“Hello, Thanks for having me. I am Chan Nyein Khin and I am a Trust Grade Foundation Year 2 doctor in acute internal medicine at Leicester Royal Infirmary. I am from Myanmar. I graduated from University of Medicine 1, Yangon in 2019.”
Reflecting on my 12-year-old self’s candy and non-sense midnight dream, I have always dreamt of being a physician - imagining myself in a white coat and with a stethoscope hanging around my neck. It is like a movie - holding the bleep and running through the hallway, doing chest compressions on the bed trolley from the ambulance while going into the resuscitation room and treating the patients in a very energetic manner. But now I woke up from my crazy dream and back to reality… it hurts, I’m joking!
I, Chan, passed the matriculation examination and entered medical school. The reason for becoming a med student was all because of my crazy childhood dream, I must admit. The decision of being an IMG doctor was implemented in my mind since the first day of medical school. But why the UK? It is one of the choices after comparing the most and least suitable options for being an IMG as a non-citizen doctor.
In terms of being an IMG doctor in the UK, I started preparing after graduation. Three steps are needed:
IELTS overall band 7.5 and individual 7 (or) OET grade B
PLAB 1 (theory test)
PLAB 2 (bedside and communication test).
The PLAB 1 test focuses on all specialities: General Medicine, Surgery, Obs and Gyn, Paeds, ENT, Epidemiology, Ethics, Oncology,Psychiatry, Palliative Medicine, Pharmacology and Radiology. It comes in the form of MCQ in the best of 5 choices. PLAB 2 is a bedside test - history taking, examination and management as well as communication stations including breaking bad news, discussion with demanding and refusing patients. All of these are about preparation and how much “you can commit and your consistency”. It was not an easy process to get to the UK - I invested my time and my mental thing. Studying for the PLAB 2 was like a whole new world for me - the healthcare system, the pathway/services and the way of communicating with patients. I have to adapt to all of these new things on my own without seeing it in reality; experiencing it only through books, so it was hard to memorise and I learnt it all by heart. I finished all 3 steps in 2021 and moved to Manchester for the PLAB 2 exam. Now, I am living in Leicester.
After I got my GMC registration after submitting and processing the files, I started writing my CV for job applications (you can apply via https://www.jobs.nhs.uk). It was quite competitive if one didn't have experience working as a doctor in the UK as a junior officer. The IMG doctor can apply for any position according to the essential and desired requirements but I strongly recommend starting from the bottom in order to learn and observe more about the NHS. After getting a number of interviews, I chose Leicester Royal Infirmary in acute internal medicine rotation as a non-training Foundation Year 2 doctor. The decision to work in medicine rotation is basically the new version of my midnight dream - I wanted to try imagining myself like in my crazy dream. But, my choice was right. I remembered clearly the very first day entering my base ward - the “geriatric ward”. I was welcomed by the consultant I had the privilege of shadowing and had many laughs and cries between them. I am really lucky to work in a very supportive and heart-warming environment pushing my everything to make me drive for medicine again. However, there are times when I feel like “Am I able to move forward? Am I able to devote my everything in the UK? Can I make it through? Can I be a better doctor? When I become a Registrar/Consultant, will I be a reliable person like them?” - there is 100% uncertainty about this new life in a new country.
The reality hit so hard - the healthcare system and their usage, the pathway, the management plan including the social plan, the multidisciplinary team, consent forms as well as DNACPR and advanced care plan discussions, breaking bad news and End of Life (EOL) care - I have zero knowledge of them and struggled to understand in reality. I never trained for it during my internship in Myanmar, and I learnt it only for the PLAB 2. So, searching for the meaning of the system in the NHS website is a part of my take-home-homework and I never felt ashamed of asking about something I don’t know. “Don’t lie to yourself and don’t pretend like you know everything. Don’t hesitate to ask. I am sure your colleagues are always there to help you”. Being honest and safe are what they expect from us.
During the day shift , I turn up every morning for ward rounds, prepping the notes and clerking the patient, then telling the story to seniors. I followed behind them carrying the patients’ notes, my head declining down and kneeling down in a caring manner, noting down every plan and comments from my seniors, completing dozens of tasks - making a referral, making a phone call, booking MRI/CT, requesting bloods, discussing with specialist, doing cannula/venepuncture/catheter and chasing the report and results. The on-call shift is like sailing a ship alone, making me regret ever thinking about my decision, holding the bleep and taking responsibility for every patient that I covered. Non-stop notifications in my bleep made my heart stop. If I am lucky enough, I could meet with a nice on-call registrar. Otherwise, it is a nightmare, managing the patient with complicated presentations and co-morbidities alone, making decisions alone while staying a safe doctor. At the end of the shift, I realised I only had one slice of bread. But it remained as a good memory like I had gone through it - bring a big smile and be proud of yourself.
During the meeting with my supervisor, he asked about my future plan and guided me to aim for “Internal Medicine Training” while encouraging me to take a risk and make myself struggle for about 3 months before application open for 2022 in November 2021. I started preparing for application scoring and studied for the interview (source - https://www.imtrecruitment.org.uk/about-imt/about-imt) and did the quality improvement project about elderly care in the trust. I am more than happy to share my experience about the IMT application process in detail, so please contact me and I am ready to answer everything.
I heard people started changing their mindset when they started university life. But I was not a student, I was an adult by the time I moved to the UK. Obviously, all my old behaviours and habits were difficult to fix. So, I must say it is hard to adapt in a new country with different cultures and languages including the greetings, different accents, weather, the office related processes, etc. But never forget to enjoy the work-life balance - a green flag for wellness. Try to engage with a new cycle of social life, meet new people and travel more. Having a chat a little bit about personal life with colleagues and consultants makes me feel closer and familiar with different cultures.
I am now just a 6-month-old IMG doctor in Leicester Royal Infirmary. There are always good days and bad days - some days you might just treat one critical patient and end the shift, some days you break bad news and cry together with the patient’s family, some days you might deliver good news while holding warm hands and another day you might get “thank you letter and gifts” for the kindness and care and some days there might be many laughs with colleagues. Among all aspects of the roller-coaster doctor life, I have overcome the difficulties little by little by adapting to the new life and studying. Be positive for every opportunity that is thrown to us. It has not been easy, being a doctor, living away from family is not a happy thing but Mark Zuckerberg and Steve Jobs saved me - I video call my mom whenever I feel stressed and never feel like I am out of this world.
This is the story of my IMG doctor pathway - still swimming and learning but trying not to sink yet. I don’t regret anything. When I look back, I am not 100% competent or on top of it, but I never thought my midnight dream would be my real dream.
Best regards
Chan Khin ( F2 )