Okay, so I have some news!
My latest paper has just been published in the NHS Workforce and Research Catalogue — and I want to talk about it in a way that actually makes sense to people who aren’t doctors, because honestly, the story behind it matters just as much as the research itself.
The paper is called Top Tips to Pass the Relating to Others Domain of the RCGP SCA. I know. Very medical-sounding. Bear with me.
So what is the SCA, and why does any of this matter?
The SCA — the Simulated Consultation Assessment — is one of the most high-stakes exams a GP trainee in the UK has to pass. It tests how you consult with patients: not just your clinical knowledge, but how you listen, connect, communicate and build trust in a ten-minute conversation.
There is one domain in particular — the Relating to Others domain — that is consistently the stumbling block for a huge number of doctors. And when I started looking at the data, something became very clear to me: International Medical Graduates, IMGs — doctors who trained outside the UK and moved here to practice — were being disproportionately affected.
Not because they were worse doctors. Not because they cared less. But because the way warmth, empathy and rapport are expressed is culturally shaped. What reads as respectful in one culture can read as distant in another. What feels like appropriate deference in Nigeria, Ghana, India or Pakistan can be misread as disengagement in a British consulting room.
These aren’t failures of ability. They are failures of the system to account for difference.
And that, right there, is what this research is about.
Where this all started
This paper is actually the follow-up to my Masters thesis — I did my MMedSci in Medical Education at the University of Nottingham, and I graduated with a Distinction. My thesis focused on the lived experiences of IMG GP registrars navigating this exact domain — what it felt like, what the barriers were, what support was missing.
That research has now been accepted for an oral presentation at the RCGP Annual Conference later this year. If there is any room in this country where a conversation like this can lead to real, structural change — it is that one.
But I didn’t want to wait until the conference to get the practical message out. So I wrote this follow-up paper as a resource — something tangible that registrars, trainers, Training Programme Directors and deaneries can actually use right now.
Why this sits so close to my heart
I am a British-Nigerian doctor. I grew up in the UK, but I trained in Nigeria — six years of medical school, a year of housemanship in a tertiary teaching hospital. I know what it is to come back to the British system and have to prove yourself all over again. I know what it is to walk into a room carrying a different cultural framework for everything — how you speak to seniors, how you show respect, how you express care — and have none of that legible to the system you’re now practicing in.
I also know that behind every IMG struggling with the SCA is a highly motivated, deeply committed doctor who crossed an ocean to serve patients in this country. They deserve better than being marked down for being human in a different way.
My mission — if you want to call it that — is to make sure that doctors have the tools to connect with their patients, wherever they trained and whatever their background. Because I believe this with everything in me: human connection is not a soft skill. It is a clinical tool. And a more personable doctor is a better doctor, full stop.
What now?
The paper is free to access and I want it everywhere. In the hands of every GP registrar preparing for their SCA. In every deanery inbox in the country. And eventually — because this problem is not unique to Britain — I want to take this message global.
Wherever doctors migrate, this tension exists. Wherever it exists, patients are affected.
If you know an IMG GP registrar, a GP trainer, a TPD, or anyone involved in postgraduate medical education — please share this with them. The link is below.
And if you are an IMG registrar reading this and you have ever walked out of a consultation feeling like you gave everything, and the marks just didn’t reflect it — this paper was written for you. You are seen. You are not the problem.
Dr ETK xo
