Professional
The art of international recruitment
Malany Kalicharan shares her experience of recruiting and managing new colleagues from around the world
Who better to lead the international recruitment of radiographers than a radiographer who has built a successful career in the NHS after coming to the UK almost 20 years ago?
Malany Kalicharan was recruited from South Africa by the University Hospitals of Leicester NHS Trust (UHL) in 2005, working as a senior radiographer specialising in CT, MRI, colonography and hysterosalpingography. She was later promoted to be a superintendent radiographer managing a busy emergency X-ray department, and was supported by the trust to complete a Chartered Manager’s Degree Apprenticeship.
Malany was then appointed to lead on the international recruitment of AHPs for Leicestershire, Leicester and Rutland Faculty - which enables system wide collaboration across professions helping to focus on local priorities - and has recruited more than 50 radiographers since August 2022. Now she is on secondment as Workforce Planning and Development Manager for UHL, covering the trust’s entire 15,000-strong workforce.
“I'm an international recruit myself, so I've walked the walk”, says Malany. “I know the journey. I know the process. So leading on it was actually very close to my heart because I know how difficult it is to leave your home and your family and to make that decision to go abroad and start from scratch somewhere else. And it's the support that you get that can make or break your journey. It's not easy, especially if you're coming with children and family.”
Malany has a collection of recruitment case studies going back to UHL’s first international recruit in 2002, which demonstrates how the right support early on can lead to a long-term, mutually beneficial relationship (see below), and feeds into her wider work as chair of the Midlands AHP Ethnic Minority Network.
“It just shows how vast and diverse our development can be, and it goes beyond clinical development. Some of my colleagues have gone into education, some of them into research, some into advanced practice. I wanted to show to newcomers that if you stick with us and you give us your loyalty you know you can grow.”
All international recruits go through a strict process to gain registration with the Health and Care Professions Council before starting a role in the UK, but the ways of working in the NHS can be very different from the systems they experienced in their home countries.
“Some of our colleagues from abroad were quite senior in their roles but when they come into the NHS it's really starting again because it's a different system”, says Malany. “And from a radiography perspective we are a lot more autonomous in the UK, whereas in other countries it can be very doctor driven.”
An induction team oversees the progress of all new starters for the first four months of their time at UHL: “It's a robust system where you will only be put on the final rota once a competency is signed off and we feel that you are good to go on your own.
“We've also developed a new role of ‘practice development lead’. These are basically clinical leads on the shop floor to help any new starters, whether international or local, to make sure everyone is coping”.
UHL has recruited widely around the globe with recent radiography recruits coming mainly from India or from the Philippines via the Middle East. They do not actively recruit from countries that the World Health Organization recognises as having the most pressing health and care workforce challenges but there are exceptions where inter-governmental agreements support managed recruitment activities.
Malany says the cultural differences experienced by international recruits can make it more difficult to acclimatise to life in the UK than facing new ways of working. She’s developed a range of resources to help the radiographers adapt, from understanding regional dialects and sayings, to opening a bank account, finding places of worship, and suggesting local activities for days off.
All new arrivals are greeted with a taxi from the airport and provided with accommodation for the first two months, a UK sim card, and vouchers for food shopping. Malany has also started a WhatsApp group to help people quickly build social networks which can be essential in providing more informal support.
“People are really good at welcoming each other because they have all done that journey and they know how frightening it can be and how exciting it is, all in one breath. I can't explain the emotion because you are literally leaving your life behind, your work, your family, to come to a new country. And then you don't know what to expect and there’s that initial feeling of loneliness. So let's provide that network system for them.”
This latest tranche of international recruits followed a UHL bid to Health Education England (now part of NHS England) for a contribution towards the recruitment costs of 30 radiographers and six occupational therapists. The drive is part of a UK-wide strategy for recruiting internationally trained radiographers, mostly in diagnostics, to boost overall workforce numbers, and the SoR has produced resources to support managers and recruits entering both the NHS and the independent sector.
Sue Johnson, a professional officer for clinical imaging at the Society, said: “While this is not new, the number of international recruits is significantly higher than it was, and work is happening in many areas of the NHS to support the new recruits in practice.
“We are keen to celebrate and promote the positive contributions of our international colleagues”
“We are keen to celebrate and promote the positive contributions of our international colleagues, as well as highlight some of the challenges of settling into a new country and a complex health environment, and as a South African recruit herself, Malany understands the challenge of recruiting, developing and supporting a diverse team.”
Malany’s advice to managers is to acknowledge and understand the backstories of their new team members, and says that regular one-to-one catch-ups are vital: “Some people will fly in their new environment but some people will need a little bit more support, and if somebody's having a bad day it doesn't mean that they are clinically incompetent. It could be that they are worried about home, or financial pressures, or they're missing their family.
“That's why it's very important to build a relationship with your internationals, understand them and their backstories so you know what you're dealing with. And a simple ‘How are you today’ can make a huge difference to somebody who's struggling”.
Case studies
The University Hospitals of Leicester NHS Trust (UHL) has been recruiting radiographers internationally since 2002 for its departments at Leicester General Hospital (LGH), Glenfield Hospital (GH) and Leicester Royal Infirmary (LHR). Here, some of those recruits share the stories of how their careers have developed since arriving in the UK.
Main image caption
Pictured back row, left to right: Eric Adjei, Alex Mariotti, Danica Masbate, Bonifacio Tanalgo, Kenneth Attama, Claudius Masakure, Thulani Ndlovu, Berntom Ouma, Sumith Raveendran. Front row, left to right: Titilope Eniola, Malany Kalicharan, Pepukai Magondo, Richard Emokpo, Gerald Vedar
Pictured back row, left to right: Eric Adjei, Alex Mariotti, Danica Masbate, Bonifacio Tanalgo, Kenneth Attama, Claudius Masakure, Thulani Ndlovu, Berntom Ouma, Sumith Raveendran. Front row, left to right: Titilope Eniola, Malany Kalicharan, Pepukai Magondo, Richard Emokpo, Gerald Vedar
Berntom Ouma
Kenya
I was the first radiographer recruited from Kenya to Leicester together with another colleague in 2002. I joined as a basic grade radiographer and after 6-8 months was promoted to Senior II link grade. In Kenya I had been a superintendent for CT and MRI at various institutions so when a new CT and MRI suite was opened at Leicester in 2004, I applied for a Senior II radiographer post in cross sectional imaging. In the same year I enrolled for a postgraduate course in medical imaging technology at the University of Bradford, qualifying in 2005. Thereafter I relocated to GH in 2005 as Senior I radiographer specialising in CT and MRI.
In 2015, I took on an advanced practitioner role in Cardiac MRI and CT, and in 2017 I enrolled for a one-year postgraduate course in cardiac stress testing at the University of Salford.
Claudius Masakure
Zimbabwe
I joined the Trust in 2002, starting as a link grade radiographer at LGH before moving to GH in 2003, where I worked as a plain film radiographer. In 2005 I became a Senior II rotational radiographer until training as a sonographer in 2010. I am now clinical lead sonographer covering the general clinical aspects of ultrasound across the Trust’s three main hospitals and the community hospitals. I have had tremendous support to complete the Pg Cert in focused ultrasound, Pg Dip in ultrasound, MSc in Inter-professional Healthcare and Management, and I have just completed another MSc in Management, becoming a Chartered Manager. I am also an honorary lecturer at De Montfort University.
Pepukai Magondo
Zimbabwe
I am a CT/MRI superintendent at UHL. My journey started in 2003 when I came from Zimbabwe to join a very diverse team in plain film as a Band 5 radiographer. I then moved to cross sectional imaging as a Band 6 radiographer. After completing a Pg Cert in CT colonography advanced practice with Keele University, I pioneered CT colonography reporting for radiographers at UHL.
Mike Sinkala
Zambia
I joined UHL in 2010, after having worked at Coventry, Imperial College London, and in Ireland. After a few years, I trained in MSK axial and appendicular skeletal) reporting at a Pg Dip level, and was offered a reporting radiographer position at Band 7 , later obtaining an MSc in clinical reporting from Canterbury Christ Church University. In 2020, I successfully completed a Pg Cert in chest and abdominal reporting at Birmingham City University, and am now studying for my PhD in health research.
Mafalda Sousa
Portugal
I moved to the UK in January 2016, and have been working as a senior radiographer in the cross-sectional department at LGH. The department has been very supportive and helped me achieve an MSc in radiography. I was fortunate to join the academic team at the University of Leicester and I am actively contributing to the development of a new diagnostic radiography degree programme, which will have its first intake of students in September 2023. I am excited to be part of creating something new and innovative in the field, and I am proud to see the programme come to fruition and hopefully make a positive impact on the education of future radiographers.
Marta da Silva (Portugal)
Portugal
I started my UK adventure in 2017 as a radiographer in plain film and CT, and always had in mind that my goal was to become a reporting radiographer. Eighteen months later I succeeded in gaining a Band 7 post reporting plain film MSK examinations and received great support in completing my MSK reporting Pg Cert. I have always been interested in research and in November 2021 was invited to present at the Portuguese national congress on the role of a reporting radiographer. I am also a part-time teacher at Leicester De Montfort University and a self-researcher when time permits.
Bonifacio Tanalgo
Philippines
I worked as a CT radiographer in the Philippines for eight years before coming to the UK in 2004. I worked as a senior carer in one of the nursing homes in Derby and in 2014 I was successful in gaining employment as a radiology department assistant (RDA) at UHL. I later applied to be a Band 3 RDA and at this point my managers realised I was a fully qualified radiographer. I was immediately guided to return to practice and gained HCPC registration in 2018. I became a Band 5 radiographer and am now a Band 6 radiographer within the plain film X-ray team. This has transformed my life and I now am back to a profession that I love.
Alex Mariotti
Italy
I joined UHL in March 2018 after graduating in radiography at the University of Bologna in Italy. I started as a Band 5 cross-sectional radiographer and after 18 months was promoted to a senior role. I have been working in the CT/MRI department at LGH for nearly five years. I work with an amazing team which made me feel valued from the first day. I applied for a CT head reporting post at LRI and have now started my Pg Cert in CT head reporting at Birmingham City University. On completion of training I will become an AP, covering reporting sessions and clinical shifts, and be involved in research and teaching.
Titilope Eniola
Nigeria
I joined the plain film team at LRI as a Band 5 rotational radiographer in March 2021. I was promoted to a Band 6 senior paediatric radiographer in March 2022 and I am grateful to my amazing team not only for helping me settle in but also with my growth and development.
Bruno Robert
India
I started my career in the UK from Kerala, India, in 2021 as a Band 5 plain film radiographer. My manager saw my potential and encouraged me to move to Band 6 and my progression to a senior role took three months. As an international staff member, I had great support from my managers and colleagues who were very helpful with my development. I now work as a senior cross sectional radiographer at LRI.
Thulani Ndlovu
Zimbabwe
I joined UHL in July 2003 as a basic plain film radiographer and quickly moved to cross-sectional imaging in CT and MRI. In 2013, I was supported to do a Pg Dip in clinical reporting (appendicular andaxial skeleton) and became a reporting radiographer, doing MSK plain film. In 2017, I was supported to do minor injuries and illness course and subsequently became involved in radiographer-led patient discharge - a very exciting role. In 2020, I was given the chance to do Pg Cert in clinical reporting of chest and abdomen, which has enabled me to be able to report all plain films.
Find out more
The SoR has a range of resources to support international recruitment and management, with more being planned. Visit www.sor.org/international.
Photography by Simon Hadley
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