International Medical Graduates represent a significant part of the UK medical workforce. Often highly qualified in their home countries, they arrive in the NHS without the experience of either system or culture. Their chance of success is determined by the orientation program and governance structures are in place to support them. In this report, we describe two structures we designed independently to support IMGs from recruitment through to their transition into working in the NHS. We describe the Epsom St Helier Academy and King’s College Orientation Programs in the pre-COVID and COVID19 era.  Our programs offer a blueprint for other healthcare organisations looking to improve the integration and experience of IMGs in the NHS. Peer reviewed by Simon Gregory & Vijay Nayar