and sort of give, give you that sort of flavor of what it means to do all these things. Which let's be honest as an I MG, we sometimes aren't as much exposed to from the countries we've trained in. So it only when I came here that I managed to, like, take a year out to just focus on doing some teaching to do some leadership, to do some quality improvement. And I really, really enjoyed that year and it sort of helped um put me on the track I think for, for leadership. Um someone's mentioned about leadership fellow jobs and those do exist. So the scheme that I was in is just one of many schemes. There's also regionally run leadership schemes. So health education England on their website have a list of all the leadership schemes they run. Um There is a Future Leaders program in uh the Northeast. Um There is specific kind of digital Health fellowships, there's Daz Fellowship. So even sometimes in some hospitals, they've created bespoke fellowship, uh leadership jobs. For instance, there's a trust that has an ICB um fellow job um that you work with your integrated care board. So I just encourage you all to go back to your diary, to your uh sort of deary website to your CBS and just sort of have a look through for the jobs that are available there and please do do apply for them. So that was a bit of a long winded answer to a question. No, that's, that's ok. Thank you so much for, for your insightful comments about how to practically um try and gain some leadership experience there as well. And I think there's a great crossover between teaching and leadership as well because in formulating some of those teaching strategies and learning how to deal with um difficult situations in that context of educational environment, you're actually gaining those skills and leadership as well. And as an education for like a test that actually some of my I MG colleagues who've done those jobs have, have really taken a lot from them as well. Um So Samir, I just wanted to come to you next. Uh I don't know if you're able to turn your video or camera on. Um Thanks and it was just on um I mean, we've talked about um international medical graduates in um in uh generally, but I really wanted to hone in on locally employed doctors. So we've had a lot of comments in the chart asking what is an led. Um So I first wanted you just to clarify what led was for those uh who uh perhaps like me are not totally aware of it. But then also, I specifically wanted to ask you um having been an led, what, how can you make use of the opportunities that Rachel has said? So practically, how can you do that in a department that may not be welcoming or a supervisor that may not appreciate the challenges of being an led. Uh So the first uh part of your question about what is an led. So L EDS is uh locally employed doctors and essentially they are any doctor who's not a consultant, who is not a, a specialty doctor or an associate specialist. So, non consultant, non SAS grade doctors are called Led Doctors. They go by 100 different uh titles and names uh trust doctor, clinical Fellow, international fellow. Uh uh Yeah, and so on. Uh there's like uh there are many, many names which are given by the, by the trust by the departments. Uh And the main problem here is that uh there's no like National Contract for L EDS. So the contracts are made uh by the trusts and that's one of the areas where uh you know, knows very well and that's where we are focusing on that. Uh All L EDS should also be on national contracts. But anyhow, uh that's a different uh discussion. Now, coming to the second part of the question about uh how to use the opportunities. Uh It's as, as Rachel was saying there's uh you know, there are, there are lots of opportunities available and one of the problems is that uh the uh not, not, most of the opportunities are friendly for led doctors because they require some time out of program. And stuff like that where, uh, that's just not possible for us. Uh, they require some funding, uh which, uh, if you're a trainee that gets paid for, uh, by the Daintree or by your school. Whereas, uh, for LS, um, it's often not possible. Some, some departments might be, you know, very proactive and do that. But, uh, um, a lot, unfortunately don't, but having said that I think there are a lot more opportunities than what they were available. A few years ago. There's a lot more awareness about who the lads are, who the SAS doctors are. Uh you know, the terms which used to be described earlier, like middle grade uh and nontrainee doctors and stuff like that, they're slowly kind of uh uh going away and uh there's a l it's uh things are slowly changing. So whatever like Rachel said about the opportunities for fellowships and stuff do find out it may be that in your local area, in your local trust that m that maybe uh they will be supportive of you to do that and that, that, that ticks off a lot of boxes again as Rachel was pointing out and it will help you with your cardio progression. So, unfortunately, the onus is on you uh there because uh uh the trainees and the consultants and stuff, they are required to do quality improvement projects and that's how uh they get a lot of opportunities and uh uh where, where they can volunteer, but for locally employed doctors, uh, it's about seeking this opportunity. So the honest is on you, I'm afraid. So you, you do need to find out what's available in your local area, in your local hospital, uh, in your local ent and whether you're avail eligible for it. And, uh, if there's any sources for funding and stuff for it, which you can tap into and II think they are a lot more available than what used to be earlier. Thank you, Samir. That's um I suppose we've talked about some really difficult topics here and there were a couple of comments in the chart talking about bullying, harassment and the challenges people have faced. So it's nice to hear that there's at least things are getting slightly better and that there's perhaps a bit of support and especially through the fantastic work that the four of you and a lot of people in the chat as well have actually done those trail blazers who perhaps been the first I MG or locally employed doctor in their trust and have paved the way for others who have followed after them. So I wanted to come to hab next if that's ok. So um HBAB, we've talked a lot about the challenges uh international medical graduates can face the specific challenges of locally employed doctors, some opportunities. And then Samir mentioned the the harsh reality, which is that the onus is on yourself really to find these opportunities. And to explain to your supervisor, your manager, your consultant about what you need. But I'm curious about how someone can juggle all those things because something part of their O OLU to earlier was that many IM GS who come to the UK are isolated, don't have a lot of family, don't have friends. So how do you juggle all of these things? Leadership opportunities, um some requirements for training or for the job, clinical shifts and then also um trying to gain these opportunities as well. And I thought as someone who's been through all of that and managed to start pediatrics off landing, you'd probably be in the best position to answer that. Yeah. Um I II think I II still don't have the magic formulary about how to take all the, all the these things together. But I do believe when you are passionate about the cause you will find time to just sort things out for us as organizing team is soft landing for me personally. It's always like either I do like for example, organizing events when you are expecting 100 plus I MG pediatrician to attend, it usually takes a lot of work in order of like recruiting speakers, arranging like running the technical part of the events, issuing certificates and answering emails, queries from different point of contacts from head of schools, from TVD, S from I MGP admissions themselves. So it's, it's, it takes a lot of time. It takes a lot of late nights, um early mornings that you need to like to wake up, for example, at 5 a.m. to answer a couple of emails before you start your commuting journey. Last year, I was commuting my husband, my ho my I had to commute about 45 minutes uh from where I live to the djs that I worked at and I technically use all my commute time in train in the train just answering emails trying to juggle the admin um to work of self landing and still it wasn't enough. Uh Despite almost like we are three or three organizers of Soland, we were trying to get on top of emails, admins answering queries and doing a lot of 1 to 1 to 1 to 1 work with our colleagues. So, and I remember uh we have been lucky by having so many mentors um who are like senior consult, senior I MG consultants who have been working in the UK for so long. And they were like, guys, how do you find work uh time to do all of that? Uh You need to pace yourself. You need to have like to take some time off in order to recharge and come back with the same passion because you are taking a lot of work. And if you don't take care of yourself, you wouldn't be able to continue. You will end up in bed now. And yeah, at some point, I think every single team member. At some point, we felt that we got a bit overwhelmed. Uh We have a responsibility when, when we started the soft landing. Basically, as founders, we were full time trainees. We need at some point to slow down our training for various reasons. And this the the less than full time day was basically trying to sort out soft landing work. But at the end of the day, it is very, very rewarding when someone emails you telling you like, I have passed my A R CPI have uh ma I made use of your tops about how to use a portfolio. Speaking to to someone who has been struggling with mental health crisis or like being off sick because they, they haven't been able to go back to work and just speaking to them, reaching out to them and create and just like signposting them to the adequate resources and the local network that they can like attach to or they can link to in order to feel better regarding having social um having some sort of social activities is very rewarding when we receive such an email. Like, like, thank you, I have passed this interview. I got this training post after the interview practice that you conducted or um I feel better. I'm back to work and I feel that I'm dealing with things in a better way. Um So yeah, and I think our family is also, I would take this opportunity to thank all of them. I think we have been very patient with us taking our very because we are using our own time, our family time in order to produce this work. And but they understandably like um they do understand the importance of the work and the passion that we carry for such work. Um Yeah, thank you so much. It's been so inspiring to hear about how you face challenges, but actually, you've got such a positive spin on things and actually where you could have stopped by just helping yourselves, you set up this organization, pediatric off landing. And for those who aren't aware, have done tremendous work at really leveling the field that attainment gap between medical graduates and UK graduates in pediatrics. That gap has been narrowed because of the work. Um hab and her colleagues have done uh and I believe is now a national initiative as well and we received a claim at the Royal College of Pediatrics and Child Health uh annual conference last year. I was at the conference and uh I was clapping from the back as well. Um Hab I just had a follow up question because you talked about um what a rewarding initiative it's been and how you've heard about, you know, a fantastic, it's been helping people through difficult periods of time. And I'm just wondering um what's been the most rewarding aspect of your leadership experience? I think for me, like as a personal gain, I would say from all of this journey. Um I was very and like I was so introvert. Um I'm kind of someone who thinks a lot but doesn't speak much. So like the whole this journey, like I was trying to fight my personal demons in terms of trying to fight my cultural and my personal inhibitions going into local regional and then national stages in order to speak about differential attendment, to speak about how to improve the supervision dynamics between international medical graduate and their supervisors. The speaker even about bullying and racism in a politically correct way in order to get like the people ears and heads around what's called what the international medical graduates do face at their workplace. Um I think I grew throughout the journey, I grew like my communication skills, my self-confidence. Um and even you kind of like, I just feel like I'm living up to my values, the values of having, of seeing justice, seeing equity, seeing um like uh inclusion of the workforce rather than having group of IM GS sticking together another group of UK Gradus sticking together with break with broken relationship in between because of like loss of communication or communication gaps or communication barriers. It is very rewarding to see how speaking up about like the specific challenges about the mentality, about the perspectives of international medical graduates in national levels and national forums can shift the the how, how the UK graduates or the seniors uh perspective about IM GS. They even like uh for example, after the last workshop that we presented in our CPC H conference about improving dynamics between uh um I MG trainees, doctors and their supervisors. Basically, that workshop was target, like we targeted the supervisors and most like, I would say 80% of the at in DS were UK graduates who are working as supervisors for supervisors for I MG. And the feedback was enormously positive for like, for the first time, I have been able to understand why my trainees, why was doing this? I'm not doing that for the first time to know that like I need to work harder or I need to go an extra mile in order to fix the dynamics in order to push them into their full potentials. Um So like so and uh like even after the workshop, like they were coming to the stage with ideas or the about or with suggestions regarding how would they, what would they change after going back, like after this workshop, going to the next supervision meeting? So it was, yeah, it just like I think um just raising the profile about the whole, the whole idea about the different needs. Maybe it's not like they need extra support, they need a tailored support in order to step up their games. Um So just as I say, it just helped about a uh like living up to my personal values as well and just, yeah, seeing things getting better. Thank you. Thank you. That's wonderful to hear how you overcome some personal battles, some personal demons and some inhibitions. And I would say uh actually introverts are some of the best leaders I've met. Actually speaking as a slight extrovert, I would say the power is a good book on the power of introverts. And I think um Samir alluded to that earlier that sometimes it's harder. Perhaps when some of these things you get intersectionality, perhaps between certain personality type and being an I MG and from a certain background and perhaps in a certain place, but I think it makes the journey even more valuable. So, uh I'm just gonna pick some questions from the audience now for our speakers cos we've heard a wider range of uh of, of answers and it's really triggered some, er, questions in the chart and some um quite pertinent points as well. So Samir, I wanted to come to you first. It's a good question from Bushra actually. Um So Bush's question is, um what about the trust for our work? There's no I MG lead there. What can we do to uh help to improve as she's on her own? And then she's not getting any time out to do any of this extra work? Um Thanks Misha for that question. And I think uh ii, my journey was uh quite similar in a very similar scenario uh When uh yeah, I was doing my, you know, from my own to help my juniors out and stuff and uh what you need to take some like step by step approach. And I'm sure Patha and others uh will have a different uh advice. Uh take, uh you know, when, when you go to the higher, you know, the managers and stuff, they, they would want to know how it will benefit the department, how it will benefit the trust. So you have to start speaking in that language, send a simple survey out to all those who joined in the last couple of years uh to see what problems they had and uh you know, simple things like did you find in your accommodation? Ok. How difficult was it to get your bank account? And how, how was it when you settled in? Were you given an induction uh which you were expecting? Uh what are the other difficulties you had uh a very simple survey and uh present that to your CD, present that in your audit meeting and stuff uh within your own department and take it up from there and similarly do similar work uh within your uh your, you know, your uh wider specialty or your trust if possible and present all this. And uh the good thing is that a lot of the guidance which is coming now, both from N HSE, from GMC and others, they, they do advise having uh a good support system for locally. Employed doctors and IM GS. Uh So you can use that as uh you know, as a uh to say that, you know, you see, we have issues. This is what the survey which I've done, which, which says that we can do better and we have this National Guidance and stuff which says that we should have some support system is in place and put this all together. And uh you should, you, the, the trust. Uh I think now if you do that with all these guidance coming in, it's very difficult for them to say no. Uh because you can tie it all to uh equality and diversity and uh you can try to uh you know, workforce uh recruitment and retention. So speaking, the language which they understand is very important. And uh yeah, I'm, I'm happy to, you know, connect offline and chat a bit more um as well if need be. Thank you, Samir. I, it's really interesting to hear, hear it from that perspective because even as a trainee or someone, not a consultant level, our thinking is different. Perhaps we don't think in terms of business case, in terms of national guidance. So I think those points you've mentioned are, are really, really important and Bushra um I know you can't speak, but thank you so much for all the work you're doing to support IM GS. I'm sure they appreciate it and we appreciate you attending this webinar as well. Um I just wanted to see if there were any other comments from any of the other panelists about how to support, um perhaps seniors who want to support IM GS. In which case, I'll go to the next questions. This one's perhaps for yourself path than anybody else um, who'd like to comment. So I suppose the question is, um and it was asked, I think by Mason earlier in the chart, how do you know when you're ready for the next leadership position? Um So I suppose both at perhaps a junior level but also perhaps if you come to a senior level. All right, how do you know you're ready? Uh You're, you're ready? I don't think age is a barrier to being any leadership position. I used to run the diabetes registrar across the country when I was a trainee. Uh That's the four on my l. So I think it's a question of more a question of why do you want to be a leader? And what do you think you can contribute more than? Oh, I want, I, you know, I would need to step into a leadership position, which is a very different question. So I think for me, it's about what do you feel you can contribute? You know, what is your style? What do you bring? And if you feel you have those qualities, the next question is, are you being stopped from going into the leadership position? I don't think there's any magic thing that happens that makes you into a leader. I personally always believed that a leader should be judged by uh their outcomes. Uh not by, you know, how many documents they create or what process they create. So, you know, you've heard an example here from what HBAB is doing, I mean, that's leadership with outcomes, right? So leadership doesn't fit any profile. Leadership is, I think in this country, a lot of things leadership is associated with Charisma, which is a problem. And I don't think that's necessarily leadership, leadership can come from anybody. So I think you're always ready. It depends to what you want to be as a leader. Uh And then you sort of step into the group. So it's more a question of if you feel you can be a leader is the system stopping you from doing it, which is a broader question, but that's what I would probably put it across. Thank you. That's quite interesting. And especially that reflection on Charisma being linked with leadership, there's definitely more to explore there. Um Partly you mentioned that what if the system is stopping you from being a leader? So how can someone identify if that's the case and how can they overcome that? So I think the question becomes more about, you know, if you want to step into the leadership space. Um What is it that you want to apply for? What post that you're going for? Where are you getting stuck. Do you have people you can go to if you're being rejected for those leadership posts? That's what I would do. So, in our local trust, we have got Portsmouth, we've got uh Najaf and Rahul who looks after the international medical graduates in particular and we encourage them to go and approach them if they want to do any leadership role, whatever it may be in the trust and what is stopping them from getting appointed. So that's what I would do. And I think one of the work that we want to do from a national level is to make sure there's an I MG lead everywhere and sort of tackle that from that point of view. So that's what I would like to have in place. Uh a particular lead looking on Im Ds and their need to progress and leadership is one of the progression that people want to do. Thank you and thank you for all the valuable work you're doing, especially at the GMC as well. I know many of us have seen um activity in certain perhaps hubs but not spread across there. So it's great that we're seeing this great leveling of of opportunity, Rachel. I just wanted to come to you next. Um because path has raised some great points about identifying a leadership opportunity, but perhaps part of that is fine, good mentorship as well. So how have you found good mentorship and what qualities can some of our colleagues look for. And I suppose, especially in the context where if you're new to the country, there might be um different cultural approaches perhaps. How can you seek out a good mentor? Yeah. II think from my experience, I can definitely say that I wouldn't be very worse if not for the kind of power of mentors. And it's really tricky because in my first class that I went to, I was um, I was given an education supervisor and II completely understand that this may not be the case where in fact, in fact, II bet it probably isn't. But she actually took the time to one day, sort of take me out for coffee. And all she did was ask questions about sort of my upbringing, what my medical school training looked like. And I think she really came from that position of, you know, I understand that you're new to the country and I'm really, I really want to sort of try and bridge that gap and understand the differences. Um And that's not a universal experience and that's why, you know, there are lots of sort of IM GS that sometimes struggle because there is that gap between them and their supervisor. Um And one of the, I think there was actually a GMC report that came out that said a lot of IM GS don't even realize the first bit of negative feedback they get is on their A RCP or it's put on their portfolio. It's not even a conversation that's had between you and your supervisor first before it actually comes on to an official documentation. So what I'm about to say might sound a bit um It might, it might require a bit of courage and it might sound a bit bold, but I think I just encourage any of you if you do have your supervisors and they may not be IM GS, There may be someone allocated to you by the trust to be just very forthcoming and open, right at the outset about sort of some difficulties you encounter and to actually tell them if you feel like I am, there's some things that I might need to learn. If you feel like there's some feedback you might want to offer me constructively. Could you tell it to me in person? And I'd almost sort of say that first in a way to sort of almost protect yourself because now you've actually communicated that to them. So they don't, you know, it would be really unfair for them to go and put it on your portfolio all of a sudden. But also you are kind of opening that dialogue to say, you know, I am new, there might be things that I might need some time to kind of get used to, but I want to build a relationship. Uh Hopefully you can tell me that and we can work on it. Um That aside, I also want to say that there is now lots of kind of um forums basically or sort of groups where, especially if you feel like communication skills and ethics. Because I think those are the bits that sometimes when you're new to the country and you're suddenly just landed in, you might struggle with because the clinical knowledge is the same. But, you know, every country sort of ethical context and how people choose to deliver news might differ. And again, for this, there are some excellent courses that are run just sort of introductory courses. So the MDU runs a fantastic introduction to UK Ethics and Law, which I would recommend to anyone starting out because it's just an overview and they do case based discussions. The welcome to the UK Practice is a free workshop that the GMC runs that you should get signed off for in terms of study leave. Um You shouldn't hopefully pay for it, but you should be allowed to go for it by your trust. Um The BMA and some other organizations also run sort of introductions to ethics and communication courses. Um And I think sometimes as IM GS, it is obviously a struggle. But I think the first couple of months, sometimes we, we may have to actually do that kind of seeking out of these courses, having those proactive discussions with our supervisors on our own just so that we kind of make sure we do our best to protect ourselves in the system there in because the reality is as, as pa has also said, sometimes the system is against us. Um And it is something that we've got to acknowledge and try and do our best to sort of um come to terms with. So that's just again, based on my experience, I understand it may not sort of necessarily work for everyone, but as much as you can, if you can be sort of um you have those conversations with your supervisor, I think you, you'll find that that helps. Thank you, Rachel. I think that's really refreshing to, to address part of what is the elephant in the room. Um In that everybody sometimes says they're open and welcoming, but I've had many instances talking to MG colleagues where the multisource feedback is, it just opens up a can of worms because someone will leave that comment there. Can I just say one thing cos you if that's all right? Yeah, go for it. So two things I think what people need to realize is that just because somebody's an I MG doesn't mean that they'll support you. I think that's very important to also understand that, right? As I always say, skin is not always kinship, right? That's number one to remember. So we will all have had local people who have been amazing mentors. Let's not, let's make that very clear just because somebody's an I MG comes from your own country doesn't mean they will support you. We've got enough examples in politics nowadays where people may be of a certain color but may not necessarily have the values that you would want for everybody to be fair. So there's that. And I think one thing which is probably not for everybody, but for a lot of people has been drilled into us uh over the course of time. II, remember the conversations I had with my parents. We do come from a background of colonialism and it's drilled into a lot of us in our psyche about coming to a different country, needing to be polite, needing to be quiet. There's a couple of things I always say politeness is uh something that should not be uh mistaken as uh as I call it bending over to do the right to, to accommodate people. Uh You should be confident of who you are, you are adults, you are qualified doctors, you come to another country to work. It's a global economy, it's a global world and thereby I should set that confidence to also it takes time to develop. But I think it's very important uh to have that confidence and not have that mindset that you come here to please anybody, you come here to work, you come here to train, you come here to earn and so it should be and you come here to make a life as everybody else is. So that confidence should be in you as well, it takes time and I think it comes with having good role models, but there are people like us also around who are also also happy to pick up a phone. So for me, it's very important. You know, my, one of my local IM GS, uh basically is, uh, homesick to sometimes invite them over for simple as I would call it, you know, dull and jowl, nothing too complicated. Just some home food, so little things like that matter. And what I would encourage everybody to do is the more you get into senior roles, make sure you pass that on to another person. That's how you cascade that thing. That, that's probably the two things I just wanted to mention. Thank you for that. That I think that's, that's quite important to mention. II think many of us are under an illusion sometimes that everybody wants to help in the NHS cos we go into that uh healthcare setting, but that's not always the same in supervision and mentorship. And I'd argue there's a difference there in mentorship and supervision as well. Your supervisor is someone who's assigned to you, but your mentor perhaps is someone who you choose for yourself based on the values that all four of our speakers have talked about whether they embody that themselves or whether um they found that in their own mentors as well. Um So I had a question for um hab actually and it was just, you you made some guidance for supervisors or for supervision meetings. Um which is fantastic. But I'm wondering as someone who's not an international medical graduate but the child of immigrants um as a UK graduate, how can I support my international medical graduate colleagues? So I'm not a supervisor, I'm not a consultant but I want to help. So how can I do that? I think um this is a very good question. Um So just the first bit regarding the supervisor bit, I think we have a work in the pipeline of the Royal College in order to tweak the content of the of supervision course for supervisors. So this is still like a work in progress going back for the nonconstant level of UK graduates who would like to support their img colleagues. I think uh the very basic acts of kindness or guidance regarding sorting out accommodation, sorting out bank details um to set up their bank accounts having like just to make sure like they know where, where to go, how to come to work. For example, for me in the first months of me, the first month in the my first month in the UK, it was a very stressful time for me because it was very difficult to get um separate like a private accommodation. Uh All of the landlord for example, wanted like a stable bank account, approve of address which was very difficult for me to obtain as someone who just came over to the UK. So um like I like, I like at that time, at that time, I went for like um a shared accommodation which was a bit difficult for me as a Muslim female. Uh just to get used to that and it was very noisy. I like I couldn't sleep and rest well at all, the hospital accommodation was full. So like the private one. So there was no option apart from the common shared ac uh shared accommodation. Um what I tend like what I personally found useful is the head of the department or uh or the or the college tutor at that point checking on me uh every morning he was like, how are you? And he was like, yeah, I'm fine. I'm fine. I'm fine. He was like, have you sorted out your accommodation? And I was like, no, actually I'm struggling. Um and then he asked why are you struggling? I said because of this and that and then I remember him taking him his taking his phone out, phoning some people in hr regarding providing me with a private accommodation or like a studio where I can live until I sort out the private accommodation. So I think um even with the colleagues, like just as I said, checking on the basic, very basic stuff will uh just like this simple act of kindness will just take them uh will help so much, especially in the first few months. The second thing is like, for example, in the first few months, all the conversations that were happening in the doctor's room or, or um like whatever like meetings, all the social conversations, I didn't feel I was included enough on those conversations. No one asked me about my, my, about my, my background. What what do I do for like life or like for my off time or my free time? All the conversations where I would say not inclusive enough for an I MG people who are talking about going to both, for example, which is not something I'm doing as a a Muslim female uh talking about their walking, their dogs, which is not something that I'm used to have a pet, which is a dog. So just about having um is shared ground regarding like um just in and going the extra mile in order to include the other colleague who is who just recently come to the UK, who don't have a social network in order like um social support network, I would say uh would make a huge difference and a huge impact. Um Yeah, it's all about making the work environment inclusive, which is I think we have still like a long way to go in order to make our workplaces or work um uh just in general or more inclusive to the diverse workforce. Thank you. I think there's some key points over there. I've definitely taken home and I think are useful for all of us in the, in the chat as well and on this call and that's about welcoming people and sometimes going beyond some of those perceptions that you have as well. Um So thank you for some of those points. Um Partha, I had a question for you, but did you want to comment on? What about that? No, II always say, and I'll say this, you know, I put a, one of my B MJ blogs in there about standing up for yourself. But um I think there is one fundamental thing. So I do obviously see lots of national policy work and do a clinical job. I always say one thing. Remember when you, when you, you will always meet four groups of people. That's what I really say typically, right? When you are here as an in G, there'll be a group of people who straight away have make no distinction between you and a local graduate and see you just as a doctor colleague who needs to be helped. There are people who exist like that. There's a second group of people who are a little bit skeptical about you feel like you probably are there to just cover the gaps, et cetera. But you need to work together as a group to try and convince them that there is a need for you and we can talk about what we are doing about it. The third group, they will basically, they will join in if everybody else is, but it's important to recognize that there is a group of people in this country who do not believe you should be here, who believe that you should be just doing the rubbish jobs who believe that you should not be ahead of a local trainee and all that sort of stuff. And don't forget that, uh, we had to intervene with the BMA as one of the, uh, one of the things that the BMA wanted to put out was I MG should have come second rank as far as going for specialty training. I jumped in Anton Emanuel. So we challenged the BMA and the that was withdrawn. So those thought processes are there in people's head, right? When the actual uh data doesn't match any of those theory. If you look at right now, what's happening with specialty training posts? And Im GS is completely skewed, completely skewed. Im Gs don't get a look in, in lots of, lots of areas. So we know that and I think one of the things we wanted to mention just to ensure that we're not doing talks. One of the things we want to do is to visit hh area and meet with the Im GS and then sit down with their execs with their data on Im GS progression leadership positions or what is happening with the led post. We would like to open those data and come and visit areas and we would like to do it on behalf of the GMC. So that should be quite powerful, gives us an opportunity to also to meet with a lot of you. Uh So hopefully 2024 we have a lot of that work. Me and Marla, we want to do that work together and that's why we are joined. So we pick up some fabulous initiatives like HAB is doing. How do you propagate them? How do you work together? So those are things in the pipeline we have. So, you know, don't give up hope I'm here. You know, I came here without any sort of mentors or backups, et cetera. And there's many us like us who are willing to help. So that's all I would say. That's, that's great. Thank you. And I think um do you mind, do you mind just asking about uh me asking about the question? Um But I think still like from our experience in uh South Landing I MG still significantly face bullying and racism. And despite the, the whole leadership gen journey till now, II think we're still finding it challenging to call out racism and bullying at the workplace. And from my position as a trainee who is not a consultant yet, I can only advise about going and speak to this one. Go speak to your um line manager if he's not responding or he is not taking actions to go to their TBD or go go to your uh freedom speak up guard to speak up guardian or do that. But still, I don't think the outcome, so many IM GS are not like they haven't been able to co to open up about, about all of these problems. And the other thing, those who had the courage to go and speak and call out those actions, they haven't received any satisfying outcome, I would say. Yeah. So um so I'm not sure what do you have in the pipeline regarding? Yeah, providing some sort of framework regarding how do we tackle those issues. So I think a lot of these posts fdss and all that sort of stuff. If I'm very honest, I'm not quite sure what it actually does. Right. Um So I, you know, I've seen, I've done a work looking at racism, I've done, you know, managed many cases uh involved with them and Chief execs and stuff and to be honest, it's not just race, the intersectionality once you cut in the sex, once you cut in your religion and the intersectionality is not small. It's huge, right? So I've dealt with when I was doing the race work for 18 months. I had dealt with what 22 cases of them. Uh I think 17 were women of color. Uh uh So, you know, excuse and I think let's also not ignore things about things that prejudices we ourselves have right within our own communities. I mean, I talked about IM GS being one but we're not right. We have our own differences based on religion. We have our own misogyny. I come from a South Asian background. Uh It does have its own misogyny. However, what much we want to deny it, it does sit amongst us. It's uh so there is that, but one thing we want to do is why could we not look at appointing somebody in each trust but based on the right values would look at these cases. Racism is something we don't wanna talk about. There's also the political rhetoric which stops us from doing it. We shall see how that changes across. But um many people are very afraid of calling out racism as it sits. Racism exists in the NHS, sexism exists in the NHS. There's no question about that and anybody who's saying it doesn't exist is not looking around, then you sort of uh sort of pull in a little bit of xenophobia as well. They all exist, right? I mean, as I said, the NHS is just a reflection of society. So I think to your question, one of the things we would want to do is exactly explore that in, in each area, right? So which is why my position in the Royal College of Physicians, why I've gone in because I don't have any focus rules apart from making sure that international medical graduates are categorically being looked after. What is the physi, what is the R cps role? Uh I haven't seen anything major on IM GS or L EDS or SAS Doctors and we need to do that. So I think having those organization as a power and sort of going there with the GMC hat on and saying, I want to tackle this as the GMC person probably gives a lot more punch to it. And I think that's what we would like to do. Uh, I encourage anybody who's in any position of power or senior to step forward. And I think that's what I keep on saying this, this NHS is full of Im Gs, right? I mean, absolutely blazing with the Im GS. Why is it just one Samir and one me and what? That, that's not true. That's not right. A lot of Im Gs are in very senior positions and they have to step up and if they don't step up, then we need to find people who be willing to step up. So that's my, that's what I like to change in the NHS is encourage more people to do what I'm doing, step up and help, you know, your folks. So, you know, and I'll finish with this. Don't forget the power of numbers right at the moment, the I MG numbers are huge power in numbers is a big, big thing. So I think if you're together, changes can be brought, look at the changes that are being brought right now by yourselves as trainee doctors in the whole conversation that's going on around the country. On PA A suddenly everybody's talking about it, right? Every college GMC BMA. So you can change the narrative. And I think IM GS are very, very important part of it. So, um you know, and, and I think that's important as we go along and that's the message I would leave for everybody. So um yeah, that, that's pretty much, I mean, promos made a point about is your own agent consultant supporting says you go to train the top, you know, you're right. And as I said, skin is not kinship. It's about values. It's about the right values just because they're from your own country will not mean uh what you are. And she has made a lovely comment. I'll, I'll end with that. She said I would like to have confidence when I grew up. You are grown up, you are grown up, you're, you're a doctor, you're a senior, you're good, you're grown up. So I think we are, we are here. What I see our position is, is to support you and stand by you with our privilege. I have the protection you don't. So when you get stuck, sort of, you know, it's my job to try and help you with, you know, and Rachel knows about my, I'll take on anybody and anybody that's pretty much my reputation. But, but that's because of the position, right? I do my work in the National Diabetes Space I have that power. So that's the, the least I can do with the, with the privilege to try and help. Thank you so much. OK. Thank you for those comments. And that's exactly why we wanted path on the panel together with our speakers. So we're at 2022 we've got eight minutes left. So I think this is a perfect time to just go through, take home point. So um if all of our speakers could just get their cameras back on and my, please feel free to give a take home point for a minute or to two minutes. Um If you don't have a take home point, you can instead answer my question uh which is just put simply what inspired you to go into leadership. So either answer that question or a take home point. Um So if we go to Rachel first, we'll then go to um Hab PAA and end with Samir. Yeah. Firstly, thank you, Kim for moderating this so expertly. And um yeah, I just thank you to all the other speakers. Thank you for um thank you to your audience for just being such an engaged interactive audience. And um I think I just want to firstly say um I, you know, it is true what pa says that moving to another country, especially if you don't have family, especially with you. If you don't have support is incredibly hard. And I sometimes think we don't recognize that you know, we've done such a huge thing. We are stronger than we realize. And um we take making a really brave decision to come. So I think the first thing I want to say to all of you is, you know, just well done and always just remember that you are so much stronger than sometimes, you know, we give ourselves credit for. And I just also want to echo the point that there is so much now that's happening to support IM GS that you are seen, you are valued. And I think more and more, hopefully, the sentiment will be that you're not just valued, but you're welcomed and you're hopefully supported to just thrive in the NHS if um there's any way that I can help or we can sort of share even as sort of the FML M TSG if we can kind of make that transition easier to support you all in that journey. That's exactly what at least my role is about. And I think this webinar has um sort of inspired me to sort of take that all the more seriously and, and do some work in that space. So um my thing is to just say, you know, congratulations for just taking the step, taking the plunge and actually getting here and that we will get through this together and I'm sure there is a path for all of you to thrive in. Yes, thank you, Rachel. We'll go to Hab next Um I echo what Rachel said about sometimes we underestimate how far did we like, how did we come or have we come in in our like journey as a condition as an and as a human beings as well? Um I also would like to say I MG support. Mm I don't want my word to be taken in like a wrong way. But I think there have been a trend about I MG support so many people talking about it, but so much less has been done in their local areas or at the, at the regional roles. I would like to say um I MG support takes a lot of passion, needs a lot of passion, a lot of understanding a lot of investment in into the case of um supporting IM GS and talking about them. Um So I just do like would like to say if anyone of the international medical graduates. Um It doesn't matter how new they are to the NHS. If you are passionate about supporting yourself or supporting your colleagues, please step up your game and adjusting to the NHS system. Is it like needs also adjust like some sort of adjustment from for our mentality and our at our like how we carry out how we carry ourselves as well in the NHS. So it's a learning journey. You keep learning every day from your colleagues, how to communicate, how to talk, how to, how to challenge and trust yourself. If you feel like you haven't been treated properly or there is anything you would like to take further, make sure there is. Um like there is a support network around you speak to your supervisors. They are not only there for like academic purposes, they uh they are there to help you as a human being, as a trainee and as a, as a doctor. Um so well done on your achievements so far and best of luck for you in the NHS. We are around. If you would like to chitchat about anything. We have all been there as a start struggling a bit. And then I think like looking back at the our journey now, I think we have um we have, yeah, we have developed, we have evolved and we are better clinicians and human beings. Now, thank you so much for those uh warming words. Uh hab we'll go to er and then si know you've already done a bit of a closing speech but any major take on points. Yeah, I mean, I'm gonna, you know, I love my Bollywood so I'm gonna leave you with a Bollywood thing to sort of always sort of consider, right? So there's a famous uh line, you know, which I love, I generally love, you know, which in simple plain terms means if you really, really want something from the heart and the whole of the world will get together to try and make it happen, you know, and I, you know, I'm not doing this uh in my life. I've been very, very fortunate. Blessed in my specialty world. I've done pretty much what I want to do my next 5, 10 years. This is it trying to help I MG. So, you know, let's play. And you're, you've got strength in numbers stand by and we can do it. There's no reason we can't. Thank you, Pat. I almost understood the entire line. You said almost um semi finally, any, any words before uh before you uh wrap up, uh it's really difficult to, you know, uh go after path after that. But I'm, I'm gonna try something as well. So a lot of people may be familiar with uh uh especially those who speak Urdu and Hindi. So, one of the things that she said was uh and that roughly translates to uh elevate your status to such a level that got uh uh they ask you about what you, where you want to be and what you want to do. So essentially as, and, and uh uh others have been saying that uh you know, you need to find those opportunities and uh follow your passion. It, it may be something you know, with very clinical, I want to improve that, you know, the outcomes of epilepsy or I want to give better support to international medical graduates. So whatever, one thing you identify, just go with that passion and try and you know, you will, you will fail a couple of times. But uh finding the right mentors and having that uh right time and right place. Uh you will get there with whatever you want to achieve. And uh yeah, we are all here for you. Thank you so much and thank you to all of our speakers. We've got a minute left and I'm gonna try and finish on time. But I want to thank you all for all the wise words you've shared today, your personal stories, your challenges and how you've overcome them and for leaving us on such an inspirational note we've heard from Rachel that actually you guys are strong. You've made it here to the NHS to the UK. We've heard from Hab saying, well, actually, people are talking more about MGS, but we also need more action as well. We've heard from path that actually the strength in numbers and that um skin is not necessarily kinship if we've got that right. But we need to stand together. And finally, we've heard from Samir that we need to elevate ourselves and actually aim for the skies. And that's what I wanted to leave you all with because actually the words we've heard from our speakers perfectly epitomize our strategy here at FML M at the trainee steering group. We want to enhance the I MG experience as well, whether you're a local employee, doctor or a trainee as well. So Rachel's working on some fantastic resources that she'll send out to all of you guys as well. But we will be hopefully following up with a, a secondary webinar as well. So thank you to all of you for attending, for taking out your evening to listen to our speakers for engaging in this topic and this discussion and we wish you truly the best. Um We know that we're expecting lots from all of you and hopefully we'll be seeing the fruits of our speakers labor and also your neighbors as well. Take care. Everybody, enjoy your evening.