Overseas doctors face new rules to work in Britain

BMJ 1995; 311 doi: (Published 18 November 1995) Cite this as: BMJ 1995;311:1324

More of the overseas doctors who apply to work in Britain will have to provide “objective evidence of capability” that they have adequate knowledge and skills, including linguistic competence, before they can register with the General Medical Council under new proposals approved last week.

The council's education committee said that it could not defend its accountability to the public under the present system whereby only a quarter of the 2500 doctors who apply from countries outside the European Economic Area (EEA) each year are tested on their knowledge of English and medical competence by taking the test set by the Professional Linguistic Assessment Board (PLAB). In 1994 the committee considered allegations of incompetence involving nearly 200 overseas doctors with limited registration, an 18% increase over the previous year.

Doctors from non-European countries have previously been exempted from the PLAB test if they have been sponsored by two specialists in their home country and have been accepted on a training course run by one of the medical royal colleges or if they have a qualification from a medical school on the GMC's approved list. Because of the difficulty in ensuring that the information on this list is accurate the council has decided that from 1 January 1996 all doctors whose qualifications are included on the more extensive list of qualifications held by the World Health Organisation will be eligible to apply for registration with the GMC. All candidates for the PLAB test will have to show their competence in English by achieving a specific grade in the international English language testing system. This is managed jointly by the British Council and the University of Cambridge, and may be taken in over 100 countries.

PLAB has decided to divide its test into two parts and is exploring the possibility of holding part one at overseas centres. Although the details have not been finalised, part one--which would have to be passed before part two was attempted--might comprise mult- iple choice questions, photographic material, and clinical problem solving.

The second part might comprise an objective structured clinical and oral examination that would assess clinical knowledge and skills as well as communication and interpersonal skills.

The GMC is also discussing with the medical royal colleges and other interested bodies whether other kinds or “objective evidence of capability” might be accepted as an alternative to a pass in the PLAB test.--LINDA BEECHAM, BMJ

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