Intended for healthcare professionals


Doctors’ language tests: five minutes with Ceri Butler

BMJ 2018; 360 doi: (Published 20 February 2018) Cite this as: BMJ 2018;360:k806
  1. Abi Rimmer
  1. The BMJ

The academic talks to Abi Rimmer about the GMC’s decision to accept the Occupational English Test (OET) in addition to the International English Language Test System (IELTS) as proof of a doctor’s language skills1

“Since I began working with refugee doctors in 2003, the most significant barrier to working in the NHS that they have faced has undoubtedly been the IELTS.

“It can take a refugee doctor anywhere between two and four years to pass the test, in addition to the amount of time that they have already spent out of practice.

“IELTS is something that we use in the university system to assess people’s ability to speak and write English at an academic level. There is a question about the appropriateness of using the test for doctors.

“If people wanted to do a masters or a PhD in addition to their clinical qualifications then perhaps having an academic English language test is appropriate. More often than not, however, you are testing doctors against a system they will never use.

“What IELTS doesn’t test is whether or not a doctor can communicate. We know that how a doctor converses in English in a clinical setting is important further down the line.

“My gut instinct is that having a test like the OET, which is based on a clinical setting, is better as a measure of a doctor’s ability than an academic English test. The OET gives us the opportunity to approach English language in a way that is appropriate for a healthcare setting.

“We need to take a more holistic approach and look at how we communicate and work in the NHS, and how that is different to the systems that these doctors have already worked in. These sorts of things need to be tackled early on in a doctor’s progress towards getting back into practice, and not wait until after they have passed the IELTS test.”


  • Ceri Butler is a doctoral student in primary care and population health, University College London


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