The Overseas Doctors Training Scheme needs appraisal. Set up 10 years ago to improve the quality of postgraduate training that overseas (non- European) doctors receive in Britain, the scheme has been popular, but it is questionable how far it has achieved its aims. If Britain is to continue to employ large numbers of overseas doctors in training grades, both through the scheme and through independent arrangements, the apparent mismatch between their expectations and the reality of what Britain offers must be tackled.

The Overseas Doctors Training Scheme has acquired a bad name. Criticised by the Overseas Doctors Association, and in a “personal view” in the BMJ by one of the very people it was set up to help, it has been accused of being “one of those well intentioned training programmes which has failed to live up to expectation.”^1,2

Although the scheme works well for some overseas doctors, others are dissatisfied with the postgraduate training they receive in Britain. This dissatisfaction is by no means confined to those on the Overseas Doctors Training Scheme. Only about 40% of overseas doctors come to Britain under its aegis, and the remainder probably experience more problems. Most of the dissatisfaction stems from not being able to find a job in the desired specialty at the “appropriate” level. Dissatisfaction also stems from alleged racial discrimination. In the past year another problem has surfaced. Legislation has been proposed to tighten existing regulations and stop overseas doctors extending their four year, work permit free training. Although this has yet to be introduced, some overseas doctors are facing professional and personal difficulties as applications for work permits or extensions to permit free status have been refused.3

This article is based on my discussions with the royal colleges, the General Medical Council, and doctors who are …