Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Down but not out
- Rahul Rao (21 April 2006)
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Tragic, but who should take the blame?
- A Joglekar (21 April 2006)
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Overseas Doctors and the new regulations
- Abhijit M Bal (22 April 2006)
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Re: Overseas Doctors and the new regulations
- Dr. George (24 April 2006)
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Too much planning or no planning at all?
- Anthony Papagiannis (25 April 2006)
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Missing bit in the main story
- Irvail Satheesh Prabhu (25 April 2006)
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Employment and Economics
- Kamal Mahawar (27 April 2006)
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Rahul Rao, Organiser/Chair, GKT SHO Scheme in Psychiatry York Clinic, Guy's Hospital, 47 Weston Street, London SE1 3RR
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Having both personal and professional exposure to the plight of International Medical Graduates, many of whose compatriots have given their blood sweat and tears to supporting the NHS since the early 1960s, the new ruling will undoubtedly affect a great number of them. There can be no rational debate around prioritising the employment of UK graduates, but the decision surrounding a categorical distinction between other EEA doctors and IMGS could be open for criticism. To take an example, the GKT SHO scheme in Psychiatry comprises some 130 doctors. Both 80 per cent of applicants to the scheme and a similar proportion of trainees within the scheme are IMGs (over 90% of whom are from the Asian sub-continent). For most of these doctors, English is their second language and most are highly proficient in it. This is supported by objective evidence of such proficiency through passing the PLAB examination. The Highly Skilled Migrant Programme may offer a 'second chance offer' to suitably qualified IMGs and some are exploring this opportunity. Also, the opportunity for face to face interviewing still exists within most, if not all, SHO schemes in Psychiatry. It is then very likely that any doubt as to competency in communication skills will 'come out in the wash'. Although there is likely to be considerable limitation to the career opportunities of IMGs, the skills and dedication that such doctors have to offer the NHS cannot be underestimated. As such, those doctors with suitable experience and qualifications should not lose heart completely. There are likely to be many spaces to watch as the dramas and tragedies unfold. Competing interests: Both parents are retired Associate Specialists |
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A Joglekar, Specialist Registrar St Mary's Dept. Of Child & Adolescent Psychiatry, 17 Paddington Green, London W2 1LG
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Most overseas doctors who have only recently come to UK probably have experienced the tragic circumstances hilighted by Dr Sareen. But who should take the blame for this. Should it be the overseas doctors & perhaps their parents for venturing in to a job market that has been known to be very competitive in the past two years? Should it be the General Medical Council for increasing the availability of the PLAB exams and creating an illusion that UK needs huge number of overseas doctors? The Home Office has compunded matters with an abrupt change in rules, but what about the factors that drive young doctors away from their homeland? Most overseas doctors will agree that apart from training, the prospect of better pay in UK is attractive. Equally, a huge majority are running away from immoral and unethical practices they would be forced to enter just to make ends meet. The latter includes having to pay commisions to General Practitioners for receiving referrals. How can one explain a situation wherein the pay for working in a call centre in India could match that of a Lecturer (after nine years in training) in a teaching hospital. Salaries of fresh Indian MBAs and software programmers are almost twice or thrice those of specialist staring work in Medical Institutes. Continuous under- investment has led to a mockery of the medical profession in India. Further the profession is so unregulated that capitalists would be least interested in investing in health care. I think the Government of India should share the blame for circumstances described by Dr Sareen. References: Letter home. Surinder Sareen
Competing interests: None declared |
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Abhijit M Bal, Specialist Registrar Department of Medical Microbiology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN
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It is high time that we all make some sense out of this confusion. First, I cannot believe that the overseas doctors have been in dark about the job situation in the United Kingdom. Most of the overseas doctors sit the PLAB and the General Medical Council website quite clearly describes the bleak job prospects following success at the PLAB. Secondly, I have come across several letters with people crying hoarse about the fact that the overseas doctors might need to sell their houses and property at short notice. I am not sure how many people on six monthly contracts actually own property in the UK and I very much doubt the veracity of such exaggerated claims. Thirdly, let us also see some advantages of the new regulations. Doctors who get employment from here on will be on work permit and hence will get the right of indefinite residence sooner. Finally, my feeling is that fresh migration will abruptly cease. This probably means that the NHS will be able to absorb those already in the UK. I advise the overseas doctors to be a little patient and give their time towards their careers instead of passionately wasting time over such issues. Competing interests: None declared |
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Dr. George, SHO -Medicine Monklands Hospital, Lanarkshire, ML6 0JS
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Sir, It is surprising that some contributors like Dr.Bal are so removed from actual reality on the ground. His argument that overseas doctors who are in the UK will find it easier to secure jobs is misplaced optmism, at best. There are a large number of advertisemnts for junior doctors which clearly state that those requiring a work permit need not apply. How would one 'find it easier' to secure an employment if they are not shortlisted for interviews in the first instance! Moreover, does it really matter whether or not one has property in the UK or not? Those owning a property will perhaps gain financially from investments while others who don't will have the added burden of raising finances to buy/rent a house in their home country. I also agree with Dr. Bal that Plab candidates have been told about bleak job prospects. However, they have not been warned that they will not be allowed to compete at a11. Competing interests: Overseas Doctor with residential properties in the UK |
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Anthony Papagiannis, Respiratory Physician St Luke's Hospital, Thessaloniki, Greece
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In 1990, in the course of an interview for a registrar post in respiratory medicine in the UK, I was told that there were already 75 senior registrars waiting for consultant posts, and that there was going to be a freeze of the intake in the specialty until all those people were appointed. I was given the go-ahead when I said that I was looking homeward for my career. The freeze happened a couple of years later. Consultant grade expansion followed, and soon there were no qualified people to fill the new posts (indeed my British friends begged me to come back for a substantive job). By that time I was established in private practice back in Greece, a country which exercises no medical workforce planning whatsoever. For a population of 11 million we have more than 60,000 doctors (both home grown and imported from points east), most of them specialized and practicing in the big cities, with the rest of the country left with a sprinkling of specialists and only a ‘skeleton crew’ of general physicians. There are waiting lists for entry in specialist training, and waiting times may be up to several years; therefore many medical graduates look abroad for their training. As the English language is more widely spoken than, say, Swedish or Dutch, no prizes are offered for guessing which country they prefer. The moral from these two tales is that there is no perfect system, as either too much planning or no planning at all may result in a quagmire. You can take your pick. Competing interests: None declared |
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Irvail Satheesh Prabhu, FY1 The Royal Oldham Hospital
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Dear Sir/Madam, It is very disheartning to see an adopted child being neglected when mother had her own!! For decades NHS has recruited overseas doctors and today overseas doctors are told to return to their country as they are needed more over there. I am sure they were needed in 60's& 70's and they are needed now as well. Let me bring to your attention, something which hasn't been discussed in this forum widely, though it is another shot in the foot by home office. On 7th March, home office also announced that international students who granduate from UK medical schools will be allowed to train for two years. That means people like me who have spent more than twenty thousand pounds per year to pay overseas student fee has to return to our home countries without acquiring any special skills. This expensive degree will be at par with medical degree at home for all practical purposes. It is the specialist training that the international students are aiming to acquire when they join the medical school. These degrees cost £90,000 (ninety thousand pounds) and it is, I would assume, a good income to UK universities. I am in no way denying that these degrees are not worth but without any special skills they will be ignored largely in any country. The training given in UK medical schools is tailored to work in NHS and just two years of training is not taking us any far in our career. It is important for all overseas students in UK medical schools to be aware of this new development and also potential international students who will be joining medical schools in summer to re-think their decision to study medicine in the UK. I really hope that Home office & Department of Health understand the implications of this ruling and make urgent changes to the same. Please do not act on a statistically insignificant, non longitudinal study. Thanking you, Yours truly, I S Prabhu Competing interests: None declared |
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Kamal Mahawar, Specialist Registrar, Department of Surgery Wansbeck General Hospital, Ashington
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I have to completely agree with the author that the NHS planners have got their manpower planning completely wrong. It is much too evident from the fact that homegrown doctors were facing unemployment and stiff competition from overseas graduates for the jobs in their own country in recent past. It is perhaps more clear from recent sacking of nurses. We, the international medical graduates, have responded to a market demand in the last few years when NHS needed doctors at all levels and it was widely advertised. I had myself come across several big newspaper advertisements in India before coming here. Let us get it clear; most of us are here either for better training or better remuneration and not to help the NHS. At the same time, from the NHS's point of view, we were needed THEN but not now. All seems fair but for the suddenness and abruptness of the change. It would have been nicer to warn us first and give us some time to pack our baggages. At the same time, I do not think NHS should even try and take a high moral ground by telling us that we are needed more in our own countries. It has simply been demand and supply so far in this case and let us not complicate things by bringing "ethics" into it. Also I think that various organizations are working here at cross purposes. GMC still continues to organize PLABs furthering false hopes of a medical career in UK. Some Royal Colleges are still examining overseas and awarding diplomas and memberships. I can only hope that all these activities would come to an immediate end until we find out how many, if any, foreign doctors would be required in the next few years. NHS has proved now that it can attract employees from around the globe and humiliate them when it so desires. "To be able to work with dignity" remains an oxymoron in the current world order. Competing interests: I am an International Medical Graduate in United Kingdom for better training and remuneration |
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