Finding a voice in UK academic psychiatry: perceived barriers and facilitators to engagement among Indian international medical graduates

Background

Academic psychiatry in the UK is in a precarious situation with diminished academic to clinical posts. There has been a growing reduction in psychiatrists engaged in academia in the last 25 years. This has coincided with increased growth of International Medical Graduates (IMG) working in UK psychiatry. IMGs may face unique barriers to involvement in research, which may contribute to the academic gap. IMGs from India form the largest minoritised ethnic group among UK psychiatrists. This study explores interest in and perceived barriers and facilitators to academic engagement among IMGs of Indian origin working in psychiatry in the UK.

Methods

A questionnaire with 14 questions was developed with the British Indian Psychiatric Association (BIPA) members. It was disseminated online among IMG psychiatrists of Indian origin. A non-discriminatory exponential snowballing technique leading to non-probability sampling was used to distribute the survey in electronic form. The survey was disseminated via a convenience sampling approach, including through local professional networks. The questionnaire covered professional characteristics, past non-UK academic involvement, and perceived interest in and barriers and facilitators to engagement in academic psychiatry in the UK. Quantitative analysis explored: non-UK academic activities including by gender; self-reported interest in academia at the time of arrival in the UK and at present; differences in self-reported interest according to gender, region of work, prior research involvement, and years of psychiatric experience/grade. Thematic analysis of free-text responses using Braun and Clarke’s methodology was undertaken.

Results

Of 89 respondents 61% reported prior, non-UK academic involvement. Male gender and having prior academic experience were significantly associated with greater academic interest at UK entry. Perceived barriers were cultural and discriminatory, structural and navigational, and capacity and resource related. Facilitators included motivation to contribute to evidence-based practice, improved balance between clinical work and research, increased opportunities, and a supportive research culture.

Conclusions

IMG psychiatrists of Indian origin are motivated to engage in research but face challenges and perceived barriers of cultural, discriminatory, and job planning factors. Similar surveys are needed to capture the unique experiences of other diaspora groups working in psychiatry to address the glass ceiling of clinical academic engagement.