Intended for healthcare professionals

Head To Head

Does it matter that medical graduates don’t get jobs as doctors? Yes

BMJ 2008; 336 doi: (Published 01 May 2008) Cite this as: BMJ 2008;336:990

Author's reply

The House of Commons Health Committee provided the best postscript to this debate in its report on Modernising Medical Careers, published on 8th May (1). It identified the need to restrict access for non-EEA doctors to UK training posts as a necessity in the light of the recent expansion of UK medical schools, and urged the Department of Health and the Home Office to "work together to resolve this embarrassing problem as a matter of urgency". The crucial importance of this issue seems at last to have been recognised, having been ducked by Tooke and most other commentators. Whether a satisfactory solution can be devised remains to be seen: the House of Lords forthright rejection of Department of Health guidance leaves a large cohort of non-EEA doctors eligible to apply for training posts for some years to come.

To respond directly to a couple of Alan Maynard's points, no-one, not even the doctors directly affected, has ever sought job guarantees. He may be right that market forces and changes in skill mix will reduce demand for doctors in the future. All one can say is that there are few signs of this happening in spite of a decade of ideologically driven "local workforce planning" devoted to that end. But if we have trained local doctors it just seems plain common sense to use them to meet staffing needs, rather than import others.

Competing interests: None declared

Competing interests: No competing interests

16 June 2008
Graham P Winyard
Winchester SO239TE