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Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire
  1. J Mahajan1,
  2. P Stark2
  1. 1Rotherham District General Hospital Trust, Rotherham, UK
  2. 2University of Sheffield, Sheffield, UK
  1. Correspondence to:
    Dr J Mahajan
    Rotherham District General Hospital Trust, Rotherham, UK;jugnu.mahajan{at}


Objective: To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK.

Methods: Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4–5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built.

Results: Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers.

Conclusions: Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.

  • IMG, international medical graduate
  • NHS, National Health Service

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  • Published Online First 25 August 2006

  • Competing interests: None declared.

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