By Dr Ian Wilson, Deputy Medical Director
Recruiting colleagues from overseas is nothing new; our NHS has depended on internationally trained clinicians since its inception. However, our need has consistently grown and finding sufficient doctors who are both well trained and able to rise to the demands of working in today’s health service, has become harder. Relying on training programmes to provide full rotas hasn’t worked for some time, and ad-hoc plugging of gaps is punitively expensive, unsustainable and often short-sighted for a Trust that takes pride in our aim to be the best.
As part of a series of innovations we have promoted, a couple of years ago the Trust undertook a highly successful recruitment trip to India, appointing a small number of exceptional doctors in Emergency Medicine and Radiology, some of whom are on the point of completing Certificate of Eligibility for Specialist Registration (CESR) applications and ready for NHS consultant posts. That success, alongside increasing workforce sustainability concerns led to a more ambitious plan for 2022.
With a target of 50 posts across ED, Acute Medicine, Anaesthesia, Paediatrics, Women’s Health, ENT, Ophthalmology, Dermatology Haematology and Paediatrics, the Trust sent a small team for a week into the heat of Trivandrum in Southern India, moving on to Mumbai, to meet, interview and recruit the best doctors to join our UK teams.
Was this a freebie? A nice jolly in the hot Indian sunshine leaving the cold and rain behind? Well, landing at around 5am with our first interviews at 2pm until late, and then every day thereafter, this was no holiday jaunt! Corporate meeting rooms are pretty much the same the world over, and recruiting is hard work! We interviewed just over a hundred people over five days in two centres and across ten specialties; we earned our keep.
Recruiting is expensive; getting it wrong costs more. Sure, you can interview by video but it tends to be a bit transactional and there’s no substitute for being in the room to assess the person not just the CV. What data exists suggests a much higher conversion rate to sustained employment from a face-to-face interview. So, whilst we were really well supported by clinical expertise calling in from the UK, most interviews had a face-to-face element and we benefitted from the clinical and cultural knowledge of Drs Anu Saxena (obstetrics) and Satish Narasimhula (anaesthesia) to get a clearer insight into candidates’ expectations and how to best challenge them so that we got the clearest pictures and made the best decisions.
There were other gains from having a team physically present, some of which caught me a little by surprise. For example, the vibe that was created just by us being out there, taking an interest in applicants and meeting with people. Mid-Yorkshire isn’t on most Indian doctor’s minds when they think of the UK. Hearing that we had sent a team over changed that. People we met, and especially people we offered posts to, told their friends, and their friends told others; and the visibility and positive attitude we took with us clearly caught on.
We spent a day at a national conference on emergency medicine. Speaking at a well-attended meeting, Emergency Medicine Consultants, Sarah Robertshaw and David Hall outlined the benefits and challenges of working in the UK, and how the structured CESR (and particularly the Mid-Yorkshire) programme works. Someone foolishly handed me a microphone so I bounced around the room taking questions and promoting our unique MYDoc model which has been successfully taken forward in surgery and which has so much more potential. I was surprised and, frankly, proud to hear how much awareness there was of that initiative, and emerging awareness of Mid-Yorkshire as a place to come to work, train and live. Although it has to be said that the crowds surrounding David and Sarah afterwards were more interested in information about passing the RCEM exams and Sarah’s experience of F1 Motorsport, respectively. Without having my own posse of adoring fans, I soon slunk off to peel myself out of my less-than fragrant suit and tie…
The standard of applicants was considerably higher than I had anticipated; our recruitment partnership with Remedium Partners has created a solid understanding of what we want and need in most of our areas and there had been some serious filtering of candidates before they were even proposed for interview. That’s not to say there were not one or two people who it was clear within a few minutes would not make the cut, and there were some who had great experience but were just not right for our teams. Those are hard decisions to make when meeting people who had travelled for many hours across the length and/or breadth of the sub-continent to come and meet us.
The week also consolidated my own thoughts on our need to think differently about matching our requirements and the people available, home and abroad. Often posts are created with tightly written, traditional expectations. On this trip we more than occasionally met highly skilled and talented people who did not quite meet an exacting profile that was set. Some of our teams felt able to think differently and flex the “ask” to fit the (excellent) applicant and make plans to mould them into our teams over time - to grow our own specialised teams and colleagues.
It is a challenge for all of us to step away from a traditional model which feels familiar and comforting but works increasingly less well in our modern workforce world. I think we have had that realisation at MYHT for some time, but it’s a journey of change with a need to keep quality and safety front and centre, and to balance opportunities and challenges, as we discover what we can do to recruit the best people who don’t necessarily fit a pre-formed mould. We did that on this trip and I’m hugely grateful to the senior clinicians who joined in remotely and felt able to take advantage of those opportunities. The challenge for the trust will now be to support teams who have embraced that challenge in developing new colleagues and consolidating our intent to be the employer of choice.
So, was it worth it? Did the investment merit the benefits? It’s an astonishing statistic that if just one (yes, reader, just one) of those recruited from this trip were to complete CESR and become a consultant in our Trust it would make this trip cost neutral. That is a great challenge for us to have and highlights how the pressures that drive us to think short term cost so very much more than taking the longer view.
This has been a week of hard work, impressively put together by the Medical Staffing Team, alongside our Remedium partners. But before a thousand violins begin to sound, I’m not going to lie - we did get well looked after, and we tasted some wonderful food, met some great people and buoyed up by Consultant of Acute Medicine, Dr Dan McNally’s relentless positivity (hiding an uncompromising approach to selection) whenever we were flagging, it’s been worthwhile.
Oh, did it work? I should say so! 52 excellent junior and middle-tier colleagues will be joining us into the new year. That’s an amazing success and, as I write this from the plane (the BACK of the plane, since you will inevitably ask) I think it’s fair to say the team are tired, but buzzing!