The GP medical training website for everyone,
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Helping Trainers Help IMGs

making truly transformative changes

A Workshop for GP Trainers
by Dr Ramesh Mehay

If you want to succeed at anything, surely you need to know the end goal – the destination.  Right?  Even Stephen Covey (7 Habits of Highly Effective People) said it  – it’s habit number 2 –“begin with the end in mind”.     You’re on the road to nowhere if you don’t have a destination. The ancient philosopher Seneca (49-62AD) said: “Let all your efforts be directed to something, let it keep that end in view“.    

Perhaps you’re thinking: “yeah, that nothing new, and it’s not exactly rocket science”, but let me ask you this.  Is it always true?  If your answer is yes, then I have another question for you.   If it’s so obvious, then why is it that many of us struggle to get to the destination even when we have previously defined it? 

Now, I am not saying that “beginning with the end in mind” is bad.   A fixed finishing point helps us define a pathway to try and get there.  Having a fixed point also helps us stop and reflect and see how we are progressing towards it.  We can see if we are doing good or veering off at a tangent.      This in itself can help fine-tune and orientate our actions and efforts in the present moment.  

But one of the problems with the “end in mind” approach is that this end can persistently hijack our attention.  It results in us constantly having a  future focus.   And when problems arise (as they inevitably do), we continue to be future-directed rather than the more meaningful act of stopping and staying in the ‘here and now’.    Fixing an endpoint and working along a concrete path towards it is restricting.   It puts pressure on the project-people to only move that way, and it does not allow for the flexibility needed in the complex process of making sense of a people’s thoughts, experiences, and learning.  

But those who embrace the natural pauses to reflect will often receive new enlightenment, such as the realisation that an alternative path is more optimal than the one you are on.  And often, there are several routes – some more colourful than others.  BUT, if you continue to put the blinkers on and fast-forward through these natural learning moments, you continue on the suboptimal path, which requires a lot of time and effort and sucks the enthusiasm out of you. On the other hand, allowing more freedom is less pressurising, more enjoyable, more flexible as blind spots are uncovered, and you step into that beautifully enriching transformation territory. 

So how does this apply to training IMGs? 

We are often consumed by the end goal, which hijacks us and prevents us from truly hitting our trainees’ natural transformative points of influence.  Yes, you have to have an end goal – (like helping them get through all the MRCGP requirements, e.g. AKT, RCA/CSA, ePortolfio, WPBA etc.), but what I am saying is not to forget the journey!  When there are natural moments of “new enlightenment” – remember to stop, pause, explore, and understand before carrying on.  You still get to the end – but you also get to make transformative educational changes along the way.   And you both learn during the process.

In this session, we will explore some of the things you can do to become a transformative teacher as well as helping IMGs to “jump through the hoops”.  We will also explore culture and diversity, compare it with your current worldview and see how it differs   Come and join me and let’s simply explore.

You will find all your resources for this workshop here.
In the future, if you want to come back to this page: Go to Bradford VTS > Teaching & Learning > Workshops by Ram


multi colored paper on brown cardboard box
Exercise 1: Poll (IMG experience)

Let’s see how many of you have had IMG experience and what it was like.

Exercise 2 - Poll (Barack Obama)

What does this quiz demonstrate?

What was the purpose of me asking you to do it?

Exercise 3 - Flashcards

Many of the descriptions on the cards could be applicants for GP training, GP trainees or even trainers themselves.


  • Turn the cards over one at a time, do not look at them in advance
  • Respond with the FIRST thing that comes into your head – share with  group.
  • Group to discuss and perhaps challenge each other; not get into cosy agreement
  • You don’t have to get through all the cards 
  • 20 minutes, then we re-group and form another group.

Asian man with a bushy black beard

Woman with short hair wearing Doc Martens

 Attractive young man with earring

 Woman carrying the Guardian

Asian man, fashionably dressed, with gold rings and state-of-the-art mobile phone

Young woman with tattoo visible creeping up her neck and also on forearms

Black man with a very strong Nigerian accent keeps calling you “Boss”

Person whose mobile phone rings when you’re talking to them

Person whose mobile phone rings when you’re talking to them

Woman with strong accent and a lot of make up

 Woman wearing large cross on fine gold chain

Exercise 4: Honesty, Openness & Trust

How can you do this in your practice?

Exercise 5 - Revisiting Basics

What sorts of things might you go back with basics for?

Exercise 6 - The MAD

The MAD is the Medical Analogies Database that I developed a couple of years ago.  Patients understand medical things so much better when referenced to an everyday analogy they are familiar with.   For example, comparing Hypertension to the plumbing in a central heating system.  Too high and the boiler (in your case, your heart) gets damaged.     You can help your IMG trainee to explain things better if they start using analogies than direct medical explanations.  

  • Have a read through some of the explanations. 
  • What do you think of them?  They are not all perfect.   But they provide a starting point.
  • Remember the KISS principle – Keep It Simple.
  • If you have just had a thought for another or one that you like to use often, please post it in the comments section on that page. 
Exercise 7 - Practise

How much practise do you do with your trainee?

10 Key Points

1. Helping IMGs starts with us, not them
2. Understand and embrace diversity POSITIVELY
3. Engage in natural conversation, which results in dual disclosure
4. Stop and Explore natural moments of discrepancy
5. Make feedback black or white.
6. Practise, practise and practice some more
7. Encourage, Motivate & Inspire
8. Some Don'ts… jokes, slang, long-windedness, stereotype
09. It's all about relationships
10. Reflect on YOU
Final note...

Remember at all times the trainee has talents. 

A more diverse workforce will have access to the broadest range of talent in the workplace and thus often opening up new markets.

I honestly believe that.  I hope I have convinced you of that too (even just a little…).

Use natural moments to transform ideas and visions.


Geert Hofstede's work on cultural dimensions. (click on this grey box)

Kate Fox Book called "Watching the English."

Bradford VTS Pages on IMGs (click on this grey box)

Bradford VTS Pages on Ethinicity, Race & Culture (click on this grey box)

Bradford VTS Pages on Equality & Diversity (click on this grey box)

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FROM 1st July 2022 • DON’T MISS OUT!


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