The themes in Chapter 6 cluster around the negotiation of cultural differences. For first-generations psychiatrists this meant learning about different cultures and practices, which often involved comparison with their formative medical school education. Adjustments were often motivated in the interests of meeting the needs of patients such as learning about cultural nuances. There were times when the psychiatrists felt like they were made to feel different and were not accepted. This happened in subtle and more overt ways, both of which pointed out their differences. Experiences ranged from cases of explicit discrimination from vulnerable patients to comments and actions within the institution, for example, that pointed out their differences. These latter practices may have been infrequent or implicit but contributed to a sense of ostracization, of feeling as if one does not quite belong. Being asked where one was from, although in itself, not intended to cause harm or offence was distancing. The psychiatrists moved between South Asian culture and British culture in their identity positions, sometimes consciously and explicitly, at other times, less so.