All You Need to Know about Clinical Attachments in the NHS: Step-by-Step Guide for International Medical Graduates

Are you an international medical graduate (IMG) aspiring to practice medicine in the UK? If so, gaining clinical work experience through a clinical attachment in the National Health Service (NHS) could be your pathway to understanding the role of a UK doctor and familiarizing yourself with NHS operations. Here's everything you need to know, step by step:

Step 1: Understand What a Clinical Attachment Is

A clinical attachment offers IMGs the opportunity to gain practical hospital experience while gaining insight into the UK's medical processes and systems. Typically lasting two to four months, clinical attachments involve observing a consultant in a relevant speciality within the NHS. As an observer, your duties are limited, primarily involving observing consultations, participating in patient administration, and taking patient histories.

Step 2: Ensure Eligibility

Before applying for a clinical attachment, ensure you meet the eligibility criteria, which typically include:

- Successful completion of a criminal records check ( this will be initiated by the trust).

- Proof of identity documents.

- Language proficiency certification (if not a native English speaker).

- Occupational health clearance from the NHS trust ( you will need to provide a record of your previous vaccine Records, if not they will do blood tests).

- Satisfactory references from referees cited in the application form.

Step 3: Explore Pathways to Finding Attachments

Apply for Established Clinical Attachment Programs: Certain hospitals don't even have a formal procedure in place to help with clinical relationships. In this instance, setting up the supervision, they will need you to get in touch with Human Resources (HR) as soon as you have located a Consultant who is willing to do so. Work closely with HR and the consultant to ensure that the agreed-upon attachment is completed.
Some NHS trusts or hospitals offer formal clinical attachment programs. Check their websites for application forms, requirements, and fees. Examples include:

Contact Individual Consultants: Research hospitals and departments of interest, then email consultants directly to inquire about clinical attachment opportunities. Customize your email to include personal details, reasons for seeking the attachment, your medical background, and your level of clinical expertise. LinkedIn as a professional platform is great for finding people who work in the institutions you are interested in. You can reach out to the people you are interested in ( who are active on LinkedIn) , and can make introductions. You probably won’t have an immediate response, but many do come back to you with a response.

Contact Individual Hospitals: Reach out to hospital education departments or directors of medical education to inquire about clinical attachment processes. Some hospitals may facilitate attachments once a supervising consultant is identified.

Seek Recommendations: Ask friends, colleagues, or fellow IMGs who have completed attachments for recommendations on consultants or hospitals open to supervising clinical attachments.

Utilize Social Media and Networking: Join IMG Facebook groups and forums to seek advice and recommendations. Engage with individuals who offer help or recommendations for finding clinical attachments.

Step 4: Prepare Your Application

Craft an email to the consultant or Human Resources and then tweak it for different circumstances. Here is the format suggested by BMA:

  • your details

  • your reasons for wanting to do a clinical attachment

  • a brief outline of your medical background, your career ambitions, why you are interested in this department/field in particular and what you hope to get from the clinical attachment

  • your level of clinical expertise and your previous work experience in the health sector

  • What stage in the process of GMC registration you have reached (i.e. whether you have taken/passed the IELTS / OETS, PLAB 1 or PLAB 2)

  • Current CV ( for guidance on how to design your CV, click on the free Course How to get your CV Shortlisted for NHS)

Step 5: Follow Up and Stay Engaged

After sending your applications, follow up with consultants or hospitals ( Human Resources) to inquire about the status of your application. Once confirmed, maintain communication with your supervisor and hospital HR to finalize arrangements for the attachment.

This will include,

  1. The length of the attachment

  2. What departments you are going to be in

  3. Who do you report to ( if you do not have a designated consultant)

  4. The paperwork that you need to fill in

    Another important thing is to ask HR about accommodations. Staying in hotels for a length of time can be very expensive. So if there is space in the temporary accommodation, this can save you the headache of commuting and also can be quite economical. If there is no such option, then look for Airbnb, Youth Hostel Accommodations or hotels in advance. Check-in Google Maps that there are regular public transport services available before you book. Sometimes the earlier you book, the cheaper it can be.

Step 6: Make the Most of Your Attachment

  • During your attachment, stay engaged and proactive. Show up in time. Go to handover, audit governance and MDT meetings. Take notes on how they are doing handover, because for a junior doctor that will be most important for you.

  • Network with medical professionals, participate in quality improvement activities and demonstrate enthusiasm and willingness to learn. Go to lunch with them, and ask about their aspirations and career plans. Get to know the nurses, as they can give you valuable tips and tricks. If you make any friends or find any inspirational colleagues, then stay connected by social media. Most will consider Facebook only for close friends and families. So, have an Instagram / Twitter (X), or LinkedIn account ready.

  • Keep a log of your experiences and achievements to aid future job applications. I will soon publish a template about what experience you should look out for and try to gain experience in ( so Subscribe to the newsletter). When you provide this to your consultant, it will be easier for him/her to provide you with a glowing reference letter.

This shows your initiative and organisational skills. Something to be kept in mind, if you are asking for a future job!

Step 7: Express Gratitude and Stay Professional

As excited as you are about your placement, remember that none of them have an incentive to help you. Sometimes they can appear closed off and can be a bit scary. So you can make yourself endearing by offering to help. Offer to make the tea or coffee if they are busy like during on-call (Offer only if you are making one for yourself) or bring in a box of chocolates with a thank-you card at the end of your placement. ( We all love a thank you card!). This could be the consultant ( especially if you are going to ask them for a referral letter) or any team member who supervised you, the host team that you shadowed and the ward where you spent most of your time. A simple card will go a long way.

These modest actions might not seem like much, but they show that you're trying your best to blend in and be a team player. Of course, it also demonstrates your gratitude in addition to this. Maintain professionalism and courtesy throughout your attachment, as positive impressions may lead to future opportunities.

By following these steps, You can navigate the process of finding and securing clinical attachments in the UK NHS. Remember, persistence, professionalism, and proactive engagement are key to making the most of this valuable opportunity. Good luck on your journey to gaining clinical experience in the NHS!

Resources

  • How to prepare for Interview - Summary

    Job interviews in the medical field can be nerve-wracking, but proper preparation can significantly increase your chances of success. In this comprehensive guide, I will break down a transcript from one of our speakers, Mr. Tanvir Hossain in the recent career webinar on how to excel in medical job interviews. These insights will help you navigate the interview process with confidence.

    1. Understand the Job Details and Requirements: The first step in medical job interview preparation is to thoroughly understand the job description and person specification. Align the requirements with your own skills and experiences to identify your strengths that match the position.

    2. The Power of a Pre-Interview Visit: While not mandatory, a pre-interview visit can provide you with invaluable insights into the workplace. It allows you to meet potential colleagues, gauge the work environment, and gather information to discuss during the interview. Demonstrating that you've taken the initiative to learn about the hospital and team can leave a positive impression.

    3. Navigating Different Interview Formats: Interview formats can vary, ranging from traditional question-and-answer sessions to more structured scenarios and stations. Be prepared for different types of medical job interview questions, such as icebreakers, clinical inquiries, health care management interview questions, and leadership challenges.

    4. The STAR and SPIES Mnemonics: For crafting well-structured responses, use mnemonic frameworks like STAR (Situation, Task, Action, Result) and SPIES (Situation, Patient Safety, Information, Escalation, Support). These tools help you organise your thoughts and provide clear, concise answers to various interview questions.

    5. Know Your CV Inside Out: Review your CV thoroughly and anticipate questions that might arise based on its content. Highlight key achievements, but also be ready to discuss any areas for improvement or challenges you have faced. Interviewers appreciate candidates who are self-aware and proactive about their development.

    6. Consider Interview Courses: Consider enrolling in interview courses tailored to your level and field. These courses often provide practise questions, strategies for answering common queries, and valuable insights from experienced professionals. But these are by no means, mandatory to succeed. What you need is a drive to do research and practice.

    7. Handling Ethical Dilemmas: Prepare for questions about ethical scenarios or challenges. Approach these questions with patient safety in mind, and consider using the SPIES mnemonic to structure your response: Situation, Patient safety, Information, Escalation, and Support.

    8. Showcasing Leadership Skills: Leadership scenarios can range from managing conflicts among colleagues to making difficult decisions. Highlight your problem-solving abilities, teamwork, and empathy. Use real-life examples to demonstrate how you have navigated leadership challenges effectively.

    9. Addressing Weaknesses: When asked about weaknesses, choose an area where you have worked to improve. Discuss how you have recognised the weakness and taken steps to enhance your skills or address the issue.

    10. Importance of Logbooks: If applicable and especially in surgical specialities , maintaining a logbook of your cases and reflections can showcase your commitment to continuous learning and patient care. It is an additional tool to demonstrate your dedication during the interview.

    Preparing for medical job interviews involves understanding the role, aligning your experiences, and crafting thoughtful responses. With the STAR and SPIES frameworks, thorough CV knowledge, and awareness of ethical considerations, you will be better equipped to shine during the interview process. Incorporate these strategies into your preparation to increase your chances of landing the medical job of your dreams.

  • Steps to Integrate Teaching into Your Medical Career

    Are you ready to unlock the incredible potential of teaching within your medical journey? Dr. Ahijit Chowdhury gave a talk about how important teaching is in building your CV. Let us break down this transformative process into actionable steps.

    1. Recognize the Significance: Understand that teaching is not just an add-on; it is a fundamental responsibility that can shape the future of healthcare. Embrace the idea that imparting knowledge is a crucial part of your role.

    2. Two-Way Learning Street: Realize that teaching benefits you as much as your students. It reinforces your understanding and keeps you updated with the dynamic medical landscape. Prepare to enhance your skills while contributing to others' growth.

    3. Leadership Amplification: Use teaching as a platform to highlight your expertise, inspire fellow colleagues, and enhance your leadership skills. Teaching and leadership go hand in hand, creating a positive cycle of growth.

    4. Boost Your CV: If you are aiming for advanced medical programs, remember that teaching experience is an asset. Engage in organizing sessions and gathering feedback to add weight to your CV during applications. The scoring system considers your teaching involvement, so don't be shy to get engaged. Organizing teaching sessions and collecting feedback will give your application a significant boost.

    5. Invest in Training: Acquire the necessary skills to become an effective medical educator. Pursue teaching qualifications such as PG Cert and PG Diploma programs or even master's-level courses. Reputable, often cost-free options are available through various universities.

    6. Overcome Apprehensions: Don't let initial intimidation hold you back. Start small, and with practice, your teaching abilities will flourish. Embrace the journey of being a lifelong learner, consistently reflecting and refining your teaching methods.

    7. Make an Impact: Understand that teaching is not just about sharing knowledge within the medical community. It helps you create a tangible difference and evolve as a medical professional yourself.

    8. Embrace Growth: Whether you're a newcomer or an experienced practitioner, teaching can accelerate your personal and professional development. Embrace the opportunity to make a real difference in the lives of patients, colleagues, and yourself.

    Remember, integrating teaching into your medical career is not just an option—it is a transformative path that can elevate both your skills and your impact on the healthcare field. So, take these steps, embrace the journey, and watch as teaching becomes an integral part of your fulfilling medical career. To the full video, click on the link https://youtu.be/ZePUIoTo80w

How to get Into Research ?

Are you wondering how to build your portfolio for research? Are you struggling to figure out where to start? Dr. Mahjabin Islam, A neurology trainee and NIHR fellow discussed ways you can get into research in her talk in our webinar - How to Build Your CV? The video is available in the link section. here is a brief summary of her talk :

- Two essential aspects were discussed: presentation and publication, which hold significant value for enhancing my application.

- The benefits of oral presentations at both national and international meetings were highlighted, emphasizing the potential to earn 7 points and gain recognition in competitive contexts.

 - Starting with smaller endeavours such as case reports, editorials, or letters to the editor was suggested for initiating publication activities.

- The importance of engaging in reviews for a strong research profile was underscored.

- A hierarchical progression in research was introduced, suggesting the commencement with case reports and a gradual transition to more intricate studies. The research process encompasses selecting a topic, identifying a problem, formulating a question, designing a study, acquiring ethics approval, conducting research, and sharing findings through presentations and publications.

- The value of mentorship, particularly from individuals possessing robust statistical expertise, was stressed.

- Beneficial resources like YouTube channels Amina Younis and talk by Andy Stapelton were recommended for accessing research guidance.

- Expressing enthusiasm and interest about research to potential mentors was deemed essential for initiating research involvement.

- Commencing with smaller projects and proactively seeking research prospects were advocated for fostering growth.

- Reflecting on personal experience, Dr. Islam shared how research contributed to confidence-building, obstacle overcoming, and new opportunities within the medical field.

HOW TO DO CLINICAL AUDIT?

Dr Sarah Amin, an acute medical trainee, discusses the concept of clinical audit in our career webinar. She explains that a clinical audit is a quality improvement process in healthcare aimed at reviewing and comparing clinical practices against set standards to identify areas for improvement. Sara shares her experience of initially finding clinical audit intimidating and unfamiliar but later understanding its simplicity and effectiveness.

She outlines the key stages of a clinical audit:

1. Choosing a Topic: Selecting a relevant topic that can lead to potential benefits for patient care.

2. Forming a Team: Building a team of professionals, either within the same specialty or multidisciplinary, to work on the audit.

3. Setting Aim, Objectives and Standards: Defining the objectives of the audit and the specific standards that will be assessed.

4. Data Collection: Gathering relevant data based on the chosen standards.

5. Data Analysis: Analysing the collected data, often using tools like Excel.

6. Presenting Findings: Sharing the results of the audit with the team, often through presentations or posters.

7. Implementing Changes: Identifying areas for improvement based on the audit results and implementing changes to clinical practice.

8. Re-Audit: Conducting a follow-up audit to assess whether the implemented changes have led to improvements.

Sara emphasizes the importance of effective communication within the team, consulting with colleagues, and reaching out to clinical audit leads. She mentions that clinical audits are valuable for professional development and applying for training posts, and completing a full audit cycle is important for recognition.

Sara's presentation encourages healthcare professionals to engage in clinical audits, overcome initial apprehensions, and contribute to improving patient care through evidence-based practice.

How to Get into Medical Leadership?

In this video, Mr.  Samail Shajahan (cardio-thoracic surgical trainee in Oxford)  discusses the topic of getting into clinical leadership or leadership. Shajahan emphasizes that leadership can be a gray area, and understanding where to start and what leadership means can be challenging. An example of leadership is highlighted through an event organized by Tani and Rafida Apple, which required structured planning, meetings, and overcoming potential difficulties. Mr. Shajahan goes on to define a clinical leader as a doctor who envisions service improvement, addresses healthcare limitations, and shares these visions with fellow physicians. The concept of effective leadership is explored, focusing on making a positive difference and facilitating innovation and change within clinical practice.

He introduces the idea of "TOC" – Transparency, Openness, and Candor – as crucial qualities for effective leadership. Transparency involves honest communication, even when results aren't positive. Openness means speaking up boldly to address concerns, while candor requires addressing situations with honesty and apologies when needed. Shajahan explains that leadership opportunities exist at all stages of a healthcare career, from medical school to becoming a consultant. Teaching and training programs, setting up journal clubs, and organizing health camps in underserved areas are ways to exhibit leadership skills. Planning, managing resources, and fostering open communication emerge as key aspects of effective clinical leadership.

Here are some actionable strategies from his talk:

1. Identify a Problem: Start by identifying a problem or area of improvement within healthcare that you are passionate about addressing.

2. Build a Team: Form a team of individuals who share your vision and are willing to contribute to solving the identified problem.

3. Communication and Transparency: Maintain open and transparent communication with your team members. Clearly explain the goals, challenges, and potential outcomes.

4. Delegate Tasks: Assign tasks and responsibilities to team members based on their skills and expertise. Distribute the workload effectively to achieve the desired outcomes.

5. Plan and Backup Plans: Develop a well-thought-out plan to tackle the problem. Consider potential obstacles and create backup plans to handle unforeseen challenges.

6. Execute the Plan: Put your plan into action, ensuring that each team member knows their role and responsibilities. Monitor progress and adjust strategies as needed.

7. Feedback and Encouragement: Continuously provide feedback and encouragement to your team. Acknowledge their efforts and recognize their contributions.

8. Resource Management: Efficiently manage resources, whether it's organizing supplies for healthcare initiatives or coordinating logistics for events.

9. Teaching and Training: Organize educational programs like workshops, courses, or journal clubs to contribute to the professional development of your peers.

10. Reflect and Analyze: After implementing your plan, analyze the outcomes and assess whether your efforts have made a positive impact.

11. Adapt and Innovate: Use the feedback and insights gained to refine your strategies and find innovative solutions to ongoing challenges.

12. Lead by Example: Demonstrate the qualities of a clinical leader by being transparent, open, and approachable. Inspire others through your actions and dedication.

13. Appreciate Team Efforts: Celebrate the achievements of your team and show gratitude for their hard work and commitment.

14. Continuous Learning: Stay updated on healthcare trends, policies, and advancements to enhance your leadership skills and knowledge.

 15. Personal Growth: Cultivate qualities like effective communication, problem-solving, and adaptability to continually improve as a leader.

Remember that clinical leadership opportunities exist at every stage of your career, from medical school to becoming a consultant or medical director. By following these actionable steps, you can actively engage in clinical leadership and make a positive impact on healthcare practices and patient outcomes.

Mastering Effective Communication - Dr. Rafida Khan

Greetings everyone, I am delighted to have this opportunity to share my insights on communication within the healthcare sector, drawing from my diverse experiences and roles. As a General Practitioner partner in Blackpool, I wear multiple hats, including serving as a Clinical Director in the Blackpool Primary Care Network, a GP trainer in the northwest, and a mentor to both GP trainees and allied healthcare professionals. Today, I'd like to explore the nuances of communication in the NHS and its pivotal role in fostering collaboration, understanding, and success.

My NHS Journey and Role Snapshot

With a journey spanning 11 years in the NHS, I've ventured through different medical domains such as general surgery, pediatrics, and internal medicine. However, my heart found its true calling in general practice. Alongside my professional journey, I'm also a dedicated mother to two toddlers. As an ardent Manchester United fan, I find passion in both medicine and my favourite football club.

The Essence of Communication: A Holistic Approach

Communication, to me, is the art of exchanging information with clarity, empathy, and understanding. When I began my NHS journey, I quickly learned that effective communication is indispensable. From the outset of a message to its delivery, every step holds significance. However, the true essence lies in the receiver's understanding of the information conveyed. In England, communication differs significantly from my home country, emphasizing the importance of adaptation.

Types of Communication and Potential Pitfalls

In the realm of communication, three dimensions play a crucial role: verbal, vocal, and visual. In my experience, certain challenges persist, including the use of jargon and language differences. As medical professionals, we tend to rely on complex terminology that might hinder clear understanding. Furthermore, cultural nuances and attention spans can impact successful communication.

Communication's Pervasive Significance

Effective communication serves as a gateway to numerous opportunities within the NHS. It paves the way for collaboration, helps professionals stay updated with evidence-based practices, and demonstrates competency and ambition. However, it's crucial to acknowledge that poor communication contributes to a substantial portion of workplace errors and complaints. Approximately 70% of workplace mistakes stem from communication breakdowns.

Navigating Conflict and Negotiation

Conflict is an inevitable part of any workplace, but its impact can be mitigated with mindful communication. Clear communication eliminates assumptions and promotes understanding. Seeking clarification, withholding judgment, and embracing deliberate silence can significantly reduce conflict. Negotiation, another vital aspect, thrives on effective communication. It involves focusing on shared interests, generating possibilities, and adhering to objective standards.

Harnessing Influence and Impact

To exert influence through communication, authenticity, and honesty are paramount. I recommend the MINDSPACE framework, a valuable tool to enhance persuasive communication. This framework emphasizes being genuine, showing the benefits to others, and maintaining unwavering commitment. By integrating these principles, you can master the art of influence and impact.

Communication Within NHS Domains

In the NHS, communication can be divided into four distinct categories: communication with management, colleagues, patients, and your team. Each category demands tailored approaches. For instance, when communicating with management, clarity, and precision are vital in emails. When interacting with colleagues and patients, empathy, inclusivity, and active listening foster rapport and understanding. Within your team, building alliances and communicating aspirations ensure a supportive network.

In conclusion, communication is the bedrock of success in the healthcare realm. Whether you're navigating conflict, negotiating, or influencing, effective communication opens doors and fosters collaboration. By embracing its principles and nuances, we can collectively elevate the quality of care we provide and the experiences we deliver.