Shifts In Professional Identity Formation Among General Practice International Medical Graduate Doctors in the UK

Background


Professional identity formation is a transformative process for International Medical Graduates (IMGs) entering the UK General Practice workforce. Unlike UK-qualified doctors, IMGs face a more complex process of identity re-formation characterised by identity dissonance, where they must negotiate a new professional persona while simultaneously maintaining their home cultural identity. This transition involves navigating the hidden curriculum of a new healthcare system and moving from paternalistic to patient-centered care.


Methodology


This study utilises a qualitative narrative inquiry approach underpinned by constructivist ontology and interpretive epistemology. The River of Life technique was employed as a research instrument, allowing participants to use storytelling to describe the highs, lows, and influencing factors of their professional journeys. This method captured rich, in-depth data regarding how GP IMGs ascribe meaning to their lived experiences within the UK healthcare system.


Findings


Identity shifts are characterised as dynamic and non-linear, influenced by an interplay of intrinsic and external factors. Intrinsic determinants include cultural heritage, religion, and personal agency, though factors such as gender and marriage often intersect to create systemic barriers, particularly for female IMGs. Externally, the UK healthcare system's flattened hierarchy, regulatory requirements (such as appraisals and revalidation), and the influence of Communities of Practice necessitate significant adaptation. IMGs often undergo periods of knowledge deconstruction and reconstruction, moving from expert to novice status as they align with UK clinical protocols.


Conclusion and Implications


Despite encountering glass ceilings, potential deskilling, and slower career progression, identity evolution serves as a vital coping mechanism for survival in a competitive environment. Successful transitions result in enhanced resilience, cultural competence, and professional credibility. These insights underscore the necessity for systemic changes and localised induction programs to provide more equitable support and transparent career pathways for the growing cohort of IMG doctors.