Career Strategy for Internationally Trained Professionals and Leadership, Pensions, and Legacy
Dr. Omosefe Christina is a Medical Doctor, Entrepreneur, and Founder of Elite Exams. She blends frontline clinical practice with medical education and community programmes to help International Medical Graduates (IMG) and African families flourish in their careers and communities in the UK.
Many internationally trained doctors arrive in the UK with a clear short-term plan. Pass the exams. Find a post. Settle in. Get through the first year. What is less often talked about is what comes after: the ten-, twenty-, or thirty-year arc of a career that is frequently more complicated to navigate than it first appeared, and far more consequential to get right.
For internationally qualified doctors building a life and a career in the NHS, the long view matters enormously. Not just for personal fulfilment, but for financial security, leadership positioning, and the kind of legacy that extends well beyond any single role or employer.
The pipeline problem is real, and getting more complex
The current landscape for international medical graduates (IMGs) in the UK is shifting in significant ways, and being clear-eyed about it is the starting point for any credible career strategy.
IMGs now make up 42% of all licensed doctors on the General Medical Council (GMC) register, a figure that reflects both the NHS’s deep structural reliance on internationally trained doctors and the unique vulnerabilities that come with that dependence. Despite these numbers, research published in 2024 found that, among surveyed IMGs, 86% had no dedicated mentor in their first NHS post, and over half had no induction. Many reported isolated roles, minimal feedback, and limited opportunities for career progression.
The data on progression tells a similarly sobering story. Figures cited by a National Institute for Health and Care Research (NIHR)-funded project indicate that fewer than 12% of overseas-trained doctors become consultants or GPs within five years of joining the register, and only around 27% within ten years. The reasons under investigation include cultural and systemic differences, discrimination, and the absence of the informal networks that tend to quietly determine who gets which opportunities.
More recently, the Medical Training (Prioritisation) Act 2026 has introduced formal prioritisation for training posts. The policy landscape is changing. Waiting for the system to provide a clear path is no longer a strategy.
Career strategy is not optional
The IMGs who progress most effectively tend to share a common approach. They treat their careers as something to be actively designed, not passively experienced.
Korn Ferry’s research on senior Black leaders, which may offer relevant insights for African diaspora professionals in the NHS, found that nearly 60% took deliberate, strategic approaches to progression: identifying gaps, building targeted skills, and creating a professional brand aligned with organisational priorities rather than waiting to be noticed. They pursued sponsors, not just mentors. They expanded their contribution beyond clinical work into quality improvement, education, and leadership roles that built institutional visibility and influence.
For overseas-trained clinicians, this kind of strategic intentionality is not a nice-to-have. It is the difference between a career that stagnates in locally employed doctor roles and one that reaches its potential.
The Royal College of Physicians has been explicit on this: there is no such thing as a non-training doctor. Every NHS doctor should have access to leadership opportunities, ePortfolio engagement, and structured development, and IMGs should actively claim these, even when they are not automatically offered.
The pension conversation nobody is having early enough
Here is something that does not get discussed enough in IMG communities: the NHS Pension Scheme is one of the most valuable financial benefits in UK employment, but its value depends on understanding eligibility, joining when appropriate, and planning over time.
The scheme underwent significant changes in April 2024, including a six-tier contribution structure and a new employer contribution rate of 23.7%. The government also abolished the lifetime allowance from April 2024. However, the standard annual allowance is £60,000, may be lower for some individuals, and limits still apply to tax-free lump sums. NHS Pension Scheme
For IMGs who arrive mid-career having built pension entitlements in another country, the challenge is building years of benefits in the UK scheme. Starting pensionable service early where possible, understanding which pay counts towards the scheme, and exploring partial retirement options, which can allow eligible members to draw between 20% and 100% of their benefits while continuing to work, are not administrative details. They are foundational financial decisions.
A doctor who joins the NHS Pension Scheme at 35 and retires at 65 has thirty years in which to build benefits. One who spends the first five of those years in roles that are not pensionable, without understanding the implications, may not realise the cost until much later.
Legacy is bigger than a job title
For African diaspora professionals and people with lived migration experience building careers in UK healthcare, the concept of legacy tends to carry particular weight, and rightly so.
Many internationally trained doctors are not just building a career. They are building proof that the journey is possible. They are mentoring the next generation of IMGs navigating the same systems. They are shaping clinical departments, training programmes, and community health outcomes in ways that will outlast any single contract.
That kind of legacy is worth planning for deliberately. It means thinking about leadership not just as a career ladder, but as a platform for what you want to change, who you want to bring with you, and what you want the NHS to look like in twenty years.
It also means thinking about financial stability not just for retirement, but as the foundation that makes sustained contribution possible. Professionals who are financially precarious cannot easily take risks, advocate for change, or invest in the community work that creates genuine, lasting impact.
The system will not plan this for you
The honest reality for internationally trained professionals in the NHS right now is that the system values their contribution without always supporting their progression. GMC figures show that 4,880 non-UK-qualified doctors left UK practice in 2024, a 26% rise from the previous year. The figure underscores the importance of addressing career progression and retention, though it does not by itself establish why those doctors left.
That does not have to be the outcome. But avoiding it takes intentionality about the roles to pursue, the networks to build, the financial decisions to make early, and the kind of career and contribution that is worth spending the next thirty years creating.
The long view, it turns out, is the most practical one.
Follow me on Facebook, Instagram, LinkedIn, and visit my website for more info!
Read more from Dr. Omosefe Christina
Dr. Omosefe Christina, Medical Doctor, CEO and Founder
Dr. Omosefe Christina creates digital learning platforms that turn frontline experience into practical support for international doctors in the UK. She is the CEO of Elite Exams, which supports the medical education of internationally trained doctors aspiring to become independent GPs. She builds digital systems, courses, platforms, and automated learning pathways to support doctors who migrate to the UK.
References:
International medical graduates: a workforce at a crossroad? Clinical Medicine (2025).
Lane, J., Shrotri, N. & Somani, B.K. (2024). Challenges and expectations of IMGs moving to the UK. Scottish Medical Journal.
University of Plymouth / NIHR SUP IMG Project (2025). Project explores barriers to NHS career progression facing IMGs.
UK Government. Medical Training (Prioritisation) Bill impact statement (2026).
Korn Ferry. (2021). Leadership lessons from senior Black leaders.
Royal College of Physicians. (2024). Pilot programme to better integrate locally employed IMGs into the NHS.
NHS Employers. (2024). NHS Pension Scheme changes from April 2024.
NHS England. Retaining doctors in late-stage career guidance.
National Health Executive. (2025). Report warns of holes in health workforce with international doctors leaving the UK.
