Editorials

Discrimination in the UK’s postgraduate examination in primary care

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5765 (Published 27 September 2013) Cite this as: BMJ 2013;347:f5765
  1. Patrick T Dowling, professor
  1. 1Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095-1683, USA
  1. pdowling{at}mednet.ucla.edu

Cannot be ruled out

Increasing globalization means that up to 230 million emigrants now live in countries around the world. Wealthy English speaking industrialized democracies such as the United Kingdom, United States, and Canada have long relied on immigrants, and their descendants, to fill voids in their healthcare workforces. A linked paper by Esmail and Roberts (doi:10.1136/bmj.f5662) raises questions of fairness and equity in the way this important group is served by our selection and training processes, and what this might mean for the quality of healthcare in multicultural populations.1

The question is timely and important. Exactly half a century after Martin Luther King made his landmark “I have a dream” speech on racial justice and equality in 1963, the US remains tethered to the world’s most wasteful and unequal healthcare delivery system. It costs almost twice as much per capita as any other health system in high income countries, yet 50 million US citizens have no health insurance, and 70 million live in designated shortage areas for primary care. Yes, we can cure disease in ways past generations never dreamt, but we still haven’t ensured that everyone has access to basic care.2 3 In the UK too, …

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