In the past 40 years, the practice of psychiatry has changed dramatically from asylums to community care to personalized home-based treatments. The personal history of working in various settings and changing NHS indicates that an ability to change one’s clinical practice is a critical skill. Being a migrant and an International Medical Graduate brings with it certain specific challenges. Personal histories provide a very specific account that is inherently incomplete and perhaps biased, but personal accounts also give history a tinge that academic accounts cannot. In this account, changes in the NHS have been discussed with regards to changes in clinical care of patients with psychiatric disorders as well as research and training.