GMC is to get legal power to check English skills of European doctorsBMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f1297 (Published 26 February 2013) Cite this as: BMJ 2013;346:f1297
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After reading the BMJ's article reporting on the GMC receiving legal powers to check the language skills of doctors from the EEA, it feels as if the proposals will still fall short of their intended purpose.
On the surface, it would appear to be a step in the right direction--after all, it does not seem fair that non UK graduates from outside the EEA have to undergo formal evaluation of their English language skills, whilst their EEA counterparts do not. This is nothing short of nonsensical--anyone who has not been educated and whose first language is not English, should be subject to exactly the same assessments of language proficiency. Anything else would be tantamount to discrimination.
However, from the article, it does not appear that the GMC has in fact been given legal powers to subject EEA doctors to the same level of language scrutiny as non-EEA colleagues. The article suggests that the GMC would only be permitted to seek confirmation of an EEA doctors' English language abilities if there was "serious and concrete" concerns which arose during the registration process. Therefore, it would appear that European doctors would only have their ability to speak English questioned if there were serious concerns. On the other hand, non-European doctors have to continue proving their English language proficiency by way of undertaking formal IELTS examinations. Where is the parity here?!
On a slight, albeit related, tangent, it appears to me that these formal examinations are often inadequate assessments of a doctors ability to communicate effectively (not just adequately) with patients, as exemplified by the discrepancies in pass rates of postgraduate clinical exams between UK and non-UK graduates (particularly in General Practice and Psychiatry). This has become such a political hot potato of late, that the respective Royal Colleges have been accused of racism by those who feel discriminated against. I vehemently disagree with those organisations who have chosen to play the victim/race card against the Royal Colleges. The discrepancies in these examinations are simply a reflection of the fact that many doctors whose first language is not English are simply not up to the job, purely from a communication perspective. Perhaps it is their IELTS examinations which are failing them, in that they do not adequately evaluate their ability to communicate in the real world, with real patients in real clinical scenarios (or even examination simulated scenarios with actors as patients!). As such, one could argue that these formal assessments of language proficiency are not fit for purpose, and are misleading the foreign doctors who are required to sit them. Perhaps, then, these doctors should divert their anger towards the bodies which set these exams, rather than falsely accusing the Royal Colleges of serious discriminatory practice, which is simply not the case.
Perhaps this is more of a pressing issue in my line of work, psychiatry, as compared to other medical specialities. Nobody can refute the fact that in psychiatry, effective communication with patients is an absolutely crucial and integral component to one's overall clinical skills. From personal experience, I cannot understate the number of times I have been appalled by the shockingly poor communication abilities of a sizeable proportion of my non-UK colleagues. Indeed, it is not an exaggeration to say that I have often had to take on the role of a translator in a conversational interchange between a senior consultant and their patient! I have worked alongside colleagues whose English language abilities can only be accurately described as being of the pigeon variety! Truly frightening. I must state for the purpose of balance, however, that I have also worked with non-UK doctors whose language and communication skills are on a par with, if not better, than my own.
However, a source of far greater alarm is what the article reports as constituting "serious and concrete" concerns in the case of EEA doctors. It reports that "a doctor turning up to their ID check with a translator" would constitute a "red flag" for language concerns!! Call me cynical, but I surely this scenario should come under the department of "stating the bleeding obvious!" What a relief that a "red flag" will be raised should a doctor turn up with a translator!! To conceive that such doctors have been permitted a licence to practise by the GMC before these new powers, is frankly astounding! Never mind a red flag, I think the GMC should raise a white flag of its own, if this really was a feasible scenario!
I am left wondering whether the above mentioned example and the others reported in the article constitute a suitably high threshold for establishing a doctor's ability to communicate with patients in English? Surely, it is absolutely paramount that a doctor is capable of comprehending their patients, and in turn, conveying information accurately, efficiently and comprehensively. Anything less than this would be tantamount to unsafe clinical practice. Effective communication is an integral component of a doctor's capacity to carry out their job safely. Surely, therefore, the GMC should be demanding far more than basic language proficiency from any doctor who practices under their regulation (EEA or non-EEA)--it should be demanding that all its doctors strive for excellence in communication. Anything less would be failing the patients the GMC is meant to be protecting.
Competing interests: No competing interests