Half Of Foreign Doctors 'Not Trained Enough'

[Dedworth]

A study finds over 50% of surgeons and GPs working in the UK, but who trained abroad, would fail exams set at the UK standard.

Foreign born doctors should face tougher tests before they can practise in Britain, claims a study which found over half may not be well-trained enough.

Researchers from University College London, Cambridge and Durham universities found the majority of the 80,000 foreign doctors registered in the UK, out of a total of 260,000, would fail exams set at the British standard.

The report has opened up the debate about the reliance of the Health Service on foreigners, with nearly two in every five staff born abroad, a figure that continues to grow.

Around 1,300 foreign doctors are licensed each year by the General Medical Council after passing exams which test their clinical and language skills.

The authors of the report are calling for the pass rate to be raised from 63% to 76% to "ensure patient safety".

Chris McManus, professor of psychology and medical education at UCL, said: "There is no real mechanism for checking that doctors coming from outside Britain have been trained to the same level as British doctors.

"We wanted to find out what level overseas doctors would have to reach if they were to be as competent as British graduates.

"I think it's inevitable that the bar will need to be set higher."

Figures from 2012 showed that of 669 doctors who were struck off or suspended in the previous five years, 420 had trained abroad.

However, the researchers warned acting on the report's recommendations could ultimately produce a major shortage of doctors in the NHS.

Dr Maureen Baker, chairman of the Royal College of General Practitioners said: "In the interests of patient safety and fairness to international medical graduates, we recommend that the current Professional and Linguistic Assessment Board standard setting process is reviewed as a matter of urgency."

A Department of Health spokesperson told Sky News: "Patient safety must be at the centre of NHS care. We are introducing new laws this year, which will allow the General Medical Council to carry out language checks on doctors.

"The GMC has set up a working party to review the exams for foreign doctors to see whether standards need to be raised."

http://news.sky.com/story/1245019/ha...trained-enough

Very worrying

If they don't meet the UK standards they should be immediately banned from practicing and in the case of non residents have their visas revoked

[Arthur Little]

Around 1,300 foreign doctors are licensed each year by the General Medical Council after passing exams which test their clinical and language skills.

The authors of the report are calling for the pass rate to be raised from 63% to 76% to "ensure patient safety".

Mightn't be such a bad ... for the sake of effective doctor/patient communication ... ... especially considering the higher pass rate of 76 percent recommended by the Report's authors is a mere 1% higher than the figure set by at least two successive Westminster Parliaments for a pass in the 'Life In The UK Test' required by married partners of British Nationals simply applying to settle permanently in this country.

[Doc Alan]

This study is of doctors in training for internal ( hospital ) medicine or general practice – NOT surgery.


We already knew that international medical graduates ( IMGs ) perform less well than UK graduates on a number of postgraduate exams in the UK. IMGs who wish to practice in the UK can be registered by passing the PLAB ( Professional and Linguistics Assessment Board ) examinations. These should be at a similar level to that of UK graduates after their first year of “ foundation training “.


The study shows that PLAB performance is a good predictor of subsequent medicine ( MRCP ) and general practice ( MRCGP ) exam performance. However, PLAB graduates do less well than UK graduates, so career progression is not the same. It could be made the same by raising the pass mark for PLAB.


Since 80,000 of the 260,000 doctors on the UK GMC Register are IMGs , there would be consequences for NHS workforce and service delivery if many of them were “ immediately banned from practising “.


At present internationally qualified doctors entering UK postgraduate training do so by one of two main routes. The majority must sit the PLAB exams. Most of these are from India, Pakistan, South Africa, Nigeria, Egypt, Sri Lanka and Iraq.


Less than 30,000 have a European ( EEA ) qualification ( with EU rights ) and are treated as EU nationals = EEA doctors. Employers are already expected to confirm communication ( written and oral English language ) skills. GMC plans for new language checks are expected to come into force this summer. The same IELTS ( International English Language Testing System ) scores should be required for EEA doctors as are already required for IMGs from outside the EEA.


Some would view an ideal NHS as having ONLY UK medical graduates. That way standards could be tightly controlled. There are enough applicants from the UK for UK medical schools. But our graduates don’t want ( and can’t be forced ) to enter unpopular specialties in undesirable areas. At present these essential posts are filled by foreign graduates. Some of these graduates also have top medical and surgical jobs in the NHS and UK universities.


Tough decisions are going to be needed for the NHS in the near future. Either standards will fall, or more resources ( money and personnel ) will be needed. Funding will have to be from general taxation and / or a dedicated ( “ hypothecated “ ) ring-fenced health tax . Alternative methods such as insurance and / or fees for attending doctors and hospital admissions will have to be considered.


The UK can’t afford to do without the third of its doctors who are foreign any time soon, but the GMC, as the responsible body, must try to make sure ALL UK doctors reach – and maintain ( through regular checks / “ revalidation “ ) - similar high standards.


We’re ALL entitled to opinions about health and health services, whether NHS or in the Philippines. There’s no doubt improvements are needed. But they could start by lowering the chances of falling ill in the first place – the usual “ lifestyle choices “ of moderation in food and alcohol intake, exercise, not smoking; and taking part in screening programmes for cancer, diabetes, and high blood pressure.


Not everyone can afford or wishes to make such choices. In the Philippines if you can’t afford to live healthily and have medical treatment when needed, the consequences are serious. At least in the UK treatment is available to all, even if standards of such treatment are not exactly the same everywhere.

[joebloggs]

you make me dedworth, i wonder how many British grads could pass IELTS and get at least 7 in each section never mind passing PLAB 1 and PLAB 2

many IMG's have gone down the same path as my misses, passed IELTS, PLAB 1 and 2 (unlike british grads) then spent 2yrs DOING FY1 AND FY2 ,THE SAME TRAINING BRITISH GRADS WOULD HAVE TO DO, IN FACT WORKING ALONG WITH BRITISH GRADS,

as for GP Training, the misses is doing the exact same training and exams as BRITISH GRADS so tell me how could 50% fail when they've done the exact training and exams as british grads, in fact if anything, my misses is more experienced than a British grad doing the same training as her (clerkship in the phils, worked as a SHO in the UK)


i bet they didn't mention this dedworth, http://www.bapio.co.uk/justice-for-gp-trainees

what's going on here then its time they took legal action against RCGP and read it before you post a reply , many have done the SAME training and EXAMS as British Grads

the problem might be not with those who like the misses who have done the same training as british grads, but those who are already consultants in their own country and , doc alan can correct me if i'm wrong might not have to take the training and exams as IMGs who are training to be a specialist in the UK, maybe that's where the problem is

[Doc Alan]

To my knowledge, ALL international ( non EEA ) doctors must sit the GMC PLAB exams in addition to meeting the language requirements via IELTS or other qualifications, if they seek UK postgraduate training in order to become consultants or GPs. New checks are expected to come into force this summer for EEA doctors.


This article includes a summary of how medical graduates are trained in the UK :-
http://www.bmj.com/content/348/bmj.g2621

[joebloggs]

maybe this is part of the problem ? , they don't need to take Plab 1 or 2.

http://www.gmc-uk.org/doctors/regist...ifications.asp

[joebloggs]

just looked at your link Doc Alan

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence.

many who take Plab1 and 2 who pass then go on to do foundation training, as my misses has

from dedworths article,

A study finds over 50% of surgeons and GPs working in the UK, but who trained abroad, would fail exams set at the UK standard.

what exams?, from your link Doc Alan its comparing IMGs who have taken the Plab1 and 2 EXAMS to Brtiish Grads who have taken FY1, well this is no exam for FY1, its a portfolio of continuous assessment

maybe Brtish grads should take the plab exams after FY1 and lets see how many fail

[Doc Alan]

maybe this is part of the problem ? , they don't need to take Plab 1 or 2.

http://www.gmc-uk.org/doctors/regist...ifications.asp

These overseas qualifications are said to meet the same standards as UK postgraduate qualifications. But the GMC points out that they are not the same as UK qualifications in every way. They also don't guarantee entry to UK specialty training.

I don't think that whether or not these doctors also have to take PLAB exams is a significant part of the problem. The study was concerned with comparison of PLAB and UK graduates' performance on Royal College of Physicians' MRCP(UK) and Royal College of General Practitioners' MRCGP exams.

[joebloggs]

The study was concerned with comparison of PLAB and UK graduates' performance on Royal College of Physicians' MRCP(UK) and Royal College of General Practitioners' MRCGP exams.

yes Doc Alan i realised that after reading your link, but British Gads can go and do foundation training and then work in a hospital without taking any exams, and if they want to go on and further their career they can go and take exams like MRCP.

setting Plab exams to a higher pass mark ( level of MRCP) seems unfair, as British grads don't have to be at this level to go and work in a hospital. there is no foundation level exam, as its continuous assessment.

but then this article is about

surgeons and GPs

not about foundation or SHO officers.