Adapting to British culture

Authors: Raj Kathane 

Publication date:  19 Jun 2004

Ramesh Mehta and Raj Kathane give some advice

Moving to the United Kingdom can be stressful, especially if you are from a developing country. It is even worse if you are to sit an exam soon after your arrival. Following are a few common cultural problems faced by the newly arrived overseas doctors and some ideas of how to get over them.

Overcoming hesitancy and feeling confident Arriving in a completely new culture can seem like being thrown in at the deep end. Believing in yourself and feeling confident is the basis of survival. You must remember that your decision to come to the United Kingdom means that you are an achiever. Some doctors begin to feel inferior for various reasons, including their colour, language, and manners. This often dents their confidence, and they become hesitant and subdued. You should try to avoid this trap. It is important to be seen as confident and articulate, but don't overdo it as this may be perceived as being rude.

Good communication is the key

Your confidence is related to your ability to communicate effectively with colleagues and patients.


Many overseas doctors are worried about their accent. In reality, what matters is whether you can be understood easily. In any country and in every language accents vary. Try to speak clearly. Your voice should be firm enough to be heard easily.

Eye contact

In many cultures looking directly at the person's eyes while speaking is considered disrespectful. However in British culture having shifty eyes or not looking at the person you are speaking to is taken to show that you have something to hide or you are not speaking the truth. Try to develop the habit of making steady eye contact during—but don't stare at them.

Shaking your head

Moving your head constantlywhen a senior is talking to you is a norm and sign of respect in some cultures. However, in British culture people are expected to treat others, whether seniors or juniors, as equals. Moving your head frequently during a conversation could be a distraction. It is important to listen to the person carefully and express your views honestly rather than agreeing to everything that has been said.

Addressing people as “Sir” or “Madam”

It is customary in many countries to address the seniors as “Sir.” In the United Kingdom the common practice is to address others by their names. For example, you can call your consultant, “Dr Smith” and your registrar by their first name.

Respectful treatment of others is a basic value in all cultures

In some cultures it is taken as an offence if you do not stand up every time your senior stands up. Once again, in the United Kingdom it will be seen as a nuisance rather than as a sign of respect.

Please and thank you

Instead, you show your respect to others by being polite and using words such as “please” and “thank you.” In British culture it is expected that you always say please when you ask for anything and say thank you when the work is done.

Controlling your temper

It is important to be able to control your temper. In some countries you need to shout or raise your voice to get work done. However, in the United Kingdom this comes across as quite offensive, and the result may be unwelcome. Instead, discuss any problems politely. You will win a lot of friends if you can be “diplomatic.”

Doctors as “gods”

Respectful treatment of others is a basic value in all cultures. This is particularly important when you speak with patients. The GMC document, The Duties of a Doctor, clearly mentions “Respect patients' dignity and privacy.” In some countries doctors are treated as “gods” and they get into the habit of being rude to patients and nursing staff. Do this at your peril.

Cultivate the art of listening

This is important in any culture. You will be able to avoid a lot of complaints and difficulties if you listen patiently and sympathetically.

Sense of humour

Try to mix with the local population. Going to a pub for a drink is normal in British culture. Once you get friendly with some local people you will feel accepted therefore more relaxed and happier. You may even start to enjoy yourself.

And finally...

Most people you will come across are good natured and friendly. A little effort on your side to understand and respect the culture of the host country will make you confident and happy.

Raj Kathane consultant child psychiatrist British Association of Physicians of Indian Origin ( [Link] )

Cite this as BMJ Careers ; doi: