Retention Charter Domain 1, action 1.1
Action 1.1: Deliver robust and holistic induction programmes with enhanced support available for new psychiatrists, those transitioning between career stages and/or returning to work after career breaks, and International Medical Graduates (IMGs).
Action 1.1 is part of Domain 1 of the RCPsych's Retention Charter for employers - which relates to creating a culture of belonging.
What stage is your organisation at?
Use this maturity matrix to assess what stage your organisation is at, in terms of Action 1.1.
Standardised induction programmes are in place for all new starters and people returning to the organisation including organisation-wide inductions and local departmental inductions.
Enhanced induction programmes and support packages exist for specific groups in need of additional support such as IMGs, doctors new to psychiatry, those transitioning between career stages, those with disabilities, and Psychiatrists returning to work/training after career breaks (e.g. following periods of ill health, carer leave, parental leave, sabbaticals, research time, etc). Enhanced induction programmes for IMGs include providing support before they migrate to the country and on arrival.
Induction programmes and support packages implement any reasonable adjustments that might be required so that Psychiatrists with disabilities or other needs can fully participate.
Provisions are in place for induction activities to be repeated, as required, at various points such as when Psychiatrists move roles, when organisational procedures change, and/or when competencies/knowledge need updating.
- Induction programmes are highly personalised with supervisors/line managers routinely providing additional training, information and resources according to the specific needs/circumstances of individuals and reasonable adjustments.
- Simulation training is offered during induction programmes for IMGs and doctors with limited prior experiences of psychiatry to enhance their skills and confidence as they settle into UK psychiatric practice.
- Enhances support is available following induction for those requiring this (eg IMGs new to UK psychiatry services) such as enhanced supervision, clinical shadowing periods, and delayed starts to the on-call rota.
- Feedback mechanisms are in place to evaluate the effectiveness of induction programmes. These mechanisms capture feedback both on completion of induction and continually afterwards as people settle into their roles.
- Induction programmes apply the principles of co-production, involving the target audience and people with relevant lived experience in their design and delivery.
- Social integration is activity encouraged when people joint the organisation, with peer connections between new starters and those already in post being facilitated through organised events and continuing social activities.
- Alongside induction, a system of buddies, champions and/or mentors exists with whom psychiatrists requiring enhanced support can receive 1-1 advice, check ins and follow-up on a regular basis.
- The effectiveness of the induction and support programme/s offered is reflected in formal feedback and data relating to patient safety and doctors' health, wellbeing and confidence. This feedback/data is contiuously utilised to make iterative improvements to induction programmes and to showcase the work of IMGs.
Advice and recommendations
Review the content of induction programmes and ensure that these cover the clinical, educational, pastoral, and practical needs of Psychiatrists joining the organisation. Embed informal networking opportunities and social events into these programmes to promote positive working relationships and peer support, such as ‘welcome events’ and ‘meet and greet’ initiatives.
Provide bespoke training for supervisors on the specific needs and challenges encountered by IMGs, Psychiatrists returning from career breaks, those working less than full time (LTFT) or moving between major career points, and Psychiatrists with long-term illnesses or disabilities.
Provide all doctors with induction booklets and repositories of information/resources to assist them with settling into the organisation and their professional roles, including signposting them to relevant guidance and support from external organisations (e.g. the GMC, BMA, RCPsych). Update these resources/booklets regularly in line with new guidance, policies, and feedback.
Identify which groups of Psychiatrists need additional support and work collaboratively with them to design tailored induction programmes addressing their specific needs, applying the principles of co-production. For example, involve IMGs with lived experience of adjusting to the UK healthcare system in the design and delivery of induction programmes for future IMGs.
Offer online workshops/discussions for IMGs preparing to move the UK so that they are aware of important practical information and arrangements required for a smooth transition including information about: immigration and Visas; UK laws; housing; banking; transport and driving; utilities; phone and broadband contracts; council tax; access to local supermarkets, restaurants, schools for children, and places of worship; registering with a GP and dentist; GMC registration; and setting up medical indemnity.
Provide timely support for IMGs soon after arrival into the UK by considering offering ‘meet and greet’ initiatives at airports, temporary interim accommodation, and salary advance schemes to support with the initial upfront costs of re-location.
Implement buddy schemes and/or mentorship programmes to support groups of Psychiatrists that might need additional support such as new starters, IMGs, Psychiatrists moving through major career points (e.g. new Consultants), and those returning from career breaks. Provide training for buddies/mentors on the specific challenges faced by these groups to increase their knowledge, skills, and quality of support offered. Consider matching Psychiatrists to buddies/mentors who work in a nearby and similar work location/department to increase the specificity of support offered and convenience of arranging meetings.
Recruit people to ‘champion’ roles to support and advocate for specific staff groups (e.g. IMG champions, LTFT champions, Return to work champions etc). Involve these champions in the design and delivery of induction programmes, ensuring that colleagues are aware of people in these roles and how to contact them.
Work with the organisational medical education team to arrange simulation training and enhanced educational support for individuals returning to clinical practice after career breaks and/or those with limited prior experience of UK psychiatry (e.g. IMGs, foundation doctors, CT1 doctors). This enhanced support might involve clinical shadowing, a period of working with a more experienced peer/buddy when starting on-call responsibilities, and additional supervision.
Regularly evaluate the content, quality, and effectiveness of induction programmes, including the support provided to doctors transitioning between career stages and returning from career breaks. This should include collating feedback (e.g. through surveys) on completion of induction programmes and obtaining follow-up data which assesses longer-term effects of the support being offered.
Links and resources
- The Advisory Conciliation and Arbitration Service (ACAS) provides guidance on supporting employees to settle into an organisation and running induction programmes. This document is not healthcare specific but contains several relevant principles and useful information.
- A comprehensive guide on ‘Welcoming and Valuing International Graduates’ has been produced with input from various organisations including NHS England and NHS Improvement, Health Education England, the General Medical Council, British Medical Association, and Medical Protection Society.
- An e-learning module has been created to introduce IMGs, employers, and educators to the national induction programme for IMGs.
- The RCPsych has created 'A Guide to Living and Working in the UK for International Medical Graduates'
- The RCPsych has a dedicated webpage of resources for supporting foundation doctors completing psychiatry placements, including a supervisors guide and slides available for use during induction presentations
- The RCPsych has a dedicated webpage for resources relating to coaching and mentoring which includes information about arranging taster sessions.
- The Academy of Medical Royal Colleges (AoMRC) has produced ‘Return to Practice Guidance’ for doctors returning to the same area of clinic practice after being absent for more than three months or after having their licence restored by the GMC
- NHS England have a dedicated webpage on ‘Supporting doctors returning to training after time out’ (SuppoRTT). Each region has a specific ‘menu’ of support options for doctors returning to training, and the below webpage contains links to various local office pages.
- NHS Learning Hub provides a ‘Reflective Roadmap for Returner Resident Doctors’ which can be used during supervision sessions to help them reflect on their needs and progress.
- NHS England provides a webpage containing links to an e-learning module on ‘building a more supportive culture’ for doctors to returning to training and a video exploring the perspectives of resident doctors, consultants, academics, and NHS leaders.
- The General Medical Council has created a mentoring toolkit to help organisations establish and run mentoring schemes.
- The RCPsych Psychiatric Resident Doctors Committee (PRDC) podcast series titled ‘You Are Not Alone’ has an episode exploring the personal experiences of IMGs in and how this has shaped their roles as current leaders and educators in psychiatry (episode 5).