As an overseas medical doctor from Africa and currently working in
the UK, I feel personally concerned by the articles of Welsh(1) and
Sridhar(2). The two articles provide very interesting points of views and
they must be commended for having brought the problem to the limelight.
However I would like to voice my own opinion about the problem. I believe
most doctors who come to the UK for training are not ignorant of the
difficulties of passing the PLAB exam and securing a training post. They
are made fully aware of this through contacts with the British Council,
the GMC and personal contacts with doctors working in the UK. They still
decide to travel to the UK because of the poor working conditions and the
unavailability of high quality training schemes in their countries. The
thinking is, "although I know it is difficult, people do make it, so why
can't I?" I therefore do not think educating doctors about the
difficulties of training in the UK is an answer. I would propose three
main solutions:
1. Restricting the number of sessions of the PLAB exam offered per
year and number of places where it can be done overseas.
2. Re-instating the old format of the PLAB exam, which according to me was
more selective. The recent changes in the PLAB exam seems to have made it
less selective as it contains only multiple choice questions and the
questions are no longer negatively marked.
3. Providing more training posts for doctors in general in order to
increase the chances of an overseas doctor getting a training post.
In response to Welsh's and Sridhar's article, a number of doctors
commented on the favouritism shown to UK doctors compared with overseas
doctors during the appointment process(3,4). What about some of us who
tend to favour nationals from our own countries when selecting candidates
for appointment? Last year, a colleague of mine was hinted about a post
that was vacant in a hospital I will not name here. When he enquired about
the post from a consultant (not of British origin) working in the
department, he was told there was no post available. However when another
colleague of the same origin as the consultant made an enquiry, he was
told there was an urgent post that needed to be filled and he was invited
for an informal interview. He was finally offered the post! Although this
is quite a dramatic case, I believe it represents the tip of the iceberg.
Lets stop throwing stones in greenhouses and practice what we preach.
References:
1 Welsh C. Training overseas doctors in the United Kingdom. BMJ
2000;321:253-4
2 Sridhar MK. What is the future for overseas graduates? BMJ
2000;321:307
3 Pal R. Sentenced before Trial, bmj.com, 2 Aug 2000
4 Mahapatra P. Institutional Racism in the National Health Service,
bmj.com, 31 Jul 2000
Rapid Response:
Let's practice what we preach!
As an overseas medical doctor from Africa and currently working in
the UK, I feel personally concerned by the articles of Welsh(1) and
Sridhar(2). The two articles provide very interesting points of views and
they must be commended for having brought the problem to the limelight.
However I would like to voice my own opinion about the problem. I believe
most doctors who come to the UK for training are not ignorant of the
difficulties of passing the PLAB exam and securing a training post. They
are made fully aware of this through contacts with the British Council,
the GMC and personal contacts with doctors working in the UK. They still
decide to travel to the UK because of the poor working conditions and the
unavailability of high quality training schemes in their countries. The
thinking is, "although I know it is difficult, people do make it, so why
can't I?" I therefore do not think educating doctors about the
difficulties of training in the UK is an answer. I would propose three
main solutions:
1. Restricting the number of sessions of the PLAB exam offered per
year and number of places where it can be done overseas.
2. Re-instating the old format of the PLAB exam, which according to me was
more selective. The recent changes in the PLAB exam seems to have made it
less selective as it contains only multiple choice questions and the
questions are no longer negatively marked.
3. Providing more training posts for doctors in general in order to
increase the chances of an overseas doctor getting a training post.
In response to Welsh's and Sridhar's article, a number of doctors
commented on the favouritism shown to UK doctors compared with overseas
doctors during the appointment process(3,4). What about some of us who
tend to favour nationals from our own countries when selecting candidates
for appointment? Last year, a colleague of mine was hinted about a post
that was vacant in a hospital I will not name here. When he enquired about
the post from a consultant (not of British origin) working in the
department, he was told there was no post available. However when another
colleague of the same origin as the consultant made an enquiry, he was
told there was an urgent post that needed to be filled and he was invited
for an informal interview. He was finally offered the post! Although this
is quite a dramatic case, I believe it represents the tip of the iceberg.
Lets stop throwing stones in greenhouses and practice what we preach.
References:
1 Welsh C. Training overseas doctors in the United Kingdom. BMJ
2000;321:253-4
2 Sridhar MK. What is the future for overseas graduates? BMJ
2000;321:307
3 Pal R. Sentenced before Trial, bmj.com, 2 Aug 2000
4 Mahapatra P. Institutional Racism in the National Health Service,
bmj.com, 31 Jul 2000
Competing interests: No competing interests