The GMC view on how it can help overseas doctorsBMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7454.s254 (Published 19 June 2004) Cite this as: BMJ 2004;328:s254
Graeme Catto, president of the General Medical Council, shares his thoughts with Rhona MacDonald
“We are absolutely dependent on good quality doctors coming to work in the United Kingdom. Anything we do from the GMC's end ought to help them,” says Professor Sir Graeme Catto, president of the General Medial Council.
The idea that the GMC may be there to help them rather than hinder them may seem incongruous with how many overseas doctors feel about it. Sir Graeme explains, “The issue is that we may not know about all the issues. We need to be aware of changing circumstances for doctors coming to work in this country. It's important to bear in mind the GMC's role. Our main responsibility is to set standards for practice in the UK. The professional and linguistic assessments board (PLAB) test is one way in which doctors can satisfy us that they meet the standards of knowledge and skills we expect for practice here. The question of employment for these doctors is not therefore primarily one for us. That said, we are as concerned as others about ensuring that doctors have access to helpful and realistic advice before embarking on the PLAB test.”
We need to be aware of changing circumstances for doctors coming to work in this country
Surprisingly, the current statistics for overseas doctors passing PLAB and finding a job apparently look good. According to GMC statistics, 90% of doctors who have passed PLAB find a job within a year.1
No or misinformation
However, Sir Graeme cautions, “Most doctors are able to find work in the United Kingdom, but I have no doubt looking at the increase in the number of doctors sitting the first and second part of the PLAB that we are going to get to a situation very soon where that is not the case.”
He continues, “Currently, we don't have any information about the quality of the jobs that these doctors coming to work in this country are able to get. There may be an issue of potential or real unemployment for doctors coming and there probably is a real issue about the quality of the posts that are available to them. We need to work effectively with the Departments of Health and make sure that doctors who are thinking of coming to this country understand what is and what isn't available.”
Can he expand on this? “I don't think there is any particular benefit in making high quality career information available only for overseas doctors. It should be for everybody and they should be directed or helped to participate in that.” He continues, “Providing that information not just on a UK-wide basis but on a regional basis might be more helpful to any doctor but also to the overseas doctors.”⇓
The problems with PLAB part 2
What about the accusation that as doctors have to come to the United Kingdom to sit part 2 of the PLAB and that the numbers sitting this exam are not limited, they come in their thousands, get stuck, and become an unused surplus?
“Information about employment should be much more readily available so doctors can assess what their chances are. There has been a perception that the United Kingdom is so short of doctors that there were jobs for almost anybody and of course that's not true.”
And about PLAB part 2 not being in the United Kingdom? “We are having a PLAB review at the current time and that is one of the issues we are looking at. The practicalities of sitting part 1 in different countries are considerable but not insurmountable. It is a much more extensive exercise to get PLAB 2 introduced in overseas countries. So we need to look at this sensibly perhaps in conjunction with other groups of people because there are currently different forms of assessment going on in many countries at the present time. We might be able to limit the costs by combining with other countries and the boards who run the exams.”
Can he tell us more? “The International Association of Medical Regulatory Authorities is beginning to work together much more effectively to help overseas doctors.” There are two reasons for that. One is of course countries such as the United Kingdom are dependent on them and the other is that medical migration is beneficial in raising the standards of medical care to patients in all countries not just the host country that the doctors migrate to.”
Other ways to help
Amanda Watson, director of GMC registration, tells us more about how the changes to the GMC registration procedures will help overseas doctors on p 255. But what else can the GMC help with. Can it help with clinical attachments?
Sir Graeme replies, “I'm not sure we could have the right input into that, although once again, coordinating these schemes and making doctors aware of what is available is the best way of dealing with that.”
What would you say to an overseas doctor who is sitting in a crummy bedsit somewhere in a bad area and is sending out 500 applications and not getting anywhere and running out of money and time in the United Kingdom?
“From my perspective what we would want to do is to see how many of such doctors exist and how we can work with others to avoid that. The GMC on its own probably can't be effective, but the GMC working together with the NHS and the Departments of Health could be much more effective in smoothing the path for such doctors.”
Useful information for overseas doctors
GMC: registration enquiries—tel + 44 (0)20 7915 3635 or email www.gmc-uk.org,
BMA International Department: tel + 44 (0)20 7383 6793, www.bma.org.uk/international,
British Council: www.britishcouncil.org/health/nacpme
Medical Royal Colleges: for a list see www.aomrc.org.uk/pages/links/collegelinks.html
Regional postgraduate medical deaneries: for a list see www.copmed.org.uk/deaneries
Home Office. www.ind.homeoffice.gov.uk