This is the first post in a continuing series on identity, leadership and what high-stakes environments teach us about both.
I have been a doctor in London for more than eight years now. And I am still learning how to communicate. When I arrived from Germany, I thought medicine was medicine — the science and the drugs are the same. What nobody told me was that the culture of medicine is different.
In Germany, I was trained to be direct, fast, precise. Say what is wrong. Say what you will do. Move on. There is even a word for it: Sachlichkeit — principled clarity. I respected this.
Then I walked into the NHS.
A midwife pulled me aside in one of my first days and, very kindly, she said: “Arndt, you are coming across as quite… abrupt.”
I had been accurate. I had been clear. What I had not been was relational. The NHS runs on relationship — on reading the room before you speak, on understanding that the team is not just the mechanism for delivering care. The team is part of the care.
It took me years to learn this. And here is what I know now: I could not do my job without both. Germany gave me rigour. Britain gave me warmth. Neither is better. They are just different maps of the same territory.
Research backs this up. Geert Hofstede’s cultural research shows Germany and the UK differ sharply on “uncertainty avoidance” — Germany favours structure and explicit communication, the UK prefers flexibility and reading context.
I am increasingly convinced that this is one of the least-talked-about challenges for international professionals. Not language. Not competence. Culture.
If you have ever felt professionally fine, but culturally slightly out of step — I’d love to hear your experience in the comments.
Next in the series: Can You Root in Two Countries?, on what it means to build a life somewhere you did not grow up.
