EDITOR, - The intercollegiate committee of the royal colleges discussed the Overseas Doctors Training Scheme in May. The objectives of the scheme, criteria for recruitment, method of organisation, financial implications, and evaluation deserve urgent consideration. It is exceptional to be able to provide a structured training with clinical participation.

Difficulties are compounded because the plans for postgraduate training in Britain (the Calman scheme) and the arrangements for staffing the health service are not coordinated. A reduction in middle grade posts - traditionally training posts - is occurring at a time when consultant posts are to be expanded. With the reduction in registrar posts some “visiting registrar” positions are being created, which are suitable for overseas doctors who already have a sound clinical grounding. These posts should give training comparable to that of career registrars (this grade will metamorphose into the unified training grade). The Royal College of Physicians of Edinburgh is promoting this scheme and plans to identify and probably interview doctors in several overseas centres.

Costs and funding were inadequately considered in the articles by Stella Lowry and Heather Cope1 and Tessa Richards.2 For many years the NHS has benefited from the work of overseas doctors, whose training it has not had to fund. The royal colleges have run the Overseas Doctors Training Scheme, finding training positions for the doctors, many of whom also provide valuable service. The government should fund the scheme before training becomes a “marketplace” issue. Some colleges believe that trainees should pay as it is less expensive for them to obtain posts through the scheme than by sitting the examinations of the …