Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7129 Volume 316 Letters Saturday 7 February 1998 UK encourages unrealistic expectations among overseas applicants for training Editor, The current situation regarding overseas graduates and training posts in the United Kingdom is unsatisfactory. I recently went through 147 applications for four senior house officer posts in medicine at the district general hospital where I work. Of these, four were from British nationals (two of whom were graduates of British universities). Most applicants were graduates from India (77), with the others being from African countries (16), Germany (9), Greece (8), the Middle East (6), Myanmar (3), Pakistan (3), and Sri Lanka (3). Most of the overseas graduates had not worked in the United Kingdom; of the few who had done, most had worked in accident and emergency, care of the elderly, or psychiatry departments. These doctors had, however, stated in their curriculum vitae that they intended to pursue training in general medicine and various medical specialties. Clearly, their choice of jobs had been dictated not by their training needs or intentions but by the service needs of the NHS. I have since found that the wide gulf between supply and demand for training posts is not restricted to medicine. Far more overseas graduates are seeking higher professional training in the United Kingdom than can be trained satisfactorily. It thus seems inappropriate, if not callous, to continue to permit large numbers of candidates to sit the Professional and Linguistic Assessment Board (PLAB) test; and even more so to start holding examinations in the candidates' home countries, encouraging more to take them. If the United Kingdom is sincere about its commitment to postgraduate medical training it must institute measures to reduce the number of overseas graduates sitting the PLAB test and coming to the United Kingdom via overseas doctors training schemes. Institutions responsible for examination and training should, in their communications with overseas doctors, state clearly the dearth of training posts in certain specialties. The more knowing among the overseas doctors here, particularly the sizeable numbers with higher qualifications in medicine and surgery who now work as general practitioners, believe that the United Kingdom has always used overseas graduates and the PLAB test to recruit doctors for the less sought after specialties.(1) Inaction about the current unsatisfactory situation will only serve to confirm this view. Of equal cause for concern must be the paucity of home graduates seeking training posts.(2) An oversupply of overseas graduates and an undersupply of local ones implies that something is fundamentally wrong with manpower planning in the NHS. The sooner the issue is addressed seriously the better for all concerned. M K Sridhar Consultant physician Mid-Staffordshire NHS Trust Hospitals, Stafford ST16 3SA References 1 Varman S S. Training for overseas doctors. BMJ 1993;306:1545-6. 2 Fletcher E W L. Home medical students account for less than half the full registrants Britain requires. BMJ 1997;314:1278. Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline