Intended for healthcare professionals


Ironing out difficulties

BMJ 2014; 348 doi: (Published 14 May 2014) Cite this as: BMJ 2014;348:g3197
  1. Tom Moberly, editor, BMJ Careers
  1. tmoberly{at}

The plight of medical graduates from other countries wanting to work in the NHS has been brought into sharp focus in recent weeks.

Last month’s judicial review into the membership examination of the Royal College of General Practitioners highlighted the importance of acting on information about disparities in pass rates across ethnic groups. Shortly after the judicial review, research into the tests that international graduates take to register with the General Medical Council also revealed some uncomfortable truths. In two studies, published in The BMJ,12 researchers showed that pass marks would have to rise substantially if international graduates were to reach the same standards as UK graduates.

In BMJ Careers this week Mohan Bhat and colleagues look at the current difficulties faced by international medical graduates working in the NHS ( They found that overseas doctors rarely have the opportunity to undertake appropriate training before starting the registration process in the UK. Often when they start work in the UK they are unfamiliar with the legal framework and cultural expectations underpinning UK medical practice. But they also face difficulties with more prosaic aspects of starting work in the UK, such as finding somewhere to live, opening a bank account, and qualifying for a driving licence.

The UK does not train as many doctors as it needs and so, to care for its population, it relies on the 1300 overseas doctors who come here every year to work. Unless the government is planning to fund this number of additional medical training places, the UK will continue to rely on overseas doctors. Ensuring that the difficulties they face when they start working in the UK are ironed out as much as possible will help not only these individuals but the health service as a whole.


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