IMGs and Beyond...
staying in the here and now
A Workshop for Northern Ireland GP Trainers
3h workshop 1400-1700 9th October 2020 via Zoom
You’re on the road to nowhere if you don’t have a destination. Isn’t that right? Am I stating the obvious? Those of you familiar with Stephen Covey’s work – it’s habit number 2 –”begin with the end in mind”. Even the ancient philosopher Seneca (49-62AD) said: “Let all your efforts be directed to something, let it keep that end in view”. So, although it is not really anything new, is it always true? If your answer is yes, then I have a question for you. If it’s so obvious, why is it that many of us struggle to get to the destination that we have already defined?
Now, I am not saying that “begin with the end in mind” is a bad thing. A fixed finishing point (i.e. a destination) helps us then define a pathway to try and get there (and by the way, there are several routes for everything – some more colourful than others). Having a fixed point also helps us stop and reflect and see how we are doing towards it. We can see if we are moving towards it or veering away. And that in itself can help fine-tune and orientate our actions and efforts in the present.
So what am I saying? Although beginning with the end in mind is a good approach, this can then hijack our attention towards a future focus rather than staying in the ‘here and now’. In addition, if you are the type of person to focus on the end goal, the plan you choose to get there means you have ditched several other alternatives (which you may not have considered). And the path chosen may be the least optimal. So, how about staying with the present, naturally exploring it and letting whatever gives birth direct you? Surely this is a better way than being hijacked and forced along an unnatural journey towards the destination?
Fixing an endpoint and working along a concrete path towards it can also be restricting. It puts pressure on the learner to only move that way and it does not allow for the flexibility needed in the complex process of making sense of a learner’s thoughts, experiences, and learning. Allowing more freedom is less pressurising, more enjoyable, more flexible as blind spots are uncovered, and naturally more transformative. But equally, we don’t want to end up with open-ended ruminating discussions that go nowhere.
In this session, we will explore what all of this means in terms of helping our IMGs (and trainees in general for that matter). We are often consumed by the end goal, which hijacks us and prevents us from truly hitting those natural transformative points of influence with our trainees. To hit them, we need to stay in the ‘here and now’ and begin with the trainee’s perspective, as we do with our patients. Have you had a trainee you have struggled with despite being clear about the end objectives and despite beginning with the end in mind? There’s probably a good reason. Take the opportunity to stop, explore and learn something about the trainee and then try again.
We shall also explore culture and diversity, compare it with your current world-view and see how it differs We will see how, as GP Trainers, we can help our IMGs at a transformative level rather than a “jump through the hoops” level. 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
or type https://tinyurl.com/alirodgers
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 to look at them in advance
- Respond with the FIRST thing that comes into their head – share it with the group.
- Group to discuss and perhaps challenge each other; not get into cosy agreement
- You don’t have to get through all the cards
- 10 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 7 - Practise
How much practise do you do with your trainee?
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.
10 Key Points
1: before working on IMGs, understanding diversity
2: helping IMGs starts with us, not them!
3: Honesty, Openness and Trust
4: STOP, and explore natural moments of discrepancy
5: Go back to basics
6: Feedback – be black or white s
7: Practise, practise and practise some more
8: Encourage, Motivate & Inspire
9: Encourage, Motivate & Inspire
10: Back to you - reflect on yourself
- Jokes – be careful. IMGs often won’t get them.
- Use proper language, not slang.
- Don’t indulge in work-place stereotypical views. Challenge them.
- It’s NOT political correctness – a term which trivializes diversity awareness.
- Don’t group them together as a lump sum when in Trainers’ workshops.
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…).