Navigating cultural differences as a Doctor in the NHS and India

Tuesday, April 25, 2023

Are you considering a career in the NHS but unsure where to start? Understanding the differences between healthcare systems worldwide can be crucial in making an informed decision. In this blog post, we will explore the differences between working in the NHS and the Indian healthcare system. We'll discuss topics such as education and training, working conditions, and patient care, all with the goal of providing you with valuable information to help support your career choices.

There are several differences between working as a doctor in the NHS and Indian healthcare systems. Some of the major differences include the healthcare infrastructure, patient population which can present unique challenges for doctors, and cultural attitudes toward healthcare. In this article, we will cover the infrastructure of the NHS, private and government healthcare in India, the typical patient pathway for a patient in the UK and India, and the demand for doctors in each country.

The NHS                                                                    

The NHS is a healthcare system in the UK that is funded by taxes and provides healthcare services at no cost to UK residents except for dental and optical services. Patients in England may have to pay for prescriptions, but some groups are exempt from fees. The government administers the NHS and employs all healthcare staff. The NHS is known as one of the best healthcare systems globally. Roughly 10% of the UK population still purchase private health insurance for faster access to elective care.

Indian Healthcare System

India's government introduced The Ayushman Bharat program in 2018 to help the poorest in the population with healthcare costs. Patients get up to $7,200 a year to use at private hospitals. Health and Wellness Centres, which provide primary care, are also part of the Ayushman Bharat program. In India, healthcare is a $90 billion industry with 70% coming from the private sector. The free healthcare infrastructure and crowded government hospitals leads some people to seek private healthcare providers.

Training as Doctor


Doctors will be enrolled in foundation training in the NHS once they have completed their MBBS. This involves six rotations covering different specialties over a two-year period (FY1 and FY2). Only after Doctors have completed FY1 will they have a GMC full registration with a license to practice. Doctors who want to complete a run-through training program will remain in the NHS for a further 7 years as they complete their specialty training (ST1-ST7) in the field they want to pursue a career. Once all training is complete, they will receive a Certificate of Completion of Training (CCT), be added to the GMC specialist register, and be eligible to work as a substantive Consultant in the NHS.

Indian Healthcare System

Doctors will need to apply for an internship once they have completed their MBBS. This could be at a government or a private hospital. Some doctors will choose to do this at a private hospital as it will be less busy, and doctors are available to learn from however the experience certificate may not always be accepted like at a government hospital. Once a doctor has their MBBS and certificate of internship they can register with the Indian Medical Council, practice medicine and start their careers.

Primary care  


Primary care is the first point of contact in the NHS and includes general practice, community pharmacy, dental, and eye health services. GP and nurse consultations and other primary care services are free to all. Patients usually see their GP or a medical professional in primary care for non-emergency issues. If further investigation or treatment is needed, the GP will refer the patient to secondary care.

Indian Healthcare System

150,000 Ayushman Bharat Health and Wellness Centres (AB-HWCs) have been created to deliver Comprehensive Primary Health Care, that is universal and free to users. There is a focus on wellness and the delivery of an expanded range of services through a continuum-of-care approach.



NHS England is the umbrella body that oversees healthcare. It is an independent body, which means that the Department for Health cannot interfere directly with its decisions. It’s responsible for ensuring that there is an effective system of Clinical Commissioning Groups (CCGs) and must provide support for commissioning.

NHS Foundation Trusts provide the care that the CCGs commission. They include hospitals, ambulances, mental health, social care, and primary care services. Secondary care is provided by specialists and healthcare professionals and patients are referred by GPs. It includes both emergency and non-emergency hospital contacts like A&E and outpatient clinics for mental and maternity health. Tertiary care is provided in specialized hospitals by specialized doctors and nurses, like in a plastic surgery unit. Patients can only access tertiary care if they are referred by a health professional working in secondary care.

Indian Healthcare System

In India, different hospitals function independently and therefore differently from one another. The government-funded function is very different from the private hospitals and each private hospital functions in its own unique way.

Demand for Doctors

  • In 2020, there were over 1.2 million doctors registered with the Indian Medical Council.
  • Between 2017 and 2021 the number of licensed doctors in the UK grew by 17% from 242,642 to 283,663.
  • In 2022, 44,785 staff employed by the NHS directly self-reported their nationality as Indian.

Why work with A&E Agency?

Doctors choose A&E Agency because of our diverse range of job opportunities combined with ongoing specialist career support. Our permanent division specialises in supporting international doctors relocating to the UK, in line with the NHS Employer code of practice. If you are a doctor and would like to discuss job opportunities available in the UK, please email

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