Challenges faced by overseas South Asian dietitians in the UK

Fareeha has a specialist interest in South Asian diets and provides advice to South Asians across the globe. She is extremely passionate about providing the best available nutrition advice to people with South Asian backgrounds, which is what led her to develop the South Asian Eatwell Guide.

Fareeha Jay, RD

Freelance Dietitian

Moving from Pakistan to the UK, Fareeha encountered surprising challenges in her work as a dietitian, not least the food and language barriers...

I did my bachelor’s degree in Dietetics at the University of Plymouth; however, the rest of my education was in Pakistan. Doing a degree in the UK was highly challenging because I was a mature student juggling the demands of family and reacquainting my studies, but also because the education system was completely different and challenging for me to grasp.

After I qualified, I started working as a diabetes specialist dietitian for an NHS-led organisation and faced some challenges. What surprised me most was all these challenges despite having studied in the UK. It made me wonder how difficult it can be for South Asian dietitians working here, with their entirely different cultural and educational backgrounds.

The nuances of communication

One of the standards of proficiency of being a member of the HCPC is to communicate effectively. I scored 7.5 in my IELTS, and all South Asian dietitians would also have scored a minimum of 6.5 to practice in the UK. Nevertheless, I still found the subtleties of language and the differences in dialect extremely challenging. Many times, nuances in language and terminology led to misunderstandings.

It became even more complex with non-verbal gestures such as eye contact and facial expressions, which I would misinterpret, or vice versa, when mine were misinterpreted. One thing that shattered my confidence was pronouncing the names of the patients. I could rarely get them right; most patients would feel highly offended. This made me extremely nervous and jittery about my work and impacted my performance.

Not speaking the way, we are expected to speak and sometimes not understanding cues may lead to bullying, harassment and bias. As I have been living in the UK for many years, I have only faced these a few times during practice. Whilst these experiences were all dealt with at the time, they led to a lot of stress and anxiety. I'm sure this is not unusual for overseas dietitians who come her to work and perhaps more so for those who have just recently immigrated.

South Asian dietitians who may have previously worked in their countries usually work in a hierarchical structure. They are part of the team but are expected to remain silent. They might continue doing the same in the UK, whereas it would be perceived as being a poor team player here.

Learning about the UK diet

As dietitians, it is essential to understand the patient-specific culture, how individuals pertain to nutrition and what foods they eat. I needed to gain an understanding of British food. I had little to no understanding before living and working here. Taking food diaries or giving food-specific advice would only be possible if I completely understood the food.

I struggled with the concept of 'ready meals', for example, and I was only familiar with South Asian fruits and vegetables, so when swede and parsnips were mentioned, I had no clue what they were!

The most difficult topic I found (and still do) was advising on alcohol. Because I don't drink and didn't grow up in an environment with alcohol, it was difficult for me to understand that alcohol is an essential part of British culture. It is part of all networking events and family celebrations here. Many times when advising patients or clients, I would forget to mention alcohol at all and I certainly struggled with advising on what types of drinks to have. This can be a big challenge for overseas South Asian dietitians initially; however, with time, we learn.

Photo by Christine Jou on Unsplash

Being culturally competent is a lifelong project. Learning takes place if a big effort is made. One way to overcome professional and cultural barriers is to develop social connections in the locality you are working.

Keeping aside all the professional challenges, overseas South Asian dietitians also face the challenge of integrating into a new community in the UK. They have to cope with moving away from their close friends and family back in their country of training. The transition of moving away and settling in the UK commonly results in feelings of loneliness and depression.

Every overseas South Asian dietitian will have a different experience; however, and, all in all, being a dietitian in the UK is a great experience where, every day, your critical skills and knowledge improve.