title: "That's your patient. There's your ventilator": exploring induction to work experiences in a group of non-UK EEA trained anaesthetists in a London hospital: a qualitative study.
abstract: BACKGROUND
  European health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London?
  
  
  METHODS
  We did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor's acclimatisation to the British system.
  
  
  RESULTS
  Acclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience.
  
  
  CONCLUSIONS
  Hospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for international staff to critically reflect on practice with local staff to acclimatise more effectively.
authors.affiliation: Education Training and Development, St Georges's Healthcare NHS Trust, Blackshaw Road, Tooting London, SW17 0QT, UK. Huon.Snelgrove@stgeorges.nhs.uk.
authors.forename: Huon
authors.initials: H
authors.lastname: Snelgrove
authors.affiliation: Clinical fellow in Anaesthesia, Frimley Park Hospital NHS Foundation Trust, Frimley Camberley, Surrey, UK. Y.Kuybida@googlemail.com.
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Kuybida
authors.affiliation: Anaesthetic Registrar, St George's Healthcare NHS Trust, Blackshaw Road, SW17 0QT, London, UK. markfleetuk@yahoo.co.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Fleet
authors.affiliation: Consultant in Intensive Care and Anaesthesia, St George's Healthcare NHS Trust, Blackshaw Road, SW17 0QT, Tooting London, UK. Greg.McAnulty@stgeorges.nhs.uk.
authors.forename: Greg
authors.initials: G
authors.lastname: McAnulty
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000592:standards*; D000776:Anesthesiology / Q000193:education* / Q000592:standards; D002983:Clinical Competence / Q000331:legislation & jurisprudence*; D003144:Communication Barriers; D005062:European Union; D005260:Female; D005550:Foreign Medical Graduates / Q000592:standards* / Q000706:statistics & numerical data; D006786:Hospitals, Urban; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D059032:Learning Curve; D008131:London; D008297:Male; D011364:Professional Practice / Q000331:legislation & jurisprudence; D036301:Qualitative Research; D018570:Risk Assessment; D013038:Specialization / Q000592:standards; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom