Becoming A Doctor In The UK: The View From An International Medical Graduate

In August 2018, Channel 4 featured a number of international medical graduates on their journey to becoming doctors in the UK in its documentary, ‘The Foreign Doctors are Coming’.

Among them is Anna Zonato, from Brazil. Here she tells us about the process she has gone through to become a licensed doctor ready to begin working in the UK.

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I am a doctor from Brazil and was until recently living and working in Curitiba, my hometown. Most people have probably never heard of it, but it’s a really nice city in Paraná state, southern Brazil. The weather there is known to be mostly cold and the streets very clean.

My journey to pursue a career in the United Kingdom started way back, while I was still a child. I had always dreamed about visiting the country and fulfilling all of the British stereotypes, such as meeting the Queen, seeing her guards and having afternoon tea like the English.

However, as time went on and I grew up, this dream kept dormant in a little space in my heart. Up until the point when I was in my fourth year as a medical student and there came an opportunity to live and study one year abroad, through a programme called Science without Borders.

I completed an English test and applied for the programme. Happily, I was selected to study at De Montfort University, in Leicester. I studied Forensic Science for a year, as Medicine was not an option. I loved the course. And I particularly loved living in England, I loved their way of doing things, the way its people are and how they accept differences so well, although not so much the weather, as it can be very cold and rainy at times. That was the year I started to seriously contemplate the idea of moving to the UK for good.

My journey to working as a doctor in the UK

After coming back home, I began research living in England and how I could use my medical qualification there. It was very confusing at first, there was a lot of information and sometimes it was too much to take in. I had spent years working hard to become a doctor and it took me a while to understand why I needed to complete a multiple choice and practical assessment (the Professional and Linguistic Assessments Board (PLAB) exams) before being able to practice in the UK.

I felt helpless at times and started to believe I was pursuing a dream that wasn’t for me. Plenty of times I almost gave up. I questioned why I would leave everything I know, everyone I love for the uncertainty of living in a completely different place where I would be speaking another language with customs unlike my own. It seemed like madness.

Nonetheless, I remained stubborn. I had the support of my family and friends, and little by little I got an idea of what the road ahead would be like. And I accepted the challenge.

I was a lot driven not only by my childhood dream, but also because I saw better opportunities for me in England as a doctor than in Brazil, especially in the NHS. The public health system in my country (aka SUS) has generally the same concept of it, but it lacks so much investment and infrastructure that it is discouraging to work there.

I went step by step, so I wouldn’t get overwhelmed or discouraged. Firstly, I had to graduate. I qualified in January 2017 and I was very happy, particularly because I had plans, plans abroad.

Next, I needed to show I was competent in the English language. I opted to take the International English Language Testing System test (IELTS). After passing the test I had to wait several months to sit PLAB 1, the multiple choice exam testing medical knowledge. The months went quicker than expected, though, since I worked part-time as a doctor in an Occupational Health clinic and studied in my free time.

On the day of the PLAB 1 test, which I sat in June, in London, I was very nervous and anxious. The room was huge, full of candidates from all over the world. Time was super rushed and I thought I wouldn’t be able to finish it all but, thankfully, there was just enough time. I thought there was no way I would pass it, yet after four long weeks waiting for the results, I was elated to know I had!

However, I still had to take PLAB 2 to get a step closer to my dream of moving to the UK. I was back in Curitiba then, so I booked my plane tickets and arrived in Manchester, where the test takes place at the GMC’s office. I gave myself a few weeks to prepare for the course and studied with other candidates for around eight hours a day.

It was tiring, nerve-racking and uncertain. We comforted each other, we cheered for each other and a true bond formed between us. I can safely say it was one of the most difficult, yet most rewarding periods of my life, among so many different cultures, diverse languages, various customs and still so many feelings in common, so much to relate to.

While studying I agreed to be filmed as part of a Channel 4 documentary. It was a good experience, as it helped me take my mind off the studies at times, although most importantly, it reminded me why I was doing all of it, why I was putting myself through this much trouble to be away from home. Moreover, I hoped other doctors could find comfort in seeing the process as well.

Again, time flew by. It was already the test day. I was more nervous than for PLAB 1, I just wanted it to be over. There had been so much preparation and investing, failing wasn’t an option, or one I could easily live with.

The test was pretty much like I was expecting it: 18 practical stations, where we would interact with patients in diverse situations. The scenario and rooms were just like the GMC video used to help prepare candidates. The time passed so quickly I could barely believe it was over and, by the end of it, I felt confused and exhausted. I hardly remembered what I had said in each station, and it still feels like a blurred day in my mind.

Two weeks later came the results, and I couldn’t be happier to find out I had passed! When I got the results I had been waiting for I was still in the UK for a job interview. I can say it was a couple of days full of thrill and excitement.

After passing, it was easy to start the online registration with GMC, I had the documents ready and sent them as soon as they were requested. I booked the ID check a few weeks after and it was a fairly easy process.

Welcome to UK practice

I also attended a free Welcome to the UK Practice session held by the GMC, which was helpful as it reinforced important GMC guidelines we should keep in mind and enabled us to interact with other newly registered or soon to be registered doctors. It also provided us with various guides and helplines for us to use before and while working in the UK. I highly recommend this workshop to everyone.

The session lasted for a few hours and had various activities and practical situations we could face while working within the NHS, which could pose a challenge if we are not familiar with the new culture. I don’t think there were too many different aspects of the British practice compared to how we do things in Brazil, apart from local protocols. I believe some medical situations are universal and similar everywhere, whilst the way we have to deal with them might differ quite a lot depending on where you are.

I didn’t know about the session before taking the practical assessment, however, I was glad to have participated. I believe attending the Welcome to UK Practice session, reading the GMC ethical guidance material we were given plus having a fair bit of common sense should be enough to avoid serious mistakes while working in the UK.

So, now that I am GMC registered, what’s my situation?

Well, I remained in Brazil for more than seven months waiting for my Certificate of Sponsorship to be issued by the UK government in order for me to apply for a visa and actually start working there. I remained hopeful, looking forward to the next chapter to start.

I have now been in the UK for just over a week as my visa has now been approved. I am just getting things in place to start working as a junior doctor in A&E at Norfolk and Norwich University Hospital NHS Trust. I plan to work as a junior doctor for some time and ideally, I would like to train to become a general surgeon. Later, I would like to specialise in a particular area, depending on what I relate to the most during the training.

And, of course, I hope to keep living in the United Kingdom and build my life and career here permanently.

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