title: Cultural dimensions in the transition of overseas medical graduates to the UK workplace.
abstract: BACKGROUND
  Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training.
  
  
  OBJECTIVE
  To examine whether Hofstede's cultural model may help us understand the changes doctors from other countries experience on coming to work in the UK, and to identify implications for supervisors and clinical teams.
  
  
  METHODS
  Telephone interviews were conducted with overseas medical graduates before starting work as a Foundation Year One (F1) doctor, followed up after four months and 12 months; and with educational supervisors. Data were analysed using a confirmatory thematic approach.
  
  
  RESULTS
  Sixty-four initial interviews were conducted with overseas doctors, 56 after four months, and 32 after 12 months. Twelve interviews were conducted with educational supervisors. The changes doctors experienced related particularly to Hofstede's dimensions of power distance (e.g. in relation to workplace hierarchies and inter-professional relationships), uncertainty avoidance (e.g. regarding ways of interacting) and individualism-collectivism (e.g., regarding doctor-patient/family relationship; assertiveness of individuals).
  
  
  CONCLUSIONS
  Hofstede's cultural dimensions may help us understand the adaptations some doctors have to make in adjusting to working in the UK NHS. This may promote awareness and understanding and greater 'cultural competence' amongst those working with them or supervising them in their training.
authors.affiliation: Durham University , UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Morrow
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rothwell
authors.forename: Bryan
authors.initials: B
authors.lastname: Burford
authors.forename: Jan
authors.initials: J
authors.lastname: Illing
mesh_terms: D003469:Culture; D004501:Education, Medical / Q000458:organization & administration; D005550:Foreign Medical Graduates / Q000523:psychology*; D005783:Gender Identity; D006801:Humans; D010817:Physician-Patient Relations; D011209:Power, Psychological; D013222:State Medicine; D035501:Uncertainty; D006113:United Kingdom